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[ { "from": "human", "value": "What is (are) Smoking and the Digestive System?" }, { "from": "gpt", "value": "Smoking contributes to many common disorders of the digestive system, such as heartburn and gastroesophageal reflux disease (GERD), peptic ulcers, and some liver diseases. Smoking increases the risk of Crohns disease, colon polyps, and pancreatitis, and it may increase the risk of gallstones." } ]

[ { "from": "human", "value": "What to do for Smoking and the Digestive System?" }, { "from": "gpt", "value": "Eating, diet, and nutrition can play a role in causing, preventing, and treating some of the diseases and disorders of the digestive system that are affected by smoking, including heartburn and GERD, liver diseases, Crohns disease, colon polyps, pancreatitis, and gallstones. More information about eating, diet, and nutrition and these conditions can be found on the Digestive Diseases A-Z list." } ]

[ { "from": "human", "value": "What to do for Smoking and the Digestive System?" }, { "from": "gpt", "value": "- Smoking has been found to increase the risk of cancers of the mouth, esophagus, stomach, and pancreas. Research suggests that smoking may also increase the risk of cancers of the liver, colon, and rectum.\n- Smoking increases the risk of heartburn and gastroesophageal reflux disease (GERD).\n- Smoking increases the risk of peptic ulcers.\n- Smoking may worsen some liver diseases, including primary biliary cirrhosis and nonalcoholic fatty liver disease (NAFLD).\n- Current and former smokers have a higher risk of developing Crohns disease than people who have never smoked.\n- People who smoke are more likely to develop colon polyps.\n- Smoking increases the risk of developing pancreatitis.\n- Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed.\n- Quitting smoking can reverse some of the effects of smoking on the digestive system." } ]

[ { "from": "human", "value": "What is (are) Graves' Disease?" }, { "from": "gpt", "value": "Graves disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States. Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.\nThe Thyroid\nThe thyroid is a 2-inch-long, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid makes two thyroid hormones, triiodothyronine (T3 ) and thyroxine (T4 ). T3 is made from T4 and is the more active hormone, directly affecting the tissues. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body.\nThyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Hyperthyroidism causes many of the bodys functions to speed up.\nThyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production.\nAutoimmune Disorder\nGraves disease is an autoimmune disorder. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the bodys own cells and organs.\nWith Graves disease, the immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI)sometimes called TSH receptor antibodythat attaches to thyroid cells. TSI mimics TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the TSI antibody instead blocks thyroid hormone production, leading to conflicting symptoms that may make correct diagnosis more difficult." } ]

[ { "from": "human", "value": "What are the symptoms of Graves' Disease?" }, { "from": "gpt", "value": "People with Graves disease may have common symptoms of hyperthyroidism such as\n- nervousness or irritability\n- fatigue or muscle weakness\n- heat intolerance\n- trouble sleeping\n- hand tremors\n- rapid and irregular heartbeat\n- frequent bowel movements or diarrhea\n- weight loss\n- goiter, which is an enlarged thyroid that may cause the neck to look swollen and can interfere with normal breathing and swallowing\nA small number of people with Graves disease also experience thickening and reddening of the skin on their shins. This usually painless problem is called pretibial myxedema or Graves dermopathy.\nIn addition, the eyes of people with Graves disease may appear enlarged because their eyelids are retractedseem pulled back into the eye socketsand their eyes bulge out from the eye sockets. This condition is called Graves ophthalmopathy (GO)." } ]

[ { "from": "human", "value": "What is (are) Graves' Disease?" }, { "from": "gpt", "value": "Graves ophthalmopathy is a condition associated with Graves disease that occurs when cells from the immune system attack the muscles and other tissues around the eyes.\nThe result is inflammation and a buildup of tissue and fat behind the eye socket, causing the eyeballs to bulge out. Rarely, inflammation is severe enough to compress the optic nerve that leads to the eye, causing vision loss.\nOther GO symptoms are\n- dry, gritty, and irritated eyes\n- puffy eyelids\n- double vision\n- light sensitivity\n- pressure or pain in the eyes\n- trouble moving the eyes\nAbout 25 to 30 percent of people with Graves disease develop mild GO, and 2 to 5 percent develop severe GO.1 This eye condition usually lasts 1 to 2 years and often improves on its own.\nGO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop and may even occur in people whose thyroid function is normal. Smoking makes GO worse.\n1Yeung SJ, Habra MA, Chiu AC. Graves disease. emedicine website. emedicine.medscape.com/article/120619-overview. Updated 2010. Accessed December 10, 2011." } ]

[ { "from": "human", "value": "How to diagnose Graves' Disease?" }, { "from": "gpt", "value": "Health care providers can sometimes diagnose Graves disease based only on a physical examination and a medical history. Blood tests and other diagnostic tests, such as the following, then confirm the diagnosis.\nTSH test. The ultrasensitive TSH test is usually the first test performed. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available.\nT3 and T4 test. Another blood test used to diagnose Graves disease measures T3 and T4 levels. In making a diagnosis, health care providers look for below-normal levels of TSH, normal to elevated levels of T4, and elevated levels of T3.\nBecause the combination of low TSH and high T3 and T4 can occur with other thyroid problems, health care providers may order other tests to finalize the diagnosis. The following two tests use small, safe doses of radioactive iodine because the thyroid uses iodine to make thyroid hormone.\nRadioactive iodine uptake test. This test measures the amount of iodine the thyroid collects from the bloodstream. High levels of iodine uptake can indicate Graves disease.\nThyroid scan. This scan shows how and where iodine is distributed in the thyroid. With Graves disease the entire thyroid is involved, so the iodine shows up throughout the gland. Other causes of hyperthyroidism such as nodulessmall lumps in the glandshow a different pattern of iodine distribution.\nTSI test. Health care providers may also recommend the TSI test, although this test usually isnt necessary to diagnose Graves disease. This test, also called a TSH antibody test, measures the level of TSI in the blood. Most people with Graves disease have this antibody, but people whose hyperthyroidism is caused by other conditions do not.\nMore information about testing for thyroid problems is provided in the NIDDK health topic, Thyroid Tests." } ]

[ { "from": "human", "value": "What are the treatments for Graves' Disease?" }, { "from": "gpt", "value": "People with Graves disease have three treatment options: radioiodine therapy, medications, and thyroid surgery. Radioiodine therapy is the most common treatment for Graves disease in the United States. Graves disease is often diagnosed and treated by an endocrinologista doctor who specializes in the bodys hormone- secreting glands.\nRadioiodine Therapy\nIn radioiodine therapy, patients take radioactive iodine-131 by mouth. Because the thyroid gland collects iodine to make thyroid hormone, it will collect the radioactive iodine from the bloodstream in the same way. Iodine-131stronger than the radioactive iodine used in diagnostic testsgradually destroys the cells that make up the thyroid gland but does not affect other body tissues.\nMany health care providers use a large enough dose of iodine-131 to shut down the thyroid completely, but some prefer smaller doses to try to bring hormone production into the normal range. More than one round of radioiodine therapy may be needed. Results take time and people undergoing this treatment may not notice improvement in symptoms for several weeks or months.\nPeople with GO should talk with a health care provider about any risks associated with radioactive iodine treatments. Several studies suggest radioiodine therapy can worsen GO in some people. Other treatments, such as prescription steroids, may prevent this complication.\nAlthough iodine-131 is not known to cause birth defects or infertility, radioiodine therapy is not used in pregnant women or women who are breastfeeding. Radioactive iodine can be harmful to the fetus thyroid and can be passed from mother to child in breast milk. Experts recommend that women wait a year after treatment before becoming pregnant.\nAlmost everyone who receives radioactive iodine treatment eventually develops hypothyroidism, which occurs when the thyroid does not make enough thyroid hormone. People with hypothyroidism must take synthetic thyroid hormone, a medication that replaces their natural thyroid hormone.\nMedications\nBeta blockers. Health care providers may prescribe a medication called a beta blocker to reduce many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. But beta blockers do not stop thyroid hormone production.\nAnti-thyroid medications. Health care providers sometimes prescribe anti-thyroid medications as the only treatment for Graves disease. Anti-thyroid medications interfere with thyroid hormone production but dont usually have permanent results. Use of these medications requires frequent monitoring by a health care provider. More often, anti-thyroid medications are used to pretreat patients before surgery or radioiodine therapy, or they are used as supplemental treatment after radioiodine therapy.\nAnti-thyroid medications can cause side effects in some people, including\n- allergic reactions such as rashes and itching\n- a decrease in the number of white blood cells in the body, which can lower a persons resistance to infection\n- liver failure, in rare cases\nIn the United States, health care providers prescribe the anti-thyroid medication methimazole (Tapazole, Northyx) for most types of hyperthyroidism.\nAnti-thyroid medications and pregnancy. Because pregnant and breastfeeding women cannot receive radioiodine therapy, they are usually treated with an anti-thyroid medication instead. However, experts agree that women in their first trimester of pregnancy should probably not take methimazole due to the rare occurrence of damage to the fetus.\nAnother anti-thyroid medication, propylthiouracil (PTU), is available for women in this stage of pregnancy or for women who are allergic to or intolerant of methimazole and have no other treatment options. Health care providers may prescribe PTU for the first trimester of pregnancy and switch to methimazole for the second and third trimesters.\nSome women are able to stop taking anti-thyroid medications in the last 4 to 8 weeks of pregnancy due to the remission of hyperthyroidism that occurs during pregnancy. However, these women should continue to be monitored for recurrence of thyroid problems following delivery.\nStudies have shown that mothers taking anti-thyroid medications may safely breastfeed. However, they should take only moderate doses, less than 1020 milligrams daily, of the anti-thyroid medication methimazole. Doses should be divided and taken after feedings, and the infants should be monitored for side effects.2\nWomen requiring higher doses of the anti-thyroid medication to control hyperthyroidism should not breastfeed.\n2Ogunyemi DA. Autoimmune thyroid disease and pregnancy. emedicine website. emedicine.medscape.com/article/261913-overview. Updated March 12, 2012. Accessed April 10, 2012.\nStop your anti-thyroid medication and call your health care provider right away if you develop any of the following while taking anti-thyroid medications:\n- fatigue\n- weakness\n- vague abdominal pain\n- loss of appetite\n- skin rash or itching\n- easy bruising\n- yellowing of the skin or whites of the eyes, called jaundice\n- persistent sore throat\n- fever\nThyroid Surgery\nSurgery is the least-used option for treating Graves disease. Sometimes surgery may be used to treat\n- pregnant women who cannot tolerate anti-thyroid medications\n- people suspected of having thyroid cancer, though Graves disease does not cause cancer\n- people for whom other forms of treatment are not successful\nBefore surgery, the health care provider may prescribe anti-thyroid medications to temporarily bring a patients thyroid hormone levels into the normal range. This presurgical treatment prevents a condition called thyroid storma sudden, severe worsening of symptomsthat can occur when hyperthyroid patients have general anesthesia.\nWhen surgery is used, many health care providers recommend the entire thyroid be removed to eliminate the chance that hyperthyroidism will return. If the entire thyroid is removed, lifelong thyroid hormone medication is necessary.\nAlthough uncommon, certain problems can occur in thyroid surgery. The parathyroid glands can be damaged because they are located very close to the thyroid. These glands help control calcium and phosphorous levels in the body. Damage to the laryngeal nerve, also located close to the thyroid, can lead to voice changes or breathing problems.\nBut when surgery is performed by an experienced surgeon, less than 1 percent of patients have permanent complications.1 People who need help finding a surgeon can contact one of the organizations listed under For More Information.\nEye Care\nThe eye problems associated with Graves disease may not improve following thyroid treatment, so the two problems are often treated separately.\nEye drops can relieve dry, gritty, irritated eyesthe most common of the milder symptoms. If pain and swelling occur, health care providers may prescribe a steroid such as prednisone. Other medications that suppress the immune response may also provide relief.\nSpecial lenses for glasses can help with light sensitivity and double vision. People with eye symptoms may be advised to sleep with their head elevated to reduce eyelid swelling. If the eyelids do not fully close, taping them shut at night can help prevent dry eyes.\nIn more severe cases, external radiation may be applied to the eyes to reduce inflammation. Like other types of radiation treatment, the benefits are not immediate; most people feel relief from symptoms 1 to 2 months after treatment.\nSurgery may be used to improve bulging of the eyes and correct the vision changes caused by pressure on the optic nerve. A procedure called orbital decompression makes the eye socket bigger and gives the eye room to sink back to a more normal position. Eyelid surgery can return retracted eyelids to their normal position." } ]

[ { "from": "human", "value": "What are the treatments for Graves' Disease?" }, { "from": "gpt", "value": "Treatment for Graves disease can sometimes affect pregnancy. After treatment with surgery or radioactive iodine, TSI antibodies can still be present in the blood, even when thyroid levels are normal. If a pregnant woman has received either of these treatments prior to becoming pregnant, the antibodies she produces may travel across the placenta to the babys bloodstream and stimulate the fetal thyroid.\nA pregnant woman who has been treated with surgery or radioactive iodine should inform her health care provider so her baby can be monitored for thyroid-related problems later in the pregnancy. Pregnant women may safely be treated with anti-thyroid medications.\nFor more information about pregnancy and anti-thyroid medications, see Medications under the section titled How is Graves disease treated?More information about pregnancy and thyroid disease is provided in the NIDDK health topic, Pregnancy and Thyroid Disease." } ]

[ { "from": "human", "value": "What to do for Graves' Disease?" }, { "from": "gpt", "value": "Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition is provided by the National Agricultural Library available at www.nutrition.gov.\nDietary Supplements\nIodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet, available at www.nlm.nih.gov/medlineplus.\nWomen need more iodine when they are pregnantabout 250 micrograms a daybecause the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met.\nTo help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health.\n3 Zimmerman MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. American Journal of Clinical Nutrition. 2009;89(2):668S672S." } ]

[ { "from": "human", "value": "What to do for Graves' Disease?" }, { "from": "gpt", "value": "- Graves disease is the most common cause of hyperthyroidism in the United States.\n- In Graves disease, the immune system stimulates the thyroid gland to make too much thyroid hormone.\n- Common symptoms of hyperthyroidism include nervousness or irritability, fatigue or muscle weakness, heat intolerance, trouble sleeping, hand tremors, rapid and irregular heartbeat, frequent bowel movements or diarrhea, weight loss, and goiter.\n- People with Graves disease may also have bulging eyes, a condition called Graves ophthalmopathy (GO).\n- Graves disease is most often treated with radioiodine therapy, which gradually destroys the cells that make up the thyroid gland. Anti-thyroid medications and surgery to remove the thyroid are sometimes used.\n- The eye problems associated with Graves disease may require separate treatment.\n- A pregnant woman who has been treated with surgery or radioactive iodine prior to becoming pregnant should inform her health care provider so her baby can be monitored for thyroid-related problems later in the pregnancy." } ]

[ { "from": "human", "value": "Who is at risk for Sexual and Urologic Problems of Diabetes??" }, { "from": "gpt", "value": "Risk factors are conditions that increase the chances of getting a particular disease. The more risk factors people have, the greater their chances of developing that disease or condition. Diabetic neuropathy and related sexual and urologic problems appear to be more common in people who\n- have poor blood glucose control\n- have high levels of blood cholesterol\n- have high blood pressure\n- are overweight\n- are older than 40\n- smoke\n- are physically inactive" } ]

[ { "from": "human", "value": "How to prevent Sexual and Urologic Problems of Diabetes?" }, { "from": "gpt", "value": "People with diabetes can lower their risk of sexual and urologic problems by keeping their blood glucose, blood pressure, and cholesterol levels close to the target numbers their health care provider recommends. Being physically active and maintaining a healthy weight can also help prevent the long-term complications of diabetes. For those who smoke, quitting will lower the risk of developing sexual and urologic problems due to nerve damage and also lower the risk for other health problems related to diabetes, including heart attack, stroke, and kidney disease.\nMore information about preventing diabetes complications is provided in the NIDDK health topic, Prevent diabetes problems: Keep your diabetes under control, available from the National Diabetes Information Clearinghouse at 1-800-860-8747." } ]

[ { "from": "human", "value": "What to do for Sexual and Urologic Problems of Diabetes?" }, { "from": "gpt", "value": "The nerve damage of diabetes may cause sexual or urologic problems.\n- Sexual problems in men with diabetes include- erectile dysfunction- retrograde ejaculation- Sexual problems in women with diabetes include- decreased vaginal lubrication and uncomfortable or painful intercourse- decreased or no sexual desire- decreased or absent sexual response- Urologic problems in men and women with diabetes include- bladder problems related to nerve damage, such as overactive bladder, poor control of sphincter muscles, and urine retention- urinary tract infections- Controlling diabetes through diet, physical activity, and medications as needed can help prevent sexual and urologic problems.\n- Treatment is available for sexual and urologic problems." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Gas?" }, { "from": "gpt", "value": "Gas is air in the digestive tract. Gas leaves the body when people burp through the mouth or pass gas through the anus*the opening at the end of the digestive tract where stool leaves the body.\nEveryone has gas. Burping and passing gas are normal. Many people believe that they burp or pass gas too often and that they have too much gas. Having too much gas is rare." } ]

