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[ { "from": "human", "value": "What are the treatments for Fecal Incontinence?" }, { "from": "gpt", "value": "Treatment for fecal incontinence may include one or more of the following:\n- eating, diet, and nutrition\n- medications\n- bowel training\n- pelvic floor exercises and biofeedback\n- surgery\n- electrical stimulation" } ]

[ { "from": "human", "value": "What to do for Fecal Incontinence?" }, { "from": "gpt", "value": "Dietary changes that may improve fecal incontinence include\n- Eating the right amount of fiber. Fiber can help with diarrhea and constipation. Fiber is found in fruits, vegetables, whole grains, and beans. Fiber supplements sold in a pharmacy or in a health food store are another common source of fiber to treat fecal incontinence. The Academy of Nutrition and Dietetics recommends consuming 20 to 35 grams of fiber a day for adults and age plus five grams for children. A 7-year-old child, for example, should get 7 plus five, or 12, grams of fiber a day. American adults consume only 15 grams a day on average.2 Fiber should be added to the diet slowly to avoid bloating.\n- Getting plenty to drink. Drinking eight 8-ounce glasses of liquid a day may help prevent constipation. Water is a good choice. Drinks with caffeine, alcohol, milk, or carbonation should be avoided if they trigger diarrhea.\nKeeping a Food Diary A food diary can help identify foods that cause diarrhea and increase the risk of fecal incontinence. A food diary should list foods eaten, portion size, and when fecal incontinence occurs. After a few days, the diary may show a link between certain foods and fecal incontinence. Eating less of foods linked to fecal incontinence may improve symptoms. A food diary can also be helpful to a health care provider treating a person with fecal incontinence. Common foods and drinks linked to fecal incontinence include\n- dairy products such as milk, cheese, and ice cream\n- drinks and foods containing caffeine\n- cured or smoked meat such as sausage, ham, and turkey\n- spicy foods\n- alcoholic beverages\n- fruits such as apples, peaches, and pears\n- fatty and greasy foods\n- sweeteners in diet drinks and sugarless gum and candy, including sorbitol, xylitol, mannitol, and fructose\nExamples of Foods That Have FiberBeans, cereals, and breadsFibercup of beans (navy, pinto, kidney, etc.), cooked6.29.6 gramscup of shredded wheat, ready-to-eat cereal2.73.8 gramscup of 100% bran, ready-to-eat cereal9.1 grams1 small oat bran muffin3.0 grams1 whole-wheat English muffin4.4 gramsFruits1 small apple, with skin3.6 grams1 medium pear, with skin5.5 gramscup of raspberries4.0 gramscup of stewed prunes3.8 gramsVegetablescup of winter squash, cooked2.9 grams1 medium sweet potato, baked in skin3.8 gramscup of green peas, cooked3.54.4 grams1 small potato, baked, with skin3.0 gramscup of mixed vegetables, cooked4.0 gramscup of broccoli, cooked2.62.8 gramscup of greens (spinach, collards, turnip greens), cooked2.53.5 grams\nMedications\nIf diarrhea is causing fecal incontinence, medication may help. Health care providers sometimes recommend using bulk laxatives, such as Citrucel and Metamucil, to develop more solid stools that are easier to control. Antidiarrheal medications such as loperamide or diphenoxylate may be recommended to slow down the bowels and help control the problem.\nBowel Training\nDeveloping a regular bowel movement pattern can improve fecal incontinence, especially fecal incontinence due to constipation. Bowel training involves trying to have bowel movements at specific times of the day, such as after every meal. Over time, the body becomes used to a regular bowel movement pattern, thus reducing constipation and related fecal incontinence. Persistence is key to successful bowel training. Achieving a regular bowel control pattern can take weeks to months.\nPelvic Floor Exercises and Biofeedback\nExercises that strengthen the pelvic floor muscles may improve bowel control. Pelvic floor exercises involve squeezing and relaxing pelvic floor muscles 50 to 100 times a day. A health care provider can help with proper technique. Biofeedback therapy may also help a person perform the exercises properly. This therapy also improves a persons awareness of sensations in the rectum, teaching how to coordinate squeezing of the external sphincter muscle with the sensation of rectal filling. Biofeedback training uses special sensors to measure bodily functions. Sensors include pressure or EMG sensors in the anus, pressure sensors in the rectum, and a balloon in the rectum to produce graded sensations of rectal fullness. The measurements are displayed on a video screen as sounds or line graphs. The health care provider uses the information to help the person modify or change abnormal function. The person practices the exercises at home. Success with pelvic floor exercises depends on the cause of fecal incontinence, its severity, and the persons motivation and ability to follow the health care providers recommendations.\nSurgery\nSurgery may be an option for fecal incontinence that fails to improve with other treatments or for fecal incontinence caused by pelvic floor or anal sphincter muscle injuries.\n- Sphincteroplasty, the most common fecal incontinence surgery, reconnects the separated ends of a sphincter muscle torn by childbirth or another injury. Sphincteroplasty is performed at a hospital by a colorectal, gynecological, or general surgeon.\n- Artificial anal sphincter involves placing an inflatable cuff around the anus and implanting a small pump beneath the skin that the person activates to inflate or deflate the cuff. This surgery is much less common and is performed at a hospital by a specially trained colorectal surgeon.\n- Nonabsorbable bulking agents can be injected into the wall of the anus to bulk up the tissue around the anus. The bulkier tissues make the opening of the anus narrower so the sphincters are able to close better. The procedure is performed in a health care providers office; anesthesia is not needed. The person can return to normal physical activities 1 week after the procedure.\n- Bowel diversion is an operation that reroutes the normal movement of stool out of the body when part of the bowel is removed. The operation diverts the lower part of the small intestine or colon to an opening in the wall of the abdomenthe area between the chest and hips. An external pouch is attached to the opening to collect stool. The procedure is performed by a surgeon in a hospital and anesthesia is used. More information about these procedures can be found in the Bowel Diversion fact sheet.\nElectrical Stimulation\nElectrical stimulation, also called sacral nerve stimulation or neuromodulation, involves placing electrodes in the sacral nerves to the anus and rectum and continuously stimulating the nerves with electrical pulses. The sacral nerves connect to the part of the spine in the hip area. A battery-operated stimulator is placed beneath the skin. Based on the persons response, the health care provider can adjust the amount of stimulation so it works best for that person. The person can turn the stimulator on or off at any time. The procedure is performed in an outpatient center using local anesthesia." } ]

[ { "from": "human", "value": "What is (are) Fecal Incontinence?" }, { "from": "gpt", "value": "Fecal incontinence can cause embarrassment, fear, and loneliness. Taking steps to cope is important. The following tips can help:\n- carrying a bag with cleanup supplies and a change of clothes when leaving the house.\n- finding public restrooms before one is needed.\n- using the toilet before leaving home.\n- wearing disposable underwear or absorbent pads inserted in the underwear.\n- using fecal deodorantspills that reduce the smell of stool and gas. Although fecal deodorants are available over the counter, a health care provider can help people find them.\nEating tends to trigger contractions of the large intestine that push stool toward the rectum and also cause the rectum to contract for 30 to 60 minutes. Both these events increase the likelihood that a person will pass gas and have a bowel movement soon after eating. This activity may increase if the person is anxious. People with fecal incontinence may want to avoid eating in restaurants or at social gatherings, or they may want to take antidiarrheal medications before eating in these situations.\nAnal Discomfort The skin around the anus is delicate and sensitive. Constipation and diarrhea or contact between skin and stool can cause pain or itching. The following steps can help relieve anal discomfort:\n- Washing the anal area after a bowel movement. Washing with water, but not soap, can help prevent discomfort. Soap can dry out the skin, making discomfort worse. Ideally, the anal area should be washed in the shower with lukewarm water or in a sitz batha special plastic tub that allows a person to sit in a few inches of warm water. No-rinse skin cleansers, such as Cavilon, are a good alternative. Wiping with toilet paper further irritates the skin and should be avoided. Premoistened, alcohol-free towelettes are a better choice.\n- Keeping the anal area dry. The anal area should be allowed to air dry after washing. If time doesnt permit air drying, the anal area can be gently patted dry with a lint-free cloth.\n- Creating a moisture barrier. A moisture barrier cream that contains ingredients such as dimethiconea type of siliconecan help form a barrier between skin and stool. The anal area should be cleaned before applying barrier cream. However, people should talk with their health care provider before using anal creams and ointments because some can irritate the anus.\n- Using nonmedicated powders. Nonmedicated talcum powder or cornstarch can also relieve anal discomfort. As with moisture barrier creams, the anal area should be clean and dry before use.\n- Using wicking pads or disposable underwear. Pads and disposable underwear with a wicking layer can pull moisture away from the skin.\n- Wearing breathable clothes and underwear. Clothes and underwear should allow air to flow and keep skin dry. Tight clothes or plastic or rubber underwear that blocks air can worsen skin problems.\n- Changing soiled underwear as soon as possible." } ]

