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These flare ups are often debilitating for individuals, and repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis

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Passage of bile acids through the enterocyte activates FXR, which promotes the synthesis of fibroblast growth factor 19 (FGF19), which also circulates through the portal vein to the liver where it activates fibroblast growth factor-receptor 4 resulting in inhibition of bile acid synthesis

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