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In these conversations, I am often asked the question: If the IBS-like symptoms and eventual pseudoobstruction reflect an autoimmune enteric neuropathy, why do the patients have IBS symptoms for so long before presenting with pseudoobstruction. The answer may be that omnipresent neuronal stem cells divide and give rise to daughter cells that differentiate into one or the other of the specific classifications of ENS neurons and thereby replace neurons killed by autoimmune attack

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