{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:07:51Z","timestamp":1790251671301,"version":"4.1.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Nutr"],"DOI":"10.1038\/s41430-026-01830-2","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:32:43Z","timestamp":1790249563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hyperammonaemic encephalopathy following bariatric surgery: detailed biochemical phenotyping and pathophysiology informed treatment"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0136-5332","authenticated-orcid":false,"given":"Jeremy","family":"Clark","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1734-2344","authenticated-orcid":false,"given":"George","family":"Roubos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Jayadiwangsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3572-6319","authenticated-orcid":false,"given":"Luke","family":"Ephraums","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Fazio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"1830_CR1","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.orcp.2023.11.001","volume":"17","author":"N Sakran","year":"2023","unstructured":"Sakran N, Parmar C, Pouwels S. Nonhepatic hyperammonemic encephalopathy following bariatric surgery: A systematic review. Obes Res Clin Pract. 2023;17:458\u201367. https:\/\/doi.org\/10.1016\/j.orcp.2023.11.001.","journal-title":"Obes Res Clin Pract"},{"key":"1830_CR2","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1007\/s11695-023-06974-9","volume":"34","author":"FK Kitaghenda","year":"2024","unstructured":"Kitaghenda FK, Hong J, Shao Y, Yao L, Zhu X. The prevalence of small intestinal bacterial overgrowth after Roux-en-Y gastric bypass (RYGB): a systematic review and meta-analysis. Obes Surg. 2024;34:250\u20137. https:\/\/doi.org\/10.1007\/s11695-023-06974-9.","journal-title":"Obes Surg"},{"key":"1830_CR3","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2469513","volume":"2022","author":"X Feng","year":"2022","unstructured":"Feng X, Li X, Zhang X, Chen W, Tian Y, Yang Q, et al. Hepatic encephalopathy in cirrhotic patients and risk of small intestinal bacterial overgrowth: a systematic review and meta-analysis. BioMed Res Int. 2022;2022:2469513. https:\/\/doi.org\/10.1155\/2022\/2469513.","journal-title":"BioMed Res Int"},{"key":"1830_CR4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s00431-010-1369-2","volume":"170","author":"J H\u00e4berle","year":"2011","unstructured":"H\u00e4berle J. Clinical practice: the management of hyperammonemia. Eur J Pediatr. 2011;170:21\u201334.","journal-title":"Eur J Pediatr"},{"key":"1830_CR5","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1152\/physrev.1990.70.3.701","volume":"70","author":"AJ Meijer","year":"1990","unstructured":"Meijer AJ, Lamers WH, Chamuleau RA. Nitrogen metabolism and ornithine cycle function. Physiol Rev. 1990;70:701\u201348. https:\/\/doi.org\/10.1152\/physrev.1990.70.3.701.","journal-title":"Physiol Rev"},{"key":"1830_CR6","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1038\/s10038-019-0614-4","volume":"64","author":"S Matsumoto","year":"2019","unstructured":"Matsumoto S, H\u00e4berle J, Kido J, Mitsubuchi H, Endo F, Nakamura K. Urea cycle disorders\u2014update. J Hum Genet. 2019;64:833\u201347. https:\/\/doi.org\/10.1038\/s10038-019-0614-4.","journal-title":"J Hum Genet"},{"key":"1830_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2023.108112","volume":"141","author":"R Posset","year":"2024","unstructured":"Posset R, Garbade SF, Gleich F, Nagamani SC, Gropman AL, Epp F, et al. Impact of supplementation with L-citrulline\/arginine after liver transplantation in individuals with urea cycle disorders. Mol Genet Metab. 2024;141:108112. https:\/\/doi.org\/10.1016\/j.ymgme.2023.108112.","journal-title":"Mol Genet Metab"},{"key":"1830_CR8","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1177\/2050640617737632","volume":"6","author":"KC Fragkos","year":"2018","unstructured":"Fragkos KC, Forbes A. Citrulline as a marker of intestinal function and absorption in clinical settings: a systematic review and meta-analysis. U Eur Gastroenterol J. 2018;6:181\u201391. https:\/\/doi.org\/10.1177\/2050640617737632.","journal-title":"U Eur Gastroenterol J"},{"key":"1830_CR9","first-page":"240","volume":"7","author":"E Aquilio","year":"1993","unstructured":"Aquilio E, Spagnoli R, Riggio D, Seri S. Effects of zinc on hepatic ornithine transcarbamylase (OTC) activity. J trace Elem electrolytes health Dis. 1993;7:240\u20131.","journal-title":"J trace Elem electrolytes health Dis"},{"key":"1830_CR10","doi-asserted-by":"publisher","first-page":"7","DOI":"10.5056\/jnm22187","volume":"30","author":"W Takakura","year":"2024","unstructured":"Takakura W, Rezaie A, Chey WD, Wang J, Pimentel M. Symptomatic response to antibiotics in patients with small intestinal bacterial overgrowth: a systematic review and meta-analysis. J Neurogastroenterol Motil. 2024;30:7 https:\/\/doi.org\/10.5056\/jnm22187.","journal-title":"J Neurogastroenterol Motil"}],"container-title":["European Journal of Clinical Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41430-026-01830-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41430-026-01830-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41430-026-01830-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:32:43Z","timestamp":1790249563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41430-026-01830-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":10,"alternative-id":["1830"],"URL":"https:\/\/doi.org\/10.1038\/s41430-026-01830-2","relation":{},"ISSN":["0954-3007","1476-5640"],"issn-type":[{"value":"0954-3007","type":"print"},{"value":"1476-5640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"28 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"We describe three cases of standard of care management, therefore, no approval by the ethics committee was required for this retrospective analysis. All three patients have given their written informed consent to publish their case.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Ethics"}}]}}