[ { "from": "human", "value": "What causes What I need to know about Gas?" }, { "from": "gpt", "value": "Gas in the digestive tract is usually caused by swallowing air and the breakdown of certain foods in the large intestine.\n*See the Pronunciation Guide for tips on how to say the underlined words.\nYou typically swallow a small amount of air when you eat and drink. You swallow more air when you\n- eat or drink too fast\n- smoke\n- chew gum\n- suck on hard candy\n- drink carbonated or fizzy drinks\n- wear loose-fitting dentures\nSome of the air you swallow leaves the stomach through the mouth when you burp. Some swallowed air is absorbed in the small intestine. Some air moves through the small intestine to the large intestine and is passed through the anus.\nThe stomach and small intestine do not fully digest all of the food you eat. Undigested carbohydratessugars, starches, and fiber found in many foodspass through to the large intestine. Bacteria in the large intestine break down undigested carbohydrates and release gas. This gas is passed through the anus.\nNormally, few bacteria live in the small intestine. Small intestinal bacterial overgrowth (SIBO) is an increase in the number of bacteria or a change in the type of bacteria in the small intestine. These bacteria can produce excess gas and may also cause diarrhea and weight loss. SIBO is usually related to diseases or disorders that damage the digestive system or affect how it works, such as Crohns disease or diabetes." } ]

[ { "from": "human", "value": "What causes What I need to know about Gas?" }, { "from": "gpt", "value": "Most foods that contain carbohydrates can cause gas. Foods that cause gas for one person may not cause gas for someone else. Some foods that contain carbohydrates and may cause gas are\n- beans\n- vegetables such as broccoli, cauliflower, cabbage, brussels sprouts, onions, mushrooms, artichokes, and asparagus\n- fruits such as pears, apples, and peaches\n- whole grains such as whole wheat and bran\n- sodas; fruit drinks, especially apple juice and pear juice; and other drinks that contain high fructose corn syrup, a sweetener made from corn\n- milk and milk products such as cheese, ice cream, and yogurt\n- packaged foodssuch as bread, cereal, and salad dressingthat contain small amounts of lactose, the sugar found in milk and foods made with milk\n- sugar-free candies and gums that contain sugar alcohols such as sorbitol, mannitol, and xylitol" } ]

[ { "from": "human", "value": "What are the symptoms of What I need to know about Gas?" }, { "from": "gpt", "value": "The most common symptoms of gas are:\n- Burping. Burping once in awhile, especially during and after meals, is normal. If you burp very often, you may be swallowing too much air. Some people with digestive problems swallow air on purpose and burp because they believe it will help them feel better.\n- Passing gas. Passing gas around 13 to 21 times a day is normal. If you think you pass gas more often than that, you may have trouble digesting certain carbohydrates.\n- Bloating. Bloating is a feeling of fullness and swelling in the abdomen, the area between the chest and hips. Disorders such as irritable bowel syndrome (IBS) can affect how gas moves through the intestines. If gas moves through your intestines too slowly, you may feel bloated.\n- Abdominal pain or discomfort. People may feel abdominal pain or discomfort when gas does not move through the intestines normally. People with IBS may be more sensitive to gas in the intestines." } ]

[ { "from": "human", "value": "What causes What I need to know about Gas?" }, { "from": "gpt", "value": "You can try to find the cause of gas by keeping a diary of what you eat and drink and how often you burp, pass gas, or have other symptoms. The diary may help you identify the foods that cause you to have gas.\nTalk with your health care provider if\n- gas symptoms often bother you\n- your symptoms change suddenly\n- you have new symptoms, especially if you are older than age 40\n- you have other symptomssuch as constipation, diarrhea, or weight lossalong with gas\nYour health care provider will ask about your diet and symptoms. Your health care provider may review your diary to see if specific foods are causing gas.\nIf milk or milk products are causing gas, your health care provider may perform blood or breath tests to check for lactose intolerance. Lactose intolerance means you have trouble digesting lactose. Your health care provider may ask you to avoid milk and milk products for a short time to see if your gas symptoms improve.\nYour health care provider may test for other digestive problems, depending on your symptoms." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Gas?" }, { "from": "gpt", "value": "You can try to treat gas on your own, before seeing your health care provider, if you think you have too much.\nSwallowing less air and changing what you eat can help prevent or reduce gas. Try the following tips:\n- Eat more slowly.\n- If you smoke, quit or cut down.\n- If you wear dentures, see your dentist and make sure your dentures fit correctly.\n- Dont chew gum or suck on hard candies.\n- Avoid carbonated drinks, such as soda and beer.\n- Drink less fruit juice, especially apple juice and pear juice.\n- Avoid or eat less of the foods that cause you to have gas.\nSome over-the-counter medicines can help reduce gas:\n- Taking alpha-galactosidase (Beano) when you eat beans, vegetables, and whole grains can reduce gas.\n- Simethicone (Gas-X, Mylanta Gas) can relieve bloating and abdominal pain or discomfort caused by gas.\n- If you are lactose intolerant, lactase tablets or liquid drops can help you digest milk and milk products. You can also find lactose-free and lactose-reduced milk and milk products at the grocery store.\nYour health care provider may prescribe medicine to help relieve gas, especially if you have SIBO or IBS." } ]

[ { "from": "human", "value": "What to do for What I need to know about Gas?" }, { "from": "gpt", "value": "Your eating habits and diet affect the amount of gas you have. For example, eating and drinking too fast can cause you to swallow more air. And you may have more gas after you eat certain carbohydrates.\nTrack what you eat and your gas symptoms to find out what foods cause you to have more gas. Avoid or eat less of the foods that cause your gas symptoms." } ]

[ { "from": "human", "value": "What to do for What I need to know about Gas?" }, { "from": "gpt", "value": "- Gas is air in the digestive tract.\n- Everyone has gas. Burping and passing gas are normal.\n- Gas in the digestive tract is usually caused by swallowing air and the breakdown of certain foods in the large intestine.\n- Most foods that contain carbohydrates can cause gas.\n- Foods that cause gas for one person may not cause gas for someone else.\n- The most common symptoms of gas are burping, passing gas, bloating, and abdominal pain or discomfort.\n- Swallowing less air and changing what you eat can help prevent or reduce gas.\n- Some over-the-counter medicines can help reduce gas." } ]

[ { "from": "human", "value": "What is (are) Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "Diabetes is a disorder of metabolismthe way our bodies use digested food for energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the body's main source of fuel.\nAfter digestion, glucose enters the bloodstream. Then glucose goes to cells throughout the body where it is used for energy. However, a hormone called insulin must be present to allow glucose to enter the cells. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.\nIn people who do not have diabetes, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. However, diabetes develops when the pancreas does not make enough insulin, or the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy.\nOver time, high blood glucose levels damage nerves and blood vessels, leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes. Uncontrolled diabetes can eventually lead to other health problems as well, such as vision loss, kidney failure, and amputations." } ]

[ { "from": "human", "value": "What is (are) Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Prediabetes is also called impaired fasting glucose or impaired glucose tolerance. Many people with prediabetes develop type 2 diabetes within 10 years. In addition, they are at risk for heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes and lower their risk of heart disease and stroke." } ]

[ { "from": "human", "value": "What is (are) Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "If you have diabetes, you are at least twice as likely as someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people. If you are middle-aged and have type 2 diabetes, some studies suggest that your chance of having a heart attack is as high as someone without diabetes who has already had one heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.\nPeople with diabetes who have already had one heart attack run an even greater risk of having a second one. In addition, heart attacks in people with diabetes are more serious and more likely to result in death. High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis)." } ]

[ { "from": "human", "value": "Who is at risk for Diabetes, Heart Disease, and Stroke??" }, { "from": "gpt", "value": "Diabetes itself is a risk factor for heart disease and stroke. Also, many people with diabetes have other conditions that increase their chance of developing heart disease and stroke. These conditions are called risk factors. One risk factor for heart disease and stroke is having a family history of heart disease. If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk.\nYou can't change whether heart disease runs in your family, but you can take steps to control the other risk factors for heart disease listed here:\n- Having central obesity. Central obesity means carrying extra weight around the waist, as opposed to the hips. A waist measurement of more than 40 inches for men and more than 35 inches for women means you have central obesity. Your risk of heart disease is higher because abdominal fat can increase the production of LDL (bad) cholesterol, the type of blood fat that can be deposited on the inside of blood vessel walls.\n- Having abnormal blood fat (cholesterol) levels.\n- LDL cholesterol can build up inside your blood vessels, leading to narrowing and hardening of your arteriesthe blood vessels that carry blood from the heart to the rest of the body. Arteries can then become blocked. Therefore, high levels of LDL cholesterol raise your risk of getting heart disease.\n- Triglycerides are another type of blood fat that can raise your risk of heart disease when the levels are high.\n- HDL (good) cholesterol removes deposits from inside your blood vessels and takes them to the liver for removal. Low levels of HDL cholesterol increase your risk for heart disease.\n- Having high blood pressure. If you have high blood pressure, also called hypertension, your heart must work harder to pump blood. High blood pressure can strain the heart, damage blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems.\n- Smoking. Smoking doubles your risk of getting heart disease. Stopping smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels. Smoking also increases the risk of other long-term complications, such as eye problems. In addition, smoking can damage the blood vessels in your legs and increase the risk of amputation." } ]

[ { "from": "human", "value": "What is (are) Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "Metabolic syndrome is a grouping of traits and medical conditions that puts people at risk for both heart disease and type 2 diabetes. It is defined by the National Cholesterol Education Program as having any three of the following five traits and medical conditions:\nTraits and Medical ConditionsDefinitionElevated waist circumferenceWaist measurement of- 40 inches or more in men- 35 inches or more in womenElevated levels of triglycerides- 150 mg/dL or higher or Taking medication for elevated triglyceride levelsLow levels of HDL (good) cholesterol- Below 40 mg/dL in men- Below 50 mg/dL in women or Taking medication for low HDL cholesterol levelsElevated blood pressure levels- 130 mm Hg or higher for systolic blood pressure or- 85 mm Hg or higher for diastolic blood pressure or Taking medication for elevated blood pressure levelsElevated fasting blood glucose levels- 100 mg/dL or higher or Taking medication for elevated blood glucose levels" } ]

[ { "from": "human", "value": "How to prevent Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "Even if you are at high risk for heart disease and stroke, you can help keep your heart and blood vessels healthy. You can do so by taking the following steps:\n- Make sure that your diet is \"heart-healthy.\" Meet with a registered dietitian to plan a diet that meets these goals:- Include at least 14 grams of fiber daily for every 1,000 calories consumed. Foods high in fiber may help lower blood cholesterol. Oat bran, oatmeal, whole-grain breads and cereals, dried beans and peas (such as kidney beans, pinto beans, and black-eyed peas), fruits, and vegetables are all good sources of fiber. Increase the amount of fiber in your diet gradually to avoid digestive problems.\n- Cut down on saturated fat. It raises your blood cholesterol level. Saturated fat is found in meats, poultry skin, butter, dairy products with fat, shortening, lard, and tropical oils such as palm and coconut oil. Your dietitian can figure out how many grams of saturated fat should be your daily maximum amount.\n- Keep the cholesterol in your diet to less than 300 milligrams a day. Cholesterol is found in meat, dairy products, and eggs.\n- Keep the amount of trans fat in your diet to a minimum. It's a type of fat in foods that raises blood cholesterol. Limit your intake of crackers, cookies, snack foods, commercially prepared baked goods, cake mixes, microwave popcorn, fried foods, salad dressings, and other foods made with partially hydrogenated oil. In addition, some kinds of vegetable shortening and margarines have trans fat. Check for trans fat in the Nutrition Facts section on the food package.\n- If you smoke, quit. Your doctor can help you find ways to quit smoking.\n- Ask your doctor whether you should take aspirin. Studies have shown that taking a low dose of aspirin every day can help reduce the risk of heart disease and stroke. However, aspirin is not safe for everyone. Your doctor can tell you whether taking aspirin is right for you and exactly how much to take.\n- Get prompt treatment for transient ischemic attacks (TIAs). Early treatment for TIAs, sometimes called mini-strokes, may help prevent or delay a future stroke. Signs of a TIA are sudden weakness, loss of balance, numbness, confusion, blindness in one or both eyes, double vision, difficulty speaking, or a severe headache." } ]

[ { "from": "human", "value": "What are the treatments for Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "You can keep track of the ABCs of diabetes to make sure your treatment is working. Talk with your health care provider about the best targets for you.\nA stands for A1C (a test that measures blood glucose control). Have an A1C test at least twice a year. It shows your average blood glucose level over the past 3 months. Talk with your doctor about whether you should check your blood glucose at home and how to do it.\nA1C targetBelow 7 percent, unless your doctor sets a different target\nBlood glucose targetsBefore meals90 to 130 mg/dL1 to 2 hours after the start of a mealLess than 180 mg/dL\nB is for blood pressure. Have it checked at every office visit.\nBlood pressure targetBelow 140/80 mm Hg, unless your doctor sets a different target\nC is for cholesterol. Have it checked at least once a year.\nBlood fat (cholesterol) targetsLDL (bad) cholesterolUnder 100 mg/dLTriglyceridesUnder 150 mg/dLHDL (good) cholesterol For men: above 40 mg/dL For women: above 50 mg/dL\nControl of the ABCs of diabetes can reduce your risk for heart disease and stroke. If your blood glucose, blood pressure, and cholesterol levels aren't on target, ask your doctor what changes in diet, activity, and medications can help you reach these goals." } ]

[ { "from": "human", "value": "What is (are) Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "Two major types of heart and blood vessel disease, also called cardiovascular disease, are common in people with diabetes: coronary artery disease (CAD) and cerebral vascular disease. People with diabetes are also at risk for heart failure. Narrowing or blockage of the blood vessels in the legs, a condition called peripheral arterial disease, can also occur in people with diabetes.\nCoronary Artery Disease\nCoronary artery disease, also called ischemic heart disease, is caused by a hardening or thickening of the walls of the blood vessels that go to your heart. Your blood supplies oxygen and other materials your heart needs for normal functioning. If the blood vessels to your heart become narrowed or blocked by fatty deposits, the blood supply is reduced or cut off, resulting in a heart attack.\nCerebral Vascular Disease\nCerebral vascular disease affects blood flow to the brain, leading to strokes and TIAs. It is caused by narrowing, blocking, or hardening of the blood vessels that go to the brain or by high blood pressure.\nStroke\nA stroke results when the blood supply to the brain is suddenly cut off, which can occur when a blood vessel in the brain or neck is blocked or bursts. Brain cells are then deprived of oxygen and die. A stroke can result in problems with speech or vision or can cause weakness or paralysis. Most strokes are caused by fatty deposits or blood clotsjelly-like clumps of blood cellsthat narrow or block one of the blood vessels in the brain or neck. A blood clot may stay where it formed or can travel within the body. People with diabetes are at increased risk for strokes caused by blood clots.\nA stroke may also be caused by a bleeding blood vessel in the brain. Called an aneurysm, a break in a blood vessel can occur as a result of high blood pressure or a weak spot in a blood vessel wall.\nTIAs\nTIAs are caused by a temporary blockage of a blood vessel to the brain. This blockage leads to a brief, sudden change in brain function, such as temporary numbness or weakness on one side of the body. Sudden changes in brain function also can lead to loss of balance, confusion, blindness in one or both eyes, double vision, difficulty speaking, or a severe headache. However, most symptoms disappear quickly and permanent damage is unlikely. If symptoms do not resolve in a few minutes, rather than a TIA, the event could be a stroke. The occurrence of a TIA means that a person is at risk for a stroke sometime in the future. See page 3 for more information on risk factors for stroke.\nHeart Failure\nHeart failure is a chronic condition in which the heart cannot pump blood properlyit does not mean that the heart suddenly stops working. Heart failure develops over a period of years, and symptoms can get worse over time. People with diabetes have at least twice the risk of heart failure as other people. One type of heart failure is congestive heart failure, in which fluid builds up inside body tissues. If the buildup is in the lungs, breathing becomes difficult.\nBlockage of the blood vessels and high blood glucose levels also can damage heart muscle and cause irregular heart beats. People with damage to heart muscle, a condition called cardiomyopathy, may have no symptoms in the early stages, but later they may experience weakness, shortness of breath, a severe cough, fatigue, and swelling of the legs and feet. Diabetes can also interfere with pain signals normally carried by the nerves, explaining why a person with diabetes may not experience the typical warning signs of a heart attack.\nPeripheral Arterial Disease\nAnother condition related to heart disease and common in people with diabetes is peripheral arterial disease (PAD). With this condition, the blood vessels in the legs are narrowed or blocked by fatty deposits, decreasing blood flow to the legs and feet. PAD increases the chances of a heart attack or stroke occurring. Poor circulation in the legs and feet also raises the risk of amputation. Sometimes people with PAD develop pain in the calf or other parts of the leg when walking, which is relieved by resting for a few minutes." } ]

