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Symptoms can develop quickly and include: feeling faint or lightheaded difficulty breathing or wheezing rapid heartbeat confusion anxiety clammy skin collapsing or losing consciousness hives swelling stomach pain, nausea, or vomiting If you or someone nearby develops these symptoms, you should: Check to see whether they have an epinephrine pen

If a patient has one of more of these high-risk features, it is very important that the disease is managed by an experienced gastroenterologist with expertise that includes IBD

9 In light of these findings, long-term use of these medications should be periodically reassessed, particularly in patients with other risk factors for vitamin B 12 deficiency

Some individuals may experience increased energy and alertness shortly after the injections, while others may notice improvements in mood and cognitive function over time