[ { "from": "human", "value": "What to do for Fecal Incontinence?" }, { "from": "gpt", "value": "- Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into ones underwear without being aware of it happening.\n- Nearly 18 million U.S. adultsabout one in 12have fecal incontinence. People with fecal incontinence should not be afraid or embarrassed to talk with their health care provider.\n- Fecal incontinence has many causes, including- diarrhea- constipation- muscle damage or weakness- nerve damage- loss of stretch in the rectum- childbirth by vaginal delivery- hemorrhoids and rectal prolapse- rectocele- inactivity- Health care providers diagnose fecal incontinence based on a persons medical history, physical exam, and medical test results.\n- Treatment for fecal incontinence may include one or more of the following:- eating, diet, and nutrition- medications- bowel training- pelvic floor exercises and biofeedback- surgery- electrical stimulation- A food diary can help identify foods that cause fecal incontinence.\n- Fecal incontinence can occur in children because of a birth defect or disease, but in most cases it occurs because of constipation." } ]

[ { "from": "human", "value": "What is (are) Abdominal Adhesions?" }, { "from": "gpt", "value": "Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs. Normally, internal tissues and organs have slippery surfaces, preventing them from sticking together as the body moves. However, abdominal adhesions cause tissues and organs in the abdominal cavity to stick together." } ]

[ { "from": "human", "value": "What is (are) Abdominal Adhesions?" }, { "from": "gpt", "value": "The abdominal cavity is the internal area of the body between the chest and hips that contains the lower part of the esophagus, stomach, small intestine, and large intestine. The esophagus carries food and liquids from the mouth to the stomach, which slowly pumps them into the small and large intestines. Abdominal adhesions can kink, twist, or pull the small and large intestines out of place, causing an intestinal obstruction. Intestinal obstruction, also called a bowel obstruction, results in the partial or complete blockage of movement of food or stool through the intestines." } ]

[ { "from": "human", "value": "What causes Abdominal Adhesions?" }, { "from": "gpt", "value": "Abdominal surgery is the most frequent cause of abdominal adhesions. Surgery-related causes include\n- cuts involving internal organs\n- handling of internal organs\n- drying out of internal organs and tissues\n- contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches\n- blood or blood clots that were not rinsed away during surgery\nAbdominal adhesions can also result from inflammation not related to surgery, including\n- appendix rupture\n- radiation treatment\n- gynecological infections\n- abdominal infections\nRarely, abdominal adhesions form without apparent cause." } ]

[ { "from": "human", "value": "Who is at risk for Abdominal Adhesions??" }, { "from": "gpt", "value": "Of patients who undergo abdominal surgery, 93 percent develop abdominal adhesions.1 Surgery in the lower abdomen and pelvis, including bowel and gynecological operations, carries an even greater chance of abdominal adhesions. Abdominal adhesions can become larger and tighter as time passes, sometimes causing problems years after surgery." } ]

[ { "from": "human", "value": "What are the symptoms of Abdominal Adhesions?" }, { "from": "gpt", "value": "In most cases, abdominal adhesions do not cause symptoms. When symptoms are present, chronic abdominal pain is the most common." } ]

[ { "from": "human", "value": "What are the complications of Abdominal Adhesions?" }, { "from": "gpt", "value": "Abdominal adhesions can cause intestinal obstruction and female infertilitythe inability to become pregnant after a year of trying.\nAbdominal adhesions can lead to female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Women with abdominal adhesions in or around their fallopian tubes have an increased chance of ectopic pregnancya fertilized egg growing outside the uterus. Abdominal adhesions inside the uterus may result in repeated miscarriagesa pregnancy failure before 20 weeks.\nSeek Help for Emergency Symptoms A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery. Symptoms of an intestinal obstruction include\n- severe abdominal pain or cramping\n- nausea\n- vomiting\n- bloating- loud bowel sounds\n- abdominal swelling\n- the inability to have a bowel movement or pass gas\n- constipationa condition in which a person has fewer than three bowel movements a week; the bowel movements may be painfulA person with these symptoms should seek medical attention immediately." } ]

[ { "from": "human", "value": "What are the symptoms of Abdominal Adhesions?" }, { "from": "gpt", "value": "A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery. Symptoms of an intestinal obstruction include\n- severe abdominal pain or cramping\n- nausea\n- vomiting\n- bloating\n- loud bowel sounds\n- abdominal swelling\n- the inability to have a bowel movement or pass gas\n- constipationa condition in which a person has fewer than three bowel movements a week; the bowel movements may be painful\nA person with these symptoms should seek medical attention immediately." } ]

[ { "from": "human", "value": "How to diagnose Abdominal Adhesions?" }, { "from": "gpt", "value": "Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. Most abdominal adhesions are found during surgery performed to examine the abdomen. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.\n- Abdominal x rays use a small amount of radiation to create an image that is recorded on film or a computer. An x ray is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. An x ray does not require anesthesia. The person will lie on a table or stand during the x ray. The x-ray machine is positioned over the abdominal area. The person will hold his or her breath as the picture is taken so that the picture will not be blurry. The person may be asked to change position for additional pictures.\n- A lower GI series is an x-ray exam that is used to look at the large intestine. The test is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. The health care provider may provide written bowel prep instructions to follow at home before the test. The person may be asked to follow a clear liquid diet for 1 to 3 days before the procedure. A laxative or an enema may be used before the test. A laxative is medication that loosens stool and increases bowel movements. An enema involves fl ushing water or laxative into the rectum using a special squirt bottle. For the test, the person will lie on a table while the radiologist inserts a flexible tube into the persons anus. The large intestine is fi lled with barium, making signs of underlying problems show up more clearly on x rays.\n- CT scans use a combination of x rays and computer technology to create images. The procedure is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. A CT scan may include the injection of a special dye, called contrast medium. The person will lie on a table that slides into a tunnel-shaped device where the x rays are taken." } ]

[ { "from": "human", "value": "What are the treatments for Abdominal Adhesions?" }, { "from": "gpt", "value": "Abdominal adhesions that do not cause symptoms generally do not require treatment. Surgery is the only way to treat abdominal adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional abdominal adhesions. People should speak with their health care provider about the best way to treat their abdominal adhesions.\nComplete intestinal obstructions usually require immediate surgery to clear the blockage. Most partial intestinal obstructions can be managed without surgery." } ]

[ { "from": "human", "value": "How to prevent Abdominal Adhesions?" }, { "from": "gpt", "value": "Abdominal adhesions are diffi cult to prevent; however, certain surgical techniques can minimize abdominal adhesions.\nLaparoscopic surgery decreases the potential for abdominal adhesions because several tiny incisions are made in the lower abdomen instead of one large incision. The surgeon inserts a laparoscopea thin tube with a tiny video camera attachedinto one of the small incisions. The camera sends a magnified image from inside the body to a video monitor. Patients will usually receive general anesthesia during this surgery.\nIf laparoscopic surgery is not possible and a large abdominal incision is required, at the end of surgery a special fi lmlike material can be inserted between organs or between the organs and the abdominal incision. The fi lmlike material, which looks similar to wax paper and is absorbed by the body in about a week, hydrates organs to help prevent abdominal adhesions.\nOther steps taken during surgery to reduce abdominal adhesions include\n- using starch- and latex-free gloves\n- handling tissues and organs gently\n- shortening surgery time\n- using moistened drapes and swabs\n- occasionally applying saline solution" } ]

[ { "from": "human", "value": "What to do for Abdominal Adhesions?" }, { "from": "gpt", "value": "Researchers have not found that eating, diet, and nutrition play a role in causing or preventing abdominal adhesions. A person with a partial intestinal obstruction may relieve symptoms with a liquid or low- fiber diet, which is more easily broken down into smaller particles by the digestive system." } ]