[ { "from": "human", "value": "What are the treatments for Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "Treatment for heart disease includes meal planning to ensure a heart-healthy diet and physical activity. In addition, you may need medications to treat heart damage or to lower your blood glucose, blood pressure, and cholesterol. If you are not already taking a low dose of aspirin every day, your doctor may suggest it. You also may need surgery or some other medical procedure.\nFor additional information about heart and blood vessel disease, high blood pressure, and high cholesterol, call the National Heart, Lung, and Blood Institute Health Information Center at 3015928573 or see www.nhlbi.nih.gov on the Internet." } ]

[ { "from": "human", "value": "What are the treatments for Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "At the first sign of a stroke, you should get medical care right away. If blood vessels to your brain are blocked by blood clots, the doctor can give you a \"clot-busting\" drug. The drug must be given soon after a stroke to be effective. Subsequent treatment for stroke includes medications and physical therapy, as well as surgery to repair the damage. Meal planning and physical activity may be part of your ongoing care. In addition, you may need medications to lower your blood glucose, blood pressure, and cholesterol and to prevent blood clots.\nFor additional information about strokes, call the National Institute of Neurological Disorders and Stroke at 18003529424 or see www.ninds.nih.gov on the Internet." } ]

[ { "from": "human", "value": "What to do for Diabetes, Heart Disease, and Stroke?" }, { "from": "gpt", "value": "- If you have diabetes, you are at least twice as likely as other people to have heart disease or a stroke.\n- Controlling the ABCs of diabetesA1C (blood glucose), blood pressure, and cholesterol-can cut your risk of heart disease and stroke.\n- Choosing foods wisely, quitting smoking, and taking medications (if needed) can all help lower your risk of heart disease and stroke.\n- If you have any warning signs of a heart attack or a stroke, get medical care immediatelydon't delay. Early treatment of heart attack and stroke in a hospital emergency room can reduce damage to the heart and the brain." } ]

[ { "from": "human", "value": "What is (are) What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "A UTI is an infection in the urinary tract. Infections are caused by microbesorganisms too small to be seen without a microscope. Bacteria * are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are quickly removed by the body before they cause symptoms. But sometimes bacteria overcome the bodys natural defenses and cause infection.\n*See the Pronunciation Guide for tips on how to say the underlined words." } ]

[ { "from": "human", "value": "What causes What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "Most UTIs are caused by bacteria that live in the bowel, the part of the digestive tract where stool is changed from liquid to solid. The bacterium Escherichia coli (E. coli) causes most UTIs. The urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act like one-way valves to prevent urine from backing up, or refluxing, toward the kidneys, and urination washes microbes out of the body. The bodys natural defenses also prevent infection. But despite these safeguards, infections still occur.\nOther factors that may cause a child to get a UTI include the following:\n- Waiting to urinate. Regular urination helps flush away bacteria. Holding urine allows bacteria to grow.\n- Making too little urine. A child that doesnt drink enough fluids may not make enough urine to flush away bacteria.\n- Constipation. Constipation is a condition in which a child has fewer than two bowel movements a week. Stools can be hard, dry, small, and difficult to pass. The hard stool in the bowel may press against the urinary tract and block the flow of urine, allowing bacteria to grow.\nSome children are just more prone to UTIs than others, just as some children are more prone to getting coughs, colds, or ear infections." } ]

[ { "from": "human", "value": "Who is at risk for What I need to know about My Child's Urinary Tract Infection??" }, { "from": "gpt", "value": "Any child can get a UTI, though girls get UTIs more often than boys.\nChildren with a condition called vesicoureteral reflux (VUR) are at higher risk for UTIs. VUR causes urine to reflux at the point where one or both ureters attach to the bladder. When urine stays in the urinary tract, bacteria have a chance to grow and spread. Infants and young children who get a UTI often have VUR.\nBoys younger than 6 months who are not circumcised are at greater risk for a UTI than circumcised boys the same age. Boys who are circumcised have had the foreskin, which is the skin that covers the tip of the penis, removed." } ]

[ { "from": "human", "value": "What are the symptoms of What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "A child with a UTI may not have any symptoms. When symptoms are present, they can range from mild to severe. UTI symptoms can include\n- fever\n- pain or burning during urination with only a few drops of urine at a time\n- irritability\n- not eating\n- nausea\n- diarrhea\n- vomiting\n- cloudy, dark, bloody, or foul-smelling urine\n- urinating often\n- pain in the back or side below the ribs\n- leaking urine into clothes or bedding in older children" } ]

[ { "from": "human", "value": "How to diagnose What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "A UTI is diagnosed by testing a sample of your childs urine. The way the urine is collected depends on your childs age:\nThe health care provider looks at the urine sample with a microscope to check for bacteria or pus. The sample is also sent to a lab. The lab performs a urine culture by placing the sample in a tube or dish with a substance that encourages any bacteria present to grow. The bacteria that grow can be identified and tested to see which medicines will work best to treat the infection. A urine culture usually takes 1 to 3 days to complete." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "Bacteria-fighting medicines called antibiotics are used to treat a UTI. While the lab is doing the urine culture, the health care provider may begin treatment with an antibiotic that treats the bacteria most likely to be causing the infection. Once culture results are known, the health care provider may switch your child to a different antibiotic that targets the specific type of bacteria.\nYour child will need to take antibiotics for at least 3 to 5 days and maybe as long as several weeks. Be sure your child takes every pill or every dose of liquid. Your child should feel better after a couple of days, but the infection might come back if your child stops taking the antibiotic too early.\nYou should let your child drink as much as your child wants. But dont force your child to drink large amounts of fluid. Call your childs health care provider if your child doesnt want to or isnt able to drink. Also, talk with your childs health care provider if your child needs medicine for the pain of a UTI. The health care provider can recommend an over-the-counter pain medicine. A heating pad on the back or abdomen may also help." } ]

[ { "from": "human", "value": "How to diagnose What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "Talk with your childs health care provider after your childs UTI is gone. The health care provider may want to do more tests to check for VUR or a blockage in the urinary tract. Repeated infections in an abnormal urinary tract may cause kidney damage. The kinds of tests ordered will depend on the child and the type of infection. VUR and blockages in the urinary tract often go away as a child grows. In some cases, surgery may be needed to correct any defects in the urinary tract. More information about tests for VUR or a blockage in the urinary tract is provided in the NIDDK health topic, Urinary Tract Infections in Children." } ]

[ { "from": "human", "value": "How to prevent What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "You can take the following steps to help prevent your child from getting a UTI:\n- Teach your child not to hold in urine and to go to the bathroom whenever your child feels the urge.\n- Teach your child how to properly clean himself or herself after using the bathroom to keep bacteria from entering the urinary tract.\n- Have your child wear loose-fitting clothes. Tight clothes can trap moisture, which allows bacteria to grow.\n- Buy your child cotton underwear. Cotton lets in air to dry the area.\n- If your child has constipation, talk with a health care provider about the best treatment options." } ]

[ { "from": "human", "value": "What to do for What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "To help prevent a UTI, make sure your child drinks enough fluids each day. Talk with your childs health care provider to find out how much fluid your child should drink." } ]

[ { "from": "human", "value": "What to do for What I need to know about My Child's Urinary Tract Infection?" }, { "from": "gpt", "value": "- A urinary tract infection (UTI) is an infection in the urinary tract. Infections are caused by microbesorganisms too small to be seen without a microscope.\n- Most UTIs are caused by bacteria that live in the bowel, the part of the digestive tract where stool is changed from liquid to solid.\n- Any child can get a UTI, though girls get UTIs more often than boys.\n- Most UTIs are not serious, but some infections can lead to serious problems.\n- A child with a UTI may not have any symptoms. When symptoms are present, they can range from mild to severe.\n- A UTI is diagnosed by testing a sample of your childs urine.\n- Bacteria-fighting medicines called antibiotics are used to treat a UTI.\n- Talk with your childs health care provider after your childs UTI is gone. The health care provider may want to do more tests to check for vesicoureteral reflux (VUR) or a blockage in the urinary tract.\n- You can take steps to help prevent your child from getting a UTI." } ]

[ { "from": "human", "value": "What is (are) Hypoglycemia?" }, { "from": "gpt", "value": "Hypoglycemia, also called low blood glucose or low blood sugar, occurs when blood glucose drops below normal levels. Glucose, an important source of energy for the body, comes from food. Carbohydrates are the main dietary source of glucose. Rice, potatoes, bread, tortillas, cereal, milk, fruit, and sweets are all carbohydrate-rich foods.\nAfter a meal, glucose is absorbed into the bloodstream and carried to the body's cells. Insulin, a hormone made by the pancreas, helps the cells use glucose for energy. If a person takes in more glucose than the body needs at the time, the body stores the extra glucose in the liver and muscles in a form called glycogen. The body can use glycogen for energy between meals. Extra glucose can also be changed to fat and stored in fat cells. Fat can also be used for energy.\nWhen blood glucose begins to fall, glucagonanother hormone made by the pancreassignals the liver to break down glycogen and release glucose into the bloodstream. Blood glucose will then rise toward a normal level. In some people with diabetes, this glucagon response to hypoglycemia is impaired and other hormones such as epinephrine, also called adrenaline, may raise the blood glucose level. But with diabetes treated with insulin or pills that increase insulin production, glucose levels can't easily return to the normal range.\nHypoglycemia can happen suddenly. It is usually mild and can be treated quickly and easily by eating or drinking a small amount of glucose-rich food. If left untreated, hypoglycemia can get worse and cause confusion, clumsiness, or fainting. Severe hypoglycemia can lead to seizures, coma, and even death.\nIn adults and children older than 10 years, hypoglycemia is uncommon except as a side effect of diabetes treatment. Hypoglycemia can also result, however, from other medications or diseases, hormone or enzyme deficiencies, or tumors." } ]

[ { "from": "human", "value": "What are the symptoms of Hypoglycemia?" }, { "from": "gpt", "value": "Hypoglycemia causes symptoms such as\n- hunger\n- shakiness\n- nervousness\n- sweating\n- dizziness or light-headedness\n- sleepiness\n- confusion\n- difficulty speaking\n- anxiety\n- weakness\nHypoglycemia can also happen during sleep. Some signs of hypoglycemia during sleep include\n- crying out or having nightmares\n- finding pajamas or sheets damp from perspiration\n- feeling tired, irritable, or confused after waking up" } ]

[ { "from": "human", "value": "What causes Hypoglycemia?" }, { "from": "gpt", "value": "Diabetes Medications\nHypoglycemia can occur as a side effect of some diabetes medications, including insulin and oral diabetes medicationspillsthat increase insulin production, such as\n- chlorpropamide (Diabinese)\n- glimepiride (Amaryl)\n- glipizide (Glucotrol, Glucotrol XL)\n- glyburide (DiaBeta, Glynase, Micronase)\n- nateglinide (Starlix)\n- repaglinide (Prandin)\n- sitagliptin (Januvia)\n- tolazamide\n- tolbutamide\nCertain combination pills can also cause hypoglycemia, including\n- glipizide + metformin (Metaglip)\n- glyburide + metformin (Glucovance)\n- pioglitazone + glimepiride (Duetact)\n- rosiglitazone + glimepiride (Avandaryl)\n- sitagliptin + metformin (Janumet)\nOther types of diabetes pills, when taken alone, do not cause hypoglycemia. Examples of these medications are\n- acarbose (Precose)\n- metformin (Glucophage)\n- miglitol (Glyset)\n- pioglitazone (Actos)\n- rosiglitazone (Avandia)\nHowever, taking these pills along with other diabetes medicationsinsulin, pills that increase insulin production, or bothincreases the risk of hypoglycemia.\nIn addition, use of the following injectable medications can cause hypoglycemia:\n- Pramlintide (Symlin), which is used along with insulin\n- Exenatide (Byetta), which can cause hypoglycemia when used in combination with chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, and tolbutamide\nMore information about diabetes medications is provided in the NIDDK health topic, What I need to know about Diabetes Medicines, or by calling 18008608747.\nOther Causes of Hypoglycemia\nIn people on insulin or pills that increase insulin production, low blood glucose can be due to\n- meals or snacks that are too small, delayed, or skipped\n- increased physical activity\n- alcoholic beverages" } ]

[ { "from": "human", "value": "How to prevent Hypoglycemia?" }, { "from": "gpt", "value": "Diabetes treatment plans are designed to match the dose and timing of medication to a person's usual schedule of meals and activities. Mismatches could result in hypoglycemia. For example, taking a dose of insulinor other medication that increases insulin levelsbut then skipping a meal could result in hypoglycemia.\nTo help prevent hypoglycemia, people with diabetes should always consider the following:\n- Their diabetes medications. A health care provider can explain which diabetes medications can cause hypoglycemia and explain how and when to take medications. For good diabetes management, people with diabetes should take diabetes medications in the recommended doses at the recommended times. In some cases, health care providers may suggest that patients learn how to adjust medications to match changes in their schedule or routine.\n- Their meal plan. A registered dietitian can help design a meal plan that fits one's personal preferences and lifestyle. Following one's meal plan is important for managing diabetes. People with diabetes should eat regular meals, have enough food at each meal, and try not to skip meals or snacks. Snacks are particularly important for some people before going to sleep or exercising. Some snacks may be more effective than others in preventing hypoglycemia overnight. The dietitian can make recommendations for snacks.\n- Their daily activity. To help prevent hypoglycemia caused by physical activity, health care providers may advise- checking blood glucose before sports, exercise, or other physical activity and having a snack if the level is below 100 milligrams per deciliter (mg/dL)- adjusting medication before physical activity- checking blood glucose at regular intervals during extended periods of physical activity and having snacks as needed- checking blood glucose periodically after physical activity- Their use of alcoholic beverages. Drinking alcoholic beverages, especially on an empty stomach, can cause hypoglycemia, even a day or two later. Heavy drinking can be particularly dangerous for people taking insulin or medications that increase insulin production. Alcoholic beverages should always be consumed with a snack or meal at the same time. A health care provider can suggest how to safely include alcohol in a meal plan.\n- Their diabetes management plan. Intensive diabetes managementkeeping blood glucose as close to the normal range as possible to prevent long-term complicationscan increase the risk of hypoglycemia. Those whose goal is tight control should talk with a health care provider about ways to prevent hypoglycemia and how best to treat it if it occurs.\nWhat to Ask the Doctor about Diabetes Medications\nPeople who take diabetes medications should ask their doctor or health care provider\n- whether their diabetes medications could cause hypoglycemia\n- when they should take their diabetes medications\n- how much medication they should take\n- whether they should keep taking their diabetes medications when they are sick\n- whether they should adjust their medications before physical activity\n- whether they should adjust their medications if they skip a meal" } ]

