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It comes in pulses, mostly at night during deep sleep, with the largest pulse in the first 60 to 90 minutes after you fall asleep

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There may be one caveat, though

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patients should then be commenced on high dose intravenous proton pump inhibitor (PPI) therapy to reduce gastric acid secretion Oesophageal varices needs urgent endoscopy and concurrent resuscitation with blood products, alongside prophylactic antibiotics and somatostatin analogues (e.g

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