[ { "from": "human", "value": "What to do for Abdominal Adhesions?" }, { "from": "gpt", "value": "- Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs. Abdominal adhesions cause tissues and organs in the abdominal cavity to stick together.\n- Abdominal surgery is the most frequent cause of abdominal adhesions. Of patients who undergo abdominal surgery, 93 percent develop abdominal adhesions.\n- In most cases, abdominal adhesions do not cause symptoms. When symptoms are present, chronic abdominal pain is the most common.\n- A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.\n- Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.\n- Surgery is the only way to treat abdominal adhesions that cause pain, intestinal obstruction, or fertility problems." } ]

[ { "from": "human", "value": "What is (are) Porphyria?" }, { "from": "gpt", "value": "Porphyrias are rare disorders that affect mainly the skin or nervous system and may cause abdominal pain. These disorders are usually inherited, meaning they are caused by abnormalities in genes passed from parents to children. When a person has a porphyria, cells fail to change body chemicals called porphyrins and porphyrin precursors into heme, the substance that gives blood its red color. The body makes heme mainly in the bone marrow and liver. Bone marrow is the soft, spongelike tissue inside the bones; it makes stem cells that develop into one of the three types of blood cellsred blood cells, white blood cells, and platelets.\nThe process of making heme is called the heme biosynthetic pathway. One of eight enzymes controls each step of the process. The body has a problem making heme if any one of the enzymes is at a low level, also called a deficiency. Porphyrins and porphyrin precursors of heme then build up in the body and cause illness." } ]

[ { "from": "human", "value": "What is (are) Porphyria?" }, { "from": "gpt", "value": "Heme is a red pigment composed of iron linked to a chemical called protoporphyrin. Heme has important functions in the body. The largest amounts of heme are in the form of hemoglobin, found in red blood cells and bone marrow. Hemoglobin carries oxygen from the lungs to all parts of the body. In the liver, heme is a component of proteins that break down hormones, medications, and other chemicals and keep liver cells functioning normally. Heme is an important part of nearly every cell in the body." } ]

[ { "from": "human", "value": "What is (are) Porphyria?" }, { "from": "gpt", "value": "Each of the eight types of porphyria corresponds to low levels of a specific enzyme in the heme biosynthetic pathway. Experts often classify porphyrias as acute or cutaneous based on the symptoms a person experiences:\n- Acute porphyrias affect the nervous system. They occur rapidly and last only a short time.\n- Cutaneous porphyrias affect the skin.\nTwo types of acute porphyrias, hereditary coproporphyria and variegate porphyria, can also have cutaneous symptoms.\nExperts also classify porphyrias as erythropoietic or hepatic:\n- In erythropoietic porphyrias, the body overproduces porphyrins, mainly in the bone marrow.\n- In hepatic porphyrias, the body overproduces porphyrins and porphyrin precursors, mainly in the liver.\nTable 1 lists each type of porphyria, the deficient enzyme responsible for the disorder, and the main location of porphyrin buildup.\nTable 1. Types of porphyria\nType of PorphyriaDeficient EnzymeMain Location of Porphyrin Buildupdelta-aminolevulinate-dehydratase deficiency porphyriadelta-aminolevulinic acid dehydrataseliveracute intermittent porphyriaporphobilinogen deaminaseliverhereditary coproporphyriacoproporphyrinogen oxidaselivervariegate porphyriaprotoporphyrinogen oxidaselivercongenital erythropoietic porphyriauroporphyrinogen III cosynthasebone marrowporphyria cutanea tardauroporphyrinogen decarboxylase (~75% deficiency)liverhepatoerythropoietic porphyriauroporphyrinogen decarboxylase (~90% deficiency)bone marrowerythropoietic protoporphyria*ferrochelatase (~75% deficiency)bone marrow\n*Protoporphyria XLPP is a variant of erythropoietic protoporphyria." } ]

[ { "from": "human", "value": "How many people are affected by Porphyria?" }, { "from": "gpt", "value": "The exact rates of porphyria are unknown and vary around the world. For example, porphyria cutanea tarda is most common in the United States, and variegate porphyria is most common in South America.1" } ]

[ { "from": "human", "value": "What causes Porphyria?" }, { "from": "gpt", "value": "Most porphyrias are inherited disorders. Scientists have identified genes for all eight enzymes in the heme biosynthetic pathway. Most porphyrias result from inheriting an abnormal gene, also called a gene mutation, from one parent. Some porphyrias, such as congenital erythropoietic porphyria, hepatoerythropoietic porphyria, and erythropoietic protoporphyria, occur when a person inherits two abnormal genes, one from each parent. The likeliness of a person passing the abnormal gene or genes to the next generation depends on the type of porphyria.\nPorphyria cutanea tarda is usually an acquired disorder, meaning factors other than genes cause the enzyme deficiency. This type of porphyria can be triggered by\n- too much iron\n- use of alcohol or estrogen\n- smoking\n- chronic hepatitis Ca long-lasting liver disease that causes inflammation, or swelling, of the liver\n- HIVthe virus that causes AIDS\n- abnormal genes associated with hemochromatosisthe most common form of iron overload disease, which causes the body to absorb too much iron\nFor all types of porphyria, symptoms can be triggered by\n- use of alcohol\n- smoking\n- use of certain medications or hormones\n- exposure to sunlight\n- stress\n- dieting and fasting" } ]

[ { "from": "human", "value": "What are the symptoms of Porphyria?" }, { "from": "gpt", "value": "Some people with porphyria-causing gene mutations have latent porphyria, meaning they have no symptoms of the disorder. Symptoms of cutaneous porphyrias include\n- oversensitivity to sunlight\n- blisters on exposed areas of the skin\n- itching and swelling on exposed areas of the skin\nSymptoms of acute porphyrias include\n- pain in the abdomenthe area between the chest and hips\n- pain in the chest, limbs, or back\n- nausea and vomiting\n- constipationa condition in which an adult has fewer than three bowel movements a week or a child has fewer than two bowel movements a week, depending on the person\n- urinary retentionthe inability to empty the bladder completely\n- confusion\n- hallucinations\n- seizures and muscle weakness\nSymptoms of acute porphyrias can develop over hours or days and last for days or weeks. These symptoms can come and go over time, while symptoms of cutaneous porphyrias tend to be more continuous. Porphyria symptoms can vary widely in severity." } ]

[ { "from": "human", "value": "How to diagnose Porphyria?" }, { "from": "gpt", "value": "A health care provider diagnoses porphyria with blood, urine, and stool tests. These tests take place at a health care providers office or a commercial facility. A blood test involves drawing blood and sending the sample to a lab for analysis. For urine and stool tests, the patient collects a sample of urine or stool in a special container. A health care provider tests the samples in the office or sends them to a lab for analysis. High levels of porphyrins or porphyrin precursors in blood, urine, or stool indicate porphyria. A health care provider may also recommend DNA testing of a blood sample to look for known gene mutations that cause porphyrias." } ]

[ { "from": "human", "value": "What are the treatments for Porphyria?" }, { "from": "gpt", "value": "Treatment for porphyria depends on the type of porphyria the person has and the severity of the symptoms.\nAcute Porphyrias\nA health care provider treats acute porphyrias with heme or glucose loading to decrease the livers production of porphyrins and porphyrin precursors. A patient receives heme intravenously once a day for 4 days. Glucose loading involves giving a patient a glucose solution by mouth or intravenously. Heme is usually more effective and is the treatment of choice unless symptoms are mild. In rare instances, if symptoms are severe, a health care provider will recommend liver transplantation to treat acute porphyria. In liver transplantation, a surgeon removes a diseased or an injured liver and replaces it with a healthy, whole liver or a segment of a liver from another person, called a donor. A patient has liver transplantation surgery in a hospital under general anesthesia. Liver transplantation can cure liver failure. More information is provided in the NIDDK health topic, Liver Transplantation.\nCutaneous Porphyrias\nThe most important step a person can take to treat a cutaneous porphyria is to avoid sunlight as much as possible. Other cutaneous porphyrias are treated as follows:\n- Porphyria cutanea tarda. A health care provider treats porphyria cutanea tarda by removing factors that tend to activate the disease and by performing repeated therapeutic phlebotomies to reduce iron in the liver. Therapeutic phlebotomy is the removal of about a pint of blood from a vein in the arm. A technician performs the procedure at a blood donation center, such as a hospital, clinic, or bloodmobile. A patient does not require anesthesia. Another treatment approach is low-dose hydroxychloroquine tablets to reduce porphyrins in the liver.\n- Erythropoietic protoporphyria. People with erythropoietic protoporphyria may be given beta-carotene or cysteine to improve sunlight tolerance, though these medications do not lower porphyrin levels. Experts recommend hepatitis A and B vaccines and avoiding alcohol to prevent protoporphyric liver failure. A health care provider may use liver transplantation or a combination of medications to treat people who develop liver failure. Unfortunately, liver transplantation does not correct the primary defect, which is the continuous overproduction of protoporphyria by bone marrow. Successful bone marrow transplantations may successfully cure erythropoietic protoporphyria. A health care provider only considers bone marrow transplantation if the disease is severe and leading to secondary liver disease.\n- Congenital erythropoietic porphyria and hepatoerythropoietic porphyria. People with congenital erythropoietic porphyria or hepatoerythropoietic porphyria may need surgery to remove the spleen or blood transfusions to treat anemia. A surgeon removes the spleen in a hospital, and a patient receives general anesthesia. With a blood transfusion, a patient receives blood through an intravenous (IV) line inserted into a vein. A technician performs the procedure at a blood donation center, and a patient does not need anesthesia.\nSecondary Porphyrinurias\nConditions called secondary porphyrinurias, such as disorders of the liver and bone marrow, as well as a number of drugs, chemicals, and toxins are often mistaken for porphyria because they lead to mild or moderate increases in porphyrin levels in the urine. Only highnot mild or moderatelevels of porphyrin or porphyrin precursors lead to a diagnosis of porphyria." } ]