[ { "from": "human", "value": "What are the treatments for Hypoglycemia?" }, { "from": "gpt", "value": "Signs and symptoms of hypoglycemia vary from person to person. People with diabetes should get to know their signs and symptoms and describe them to their friends and family so they can help if needed. School staff should be told how to recognize a child's signs and symptoms of hypoglycemia and how to treat it.\nPeople who experience hypoglycemia several times in a week should call their health care provider. They may need a change in their treatment plan: less medication or a different medication, a new schedule for insulin or medication, a different meal plan, or a new physical activity plan.\nPrompt Treatment for Hypoglycemia\nWhen people think their blood glucose is too low, they should check the blood glucose level of a blood sample using a meter. If the level is below 70 mg/dL, one of these quick-fix foods should be consumed right away to raise blood glucose:\n- 3 or 4 glucose tablets\n- 1 serving of glucose gelthe amount equal to 15 grams of carbohydrate\n- 1/2 cup, or 4 ounces, of any fruit juice\n- 1/2 cup, or 4 ounces, of a regularnot dietsoft drink\n- 1 cup, or 8 ounces, of milk\n- 5 or 6 pieces of hard candy\n- 1 tablespoon of sugar or honey\nRecommended amounts may be less for small children. The child's doctor can advise about the right amount to give a child.\nThe next step is to recheck blood glucose in 15 minutes to make sure it is 70 mg/dL or above. If it's still too low, another serving of a quick-fix food should be eaten. These steps should be repeated until the blood glucose level is 70 mg/dL or above. If the next meal is an hour or more away, a snack should be eaten once the quick-fix foods have raised the blood glucose level to 70 mg/dL or above.\nFor People Who Take Acarbose (Precose) or Miglitol (Glyset)\nPeople who take either of these diabetes medications should know that only pure glucose, also called dextroseavailable in tablet or gel formwill raise their blood glucose level during a low blood glucose episode. Other quick-fix foods and drinks won't raise the level quickly enough because acarbose and miglitol slow the digestion of other forms of carbohydrate.\nHelp from Others for Severe Hypoglycemia\nSevere hypoglycemiavery low blood glucosecan cause a person to pass out and can even be life threatening. Severe hypoglycemia is more likely to occur in people with type 1 diabetes. People should ask a health care provider what to do about severe hypoglycemia. Another person can help someone who has passed out by giving an injection of glucagon. Glucagon will rapidly bring the blood glucose level back to normal and help the person regain consciousness. A health care provider can prescribe a glucagon emergency kit. Family, friends, or coworkersthe people who will be around the person at risk of hypoglycemiacan learn how to give a glucagon injection and when to call 911 or get medical help.\nPhysical Activity and Blood Glucose Levels\nPhysical activity has many benefits for people with diabetes, including lowering blood glucose levels. However, physical activity can make levels too low and can cause hypoglycemia up to 24 hours afterward. A health care provider can advise about checking the blood glucose level before exercise. For those who take insulin or one of the oral medications that increase insulin production, the health care provider may suggest having a snack if the glucose level is below 100 mg/dL or adjusting medication doses before physical activity to help avoid hypoglycemia. A snack can prevent hypoglycemia. The health care provider may suggest extra blood glucose checks, especially after strenuous exercise.\nHypoglycemia When Driving\nHypoglycemia is particularly dangerous if it happens to someone who is driving. People with hypoglycemia may have trouble concentrating or seeing clearly behind the wheel and may not be able to react quickly to road hazards or to the actions of other drivers. To prevent problems, people at risk for hypoglycemia should check their blood glucose level before driving. During longer trips, they should check their blood glucose level frequently and eat snacks as needed to keep the level at 70 mg/dL or above. If necessary, they should stop for treatment and then make sure their blood glucose level is 70 mg/dL or above before starting to drive again.\nHypoglycemia Unawareness\nSome people with diabetes do not have early warning signs of low blood glucose, a condition called hypoglycemia unawareness. This condition occurs most often in people with type 1 diabetes, but it can also occur in people with type 2 diabetes. People with hypoglycemia unawareness may need to check their blood glucose level more often so they know when hypoglycemia is about to occur. They also may need a change in their medications, meal plan, or physical activity routine.\nHypoglycemia unawareness develops when frequent episodes of hypoglycemia lead to changes in how the body reacts to low blood glucose levels. The body stops releasing the hormone epinephrine and other stress hormones when blood glucose drops too low. The loss of the body's ability to release stress hormones after repeated episodes of hypoglycemia is called hypoglycemia-associated autonomic failure, or HAAF.\nEpinephrine causes early warning symptoms of hypoglycemia such as shakiness, sweating, anxiety, and hunger. Without the release of epinephrine and the symptoms it causes, a person may not realize that hypoglycemia is occurring and may not take action to treat it. A vicious cycle can occur in which frequent hypoglycemia leads to hypoglycemia unawareness and HAAF, which in turn leads to even more severe and dangerous hypoglycemia. Studies have shown that preventing hypoglycemia for a period as short as several weeks can sometimes break this cycle and restore awareness of symptoms. Health care providers may therefore advise people who have had severe hypoglycemia to aim for higher-than-usual blood glucose targets for short-term periods.\nBeing Prepared for Hypoglycemia\nPeople who use insulin or take an oral diabetes medication that can cause low blood glucose should always be prepared to prevent and treat low blood glucose by\n- learning what can trigger low blood glucose levels\n- having their blood glucose meter available to test glucose levels; frequent testing may be critical for those with hypoglycemia unawareness, particularly before driving a car or engaging in any hazardous activity\n- always having several servings of quick-fix foods or drinks handy\n- wearing a medical identification bracelet or necklace\n- planning what to do if they develop severe hypoglycemia\n- telling their family, friends, and coworkers about the symptoms of hypoglycemia and how they can help if needed\nNormal and Target Blood Glucose RangesNormal Blood Glucose Levels in People Who Do Not Have DiabetesUpon wakingfasting70 to 99 mg/dLAfter meals70 to 140 mg/dLTarget Blood Glucose Levels in People Who Have DiabetesBefore meals70 to 130 mg/dL1 to 2 hours after the start of a mealbelow 180 mg/dL\nFor people with diabetes, a blood glucose level below 70 mg/dL is considered hypoglycemia." } ]

[ { "from": "human", "value": "What to do for Hypoglycemia?" }, { "from": "gpt", "value": "Two types of hypoglycemia can occur in people who do not have diabetes:\n- Reactive hypoglycemia, also called postprandial hypoglycemia, occurs within 4 hours after meals.\n- Fasting hypoglycemia, also called postabsorptive hypoglycemia, is often related to an underlying disease.\nSymptoms of both reactive and fasting hypoglycemia are similar to diabetes-related hypoglycemia. Symptoms may include hunger, sweating, shakiness, dizziness, light-headedness, sleepiness, confusion, difficulty speaking, anxiety, and weakness.\nTo find the cause of a patient's hypoglycemia, the doctor will use laboratory tests to measure blood glucose, insulin, and other chemicals that play a part in the body's use of energy.\nReactive Hypoglycemia\nDiagnosis\nTo diagnose reactive hypoglycemia, the doctor may\n- ask about signs and symptoms\n- test blood glucose while the patient is having symptoms by taking a blood sample from the arm and sending it to a laboratory for analysis*\n- check to see whether the symptoms ease after the patient's blood glucose returns to 70 mg/dL or above after eating or drinking\nA blood glucose level below 70 mg/dL at the time of symptoms and relief after eating will confirm the diagnosis. The oral glucose tolerance test is no longer used to diagnose reactive hypoglycemia because experts now know the test can actually trigger hypoglycemic symptoms.\nCauses and Treatment\nThe causes of most cases of reactive hypoglycemia are still open to debate. Some researchers suggest that certain people may be more sensitive to the body's normal release of the hormone epinephrine, which causes many of the symptoms of hypoglycemia. Others believe deficiencies in glucagon secretion might lead to reactive hypoglycemia.\nA few causes of reactive hypoglycemia are certain, but they are uncommon. Gastricor stomachsurgery can cause reactive hypoglycemia because of the rapid passage of food into the small intestine. Rare enzyme deficiencies diagnosed early in life, such as hereditary fructose intolerance, also may cause reactive hypoglycemia.\nTo relieve reactive hypoglycemia, some health professionals recommend\n- eating small meals and snacks about every 3 hours\n- being physically active\n- eating a variety of foods, including meat, poultry, fish, or nonmeat sources of protein; starchy foods such as whole-grain bread, rice, and potatoes; fruits; vegetables; and dairy products\n- eating foods high in fiber\n- avoiding or limiting foods high in sugar, especially on an empty stomach\nThe doctor can refer patients to a registered dietitian for personalized meal planning advice. Although some health professionals recommend a diet high in protein and low in carbohydrates, studies have not proven the effectiveness of this kind of diet to treat reactive hypoglycemia.\nFasting Hypoglycemia\nDiagnosis\nFasting hypoglycemia is diagnosed from a blood sample that shows a blood glucose level below 50 mg/dL after an overnight fast, between meals, or after physical activity.\nCauses and Treatment\nCauses of fasting hypoglycemia include certain medications, alcoholic beverages, critical illnesses, hormonal deficiencies, some kinds of tumors, and certain conditions occurring in infancy and childhood.\nMedications. Medications, including some used to treat diabetes, are the most common cause of hypoglycemia. Other medications that can cause hypoglycemia include\n- salicylates, including aspirin, when taken in large doses\n- sulfa medications, which are used to treat bacterial infections\n- pentamidine, which treats a serious kind of pneumonia\n- quinine, which is used to treat malaria\nIf using any of these medications causes a person's blood glucose level to fall, the doctor may advise stopping the medication or changing the dose.\nAlcoholic beverages. Drinking alcoholic beverages, especially binge drinking, can cause hypoglycemia. The body's breakdown of alcohol interferes with the liver's efforts to raise blood glucose. Hypoglycemia caused by excessive drinking can be serious and even fatal.\nCritical illnesses. Some illnesses that affect the liver, heart, or kidneys can cause hypoglycemia. Sepsis, which is an overwhelming infection, and starvation are other causes of hypoglycemia. In these cases, treating the illness or other underlying cause will correct the hypoglycemia.\nHormonal deficiencies. Hormonal deficiencies may cause hypoglycemia in very young children, but rarely in adults. Shortages of cortisol, growth hormone, glucagon, or epinephrine can lead to fasting hypoglycemia. Laboratory tests for hormone levels will determine a diagnosis and treatment. Hormone replacement therapy may be advised.\nTumors. Insulinomas are insulin-producing tumors in the pancreas. Insulinomas can cause hypoglycemia by raising insulin levels too high in relation to the blood glucose level. These tumors are rare and do not normally spread to other parts of the body. Laboratory tests can pinpoint the exact cause. Treatment involves both short-term steps to correct the hypoglycemia and medical or surgical measures to remove the tumor.\nConditions occurring in infancy and childhood. Children rarely develop hypoglycemia. If they do, causes may include the following:\n- Brief intolerance to fasting, often during an illness that disturbs regular eating patterns. Children usually outgrow this tendency by age 10.\n- Hyperinsulinism, which is the overproduction of insulin. This condition can result in temporary hypoglycemia in newborns, which is common in infants of mothers with diabetes. Persistent hyperinsulinism in infants or children is a complex disorder that requires prompt evaluation and treatment by a specialist.\n- Enzyme deficiencies that affect carbohydrate metabolism. These deficiencies can interfere with the body's ability to process natural sugars, such as fructose and galactose, glycogen, or other metabolites.\n- Hormonal deficiencies such as lack of pituitary or adrenal hormones.\n*A personal blood glucose monitor cannot be used to diagnose reactive hypoglycemia." } ]

[ { "from": "human", "value": "What to do for Hypoglycemia?" }, { "from": "gpt", "value": "Diabetes-related Hypoglycemia\n- When people with diabetes think their blood glucose level is low, they should check it and treat the problem right away.\n- To treat hypoglycemia, people should have a serving of a quick-fix food, wait 15 minutes, and check their blood glucose again. They should repeat the treatment until their blood glucose is 70 mg/dL or above.\n- People at risk for hypoglycemia should keep quick-fix foods in the car, at workanywhere they spend time.\n- People at risk for hypoglycemia should be careful when driving. They should check their blood glucose frequently and snack as needed to keep their level 70 mg/dL or above.\nHypoglycemia Unrelated to Diabetes\n- In reactive hypoglycemia, symptoms occur within 4 hours of eating. People with reactive hypoglycemia are usually advised to follow a healthy eating plan recommended by a registered dietitian.\n- Fasting hypoglycemia can be caused by certain medications, critical illnesses, hereditary enzyme or hormonal deficiencies, and some kinds of tumors. Treatment targets the underlying problem." } ]

[ { "from": "human", "value": "What is (are) Overview of Kidney Disease in Children?" }, { "from": "gpt", "value": "The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. The kidneys work around the clock; a person does not control what they do. Ureters are the thin tubes of muscleone on each side of the bladderthat carry urine from each of the kidneys to the bladder. The bladder stores urine until the person finds an appropriate time and place to urinate.\nThe kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called a glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which changes the fluid by sending needed minerals back to the bloodstream and removing wastes. The final product becomes urine.\nThe kidneys also control the level of minerals such as sodium, phosphorus, and potassium in the body, and produce an important hormone to prevent anemia. Anemia is a condition in which the number of red blood cells is less than normal, resulting in less oxygen carried to the bodys cells." } ]

[ { "from": "human", "value": "What causes Overview of Kidney Disease in Children?" }, { "from": "gpt", "value": "Kidney disease in children can be caused by\n- birth defects\n- hereditary diseases\n- infection\n- nephrotic syndrome\n- systemic diseases\n- trauma\n- urine blockage or reflux\nFrom birth to age 4, birth defects and hereditary diseases are the leading causes of kidney failure. Between ages 5 and 14, kidney failure is most commonly caused by hereditary diseases, nephrotic syndrome, and systemic diseases. Between ages 15 and 19, diseases that affect the glomeruli are the leading cause of kidney failure, and hereditary diseases become less common.1\nBirth Defects\nA birth defect is a problem that happens while a baby is developing in the mothers womb. Birth defects that affect the kidneys include renal agenesis, renal dysplasia, and ectopic kidney, to name a few. These defects are abnormalities of size, structure, or position of the kidneys:\n- renal agenesischildren born with only one kidney\n- renal dysplasiachildren born with both kidneys, yet one does not function\n- ectopic kidneychildren born with a kidney that is located below, above, or on the opposite side of its usual position\nIn general, children with these conditions lead full, healthy lives. However, some children with renal agenesis or renal dysplasia are at increased risk for developing kidney disease.\nHereditary Diseases\nHereditary kidney diseases are illnesses passed from parent to child through the genes. One example is polycystic kidney disease (PKD), characterized by many grapelike clusters of fluid-filled cystsabnormal sacsthat make both kidneys larger over time. These cysts take over and destroy working kidney tissue. Another hereditary disease is Alport syndrome, which is caused by a mutation in a gene for a type of protein called collagen that makes up the glomeruli. The condition leads to scarring of the kidneys. Alport syndrome generally develops in early childhood and is more serious in boys than in girls. The condition can lead to hearing and vision problems in addition to kidney disease.\nInfection\nHemolytic uremic syndrome and acute post-streptococcal glomerulonephritis are kidney diseases that can develop in a child after an infection.\n- Hemolytic uremic syndrome is a rare disease that is often caused by the Escherichia coli (E. coli) bacterium found in contaminated foods, such as meat, dairy products, and juice. Hemolytic uremic syndrome develops when E. coli bacteria lodged in the digestive tract make toxins that enter the bloodstream. The toxins start to destroy red blood cells and damage the lining of the blood vessels, including the glomeruli. Most children who get an E. coli infection have vomiting, stomach cramps, and bloody diarrhea for 2 to 3 days. Children who develop hemolytic uremic syndrome become pale, tired, and irritable. Hemolytic uremic syndrome can lead to kidney failure in some children.\n- Post-streptococcal glomerulonephritis can occur after an episode of strep throat or a skin infection. The Streptococcus bacterium does not attack the kidneys directly; instead, the infection may stimulate the immune system to overproduce antibodies. Antibodies are proteins made by the immune system. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. When the extra antibodies circulate in the blood and finally deposit in the glomeruli, the kidneys can be damaged. Most cases of post-streptococcal glomerulonephritis develop 1 to 3 weeks after an untreated infection, though it may be as long as 6 weeks. Post-streptococcal glomerulonephritis lasts only a brief time and the kidneys usually recover. In a few cases, kidney damage may be permanent.\nNephrotic Syndrome\nNephrotic syndrome is a collection of symptoms that indicate kidney damage. Nephrotic syndrome includes all of the following conditions:\n- albuminuriawhen a persons urine contains an elevated level of albumin, a protein typically found in the blood\n- hyperlipidemiahigher-than-normal fat and cholesterol levels in the blood\n- edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face\n- hypoalbuminemialow levels of albumin in the blood\nNephrotic syndrome in children can be caused by the following conditions:\n- Minimal change disease is a condition characterized by damage to the glomeruli that can be seen only with an electron microscope, which shows tiny details better than any other type of microscope. The cause of minimal change disease is unknown; some health care providers think it may occur after allergic reactions, vaccinations, and viral infections.\n- Focal segmental glomerulosclerosis is scarring in scattered regions of the kidney, typically limited to a small number of glomeruli.\n- Membranoproliferative glomerulonephritis is a group of autoimmune diseases that cause antibodies to build up on a membrane in the kidney. Autoimmune diseases cause the bodys immune system to attack the bodys own cells and organs.\nSystemic Diseases\nSystemic diseases, such as systemic lupus erythematosus (SLE or lupus) and diabetes, involve many organs or the whole body, including the kidneys:\n- Lupus nephritis is kidney inflammation caused by SLE, which is an autoimmune disease.\n- Diabetes leads to elevated levels of blood glucose, also called blood sugar, which scar the kidneys and increase the speed at which blood flows into the kidneys. Faster blood flow strains the glomeruli, decreasing their ability to filter blood, and raises blood pressure. Kidney disease caused by diabetes is called diabetic kidney disease. While diabetes is the number one cause of kidney failure in adults, it is an uncommon cause during childhood.\nMore information about systemic kidney diseases is provided in the NIDDK health topics:\n- Lupus Nephritis\n- Kidney Disease of Diabetes\nTrauma\nTraumas such as burns, dehydration, bleeding, injury, or surgery can cause very low blood pressure, which decreases blood flow to the kidneys. Low blood flow can result in acute kidney failure.\nUrine Blockage or Reflux\nWhen a blockage develops between the kidneys and the urethra, urine can back up into the kidneys and cause damage. Refluxurine flowing from the bladder up to the kidneyhappens when the valve between the bladder and the ureter does not close all the way." } ]

