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Delayed gastric emptying causes the stomach to remain filled with acidic contents for a longer period, increasing the risk that these will flow back into the esophagus and thereby worsen heartburn, acid regurgitation, or chest pain

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As a result, SAM is converted subsequently to S-adenosylhomocysteine and homocysteine which in turn, can be remethylated back to methionine or can be further metabolised in the transsulfuration pathway to form cysteine, in a B 6 -dependent process (Reference Bottiglieri11)