[ { "from": "human", "value": "What to do for Porphyria?" }, { "from": "gpt", "value": "People with an acute porphyria should eat a diet with an average-to-high level of carbohydrates. The recommended dietary allowance for carbohydrates is 130 g per day for adults and children 1 year of age or older; pregnant and breastfeeding women need higher intakes.2 People should avoid limiting intake of carbohydrates and calories, even for short periods of time, as this type of dieting or fasting can trigger symptoms. People with an acute porphyria who want to lose weight should talk with their health care providers about diets they can follow to lose weight gradually.\nPeople undergoing therapeutic phlebotomies should drink plenty of milk, water, or juice before and after each procedure.\nA health care provider may recommend vitamin and mineral supplements for people with a cutaneous porphyria." } ]

[ { "from": "human", "value": "What to do for Porphyria?" }, { "from": "gpt", "value": "- Porphyrias are rare disorders that affect mainly the skin or nervous system and may cause abdominal pain.\n- Each of the eight types of porphyria corresponds to low levels of a specific enzyme in the heme biosynthetic pathway.\n- The exact rates of porphyria are unknown and vary around the world. For example, porphyria cutanea tarda is most common in the United States, and variegate porphyria is most common in South America.\n- Most porphyrias result from inheriting an abnormal gene, also called a gene mutation, from one parent.\n- Porphyria cutanea tarda is usually an acquired disorder, meaning factors other than genes cause the enzyme deficiency.\n- Symptoms of cutaneous porphyrias include- oversensitivity to sunlight- blisters on exposed areas of the skin- itching and swelling on exposed areas of the skin- Symptoms of acute porphyrias include- pain in the abdomen- pain in the chest, limbs, or back- nausea and vomiting- constipation- urinary retention- confusion- hallucinations- seizures and muscle weakness- A health care provider diagnoses porphyria with blood, urine, and stool tests.\n- Treatment for porphyria depends on the type of porphyria the person has and the severity of the symptoms." } ]

[ { "from": "human", "value": "What is (are) Polycystic Kidney Disease?" }, { "from": "gpt", "value": "Polycystic kidney disease is a genetic disorder that causes numerous cysts to grow in the kidneys. A kidney cyst is an abnormal sac filled with fluid. PKD cysts can greatly enlarge the kidneys while replacing much of their normal structure, resulting in chronic kidney disease (CKD), which causes reduced kidney function over time. CKD may lead to kidney failure, described as end-stage kidney disease or ESRD when treated with a kidney transplant or blood-filtering treatments called dialysis. The two main types of PKD are autosomal dominant PKD and autosomal recessive PKD.\nPKD cysts are different from the usually harmless simple cysts that often form in the kidneys later in life. PKD cysts are more numerous and cause complications, such as high blood pressure, cysts in the liver, and problems with blood vessels in the brain and heart." } ]

[ { "from": "human", "value": "What causes Polycystic Kidney Disease?" }, { "from": "gpt", "value": "A gene mutation, or defect, causes polycystic kidney disease. Genes provide instructions for making proteins in the body. A gene mutation is a permanent change in the deoxyribonucleic acid (DNA) sequence that makes up a gene. In most cases of PKD, a person inherits the gene mutation, meaning a parent passes it on in his or her genes. In the remaining cases, the gene mutation develops spontaneously. In spontaneous cases, neither parent carries a copy of the mutated gene.\nResearchers have found three different gene mutations associated with PKD. Two of the genes are associated with autosomal dominant PKD. The third gene is associated with autosomal recessive PKD. Gene mutations that cause PKD affect proteins that play a role in kidney development.\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 inherit two copies of most genes; one copy 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, a person can pass it to his or her children. Read more about genes and genetic conditions in the U.S. National Library of Medicines (NLMs) Genetics Home Reference." } ]

[ { "from": "human", "value": "How many people are affected by Polycystic Kidney Disease?" }, { "from": "gpt", "value": "Estimates of PKDs prevalence range from one in 400 to one in 1,000 people.1 According to the United States Renal Data System, PKD accounts for 2.2 percent of new cases of kidney failure each year in the United States. Annually, eight people per 1 million have kidney failure as a result of PKD.2\nPolycystic kidney disease exists around the world and in all races. The disorder occurs equally in women and men, although men are more likely to develop kidney failure from PKD. Women with PKD and high blood pressure who have had more than three pregnancies also have an increased chance of developing kidney failure." } ]

[ { "from": "human", "value": "What is (are) Polycystic Kidney Disease?" }, { "from": "gpt", "value": "Autosomal dominant PKD is the most common form of PKD and the most common inherited disorder of the kidneys.3 The term autosomal dominant means a child can get the disorder by inheriting the gene mutation from only one parent. Each child of a parent with an autosomal dominant mutation has a 50 percent chance of inheriting the mutated gene. About 10 percent of autosomal dominant PKD cases occur spontaneously.4\nThe following chart shows the chance of inheriting an autosomal dominant gene mutation:\nHealth care providers identify most cases of autosomal dominant PKD between the ages of 30 and 50.4 For this reason, health care providers often call autosomal dominant PKD adult PKD. However, the onset of kidney damage and how quickly the disorder progresses varies. In some cases, cysts may form earlier in life and grow quickly, causing symptoms in childhood.\nThe cysts grow out of nephrons, the tiny filtering units inside the kidneys. The cysts eventually separate from the nephrons and continue to enlarge. The kidneys enlarge along with the cystswhich can number in the thousandswhile roughly retaining their kidney shape. In fully developed autosomal dominant PKD, a cyst-filled kidney can weigh as much as 20 to 30 pounds." } ]

[ { "from": "human", "value": "What are the symptoms of Polycystic Kidney Disease?" }, { "from": "gpt", "value": "In many cases, PKD does not cause signs or symptoms until cysts are half an inch or larger. When present, the most common symptoms are pain in the back and sidesbetween the ribs and hipsand headaches. The pain can be temporary or persistent, mild or severe. Hematuriablood in the urinemay also be a sign of autosomal dominant PKD." } ]