[ { "from": "human", "value": "How to diagnose Overview of Kidney Disease in Children?" }, { "from": "gpt", "value": "A health care provider diagnoses kidney disease in children by completing a physical exam, asking for a medical history, and reviewing signs and symptoms. To confirm diagnosis, the health care provider may order one or more of the following tests:\nUrine Tests\nDipstick test for albumin. The presence of albumin in urine is a sign that the kidneys may be damaged. Albumin in urine can be detected with a dipstick test performed on a urine sample. The urine sample is collected in a special container in a health care providers office or a commercial facility and can be tested in the same location or sent to a lab for analysis. With a dipstick test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the persons urine sample. Patches on the dipstick change color when albumin is present in urine.\nUrine albumin-to-creatinine ratio. A more precise measurement, such as a urine albumin-to-creatinine ratio, may be necessary to confirm kidney disease. Unlike a dipstick test for albumin, a urine albumin-to-creatinine ratiothe ratio between the amount of albumin and the amount of creatinine in urineis not affected by variation in urine concentration.\nBlood test. Blood drawn in a health care providers office and sent to a lab for analysis can be tested to estimate how much blood the kidneys filter each minute, called the estimated glomerular filtration rate or eGFR.\nImaging studies. Imaging studies provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys and identify any abnormalities.\nKidney biopsy. Kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. Biopsy results show the cause of the kidney disease and extent of damage to the kidneys." } ]

[ { "from": "human", "value": "What are the treatments for Overview of Kidney Disease in Children?" }, { "from": "gpt", "value": "Treatment for kidney disease in children depends on the cause of the illness. A child may be referred to a pediatric nephrologista doctor who specializes in treating kidney diseases and kidney failure in childrenfor treatment.\nChildren with a kidney disease that is causing high blood pressure may need to take medications to lower their blood pressure. Improving blood pressure can significantly slow the progression of kidney disease. The health care provider may prescribe\n- angiotensin-converting enzyme (ACE) inhibitors, which help relax blood vessels and make it easier for the heart to pump blood\n- angiotensin receptor blockers (ARBs), which help relax blood vessels and make it easier for the heart to pump blood\n- diuretics, medications that increase urine output\nMany children require two or more medications to control their blood pressure; other types of blood pressure medications may also be needed.\nAs kidney function declines, children may need treatment for anemia and growth failure. Anemia is treated with a hormone called erythropoietin, which stimulates the bone marrow to produce red blood cells. Children with growth failure may need to make dietary changes and take food supplements or growth hormone injections.\nChildren with kidney disease that leads to kidney failure must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation. More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children.\nBirth Defects\nChildren with renal agenesis or renal dysplasia should be monitored for signs of kidney damage. Treatment is not needed unless damage to the kidney occurs. More information is provided in the NIDDK health topic, Solitary Kidney.\nEctopic kidney does not need to be treated unless it causes a blockage in the urinary tract or damage to the kidney. When a blockage is present, surgery may be needed to correct the position of the kidney for better drainage of urine. If extensive kidney damage has occurred, surgery may be needed to remove the kidney. More information is provided in the NIDDK health topic, Ectopic Kidney.\nHereditary Diseases\nChildren with PKD tend to have frequent urinary tract infections, which are treated with bacteria-fighting medications called antibiotics. PKD cannot be cured, so children with the condition receive treatment to slow the progression of kidney disease and treat the complications of PKD. More information is provided in the NIDDK health topic, Polycystic Kidney Disease.\nAlport syndrome also has no cure. Children with the condition receive treatment to slow disease progression and treat complications until the kidneys fail. More information is provided in the NIDDK health topic, Glomerular Diseases.\nInfection\nTreatment for hemolytic uremic syndrome includes maintaining normal salt and fluid levels in the body to ease symptoms and prevent further problems. A child may need a transfusion of red blood cells delivered through an intravenous (IV) tube. Some children may need dialysis for a short time to take over the work the kidneys usually do. Most children recover completely with no long-term consequences. More information is provided in the NIDDK health topic, Hemolytic Uremic Syndrome in Children.\nChildren with post-streptococcal glomerulonephritis may be treated with antibiotics to destroy any bacteria that remain in the body and with medications to control swelling and high blood pressure. They may also need dialysis for a short period of time. More information about post-streptococcal glomerulonephritis is provided in the NIDDK health topic, Glomerular Diseases.\nNephrotic Syndrome\nNephrotic syndrome due to minimal change disease can often be successfully treated with corticosteroids. Corticosteroids decrease swelling and reduce the activity of the immune system. The dosage of the medication is decreased over time. Relapses are common; however, they usually respond to treatment. Corticosteroids are less effective in treating nephrotic syndrome due to focal segmental glomerulosclerosis or membranoproliferative glomerulonephritis. Children with these conditions may be given other immunosuppressive medications in addition to corticosteroids. Immunosuppressive medications prevent the body from making antibodies. More information is provided in the NIDDK health topic, Childhood Nephrotic Syndrome.\nSystemic Diseases\nLupus nephritis is treated with corticosteroids and other immunosuppressive medications. A child with lupus nephritis may also be treated with blood pressure-lowering medications. In many cases, treatment is effective in completely or partially controlling lupus nephritis. More information is provided in the NIDDK health topic, Lupus Nephritis.\nDiabetic kidney disease usually takes many years to develop. Children with diabetes can prevent or slow the progression of diabetic kidney disease by taking medications to control high blood pressure and maintaining normal blood glucose levels. More information is provided in the NIDDK health topic, Kidney Disease of Diabetes.\nTrauma\nThe types of trauma described above can be medically treated, though dialysis may be needed for a short time until blood flow and blood pressure return to normal.\nUrine Blockage and Reflux\nTreatment for urine blockage depends on the cause and severity of the blockage. In some cases, the blockage goes away without treatment. For children who continue to have urine blockage, surgery may be needed to remove the obstruction and restore urine flow. After surgery, a small tube, called a stent, may be placed in the ureter or urethra to keep it open temporarily while healing occurs. More information is provided in the NIDDK health topic, Urine Blockage in Newborns.\nTreatment for reflux may include prompt treatment of urinary tract infections and long-term use of antibiotics to prevent infections until reflux goes away on its own. Surgery has also been used in certain cases. More information is provided in the NIDDK health topic, Vesicoureteral Reflux." } ]

[ { "from": "human", "value": "What to do for Overview of Kidney Disease in Children?" }, { "from": "gpt", "value": "For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work. Parents or guardians should always consult with their childs health care team before making any dietary changes. Staying healthy with CKD requires paying close attention to the following elements of a diet:\n- Protein. Children with CKD should eat enough protein for growth while limiting high protein intake. Too much protein can put an extra burden on the kidneys and cause kidney function to decline faster. Protein needs increase when a child is on dialysis because the dialysis process removes protein from the childs blood. The health care team recommends the amount of protein needed for the child. Foods with protein include- eggs- milk- cheese- chicken- fish- red meats- beans- yogurt- cottage cheese- Sodium. The amount of sodium children need depends on the stage of their kidney disease, their age, and sometimes other factors. The health care team may recommend limiting or adding sodium and salt to the diet. Foods high in sodium include- canned foods- some frozen foods- most processed foods- some snack foods, such as chips and crackers- Potassium. Potassium levels need to stay in the normal range for children with CKD, because too little or too much potassium can cause heart and muscle problems. Children may need to stay away from some fruits and vegetables or reduce the number of servings and portion sizes to make sure they do not take in too much potassium. The health care team recommends the amount of potassium a child needs. Low-potassium fruits and vegetables include- apples- cranberries- strawberries- blueberries- raspberries- pineapple- cabbage- boiled cauliflower- mustard greens- uncooked broccoli- High-potassium fruits and vegetables include- oranges- melons- apricots- bananas- potatoes- tomatoes- sweet potatoes- cooked spinach- cooked broccoli- Phosphorus. Children with CKD need to control the level of phosphorus in their blood because too much phosphorus pulls calcium from the bones, making them weaker and more likely to break. Too much phosphorus also can cause itchy skin and red eyes. As CKD progresses, a child may need to take a phosphate binder with meals to lower the concentration of phosphorus in the blood. Phosphorus is found in high-protein foods. Foods with low levels of phosphorus include- liquid nondairy creamer- green beans- popcorn- unprocessed meats from a butcher- lemon-lime soda- root beer- powdered iced tea and lemonade mixes- rice and corn cereals- egg white- sorbet- Fluids. Early in CKD, a childs damaged kidneys may produce either too much or too little urine, which can lead to swelling or dehydration. As CKD progresses, children may need to limit fluid intake. The health care provider will tell the child and parents or guardians the goal for fluid intake.\nMore information is provided in the NIDDK health topics, Nutrition for Chronic Kidney Disease in Children and Kidney Failure: Eat Right to Feel Right on Hemodialysis." } ]

[ { "from": "human", "value": "What to do for Overview of Kidney Disease in Children?" }, { "from": "gpt", "value": "- Kidney disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions. Acute kidney disease develops suddenly, lasts a short time, and can be serious with long-lasting consequences, or may go away completely once the underlying cause has been treated.\n- Chronic kidney disease (CKD) does not go away with treatment and tends to get worse over time.\n- Kidney disease in children can be caused by- birth defects- hereditary diseases- infection- nephrotic syndrome- systemic diseases- trauma- urine blockage or reflux- A health care provider diagnoses kidney disease in children by completing a physical exam, asking for a medical history, and reviewing signs and symptoms. To confirm diagnosis, the health care provider may order one or more of the following tests:- urine tests- blood test- imaging studies- kidney biopsy- Treatment for kidney disease in children depends on the cause of the illness.\n- Children with a kidney disease that is causing high blood pressure may need to take medications to lower their blood pressure. Improving blood pressure can significantly slow the progression of kidney disease. As kidney function declines, children may need treatment for anemia and growth failure.\n- Children with kidney disease that leads to kidney failure must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation.\n- For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work. Parents or guardians should always consult with their childs health care team before making any dietary changes." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Lactose Intolerance?" }, { "from": "gpt", "value": "Lactose\n*\nintestine\nlactase\n,\nenzyme\n*See the Pronunciation Guide for tips on how to say the words in bold type." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Lactose Intolerance?" }, { "from": "gpt", "value": "Lactose intolerance means you have symptoms such as bloating, diarrhea, and gas after you have milk or milk products.\nIf your small intestine does not produce much lactase, you cannot break down much lactose. Lactose that does not break down goes to your colon. The colon is an organ that absorbs water from stool and changes it from a liquid to a solid form. In your colon, bacteria that normally live in the colon break down the lactose and create fluid and gas, causing you to have symptoms.\nThe causes of low lactase in your small intestine can include the following:\n- In some people, the small intestine makes less lactase starting at about age 2, which may lead to symptoms of lactose intolerance. Other people start to have symptoms later, when they are teenagers or adults.\n- Infection, disease, or other problems that harm the small intestine can cause low lactase levels. Low lactase levels can cause you to become lactose intolerant until your small intestine heals.\n- Being born early may cause babies to be lactose intolerant for a short time after they are born.\n- In a rare form of lactose intolerance, the small intestine produces little or no lactase enzyme from birth.\nNot all people with low lactase levels have symptoms. If you have symptoms, you are lactose intolerant.\nMost people who are lactose intolerant can have some milk or milk products and not have symptoms. The amount of lactose that causes symptoms is different from person to person.\nPeople sometimes confuse lactose intolerance with a milk allergy. While lactose intolerance is a digestive problem, a milk allergy is a reaction by the bodys immune system to one or more milk proteins. If you have a milk allergy, having even a small amount of milk or milk product can be life threatening. A milk allergy most commonly occurs in the first year of life. Lactose intolerance occurs more often during the teen years or adulthood." } ]

[ { "from": "human", "value": "What are the symptoms of What I need to know about Lactose Intolerance?" }, { "from": "gpt", "value": "Common symptoms of lactose intolerance include\n- bloating, a feeling of fullness or swelling, in your belly\n- pain in your belly\n- diarrhea\n- gas\n- nausea\nYou may feel symptoms 30 minutes to 2 hours after you have milk or milk products. You may have mild or severe symptoms." } ]

[ { "from": "human", "value": "What to do for What I need to know about Lactose Intolerance?" }, { "from": "gpt", "value": "Talk with your doctor about your dietary plan. A dietary plan can help you manage the symptoms of lactose intolerance and get enough nutrients. If you have a child with lactose intolerance, follow the diet plan that your childs doctor recommends.\nMilk and milk products. You may be able to have milk and milk products without symptoms if you\n- drink small amounts of milkhalf a cup or lessat a time\n- drink small amounts of milk with meals, such as having milk with cereal or having cheese with crackers\n- add small amounts of milk and milk products to your diet a little at a time and see how you feel\n- eat milk products that are easier for people with lactose intolerance to break down:- yogurt- hard cheeses such as cheddar and Swiss\nLactose-free and lactose-reduced milk and milk products. You can find lactose-free and lactose-reduced milk and milk products at the grocery store. These products are just as healthy for you as regular milk and milk products.\nLactase products. You can use lactase tablets and drops when you have milk and milk products. The lactase enzyme breaks down the lactose in food. Using lactase tablets or drops can help you prevent symptoms of lactose intolerance. Check with your doctor before using these products. Some people, such as young children and pregnant and breastfeeding women, may not be able to use these products.\nCalcium and Vitamin D If you are lactose intolerant, make sure you get enough calcium each day. Milk and milk products are the most common sources of calcium. Other foods that contain calcium include\n- fish with soft bones, such as canned salmon or sardines\n- broccoli and other leafy green vegetables\n- oranges\n- almonds, Brazil nuts, and dried beans\n- tofu\n- products with the label showing added calcium, such as cereals, fruit juices, and soy milkVitamin D helps the body absorb and use calcium. Be sure to eat foods that contain vitamin D, such as eggs, liver, and certain kinds of fish, such as salmon. Also, being outside in the sunlight helps your body make vitamin D. Some companies add vitamin D to milk and milk products. If you are able to drink small amounts of milk or eat yogurt, choose those that have vitamin D added. Talk with your doctor about how to get enough nutrientsincluding calcium and vitamin Din your diet or your childs diet. Ask if you should also take a supplement to get enough calcium and vitamin D. For safety reasons, talk with your doctor before using dietary supplements or any other nonmainstream medicine together with or in place of the treatment your doctor prescribes. Read more at www.ods.od.nih.gov and www.nccam.nih.gov." } ]

[ { "from": "human", "value": "What to do for What I need to know about Lactose Intolerance?" }, { "from": "gpt", "value": "- Lactose is a sugar found in milk and milk products.\n- Lactose intolerance means you have symptoms such as bloating, diarrhea, and gas after you have milk or milk products.\n- Your doctor will try to find out if you have lactose intolerance with a medical, family, and diet history; a physical exam; and medical tests.\n- Most people with lactose intolerance can eat or drink some lactose without symptoms.\n- If you have lactose intolerance, you can make changes to what you eat and drink. Some people may only need to have less lactose. Others may need to avoid lactose altogether.\n- Talk with your doctor about how to get enough nutrientsincluding calcium and vitamin Din your diet or your childs diet. Ask if you should also take a supplement to get enough calcium and vitamin D. For safety reasons, talk with your doctor before using dietary supplements or any other nonmainstream medicine together with or in place of the treatment your doctor prescribes.\n- Lactose is in many food products and in some medicines." } ]

[ { "from": "human", "value": "What is (are) Peyronie's Disease?" }, { "from": "gpt", "value": "Peyronies disease is a disorder in which scar tissue, called a plaque, forms in the penisthe male organ used for urination and sex. The plaque builds up inside the tissues of a thick, elastic membrane called the tunica albuginea. The most common area for the plaque is on the top or bottom of the penis. As the plaque builds up, the penis will curve or bend, which can cause painful erections. Curves in the penis can make sexual intercourse painful, difficult, or impossible. Peyronies disease begins with inflammation, or swelling, which can become a hard scar.\nThe plaque that develops in Peyronies disease is not the same plaque that can develop in a persons arteries. The plaque seen in Peyronies disease is benign, or noncancerous, and is not a tumor. Peyronies disease is not contagious or caused by any known transmittable disease.\nEarly researchers thought Peyronies disease was a form of impotence, now called erectile dysfunction (ED). ED happens when a man is unable to achieve or keep an erection firm enough for sexual intercourse. Some men with Peyronies disease may have ED. Usually men with Peyronies disease are referred to a urologista doctor who specializes in sexual and urinary problems." } ]

[ { "from": "human", "value": "What causes Peyronie's Disease?" }, { "from": "gpt", "value": "Medical experts do not know the exact cause of Peyronies disease. Many believe that Peyronies disease may be the result of\n- acute injury to the penis\n- chronic, or repeated, injury to the penis\n- autoimmune diseasea disorder in which the bodys immune system attacks the bodys own cells and organs\nInjury to the Penis\nMedical experts believe that hitting or bending the penis may injure the tissues inside. A man may injure the penis during sex, athletic activity, or an accident. Injury ruptures blood vessels, which leads to bleeding and swelling inside the layers of the tunica albuginea. Swelling inside the penis will block blood flow through the layers of tissue inside the penis. When the blood cant flow normally, clots can form and trap immune system cells. As the injury heals, the immune system cells may release substances that lead to the formation of too much scar tissue. The scar tissue builds up and forms a plaque inside the penis. The plaque reduces the elasticity of tissues and flexibility of the penis during erection, leading to curvature. The plaque may further harden because of calcificationthe process in which calcium builds up in body tissue.\nAutoimmune Disease\nSome medical experts believe that Peyronies disease may be part of an autoimmune disease. Normally, the immune system is the bodys way of protecting itself from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Men who have autoimmune diseases may develop Peyronies disease when the immune system attacks cells in the penis. This can lead to inflammation in the penis and can cause scarring. Medical experts do not know what causes autoimmune diseases. Some of the autoimmune diseases associated with Peyronies disease affect connective tissues. Connective tissue is specialized tissue that supports, joins, or separates different types of tissues and organs of the body." } ]

[ { "from": "human", "value": "How many people are affected by Peyronie's Disease?" }, { "from": "gpt", "value": "Researchers estimate that Peyronies disease may affect 1 to 23 percent of men between 40 and 70 years of age.1 However, the actual occurrence of Peyronies disease may be higher due to mens embarrassment and health care providers limited reporting.1 The disease is rare in young men, although it has been reported in men in their 30s.1 The chance of developing Peyronies disease increases with age." } ]

[ { "from": "human", "value": "What are the symptoms of Peyronie's Disease?" }, { "from": "gpt", "value": "The signs and symptoms of Peyronies disease may include\n- hard lumps on one or more sides of the penis\n- pain during sexual intercourse or during an erection\n- a curve in the penis either with or without an erection\n- narrowing or shortening of the penis\n- ED\nSymptoms of Peyronies disease range from mild to severe. Symptoms may develop slowly or appear quickly. In many cases, the pain decreases over time, although the curve in the penis may remain. In milder cases, symptoms may go away without causing a permanent curve." } ]

[ { "from": "human", "value": "What are the complications of Peyronie's Disease?" }, { "from": "gpt", "value": "Complications of Peyronies disease may include\n- the inability to have sexual intercourse\n- ED\n- anxiety, or stress, about sexual abilities or the appearance of the penis\n- stress on a relationship with a sexual partner\n- problems fathering a child because intercourse is difficult" } ]

[ { "from": "human", "value": "How to diagnose Peyronie's Disease?" }, { "from": "gpt", "value": "A urologist diagnoses Peyronies disease based on\n- a medical and family history\n- a physical exam\n- imaging tests\nMedical and Family History\nTaking a medical and family history is one of the first things a urologist may do to help diagnose Peyronies disease. He or she will ask the man to provide a medical and family history, which may include the following questions:\n- What is the mans ability to have an erection?\n- What are the problems with sexual intercourse?\n- When did the symptoms begin?\n- What is the family medical history?\n- What medications is the man taking?\n- What other symptoms is the man experiencing?\n- What other medical conditions does the man have?\nPhysical Exam\nA physical exam may help diagnose Peyronies disease. During a physical exam, a urologist usually examines the mans body, including the penis.\nA urologist can usually feel the plaque in the penis with or without an erection. Sometimes the urologist will need to examine the penis during an erection. The urologist will give the man an injectable medication to cause an erection.\nImaging Tests\nTo help pinpoint the location of the plaque buildup inside the penis, a urologist may perform\n- ultrasound of the penis\n- an x ray of the penis\nFor both tests, a specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images. The patient does not need anesthesia.\nUltrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure.\nX ray. An x ray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. The man will lie on a table or stand during the x ray, and the technician may ask the man to change positions for additional pictures." } ]

[ { "from": "human", "value": "What are the treatments for Peyronie's Disease?" }, { "from": "gpt", "value": "A urologist may treat Peyronies disease with nonsurgical treatments or surgery.\nThe goal of treatment is to reduce pain and restore and maintain the ability to have intercourse. Men with small plaques, minimal penile curvature, no pain, and satisfactory sexual function may not need treatment until symptoms get worse. Peyronies disease often resolves on its own without treatment.\nA urologist may recommend changes in a mans lifestyle to reduce the risk of ED associated with Peyronies disease.\nNonsurgical Treatments\nNonsurgical treatments include medications and medical therapies.\nMedications. A urologist may prescribe medications aimed at decreasing a mans penile curvature, plaque size, and inflammation. A man may take prescribed medications to treat Peyronies disease orallyby mouthor a urologist may inject medications directly into the plaque. Verapamil is one type of topical medication that a man may apply to the skin over the plaque.\n- Oral medications. Oral medications may include- vitamin E- potassium para-aminobenzoate (Potaba)- tamoxifen- colchicine- acetyl-L-carnitine- pentoxifylline- Injections. Medications injected directly into plaques may include- verapamil- interferon alpha 2b- steroids- collagenase (Xiaflex)\nTo date, collagenase is the first and only medication specifically approved for Peyronies disease.\nMedical therapies. A urologist may use medical therapies to break up scar tissue and decrease plaque size and curvature. Therapies to break up scar tissue may include\n- high-intensity, focused ultrasound directed at the plaque\n- radiation therapyhigh-energy rays, such as x rays, aimed at the plaque\n- shockwave therapyfocused, low-intensity electroshock waves directed at the plaque\nA urologist may use iontophoresispainless, low-level electric current that delivers medications through the skin over the plaqueto decrease plaque size and curvature.\nA urologist may use mechanical traction and vacuum devices aimed at stretching or bending the penis to reduce curvature.\nSurgery\nA urologist may recommend surgery to remove plaque or help straighten the penis during an erection. Medical experts recommend surgery for long-term cases when\n- symptoms have not improved\n- erections, intercourse, or both are painful\n- the curve or bend in the penis does not allow the man to have sexual intercourse\nSome men may develop complications after surgery, and sometimes surgery does not correct the effects of Peyronies diseasesuch as shortening of the penis. Some surgical methods can cause shortening of the penis. Medical experts suggest waiting 1 year or more from the onset of symptoms before having surgery because the course of Peyronies disease is different in each man.\nA urologist may recommend the following surgeries:\n- grafting. A urologist will cut or remove the plaque and attach a patch of skin, a vein, or material made from animal organs in its place. This procedure may straighten the penis and restore some lost length from Peyronies disease. However, some men may experience numbness of the penis and ED after the procedure.\n- plication. A urologist will remove or pinch a piece of the tunica albuginea from the side of the penis opposite the plaque, which helps to straighten the penis. This procedure is less likely to cause numbness or ED. Plication cannot restore length or girth of the penis and may cause shortening of the penis.\n- device implantation. A urologist implants a device into the penis that can cause an erection and help straighten it during an erection. Penile implants may be considered if a man has both Peyronies disease and ED. In some cases, an implant alone will straighten the penis adequately. If the implant alone does not straighten the penis, a urologist may combine implantation with one of the other two surgeries. Once a man has an implant, he must use the device to have an erection.\nA urologist performs these surgeries in a hospital.\nLifestyle Changes\nA man can make healthy lifestyle changes to reduce the chance of ED associated with Peyronies disease by\n- quitting smoking\n- reducing alcohol consumption\n- exercising regularly\n- avoiding illegal drugs\nMore information is provided in the NIDDK health topic, Erectile Dysfunction." } ]

[ { "from": "human", "value": "How to prevent Peyronie's Disease?" }, { "from": "gpt", "value": "Researchers do not know how to prevent Peyronies disease." } ]

[ { "from": "human", "value": "What to do for Peyronie's Disease?" }, { "from": "gpt", "value": "Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Peyronies disease." } ]

[ { "from": "human", "value": "What to do for Peyronie's Disease?" }, { "from": "gpt", "value": "- Peyronies disease is a disorder in which scar tissue, called a plaque, forms in the penisthe male organ used for urination and sex.\n- Medical experts do not know the exact cause of Peyronies disease. Many believe that Peyronies disease may be the result of- acute injury to the penis- chronic, or repeated, injury to the penis- autoimmune diseasea disorder in which the bodys immune system attacks the bodys own cells and organs- The following factors may increase a mans chance of developing Peyronies disease:- vigorous sexual or nonsexual activities that cause microscopic injury to the penis- certain connective tissue and autoimmune disorders- a family history of Peyronies disease- aging- The signs and symptoms of Peyronies disease may include- hard lumps on one or more sides of the penis- pain during sexual intercourse or during an erection- a curve in the penis either with or without an erection- narrowing or shortening of the penis- erectile dysfunction (ED)- Complications of Peyronies disease may include- the inability to have sexual intercourse- ED- anxiety, or stress, about sexual abilities or the appearance of the penis- stress on a relationship with a sexual partner- problems fathering a child because intercourse is difficult- A urologist diagnoses Peyronies disease based on- a medical and family history- a physical exam- imaging tests- A urologist may treat Peyronies disease with nonsurgical treatments or surgery.\n- Researchers do not know how to prevent Peyronies disease." } ]

[ { "from": "human", "value": "What is (are) Acromegaly?" }, { "from": "gpt", "value": "Acromegaly is a hormonal disorder that results from too much growth hormone (GH) in the body. The pituitary, a small gland in the brain, makes GH. In acromegaly, the pituitary produces excessive amounts of GH. Usually the excess GH comes from benign, or noncancerous, tumors on the pituitary. These benign tumors are called adenomas.\nAcromegaly is most often diagnosed in middle-aged adults, although symptoms can appear at any age. If not treated, acromegaly can result in serious illness and premature death. Acromegaly is treatable in most patients, but because of its slow and often \"sneaky\" onset, it often is not diagnosed early or correctly. The most serious health consequences of acromegaly are type 2 diabetes, high blood pressure, increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into colon cancer if not removed.\nWhen GH-producing tumors occur in childhood, the disease that results is called gigantism rather than acromegaly. A child's height is determined by the length of the so-called long bones in the legs. In response to GH, these bones grow in length at the growth platesareas near either end of the bone. Growth plates fuse after puberty, so the excessive GH production in adults does not result in increased height. However, prolonged exposure to excess GH before the growth plates fuse causes increased growth of the long bones and thus increased height. Pediatricians may become concerned about this possibility if a child's growth rate suddenly and markedly increases beyond what would be predicted by previous growth and how tall the child's parents are." } ]

[ { "from": "human", "value": "What are the symptoms of Acromegaly?" }, { "from": "gpt", "value": "The name acromegaly comes from the Greek words for \"extremities\" and \"enlargement,\" reflecting one of its most common symptomsthe abnormal growth of the hands and feet. Swelling of the hands and feet is often an early feature, with patients noticing a change in ring or shoe size, particularly shoe width. Gradually, bone changes alter the patient's facial features: The brow and lower jaw protrude, the nasal bone enlarges, and the teeth space out.\nOvergrowth of bone and cartilage often leads to arthritis. When tissue thickens, it may trap nerves, causing carpal tunnel syndrome, which results in numbness and weakness of the hands. Body organs, including the heart, may enlarge.\nOther symptoms of acromegaly include\n- joint aches\n- thick, coarse, oily skin\n- skin tags\n- enlarged lips, nose, and tongue\n- deepening of the voice due to enlarged sinuses and vocal cords\n- sleep apnea-breaks in breathing during sleep due to obstruction of the airway\n- excessive sweating and skin odor\n- fatigue and weakness\n- headaches\n- impaired vision\n- abnormalities of the menstrual cycle and sometimes breast discharge in women\n- erectile dysfunction in men\n- decreased libido" } ]

[ { "from": "human", "value": "What causes Acromegaly?" }, { "from": "gpt", "value": "Acromegaly is caused by prolonged overproduction of GH by the pituitary gland. The pituitary produces several important hormones that control body functions such as growth and development, reproduction, and metabolism. But hormones never seem to act simply and directly. They usually \"cascade\" or flow in a series, affecting each other's production or release into the bloodstream.\nGH is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the hypothalamus. The hypothalamus makes hormones that regulate the pituitary. One of the hormones in the GH series, or \"axis,\" is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.\nSecretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.\nThe hypothalamus makes another hormone called somatostatin, which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.\nPituitary Tumors\nIn more than 95 percent of people with acromegaly, a benign tumor of the pituitary gland, called an adenoma, produces excess GH. Pituitary tumors are labeled either micro- or macro-adenomas, depending on their size. Most GH-secreting tumors are macro-adenomas, meaning they are larger than 1 centimeter. Depending on their location, these larger tumors may compress surrounding brain structures. For example, a tumor growing upward may affect the optic chiasm-where the optic nerves crossleading to visual problems and vision loss. If the tumor grows to the side, it may enter an area of the brain called the cavernous sinus where there are many nerves, potentially damaging them.\nCompression of the surrounding normal pituitary tissue can alter production of other hormones. These hormonal shifts can lead to changes in menstruation and breast discharge in women and erectile dysfunction in men. If the tumor affects the part of the pituitary that controls the thyroidanother hormone-producing glandthen thyroid hormones may decrease. Too little thyroid hormone can cause weight gain, fatigue, and hair and skin changes. If the tumor affects the part of the pituitary that controls the adrenal gland, the hormone cortisol may decrease. Too little cortisol can cause weight loss, dizziness, fatigue, low blood pressure, and nausea.\nSome GH-secreting tumors may also secrete too much of other pituitary hormones. For example, they may produce prolactin, the hormone that stimulates the mammary glands to produce milk. Rarely, adenomas may produce thyroid-stimulating hormone. Doctors should assess all pituitary hormones in people with acromegaly.\nRates of GH production and the aggressiveness of the tumor vary greatly among people with adenomas. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow more rapidly and invade surrounding brain areas or the venous sinuses, which are located near the pituitary gland. Younger patients tend to have more aggressive tumors. Regardless of size, these tumors are always benign.\nMost pituitary tumors develop spontaneously and are not genetically inherited. They are the result of a genetic alteration in a single pituitary cell, which leads to increased cell division and tumor formation. This genetic change, or mutation, is not present at birth, but happens later in life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells. It permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary cell growth and GH oversecretion currently are the subject of intensive research.\nNonpituitary Tumors\nRarely, acromegaly is caused not by pituitary tumors but by tumors of the pancreas, lungs, and other parts of the brain. These tumors also lead to excess GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.\nIn patients with GHRH-producing, non-pituitary tumors, the pituitary still may be enlarged and may be mistaken for a tumor. Physicians should carefully analyze all \"pituitary tumors\" removed from patients with acromegaly so they do not overlook the rare possibility that a tumor elsewhere in the body is causing the disorder." } ]

[ { "from": "human", "value": "How many people are affected by Acromegaly?" }, { "from": "gpt", "value": "Small pituitary adenomas are common, affecting about 17 percent of the population.1 However, research suggests most of these tumors do not cause symptoms and rarely produce excess GH.2 Scientists estimate that three to four out of every million people develop acromegaly each year and about 60 out of every million people suffer from the disease at any time.3 Because the clinical diagnosis of acromegaly is often missed, these numbers probably underestimate the frequency of the disease." } ]

[ { "from": "human", "value": "How to diagnose Acromegaly?" }, { "from": "gpt", "value": "Blood tests\nIf acromegaly is suspected, a doctor must measure the GH level in a persons blood to determine if it is elevated. However, a single measurement of an elevated blood GH level is not enough to diagnose acromegaly: Because GH is secreted by the pituitary in impulses, or spurts, its concentration in the blood can vary widely from minute to minute. At a given moment, a person with acromegaly may have a normal GH level, whereas a GH level in a healthy person may even be five times higher.\nMore accurate information is obtained when GH is measured under conditions that normally suppress GH secretion. Health care professionals often use the oral glucose tolerance test to diagnose acromegaly because drinking 75 to 100 grams of glucose solution lowers blood GH levels to less than 1 nanogram per milliliter (ng/ml) in healthy people. In people with GH overproduction, this suppression does not occur. The oral glucose tolerance test is a highly reliable method for confirming a diagnosis of acromegaly.\nPhysicians also can measure IGF-I levels, which increase as GH levels go up, in people with suspected acromegaly. Because IGF-I levels are much more stable than GH levels over the course of the day, they are often a more practical and reliable screening measure. Elevated IGF-I levels almost always indicate acromegaly. However, a pregnant womans IGF-I levels are two to three times higher than normal. In addition, physicians must be aware that IGF-I levels decline with age and may also be abnormally low in people with poorly controlled diabetes or liver or kidney disease.\nImaging\nAfter acromegaly has been diagnosed by measuring GH or IGF-I levels, a magnetic resonance imaging (MRI) scan of the pituitary is used to locate and detect the size of the tumor causing GH overproduction. MRI is the most sensitive imaging technique, but computerized tomography (CT) scans can be used if the patient should not have MRI. For example, people who have pacemakers or other types of implants containing metal should not have an MRI scan because MRI machines contain powerful magnets.\nIf a head scan fails to detect a pituitary tumor, the physician should look for non-pituitary \"ectopic\" tumors in the chest, abdomen, or pelvis as the cause of excess GH. The presence of such tumors usually can be diagnosed by measuring GHRH in the blood and by a CT scan of possible tumor sites.\nRarely, a pituitary tumor secreting GH may be too tiny to detect even with a sensitive MRI scan." } ]