[ { "from": "human", "value": "What are the complications of Polycystic Kidney Disease?" }, { "from": "gpt", "value": "The complications of autosomal dominant PKD include the following:\n- Pain. Cyst infection, other types of urinary tract infections (UTIs), bleeding into cysts, kidney stones, or stretching of the fibrous tissue around the kidney because of cyst growth can cause pain in the area of the kidneys.\n- High blood pressure. High blood pressure is present in about half of the people with autosomal dominant PKD and normal kidney function between the ages of 20 and 35.4 Almost 100 percent of people with kidney failure and autosomal dominant PKD have high blood pressure.1 High blood pressuregreater than 140/90 mm Hgincreases the likelihood of heart disease and stroke, as well as adding to the damage already done to the kidneys by the cysts.\n- Kidney failure. Kidney failure means the kidneys no longer work well enough to maintain health. A person with kidney failure may have the following symptoms:- little or no urination- edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face- drowsiness- fatigue, or feeling tired- generalized itching or numbness- dry skin- headaches- weight loss- appetite loss- nausea- vomiting- sleep problems- trouble concentrating- darkened skin- muscle cramps- shortness of breath- chest pain\nUntreated kidney failure can lead to coma and death. More than half of people with autosomal dominant PKD progress to kidney failure by age 70.1\n- UTIs. Kidney cysts block the flow of urine through the kidneys. Stagnant urine can set the stage for infection. Bacteria enter the urinary tract through the urethra and spread up to the kidneys. Sometimes, the kidney cysts become infected. UTIs may cause scarring in the kidneys.\n- Kidney stones. About 20 percent of people with autosomal dominant PKD have kidney stones.1 Kidney stones can block the flow of urine and cause pain.\n- Liver cysts. Liver cysts are the most common nonkidney complication of autosomal dominant PKD.1 Liver cysts generally cause no symptoms.\n- Pancreatic cysts. PKD can also cause cysts in the pancreas. Pancreatic cysts rarely cause pancreatitisinflammation, or swelling, of the pancreas.\n- Abnormal heart valves. Abnormal heart valves may occur in up to 25 percent of people with autosomal dominant PKD.1 Insufficient blood flow in the aortathe large artery that carries blood from the heartmay result from the abnormal heart valves.\n- Diverticula. Diverticula are small pouches, or sacs, that push outward through weak spots in the colon wall. This complication is more common in people with PKD who have kidney failure.1\n- Brain aneurysms. An aneurysm is a bulge in the wall of a blood vessel. Aneurysms in the brain might cause headaches that are severe or feel different from other headaches. Brain aneurysms can rupture, or break open, causing bleeding inside the skull. A ruptured aneurysm in the brain is a life-threatening condition and requires immediate medical attention." } ]

[ { "from": "human", "value": "What is (are) Polycystic Kidney Disease?" }, { "from": "gpt", "value": "Autosomal recessive PKD is a rare genetic disorder that affects the liver as well as the kidneys. The signs of autosomal recessive PKD frequently appear in the earliest months of life, even in the womb, so health care providers often call it infantile PKD. In an autosomal recessive disorder, the child has to inherit the gene mutation from both parents to have an increased likelihood for the disorder. The chance of a child inheriting autosomal recessive mutations from both parents with a gene mutation is 25 percent, or one in four. If only one parent carries the mutated gene, the child will not get the disorder, although the child may inherit the gene mutation. The child is a carrier of the disorder and can pass the gene mutation to the next generation. Genetic testing can show whether a parent or child is a carrier of the mutated gene. Autosomal recessive disorders do not typically appear in every generation of an affected family.\nThe following chart shows the chance of inheriting an autosomal recessive mutation from parents who both carry the mutated gene:\nRead more about how people inherit genetic conditions at the NLMs Genetics Home Reference." } ]

[ { "from": "human", "value": "What are the symptoms of Polycystic Kidney Disease?" }, { "from": "gpt", "value": "An early sign of autosomal recessive PKD is an enlarged kidney, seen in a fetus or an infant using ultrasound. Kidney function is crucial for early physical development, so children with autosomal recessive PKD and decreased kidney function are usually smaller-than-average size, a condition called growth failure.\nSome people with autosomal recessive PKD do not develop signs or symptoms until later in childhood or even adulthood." } ]

[ { "from": "human", "value": "What are the complications of Polycystic Kidney Disease?" }, { "from": "gpt", "value": "Babies with the most severe cases of autosomal recessive PKD often die hours or days after birth because they cannot breathe well enough to sustain life. Their lungs do not develop as they should during the prenatal period. Pressure from enlarged kidneys also contributes to breathing problems.\nChildren born with autosomal recessive PKD often develop kidney failure before reaching adulthood.\nLiver scarring occurs in all people with autosomal recessive PKD and is usually present at birth. However, liver problems tend to become more of a concern as people with autosomal recessive PKD grow older. Liver scarring can lead to progressive liver dysfunction and other problems.\nAdditional complications of autosomal recessive PKD include high blood pressure and UTIs." } ]

[ { "from": "human", "value": "How to prevent Polycystic Kidney Disease?" }, { "from": "gpt", "value": "Scientists have not yet found a way to prevent PKD. However, people with PKD may slow the progression of kidney damage caused by high blood pressure through lifestyle changes, diet, and blood pressure medications. People with PKD should be physically active 30 minutes a day most days of the week. See Eating, Diet, and Nutrition for diet advice on lowering blood pressure and slowing the progression of kidney disease in general. If lifestyle and diet changes do not control a persons blood pressure, a health care provider may prescribe one or more blood pressure medications, including ACE inhibitors or ARBs." } ]

[ { "from": "human", "value": "What to do for Polycystic Kidney Disease?" }, { "from": "gpt", "value": "A dietitian specializes in helping people who have kidney disease choose the right foods and plan healthy meals. People with any kind of kidney disease, including PKD, should talk with a dietitian about foods that should be added to their diet and foods that might be harmful.\nPKD may require diet changes for blood pressure control. Kidney disease in general also calls for certain diet changes.\nFollowing a healthy eating plan can help lower blood pressure. A health care provider may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan, which focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in sodium, which often comes from salt. The DASH eating plan\n- is low in fat and cholesterol\n- features fat-free or low-fat milk and dairy products, fish, poultry, and nuts\n- suggests less red meat, sweets, added sugars, and sugar-containing beverages\n- is rich in nutrients, protein, and fiber\nMore information about the DASH eating planis available from the National Heart, Lung, and Blood Institute.\nAs your kidneys become more damaged, you may need to eat foods that are lower in phosphorus and potassium. The health care provider will use lab tests to watch your levels.\nFoods high in potassium include\n- bananas\n- oranges\n- potatoes\n- tomatoes\nLower-potassium foods include\n- apples\n- peaches\n- carrots\n- green beans\nFoods higher in phosphorus include\n- large portions of meat, fish and dairy foods\n- bran cereals and oatmeal\n- beans and nuts\n- colas\nLower-phosphorus alternatives include\n- fresh fruits and vegetables\n- breads\n- pasta\n- rice\n- corn and rice cereals\n- light-colored sodas\nPeople with kidney disease and high blood pressure should also limit how much sodium they get to 2,300 mg or less each day.5\nPeople with CKD may need to watch how much protein they eat. Everyone needs protein. However, protein breaks down into wastes the kidneys must remove. Large amounts of protein make the kidneys work harder. High-quality proteins such as meat, fish, and eggs create fewer wastes than other sources of protein. Beans, whole grains, soy products, nuts and nut butters, and dairy products can also be good sources of protein. Most people eat more protein than they need. Eating high-quality protein and smaller portions of protein can help protect the kidneys.\nMore information about nutrition for kidney disease is provided in the NIDDK health topics:\n- Nutrition for Children with Chronic Kidney Disease\n- Nutrition for Adults with Early Chronic Kidney Disease\n- Nutrition for Adults with Advanced Chronic Kidney Disease\nThe National Kidney Disease Education Program offers a series of easy-to-read fact sheets about nutrition for people with CKD." } ]

[ { "from": "human", "value": "What to do for Polycystic Kidney Disease?" }, { "from": "gpt", "value": "- Polycystic kidney disease (PKD) is a genetic disorder that causes numerous cysts to grow in the kidneys.\n- A gene mutation, or defect, causes polycystic kidney disease.\n- Autosomal dominant PKD is the most common form of PKD and the most common inherited disorder of the kidneys.\n- Health care providers identify most cases of autosomal dominant PKD between the ages of 30 and 50.\n- The most common symptoms of PKD are pain in the back and sidesbetween the ribs and hipsand headaches. The pain can be temporary or persistent, mild or severe. Hematuriablood in the urinemay also be a sign of autosomal dominant PKD.\n- The complications of autosomal dominant PKD include the following:- pain- high blood pressure- kidney failure- urinary tract infections (UTIs)- kidney stones- liver cysts- pancreatic cysts- abnormal heart valves- diverticula- brain aneurysms- A health care provider diagnoses autosomal dominant PKD using imaging tests and genetic testing.\n- A radiologista doctor who specializes in medical imagingwill interpret the images produced by the following imaging tests:- ultrasound- computerized tomography scans- magnetic resonance imaging- Genetic testing can show whether a persons cells carry a gene mutation that causes autosomal dominant PKD. A health care provider may also use genetic testing results to determine whether someone with a family history of PKD is likely to develop the disorder in the future. Prenatal testing can diagnose autosomal recessive PKD in unborn children.\n- Although a cure for autosomal dominant PKD is not currently available, treatment can ease symptoms and prolong life.\n- Autosomal recessive PKD is a rare genetic disorder that affects the liver as well as the kidneys.\n- The complications of autosomal recessive PKD include the following:- death due to breathing problems- kidney failure- liver scarring- high blood pressure- UTIs- A health care provider diagnoses autosomal recessive PKD with ultrasound imaging, even in a fetus or newborn.\n- Treatments for autosomal recessive PKD focus on the symptoms and complications.\n- Scientists have not yet found a way to prevent PKD. However, people with PKD may slow the progression of kidney damage caused by high blood pressure through lifestyle changes, diet, and blood pressure medications.\n- People with any kind of kidney disease, including PKD, should talk with a dietitian about foods they should add to their diet and foods that might be harmful." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "You have two kidneys. The kidneys are shaped like beans. Each kidney is about the size of a fist. They are located just below your ribcage, one on each side of your spine. Your kidneys filter your blood. Each kidney is made of 1 million little filters. During every minute of every day, these filters take out waste materials that can hurt you. They also take out extra fluid from your blood. The wastes and extra fluid make urine. The urine flows from your kidneys to your bladder through tubes called ureters.The bladder stores urine until you urinate. Then, urine leaves the body through a tube called the urethra.\n*See the Pronunciation Guide for tips on how to say the the words in bold type." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "Kidney failure means your kidneys no longer filter your blood well enough to keep you healthy. Failing kidneys do a poor job of removing wastes and extra fluid from your blood. Wastes and extra fluid begin to build up. The buildup of wastes can make you sick. You may have the following symptoms:\n- ankle, face, or belly swelling\n- stomach sickness\n- throwing up\n- loss of appetite\n- loss of sense of taste\n- feeling tired\n- weakness\n- confusion\n- headaches" } ]

[ { "from": "human", "value": "What causes What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "Diabetes and high blood pressure are the most common causes of kidney failure. Other factors include heart and blood vessel disease and a family history of kidney failure. African Americans, Hispanics/Latinos, and American Indians are more likely to have kidney failure." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "The treatments for kidney failure are\n- hemodialysis\n- peritoneal dialysis\n- a kidney transplant\n- conservative management" } ]

[ { "from": "human", "value": "What is (are) What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "Hemodialysis is a treatment for kidney failure that is done in a center several times per week. Some people learn to do hemodialysis in their homes. Hemodialysis uses a machine to filter your blood when your kidneys are too sick to filter any more. With hemodialysis, your blood is filtered outside of your body. Unfiltered blood is removed from the body and flows to the dialyzer to be cleaned. Filtered blood flows back to the body. First, a dialysis nurse places two needles into your arm. A pump on the hemodialysis machine draws your blood through one of the needles into a tube. The tube takes the blood to a filter, called a dialyzer. Inside the dialyzer, your blood flows through thin fibers that are like straws. The wastes and extra fluid leave the blood through tiny holes in the fibers. Then, a different tube carries the filtered blood back to your body through the second needle. The hemodialysis machine throws out the wastes and extra fluid, just like how your body makes urine. Hemodialysis does not make the kidneys better. However, it may help you feel better by filtering your blood when your kidneys fail." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "Peritoneal dialysis uses the lining of your belly to filter your blood inside your body. You can do peritoneal dialysis at home because it uses your body to filter. A doctor will place a soft tube called a catheter in your belly a few weeks before you start treatment. The catheter stays in your belly permanently.\nThe catheter lets you put a kind of salty water from a plastic bag into your belly. Then, you can move around and go about your day. While the salty water is inside your belly, it soaks up wastes and extra fluid from your body. After a few hours, you drain the salty water from your belly into a drain bag. The salty water removes wastes and extra fluid from your body. The salty water can be thrown away into a toilet or tub. Then you start over with a fresh bag of salty water. You will empty and fill your belly four to six times a day.\nThe salty water is always in your belly soaking up wastes and extra fluid. Peritoneal dialysis does not make the kidneys better. However, it may help you feel better by filtering your blood when your kidneys fail.\nIs dialysis a cure for kidney failure? No. Hemodialysis and peritoneal dialysis help you feel better and live longer; however, they do not cure kidney failure. Although people with kidney failure are now living longer than ever, over the years kidney disease can cause problems such as heart disease, bone disease, arthritis, nerve damage, infertility, and malnutrition. These problems wont go away with dialysis; however, doctors now have new and better ways to prevent or treat them. You should discuss these problems and their treatments with your doctor." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "A kidney transplant places a healthy kidney from another person into your body. The kidney may come from someone who has just died. Your doctor will place your name on a waiting list for a kidney. A family member or friend might be able to give you a kidney. Then you dont have to wait.\nOnce it is placed inside your body, the new kidney takes over filtering your blood. The damaged kidneys usually stay where they are. The new kidney is placed in the front-lower abdomen, on one side of the bladder. Your body normally attacks anything that shouldnt be there, such as bacteria. The body will think the new kidney shouldnt be there. You will take medicines called immunosuppressants to keep your body from attacking the new kidney.\nMore information is provided in the NIDDK health topics:\n- Treatment Methods for Kidney Failure: Hemodialysis\n- Home Hemodialysis\n- Treatment Methods for Kidney Failure: Peritoneal Dialysis\n- Treatment Methods for Kidney Failure: Transplantation" } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "Conservative management means your doctors take care of you without dialysis or a transplant. The doctors may give you medicines that make you feel more comfortable. You can have conservative management in your home. You may want to go to a hospice, a special place where you receive nursing care. Some people choose conservative management when dialysis or a transplant would not help them live longer or would make them suffer longer. Without dialysis or a transplant, you may live for a few weeks or several months." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "If you have kidney failure, learn about the treatments and think about which one best fits you. Talk with people who are on hemodialysis or peritoneal dialysis. Ask what is good and bad about each treatment. If you make a choice and find you dont like it, talk with your doctor about trying something else. Ask your doctor about the transplant waiting list and the medicines needed after a transplant. Talk with people who have had kidney transplants and ask how it has changed their lives.\nIf you plan to keep working, think about which treatment choice would make working easier. If spending time with family and friends means a lot to you, ask which treatment gives you the most free time. Find out which treatment will give you the best chance to be healthy and live longer.\nIf you are thinking about conservative management, you may wish to speak with your family, friends, doctor, or mental health counselor as you decide.\nYou can take control of your care by talking with your doctor. You may need time to get used to your new treatment. Kidney failure can make your life harder. Treatments can help improve your life." } ]

[ { "from": "human", "value": "What to do for What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "Eating healthy foods can help you keep up your energy and strength. All dialysis and transplant centers have a dietitian. The dietitian helps people with kidney failure learn about healthy food choices. You should talk with your centers dietitian to make a meal plan.\nThe best diet for you will depend on which kidney failure treatment you choose after talking with your doctor.\n- Hemodialysis- Limit how much liquid and water you drink. Fluid can build up in your body between hemodialysis sessions. Also, many foods contain water. The extra fluid in your body can cause swelling and high blood pressure. Extra fluid in your body makes your heart work harder.\n-- Limit sodium, or salt. Watch out for sodium in frozen foods and prepared meals. You can also find sodium in canned foods, hot dogs, and fast food. Sodium makes you thirsty, which makes you drink more water and other liquids than you should.\n- Read more in the National Kidney Disease Education Program (NKDEP) fact sheet Sodium.\n- Limit potassium. Potassium is found in many fruits and vegetables such as potatoes, tomatoes, oranges, and bananas. Too much potassium can make your heart beat unevenly. Hemodialysis does not remove potassium from your body well.\n- Read more in the NKDEP fact sheet Potassium.\n- Eat protein-rich foods such as meat, fish, and eggs. Hemodialysis removes protein from your body.\n- Read more in the NKDEP fact sheet Protein.\n- Limit phosphorus. Phosphorus helps your bones, blood vessels, and muscles work.\n- However, too much phosphorus can make your bones weak. Limiting phosphorus can be hard. Foods that contain phosphorus, such as meat and milk, also contain protein that you need. You should be careful to eat enough protein, yet not so much that you get too much phosphorus. You can avoid other foods that contain phosphorus, such as cola, tea, beans, and nuts.\n- Read more in the NKDEP fact sheet Phosphorus.\n- Find healthy ways to add calories to your diet. Calories are found in all foods and give your body energy. Many people on hemodialysis do not have a good appetite and do not get enough calories. Vegetable oils are good sources of calories. Vegetable oils include olive oil, canola oil, and safflower oil. Use them on breads, rice, and noodles. Hard candy, sugar, honey, jam, and jelly provide calories and energy. However, if you have diabetes, speak with your doctor or dietitian before eating extra sweets.\n- More information about nutrition for people who are on hemodialysis is provided in the NIDDK health topic, Eat Right to Feel Right on Hemodialysis.\n- Peritoneal dialysis- Drink as much water and other liquids as you need. If you are holding too much fluid or too little fluid, your doctor needs to know.\n- Limit sodium to control your thirst and help prevent heart problems. You can use spices other than salt to flavor your food.\n-- You may need to eat more potassium-rich foods. Peritoneal dialysis removes potassium from your body. Talk with your doctor or dietitian about the right amount of potassium for you.\n- Eat protein-rich foods. Peritoneal dialysis removes even more protein from your body than hemodialysis.\n- Limit phosphorus to keep your bones strong.\n- You may need to limit your calorie intake. The salty water also contains some sugar. Your body absorbs the sugar, which can cause you to gain weight.\n- Kidney transplant- Limit sodium to help prevent heart problems.\n- You should be able to eat normal amounts of phosphorus and potassium. You may need to adjust the amounts if blood tests show a problem.\n-- Eat protein-rich foods to repair muscle breakdown and protect against infection.\n- You may need to limit your calories. The medicines you take can make you gain weight.\n- Conservative management- Limit protein to prevent the buildup of wastes in your blood.\nYou may have other needs and limits, depending on how well your treatments work." } ]