[ { "from": "human", "value": "What are the treatments for Acromegaly?" }, { "from": "gpt", "value": "Currently, treatment options include surgical removal of the tumor, medical therapy, and radiation therapy of the pituitary.\nGoals of treatment are to\n- reduce excess hormone production to normal levels\n- relieve the pressure that the growing pituitary tumor may be exerting on the surrounding brain areas\n- preserve normal pituitary function or treat hormone deficiencies\n- improve the symptoms of acromegaly\nSurgery\nSurgery is the first option recommended for most people with acromegaly, as it is often a rapid and effective treatment. The surgeon reaches the pituitary via an incision through the nose or inside the upper lip and, with special tools, removes the tumor tissue in a procedure called transsphenoidal surgery. This procedure promptly relieves the pressure on the surrounding brain regions and leads to a rapid lowering of GH levels. If the surgery is successful, facial appearance and soft tissue swelling improve within a few days.\nSurgery is most successful in patients with blood GH levels below 45 ng/ml before the operation and with pituitary tumors no larger than 10 millimeters (mm) in diameter. Success depends in large part on the skill and experience of the surgeon, as well as the location of the tumor. Even with the most experienced neurosurgeon, the chance of a cure is small if the tumor has extended into critical brain structures or into the cavernous sinus where surgery could be risky.\nThe success rate also depends on what level of GH is defined as a cure. The best measure of surgical success is normalization of GH and IGF-I levels. The overall rate of remission-control of the disease-after surgery ranges from 55 to 80 percent. (See For More Information to locate a board-certified neurosurgeon.)\nA possible complication of surgery is damage to the surrounding normal pituitary tissue, which requires lifelong use of pituitary hormone replacement. The part of the pituitary that stores antidiuretic hormonea hormone important in water balancemay be temporarily or, rarely, permanently damaged and the patient may require medical therapy. Other potential problems include cerebrospinal fluid leaks and, rarely, meningitis. Cerebrospinal fluid bathes the brain and can leak from the nose if the incision area doesnt heal well. Meningitis is a bacterial or viral infection of the meninges, the outer covering of the brain.\nEven when surgery is successful and hormone levels return to normal, people with acromegaly must be carefully monitored for years for possible recurrence of the disease. More commonly, hormone levels improve, but do not return to normal. Additional treatment, usually medications, may be required.\nMedical Therapy\nMedical therapy is most often used if surgery does not result in a cure and sometimes to shrink large tumors before surgery. Three medication groups are used to treat acromegaly.\nSomatostatin analogs (SSAs) are the first medication group used to treat acromegaly. They shut off GH production and are effective in lowering GH and IGF-I levels in 50 to 70 percent of patients. SSAs also reduce tumor size in around 0 to 50 percent of patients but only to a modest degree. Several studies have shown that SSAs are safe and effective for long-term treatment and in treating patients with acromegaly caused by nonpituitary tumors. Long-acting SSAs are given by intramuscular injection once a month.\nDigestive problems-such as loose stools, nausea, and gas-are a side effect in about half of people taking SSAs. However, the effects are usually temporary and rarely severe. About 10 to 20 percent of patients develop gallstones, but the gallstones do not usually cause symptoms. In rare cases, treatment can result in elevated blood glucose levels. More commonly, SSAs reduce the need for insulin and improve blood glucose control in some people with acromegaly who already have diabetes.\nThe second medication group is the GH receptor antagonists (GHRAs), which interfere with the action of GH. They normalize IGF-I levels in more than 90 percent of patients. They do not, however, lower GH levels. Given once a day through injection, GHRAs are usually well-tolerated by patients. The long-term effects of these drugs on tumor growth are still under study. Side effects can include headaches, fatigue, and abnormal liver function.\nDopamine agonists make up the third medication group. These drugs are not as effective as the other medications at lowering GH or IGF-I levels, and they normalize IGF-I levels in only a minority of patients. Dopamine agonists are sometimes effective in patients who have mild degrees of excess GH and have both acromegaly and hyperprolactinemiatoo much of the hormone prolactin. Dopamine agonists can be used in combination with SSAs. Side effects can include nausea, headache, and lightheadedness.\nAgonist: A drug that binds to a receptor of a cell and triggers a response by the cell, mimicking the action of a naturally occurring substance. Antagonist: A chemical that acts within the body to reduce the physiological activity of another chemical substance or hormone.\nRadiation Therapy\nRadiation therapy is usually reserved for people who have some tumor remaining after surgery and do not respond to medications. Because radiation leads to a slow lowering of GH and IGF-I levels, these patients often also receive medication to lower hormone levels. The full effect of this therapy may not occur for many years.\nThe two types of radiation delivery are conventional and stereotactic. Conventional radiation delivery targets the tumor with external beams but can damage surrounding tissue. The treatment delivers small doses of radiation multiple times over 4 to 6 weeks, giving normal tissue time to heal between treatments.\nStereotactic delivery allows precise targeting of a high-dose beam of radiation at the tumor from varying angles. The patient must wear a rigid head frame to keep the head still. The types of stereotactic radiation delivery currently available are proton beam, linear accelerator (LINAC), and gamma knife. With stereotactic delivery, the tumor must be at least 5 mm from the optic chiasm to prevent radiation damage. This treatment can sometimes be done in a single session, reducing the risk of damage to surrounding tissue.\nAll forms of radiation therapy cause a gradual decline in production of other pituitary hormones over time, resulting in the need for hormone replacement in most patients. Radiation also can impair a patients fertility. Vision loss and brain injury are rare complications. Rarely, secondary tumors can develop many years later in areas that were in the path of the radiation beam." } ]

[ { "from": "human", "value": "What are the treatments for Acromegaly?" }, { "from": "gpt", "value": "No single treatment is effective for all patients. Treatment should be individualized, and often combined, depending on patient characteristics such as age and tumor size.\nIf the tumor has not yet invaded surrounding nonpituitary tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. Even if a cure is not possible, surgery may be performed if the patient has symptoms of neurological problems such as loss of peripheral vision or cranial nerve problems. After surgery, hormone levels are measured to determine whether a cure has been achieved. This determination can take up to 8 weeks because IGF-I lasts a long time in the body's circulation. If cured, a patient must be monitored for a long time for increasing GH levels.\nIf surgery does not normalize hormone levels or a relapse occurs, an endocrinologist should recommend additional drug therapy. With each medication, long-term therapy is necessary because their withdrawal can lead to rising GH levels and tumor re-expansion.\nRadiation therapy is generally reserved for patients whose tumors are not completely removed by surgery, who are not good candidates for surgery because of other health problems, or who do not respond adequately to surgery and medication." } ]

[ { "from": "human", "value": "What to do for Acromegaly?" }, { "from": "gpt", "value": "- Acromegaly is a hormonal disorder that results from too much growth hormone (GH) in the body.\n- In most people with acromegaly, a benign tumor of the pituitary gland produces excess GH.\n- Common features of acromegaly include abnormal growth of the hands and feet; bone growth in the face that leads to a protruding lower jaw and brow and an enlarged nasal bone; joint aches; thick, coarse, oily skin; and enlarged lips, nose, and tongue.\n- Acromegaly can cause sleep apnea, fatigue and weakness, headaches, impaired vision, menstrual abnormalities in women, and erectile dysfunction in men.\n- Acromegaly is diagnosed through a blood test. Magnetic resonance imaging (MRI) of the pituitary is then used to locate and detect the size of the tumor causing GH overproduction.\n- The first line of treatment is usually surgical removal of the tumor. Medication or radiation may be used instead of or in addition to surgery." } ]

[ { "from": "human", "value": "What is (are) Gastroparesis?" }, { "from": "gpt", "value": "Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether." } ]

[ { "from": "human", "value": "What causes Gastroparesis?" }, { "from": "gpt", "value": "Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. Other identifiable causes of gastroparesis include intestinal surgery and nervous system diseases such as Parkinsons disease or multiple sclerosis. For reasons that are still unclear, gastroparesis is more commonly found in women than in men." } ]

[ { "from": "human", "value": "What are the symptoms of Gastroparesis?" }, { "from": "gpt", "value": "The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested foodsometimes several hours after a meal. Other symptoms of gastroparesis include\n- gastroesophageal reflux (GER), also called acid reflux or acid regurgitationa condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomach\n- pain in the stomach area\n- abdominal bloating\n- lack of appetite\nSymptoms may be aggravated by eating greasy or rich foods, large quantities of foods with fibersuch as raw fruits and vegetablesor drinking beverages high in fat or carbonation. Symptoms may be mild or severe, and they can occur frequently in some people and less often in others. The symptoms of gastroparesis may also vary in intensity over time in the same individual. Sometimes gastroparesis is difficult to diagnose because people experience a range of symptoms similar to those of other diseases." } ]

[ { "from": "human", "value": "How to diagnose Gastroparesis?" }, { "from": "gpt", "value": "Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the GI tract, and gastric emptying tests. Tests may also identify a nutritional disorder or underlying disease. To rule out any blockage or other structural problems, the health care provider may perform one or more of the following tests:\n- Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract, which includes the esophagus, stomach, and duodenumthe first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologista doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoarssolid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomachthat are sometimes softened, dissolved, or broken up during an upper GI endoscopy.\n- Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test.\n- Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a persons digestive symptoms, rather than gastroparesis.\n- Gastric emptying scintigraphy. The test involves eating a bland mealsuch as eggs or an egg substitutethat contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed.\n- SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the persons waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract.\n- Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying." } ]

[ { "from": "human", "value": "What are the treatments for Gastroparesis?" }, { "from": "gpt", "value": "Treatment of gastroparesis depends on the severity of the persons symptoms. In most cases, treatment does not cure gastroparesis, which is usually a chronic, or long-lasting, condition. Gastroparesis is also a relapsing conditionthe symptoms can come and go for periods of time. Treatment helps people manage the condition so they can be as comfortable and active as possible." } ]

[ { "from": "human", "value": "What to do for Gastroparesis?" }, { "from": "gpt", "value": "Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a mealinstead of lying downmay assist with gastric emptying.\nA health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars.\nWhen a person has severe symptoms, a liquid or pured diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a pured diet helps improve symptoms. Pured fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met.\nWhen the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given.\nMedications\nSeveral prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment.\nMetoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesiaa disorder that affects movement.\nErythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps.\nOther medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting.\nBotulinum Toxin\nBotulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.1\nGastric Electrical Stimulation\nThis treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscopea thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms.\nJejunostomy\nIf medications and dietary changes dont work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe.\nParenteral Nutrition\nWhen gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutritionan IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis." } ]

[ { "from": "human", "value": "What are the treatments for Gastroparesis?" }, { "from": "gpt", "value": "An elevated blood glucose level directly interferes with normal stomach emptying, so good blood glucose control in people with diabetes is important. However, gastroparesis can make blood glucose control difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Gastric emptying is unpredictable with gastroparesis, causing a persons blood glucose levels to be erratic and difficult to control.\nThe primary treatment goals for gastroparesis related to diabetes are to improve gastric emptying and regain control of blood glucose levels. In addition to the dietary changes and treatments already described, a health care provider will likely adjust the persons insulin regimen.\nTo better control blood glucose, people with diabetes and gastroparesis may need to\n- take insulin more often or change the type of insulin they take\n- take insulin after meals, instead of before\n- check blood glucose levels frequently after eating and administer insulin when necessary\nA health care provider will give specific instructions for taking insulin based on the individuals needs and the severity of gastroparesis.\nIn some cases, the dietitian may suggest eating several liquid or pured meals a day until gastroparesis symptoms improve and blood glucose levels are more stable." } ]

[ { "from": "human", "value": "What is (are) Gastroparesis?" }, { "from": "gpt", "value": "The problems of gastroparesis can include\n- severe dehydration due to persistent vomiting\n- gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis irritation of the esophagus\n- bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form\n- difficulty managing blood glucose levels in people with diabetes\n- malnutrition due to poor absorption of nutrients or a low calorie intake\n- decreased quality of life, including work absences due to severe symptoms" } ]

[ { "from": "human", "value": "What to do for Gastroparesis?" }, { "from": "gpt", "value": "- Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine.\n- Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether.\n- Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests.\n- Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve.\n- The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite.\n- Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests.\n- Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or pured diet may be prescribed.\n- Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition.\n- For people with gastroparesis and diabetes, a health care provider will likely adjust the persons insulin regimen." } ]

[ { "from": "human", "value": "What is (are) Alagille Syndrome?" }, { "from": "gpt", "value": "Alagille syndrome is a genetic condition that results in various symptoms in different parts of the body, including the liver. A person with Alagille syndrome has fewer than the normal number of small bile ducts inside the liver. The liver is the organ in the abdomenthe area between the chest and hipsthat makes blood proteins and bile, stores energy and nutrients, fights infection, and removes harmful chemicals from the blood.\nBile ducts are tubes that carry bile from the liver cells to the gallbladder for storage and to the small intestine for use in digestion. Bile is fluid made by the liver that carries toxins and waste products out of the body and helps the body digest fats and the fat-soluble vitamins A, D, E, and K. In people with Alagille syndrome, the decreased number of bile ducts causes bile to build up in the liver, a condition also called cholestasis, leading to liver damage and liver disease." } ]

[ { "from": "human", "value": "What is (are) Alagille Syndrome?" }, { "from": "gpt", "value": "The digestive system is made up of the gastrointestinal (GI) tractalso called the digestive tractand the liver, pancreas, and gallbladder. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestinewhich includes the colon and rectumand anus. Food enters the mouth and passes to the anus through the hollow organs of the digestive system. The liver, pancreas, and gallbladder are the solid organs of the digestive system. The digestive system helps the body digest food." } ]

[ { "from": "human", "value": "What causes Alagille Syndrome?" }, { "from": "gpt", "value": "Alagille syndrome is caused by a gene mutation, or defect. Genes provide instructions for making proteins in the body. A gene mutation is a permanent change in the DNA sequence that makes up a gene. DNA, or deoxyribonucleic acid, is the material inside cells that carries genetic information and passes genes from parent to child. Approximately 30 to 50 percent of people with Alagille syndrome have an inherited gene mutation, meaning it has been passed on by a parent. In the remaining cases, the gene mutation develops spontaneously.1 In spontaneous cases, neither parent carries a copy of the mutated gene.\nMost cases of Alagille syndrome are caused by a mutation in the JAGGED1 (JAG1) gene. In less than 1 percent of cases, a mutation in the NOTCH2 gene is the cause.2\nGenetic Disorders Each cell contains thousands of genes that provide the instructions for making proteins for growth and repair of the body. If a gene has a mutation, the protein made by that gene may not function properly, which sometimes creates a genetic disorder. Not all gene mutations cause a disorder. People have two copies of most genes; one copy is inherited from each parent. A genetic disorder occurs when one or both parents pass a mutated gene to a child at conception. A genetic disorder can also occur through a spontaneous gene mutation, meaning neither parent carries a copy of the mutated gene. Once a spontaneous gene mutation has occurred in a person, it can be passed to the person's children. Read more about genes and genetic conditions at the U.S. National Library of Medicine's (NLM's) Genetics Home Reference at www.ghr.nlm.nih.gov." } ]

[ { "from": "human", "value": "How many people are affected by Alagille Syndrome?" }, { "from": "gpt", "value": "Alagille syndrome occurs in about one of every 30,000 live births.3 The disorder affects both sexes equally and shows no geographical, racial, or ethnic preferences.\nJAG1 and NOTCH2 gene mutations are inherited in an autosomal dominant way, which means a child can get Alagille syndrome by inheriting either of the gene mutations from only one parent. Each child of a parent with an autosomal dominant mutation has a 50 percent chance of inheriting the mutated gene.\nThe following chart shows the chance of inheriting an autosomal dominant gene mutation:\nThe gene mutations that cause Alagille syndrome may cause mild or subtle symptoms. Some people may not know they are affected, while others with the gene mutation may develop more serious characteristics of Alagille syndrome. A person with a gene mutation, whether showing serious symptoms or not, has Alagille syndrome and can pass the gene mutation to a child.\nRead more about how genetic conditions are inherited at the NLM's Genetics Home Reference website at www.ghr.nlm.nih.gov." } ]

[ { "from": "human", "value": "What are the symptoms of Alagille Syndrome?" }, { "from": "gpt", "value": "The signs and symptoms of Alagille syndrome and their severity vary, even among people in the same family sharing the same gene mutation.\nLiver\nIn some people, problems in the liver may be the first signs and symptoms of the disorder. These signs and symptoms can occur in children and adults with Alagille syndrome, and in infants as early as the first 3 months of life.\nJaundice. Jaundicewhen the skin and whites of the eyes turn yellowis a result of the liver not removing bilirubin from the blood. Bilirubin is a reddish-yellow substance formed when hemoglobin breaks down. Hemoglobin is an iron-rich protein that gives blood its red color. Bilirubin is absorbed by the liver, processed, and released into bile. Blockage of the bile ducts forces bilirubin and other elements of bile to build up in the blood.\nJaundice may be difficult for parents and even health care providers to detect. Many healthy newborns have mild jaundice during the first 1 to 2 weeks of life due to an immature liver. This normal type of jaundice disappears by the second or third week of life, whereas the jaundice of Alagille syndrome deepens. Newborns with jaundice after 2 weeks of life should be seen by a health care provider to check for a possible liver problem.\nDark urine and gray or white stools. High levels of bilirubin in the blood that pass into the urine can make the urine darker, while stool lightens from a lack of bilirubin reaching the intestines. Gray or white bowel movements after 2 weeks of age are a reliable sign of a liver problem and should prompt a visit to a health care provider.\nPruritus. The buildup of bilirubin in the blood may cause itching, also called pruritus. Pruritus usually starts after 3 months of age and can be severe.\nXanthomas. Xanthomas are fatty deposits that appear as yellow bumps on the skin. They are caused by abnormally high cholesterol levels in the blood, common in people with liver disease. Xanthomas may appear anywhere on the body. However, xanthomas are usually found on the elbows, joints, tendons, knees, hands, feet, or buttocks.\nOther Signs and Symptoms of Alagille Syndrome\nCertain signs of Alagille syndrome are unique to the disorder, including those that affect the vertebrae and facial features.\nFace. Many children with Alagille syndrome have deep-set eyes, a straight nose, a small and pointed chin, large ears, and a prominent, wide forehead. These features are not usually recognized until after infancy. By adulthood, the chin is more prominent.\nEyes. Posterior embryotoxon is a condition in which an opaque ring is present in the cornea, the transparent covering of the eyeball. The abnormality is common in people with Alagille syndrome, though it usually does not affect vision.\nSkeleton. The most common skeletal defect in a person with Alagille syndrome is when the shape of the vertebraebones of the spinegives the appearance of flying butterflies. This defect, known as \"butterfly\" vertebrae, rarely causes medical problems or requires treatment.\nHeart and blood vessels. People with Alagille syndrome may have the following signs and symptoms having to do with the heart and blood vessels:\n- heart murmuran extra or unusual sound heard during a heartbeat. A heart murmur is the most common sign of Alagille syndrome other than the general symptoms of liver disease.1 Most people with Alagille syndrome have a narrowing of the blood vessels that carry blood from the heart to the lungs.1 This narrowing causes a murmur that can be heard with a stethoscope. Heart murmurs usually do not cause problems.\n- heart walls and valve problems. A small number of people with Alagille syndrome have serious problems with the walls or valves of the heart. These conditions may need treatment with medications or corrective surgery.\n- blood vessel problems. People with Alagille syndrome may have abnormalities of the blood vessels in the head and neck. This serious complication can lead to internal bleeding or stroke. Alagille syndrome can also cause narrowing or bulging of other blood vessels in the body.\nKidney disease. A wide range of kidney diseases can occur in Alagille syndrome. The kidneys are two bean-shaped organs, each about the size of a fist, that filter wastes and extra fluid from the blood. Some people have small kidneys or have cystsfluid-filled sacsin the kidneys. Kidney function can also decrease." } ]

[ { "from": "human", "value": "What are the complications of Alagille Syndrome?" }, { "from": "gpt", "value": "The complications of Alagille syndrome include liver failure, portal hypertension, and growth problems. People with Alagille syndrome usually have a combination of complications, and may not have every complication listed below.\nLiver failure. Over time, the decreased number of bile ducts may lead to chronic liver failure, also called end-stage liver disease. This condition progresses over months, years, or even decades. The liver can no longer perform important functions or effectively replace damaged cells. A person may need a liver transplant. A liver transplant is surgery to remove a diseased or an injured liver and replace it with a healthy whole liver or a segment of a liver from another person, called a donor.\nPortal hypertension. The spleen is the organ that cleans blood and makes white blood cells. White blood cells attack bacteria and other foreign cells. Blood flow from the spleen drains directly into the liver. When a person with Alagille syndrome has advanced liver disease, the blood flow backs up into the spleen and other blood vessels. This condition is called portal hypertension. The spleen may become larger in the later stages of liver disease. A person with an enlarged spleen should avoid contact sports to protect the organ from injury. Advanced portal hypertension can lead to serious bleeding problems.\nGrowth problems. Alagille syndrome can lead to poor growth in infants and children, as well as delayed puberty in older children. Liver disease can cause malabsorption, which can result in growth problems. Malabsorption is the inability of the small intestine to absorb nutrients from foods, which results in protein, calorie, and vitamin deficiencies. Serious heart problems, if present in Alagille syndrome, can also affect growth.\nMalabsorption. People with Alagille syndrome may have diarrhealoose, watery stoolsdue to malabsorption. The condition occurs because bile is necessary for the digestion of food. Malabsorption can lead to bone fractures, eye problems, blood-clotting problems, and learning delays.\nLong-term Outlook\nThe long-term outlook for people with Alagille syndrome depends on several factors, including the severity of liver damage and heart problems. Predicting who will experience improved bile flow and who will progress to chronic liver failure is difficult. Ten to 30 percent of people with Alagille syndrome will eventually need a liver transplant.3\nMany adults with Alagille syndrome whose symptoms improve with treatment lead normal, productive lives. Deaths in people with Alagille syndrome are most often caused by chronic liver failure, heart problems, and blood vessel problems." } ]

[ { "from": "human", "value": "How to diagnose Alagille Syndrome?" }, { "from": "gpt", "value": "A health care provider diagnoses Alagille syndrome by performing a thorough physical exam and ordering one or more of the following tests and exams:\n- blood test\n- urinalysis\n- x ray\n- abdominal ultrasound\n- cardiology exam\n- slit-lamp exam\n- liver biopsy\n- genetic testing\nAlagille syndrome can be difficult to diagnose because the signs and symptoms vary and the syndrome is so rare.\nFor a diagnosis of Alagille syndrome, three of the following symptoms typically should be present:\n- liver symptoms, such as jaundice, pruritus, malabsorption, and xanthomas\n- heart abnormalities or murmurs\n- skeletal abnormalities\n- posterior embryotoxon\n- facial features typical of Alagille syndrome\n- kidney disease\n- blood vessel problems\nA health care provider may perform a liver biopsy to diagnose Alagille syndrome; however, it is not necessary to make a diagnosis. A diagnosis can be made in a person who does not meet the clinical criteria of Alagille syndrome yet does have a gene mutation of JAG1. The health care provider may have a blood sample tested to look for the JAG1 gene mutation. The gene mutation can be identified in 94 percent of people with a diagnosis of Alagille syndrome.2\nBlood test. A blood test involves drawing blood at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. The blood test can show nutritional status and the presence of liver disease and kidney function.\nUrinalysis. Urinalysis is the testing of a urine sample. The urine sample is collected in a special container in a health care provider's office or a commercial facility and can be tested in the same location or sent to a lab for analysis. Urinalysis can show many problems of the urinary tract and other body systems. The sample may be observed for color, cloudiness, or concentration; signs of drug use; chemical composition, including glucose; the presence of protein, blood cells, or bacteria; or other signs of disease.\nX ray. An x ray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. An x-ray technician performs the x ray at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. Anesthesia is not needed. The patient will lie on a table or stand during the x ray. The technician positions the x-ray machine over the spine area to look for \"butterfly\" vertebrae. The patient will hold his or her breath as the picture is taken so that the picture will not be blurry. The patient may be asked to change position for additional pictures.\nAbdominal ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The transducer can be moved to different angles to make it possible to examine different organs. In abdominal ultrasound, the health care provider applies a gel to the patient's abdomen and moves a handheld transducer over the skin. The gel allows the transducer to glide easily, and it improves the transmission of the signals. A specially trained technician performs the procedure in a health care provider's office, an outpatient center, or a hospital, and a radiologist interprets the images; anesthesia is not needed. The images can show an enlarged liver or rule out other conditions.\nCardiology exam. A cardiologista doctor who treats people who have heart problemsperforms a cardiology exam in a health care provider's office, an outpatient center, or a hospital. During a full exam, a cardiologist may inspect the patient's physical appearance, measure pulse rate and blood pressure, observe the jugular vein, check for rapid or skipped heartbeats, listen for variations in heart sounds, and listen to the lungs.\nSlit-lamp exam. An ophthalmologista doctor who diagnoses and treats all eye diseases and eye disordersperforms a slit-lamp exam to diagnose posterior embryotoxon. The ophthalmologist examines the eye with a slit lamp, a microscope combined with a high-intensity light that shines a thin beam on the eye. While sitting in a chair, the patient will rest his or her head on the slit lamp. A yellow dye may be used to examine the cornea and tear layer. The dye is applied as a drop, or the specialist may touch a strip of paper stained with the dye to the white of the patient's eye. The specialist will also use drops in the patient's eye to dilate the pupil.\nLiver biopsy. A liver biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to stop taking certain medications temporarily before the liver biopsy. The patient may be asked to fast for 8 hours before the procedure.\nDuring the procedure, the patient lies on a table, right hand resting above the head. A local anesthetic is applied to the area where the biopsy needle will be inserted. If needed, sedatives and pain medication are also given. The health care provider uses a needle to take a small piece of liver tissue. The health care provider may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient should lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home.\nGenetic testing. The health care provider may refer a person suspected of having Alagille syndrome to a geneticista doctor who specializes in genetic disorders. For a genetic test, the geneticist takes a blood or saliva sample and analyzes the DNA for the JAG1 gene mutation. The geneticist tests for the JAG1 gene mutation first, since it is more common in Alagille syndrome than NOTCH2. Genetic testing is often done only by specialized labs. The results may not be available for several months because of the complexity of the testing.\nThe usefulness of genetic testing for Alagille syndrome is limited by two factors:\n- Detection of a mutated gene cannot predict the onset of symptoms or how serious the disorder will be.\n- Even if a mutated gene is found, no specific cure for the disorder exists.\nWhen to Consider Genetic Counseling People who are considering genetic testing may want to consult a genetics counselor. Genetic counseling can help family members understand how test results may affect them individually and as a family. Genetic counseling is provided by genetics professionalshealth care professionals with specialized degrees and experience in medical genetics and counseling. Genetics professionals include geneticists, genetics counselors, and genetics nurses. Genetics professionals work as members of health care teams, providing information and support to individuals or families who have genetic disorders or a higher chance of having an inherited condition. Genetics professionals\n- assess the likelihood of a genetic disorder by researching a family's history, evaluating medical records, and conducting a physical exam of the patient and other family members\n- weigh the medical, social, and ethical decisions surrounding genetic testing\n- provide support and information to help a person make a decision about testing\n- interpret the results of genetic tests and medical data\n- provide counseling or refer individuals and families to support services\n- serve as patient advocates\n- explain possible treatments or preventive measures\n- discuss reproductive optionsGenetic counseling may be useful when a family member is deciding whether to have genetic testing and again later when test results are available." } ]

[ { "from": "human", "value": "What are the treatments for Alagille Syndrome?" }, { "from": "gpt", "value": "Treatment for Alagille syndrome includes medications and therapies that increase the flow of bile from the liver, promote growth and development in infants' and children's bodies, correct nutritional deficiencies, and reduce the person's discomfort. Ursodiol (Actigall, Urso) is a medication that increases bile flow. Other treatments address specific symptoms of the disorder.\nLiver failure. People with Alagille syndrome who develop end-stage liver failure need a liver transplant with a whole liver from a deceased donor or a segment of a liver from a living donor. People with Alagille syndrome who also have heart problems may not be candidates for a transplant because they could be more likely to have complications during and after the procedure. A liver transplant surgical team performs the transplant in a hospital.\nMore information is provided in the NIDDK health topic, Liver Transplantation.\nPruritus. Itching may decrease when the flow of bile from the liver is increased. Medications such as cholestyramine (Prevalite), rifampin (Rifadin, Rimactane), naltrexone (Vivitrol), or antihistamines may be prescribed to relieve pruritus. People should hydrate their skin with moisturizers and keep their fingernails trimmed to prevent skin damage from scratching. People with Alagille syndrome should avoid baths and take short showers to prevent the skin from drying out.\nIf severe pruritus does not improve with medication, a procedure called partial external biliary diversion may provide relief from itching. The procedure involves surgery to connect one end of the small intestine to the gallbladder and the other end to an opening in the abdomencalled a stomathrough which bile leaves the body and is collected in a pouch. A surgeon performs partial external biliary diversion in a hospital. The patient will need general anesthesia.\nMalabsorption and growth problems. Infants with Alagille syndrome are given a special formula that helps the small intestine absorb much-needed fat. Infants, children, and adults can benefit from a high-calorie diet, calcium, and vitamins A, D, E, and K. They may also need additional zinc. If someone with Alagille syndrome does not tolerate oral doses of vitamins, a health care provider may give the person injections for a period of time. A child may receive additional calories through a tiny tube that is passed through the nose into the stomach. If extra calories are needed for a long time, a health care provider may place a tube, called a gastrostomy tube, directly into the stomach through a small opening made in the abdomen. A child's growth may improve with increased nutrition and flow of bile from the liver.\nXanthomas. For someone who has Alagille syndrome, these fatty deposits typically worsen over the first few years of life and then improve over time. They may eventually disappear in response to partial external biliary diversion or the medications used to increase bile flow." } ]

[ { "from": "human", "value": "How to prevent Alagille Syndrome?" }, { "from": "gpt", "value": "Scientists have not yet found a way to prevent Alagille syndrome. However, complications of the disorder can be managed with the help of health care providers. Routine visits with a health care team are needed to prevent complications from becoming worse." } ]

[ { "from": "human", "value": "What to do for Alagille Syndrome?" }, { "from": "gpt", "value": "Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Alagille syndrome. However, these factors are important for people with Alagille syndrome, particularly children, who are malnourished, growing poorly, or have delayed puberty. Caregivers and parents of children with Alagille syndrome should try to maximize their children's potential for growth through good eating, diet, and nutrition.\nA nutritionist or a dietitiana person with training in nutrition and dietcan work with someone with Alagille syndrome and his or her health care team to build an appropriate healthy eating plan. A person with Alagille syndrome may need to take dietary supplements or vitamins in addition to eating a set number of calories, based on the type of complications the person has. Researchers consider good nutrition to be one of the most important aspects of managing the disorder.\nIf potential liver problems are present, a person with Alagille syndrome should not drink alcoholic beverages without talking with his or her health care provider first.\nAdditionally, eating, diet, and nutrition play a part in overall health and preventing further health problems." } ]

[ { "from": "human", "value": "What to do for Alagille Syndrome?" }, { "from": "gpt", "value": "- Alagille syndrome is a genetic condition that results in various symptoms in different parts of the body, including the liver.\n- A person with Alagille syndrome has fewer than the normal number of small bile ducts inside the liver.\n- In people with Alagille syndrome, the decreased number of bile ducts causes bile to build up in the liver, a condition also called cholestasis, leading to liver damage and liver disease.\n- Alagille syndrome is caused by a gene mutation, or defect. Approximately 30 to 50 percent of people with Alagille syndrome have an inherited gene mutation, meaning it has been passed on by a parent.\n- Alagille syndrome occurs in about one of every 30,000 live births. The disorder affects both sexes equally and shows no geographical, racial, or ethnic preferences.\n- The gene mutations that cause Alagille syndrome may cause mild or subtle symptoms. Some people may not know they are affected.\n- The signs and symptoms of Alagille syndrome and their severity vary, even among people in the same family sharing the same gene mutation.\n- In some people, problems in the liver may be the first signs and symptoms of the disorder.\n- The complications of Alagille syndrome include liver failure, portal hypertension, and growth problems.\n- Ten to 30 percent of people with Alagille syndrome will eventually need a liver transplant.\n- A health care provider diagnoses Alagille syndrome by performing a thorough physical exam and other tests.\n- Genetic counseling can help family members understand how genetic test results may affect them individually and as a family.\n- Treatment for Alagille syndrome includes medications and therapies that increase the flow of bile from the liver, promote growth and development in infants' and children's bodies, correct nutritional deficiencies, and reduce the person's discomfort.\n- Scientists have not yet found a way to prevent Alagille syndrome.\n- Caregivers and parents of children with Alagille syndrome should try to maximize their children's potential for growth through good eating, diet, and nutrition." } ]

[ { "from": "human", "value": "What is (are) IgA Nephropathy?" }, { "from": "gpt", "value": "IgA nephropathy, also known as Bergers disease, is a kidney disease that occurs when IgA deposits build up in the kidneys, causing inflammation that damages kidney tissues. IgA is an antibodya protein made by the immune system to protect the body from foreign substances such as bacteria or viruses. Most people with IgA nephropathy receive care from a nephrologist, a doctor who specializes in treating people with kidney disease." } ]