[ { "from": "human", "value": "What to do for What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "- Kidney failure means your kidneys no longer filter your blood well enough to keep you healthy.\n- The treatments for kidney failure are- hemodialysis- peritoneal dialysis- a kidney transplant- conservative management- Hemodialysis uses a machine to filter your blood when your kidneys are too sick to filter any more.\n- Peritoneal dialysis uses the lining of your belly to filter your blood inside your body.\n- A kidney transplant places a healthy kidney from another person into your body.\n- Conservative management means your doctors take care of you without dialysis or a transplant. The doctors may give you medicines that make you feel more comfortable.\n- All dialysis and transplant centers have a dietitian. The dietitian helps people with kidney failure learn about healthy food choices." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Kidney Failure and How Its Treated?" }, { "from": "gpt", "value": "You and your doctor will work together to choose a treatment that's best for you. The publications of the NIDDK Kidney Failure Series can help you learn about the specific issues you will face.\nBooklets\n- What I need to know about Kidney Failure and How its Treated\n- Treatment Methods for Kidney Failure: Hemodialysis\n- Treatment Methods for Kidney Failure: Peritoneal Dialysis\n- Treatment Methods for Kidney Failure: Kidney Transplantation\n- Kidney Failure: Eat Right to Feel Right on Hemodialysis\nFact Sheets\n- Kidney Failure: What to Expect\n- Vascular Access for Hemodialysis\n- Hemodialysis Dose and Adequacy\n- Peritoneal Dialysis Dose and Adequacy\n- Amyloidosis and Kidney Disease\n- Anemia in Chronic Kidney Disease\n- Chronic Kidney Disease-Mineral and Bone Disorder\n- Financial Help for Treatment of Kidney Failure\nLearning as much as you can about your treatment will help make you an important member of your health care team.\nThis content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.\nThe NIDDK would like to thank: Neil R. Powe, M.D., M.P.H., M.B.A., University of California, San Francisco; Delphine Tuot, M.D.C.M., M.A.S., University of California, San Francisco; Vicki McClelland and Brian Testerman, both of the Free Medical Clinic of Northern Shenandoah Valley in Winchester, VA\nThis information is not copyrighted. The NIDDK encourages people to share this content freely.\nSeptember 2014" } ]

[ { "from": "human", "value": "What is (are) Perineal Injury in Males?" }, { "from": "gpt", "value": "Perineal injury is an injury to the perineum, the part of the body between the anus and the genitals, or sex organs. In males, the perineum is the area between the anus and the scrotum, the external pouch of skin that holds the testicles. Injuries to the perineum can happen suddenly, as in an accident, or gradually, as the result of an activity that persistently puts pressure on the perineum. Sudden damage to the perineum is called an acute injury, while gradual damage is called a chronic injury." } ]

[ { "from": "human", "value": "What are the complications of Perineal Injury in Males?" }, { "from": "gpt", "value": "Injury to the blood vessels, nerves, and muscles in the perineum can lead to complications such as\n- bladder control problems\n- sexual problems\nBladder control problems. The nerves in the perineum carry signals from the bladder to the spinal cord and brain, telling the brain when the bladder is full. Those same nerves carry signals from the brain to the bladder and pelvic floor muscles, directing those muscles to hold or release urine. Injury to those nerves can block or interfere with the signals, causing the bladder to squeeze at the wrong time or not to squeeze at all. Damage to the pelvic floor muscles can cause bladder and bowel control problems.\nSexual problems. The perineal nerves also carry signals between the genitals and the brain. Injury to those nerves can interfere with the sensations of sexual contact.\nSignals from the brain direct the smooth muscles in the genitals to relax, causing greater blood flow into the penis. In men, damaged blood vessels can cause erectile dysfunction (ED), the inability to achieve or maintain an erection firm enough for sexual intercourse. An internal portion of the penis runs through the perineum and contains a section of the urethra. As a result, damage to the perineum may also injure the penis and urethra." } ]

[ { "from": "human", "value": "What causes Perineal Injury in Males?" }, { "from": "gpt", "value": "Common causes of acute perineal injury in males include\n- perineal surgery\n- straddle injuries\n- sexual abuse\n- impalement\nPerineal Surgery\nAcute perineal injury may result from surgical procedures that require an incision in the perineum:\n- A prostatectomy is the surgical removal of the prostate to treat prostate cancer. The prostate, a walnut-shaped gland in men, surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen. The surgeon chooses the location for the incision based on the patients physical characteristics, such as size and weight, and the surgeons experience and preferences. In one approach, called the radical perineal prostatectomy, the surgeon makes an incision between the scrotum and the anus. In a retropubic prostatectomy, the surgeon makes the incision in the lower abdomen, just above the penis. Both approaches can damage blood vessels and nerves affecting sexual function and bladder control.\n- Perineal urethroplasty is surgery to repair stricture, or narrowing, of the portion of the urethra that runs through the perineum. Without this procedure, some men would not be able to pass urine. However, the procedure does require an incision in the perineum, which can damage blood vessels or nerves.\n- Colorectal or anal cancer surgery can injure the perineum by cutting through some of the muscle around the anus to remove a tumor. One approach to anal cancer surgery involves making incisions in the abdomen and the perineum.\nSurgeons try to avoid procedures that damage a persons blood vessels, perineal nerves, and muscles. However, sometimes a perineal incision may achieve the best angle to remove a life-threatening cancer.\nPeople should discuss the risks of any planned surgery with their health care provider so they can make an informed decision and understand what to expect after the operation.\nStraddle Injuries\nStraddle injuries result from falls onto objects such as metal bars, pipes, or wooden rails, where the persons legs are on either side of the object and the perineum strikes the object forcefully. These injuries include motorcycle and bike riding accidents, saddle horn injuries during horseback riding, falls on playground equipment such as monkey bars, and gymnastic accidents on an apparatus such as the parallel bars or pommel horse.\nIn rare situations, a blunt injury to the perineum may burst a blood vessel inside the erectile tissue of the penis, causing a persistent partial erection that can last for days to years. This condition is called high-flow priapism. If not treated, ED may result.\nSexual Abuse\nForceful and inappropriate sexual contact can result in perineal injury. When health care providers evaluate injuries in the genital area, they should consider the possibility of sexual abuse, even if the person or family members say the injury is the result of an accident such as a straddle injury. The law requires that health care providers report cases of sexual abuse that come to their attention. The person and family members should understand the health care provider may ask some uncomfortable questions about the circumstances of the injury.\nImpalement\nImpalement injuries may involve metal fence posts, rods, or weapons that pierce the perineum. Impalement is rare, although it may occur where moving equipment and pointed tools are in use, such as on farms or construction sites. Impalement can also occur as the result of a fall, such as from a tree or playground equipment, onto something sharp. Impalement injuries are most common in combat situations. If an impalement injury pierces the skin and muscles, the injured person needs immediate medical attention to minimize blood loss and repair the injury." } ]

[ { "from": "human", "value": "What causes Perineal Injury in Males?" }, { "from": "gpt", "value": "Chronic perineal injury most often results from a job-or sport-related practicesuch as bike, motorcycle, or horseback ridingor a long-term condition such as chronic constipation.\nBike Riding\nSitting on a narrow, saddle-style bike seatwhich has a protruding nose in the frontplaces far more pressure on the perineum than sitting in a regular chair. In a regular chair, the flesh and bone of the buttocks partially absorb the pressure of sitting, and the pressure occurs farther toward the back than on a bike seat. The straddling position on a narrow seat pinches the perineal blood vessels and nerves, possibly causing blood vessel and nerve damage over time. Research shows wider, noseless seats reduce perineal pressure.1\nOccasional bike riding for short periods of time may pose no risk. However, men who ride bikes several hours a weeksuch as competitive bicyclists, bicycle couriers, and bicycle patrol officershave a significantly higher risk of developing mild to severe ED.2 The ED may be caused by repetitive pressure on blood vessels, which constricts them and results in plaque buildup in the vessels.\nOther activities that involve riding saddle-style include motorcycle and horseback riding. Researchers have studied bike riding more extensively than these other activities; however, the few studies published regarding motorcycle and horseback riding suggest motorcycle riding increases the risk of ED and urinary symptoms.3 Horseback riding appears relatively safe in terms of chronic injury,4 although the action of bouncing up and down, repeatedly striking the perineum, has the potential for causing damage.\nConstipation\nConstipation is defined as having a bowel movement fewer than three times per week. People with constipation usually have hard, dry stools that are small in size and difficult to pass. Some people with constipation need to strain to pass stools. This straining creates internal pressure that squeezes the perineum and can damage the perineal blood vessels and nerves. More information is provided in the NIDDK health topic, Constipation." } ]

[ { "from": "human", "value": "Who is at risk for Perineal Injury in Males??" }, { "from": "gpt", "value": "Men who have perineal surgery are most likely to have an acute perineal injury. Straddle injuries are most common among people who ride motorcycles, bikes, or horses and children who use playground equipment. Impalement injuries are most common in military personnel engaged in combat. Impalement injuries can also occur in construction or farm workers.\nChronic perineal injuries are most common in people who ride bikes as part of a job or sport, or in people with constipation." } ]

[ { "from": "human", "value": "What are the treatments for Perineal Injury in Males?" }, { "from": "gpt", "value": "Treatments for perineal injury vary with the severity and type of injury. Tears or incisions may require stitches. Traumatic or piercing injuries may require surgery to repair damaged pelvic floor muscles, blood vessels, and nerves. Treatment for these acute injuries may also include antibiotics to prevent infection. After a health care provider stabilizes an acute injury so blood loss is no longer a concern, a person may still face some long-term effects of the injury, such as bladder control and sexual function problems. A health care provider can treat high-flow priapism caused by a blunt injury to the perineum with medication, blockage of the burst blood vessel under x-ray guidance, or surgery.\nIn people with a chronic perineal injury, a health care provider will treat the complications of the condition. More information is provided in the NIDDK health topics:\n- Erectile Dysfunction\n- Urinary Incontinence in Men\nMore information about the lower urinary tract is provided in the NIDDK health topic, The Urinary Tract and How It Works." } ]

[ { "from": "human", "value": "How to prevent Perineal Injury in Males?" }, { "from": "gpt", "value": "Preventing perineal injury requires being aware of and taking steps to minimize the dangers of activities such as construction work or bike riding:\n- People should talk with their health care provider about the benefits and risks of perineal surgery well before the operation.\n- People who play or work around moving equipment or sharp objects should wear protective gear whenever possible.\n- People who ride bikes, motorcycles, or horses should find seats or saddles designed to place the most pressure on the buttocks and minimize pressure on the perineum. Many health care providers advise bike riders to use noseless bike seats and to ride in an upright position rather than lean over the handle bars. The National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention, recommends noseless seats for people who ride bikes as part of their job.1\n- People with constipation should talk with their health care provider about whether to take a laxative or stool softener to minimize straining during a bowel movement." } ]

[ { "from": "human", "value": "What to do for Perineal Injury in Males?" }, { "from": "gpt", "value": "To prevent constipation, a diet with 20 to 35 grams of fiber each day helps the body form soft, bulky stool that is easier to pass. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, brussels sprouts, cabbage, and carrots. For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important. A health care provider can give information about how changes in eating, diet, and nutrition could help with constipation." } ]

[ { "from": "human", "value": "What to do for Perineal Injury in Males?" }, { "from": "gpt", "value": "- Perineal injury is an injury to the perineum, the part of the body between the anus and the genitals, or sex organs. In males, the perineum is the area between the anus and the scrotum, the external pouch of skin that holds the testicles.\n- Injury to the blood vessels, nerves, and muscles in the perineum can lead to complications such as- bladder control problems- sexual problems- Common causes of acute perineal injury in males include- perineal surgery- straddle injuries- sexual abuse- impalement- Chronic perineal injury most often results from a job- or sport-related practicesuch as bike, motorcycle, or horseback ridingor a long-term condition such as chronic constipation.\n- Traumatic or piercing injuries may require surgery to repair damaged pelvic floor muscles, blood vessels, and nerves. Treatment for these acute injuries may also include antibiotics to prevent infection.\n- In people with a chronic perineal injury, a health care provider will treat the complications of the condition, such as erectile dysfunction (ED) and urinary incontinence.\n- Preventing perineal injury requires being aware of and taking steps to minimize the dangers of activities such as construction work or bike riding.\n- The National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention, recommends noseless seats for people who ride bikes as part of their job." } ]

[ { "from": "human", "value": "What is (are) Ectopic Kidney?" }, { "from": "gpt", "value": "An ectopic kidney is a birth defect in which a kidney is located below, above, or on the opposite side of its usual position. About one in 900 people has an ectopic kidney.1" } ]

[ { "from": "human", "value": "What is (are) Ectopic Kidney?" }, { "from": "gpt", "value": "The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine a person produces each day. The urine flows to the bladder through tubes called ureters where it is stored until being released through urination." } ]

[ { "from": "human", "value": "What causes Ectopic Kidney?" }, { "from": "gpt", "value": "During fetal development, a babys kidneys first appear as buds inside the pelvisthe bowl-shaped bone that supports the spine and holds up the digestive, urinary, and reproductive organsnear the bladder. As the kidneys develop, they move gradually toward their usual position in the back near the rib cage. Sometimes, one of the kidneys remains in the pelvis or stops moving before it reaches its usual position. In other cases, the kidney moves higher than the usual position. Rarely does a child have two ectopic kidneys.\nMost kidneys move toward the rib cage, but one may cross over so that both kidneys are on the same side of the body. When a crossover occurs, the two kidneys often grow together and become fused.\nFactors that may lead to an ectopic kidney include\n- poor development of a kidney bud\n- a defect in the kidney tissue responsible for prompting the kidney to move to its usual position\n- genetic abnormalities\n- the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects" } ]

[ { "from": "human", "value": "What are the symptoms of Ectopic Kidney?" }, { "from": "gpt", "value": "An ectopic kidney may not cause any symptoms and may function normally, even though it is not in its usual position. Many people have an ectopic kidney and do not discover it until they have tests done for other reasons. Sometimes, a health care provider may discover an ectopic kidney after feeling a lump in the abdomen during an examination. In other cases, an ectopic kidney may cause abdominal pain or urinary problems." } ]

[ { "from": "human", "value": "What are the complications of Ectopic Kidney?" }, { "from": "gpt", "value": "Possible complications of an ectopic kidney include problems with urine drainage from that kidney. Sometimes, urine can even flow backwards from the bladder to the kidney, a problem called vesicoureteral reflux (VUR). More information about VUR is provided in the NIDDK health topic, Vesicoureteral Reflux.\nAbnormal urine flow and the placement of the ectopic kidney can lead to various problems:\n- Infection. Normally, urine flow washes out bacteria and keeps them from growing in the kidneys and urinary tract. When a kidney is out of the usual position, urine may get trapped in the ureter or in the kidney itself. Urine that remains in the urinary tract gives bacteria the chance to grow and spread. Symptoms of a urinary tract infection include frequent or painful urination, back or abdominal pain, fever, chills, and cloudy or foul-smelling urine.\n- Stones. Urinary stones form from substances found in the urine, such as calcium and oxalate. When urine remains in the urinary tract for too long, the risk that these substances will have time to form stones is increased. Symptoms of urinary stones include extreme pain in the back, side, or pelvis; blood in the urine; fever or chills; vomiting; and a burning feeling during urination.\n- Kidney damage. If urine backs up all the way to the kidney, damage to the kidney can occur. As a result, the kidney cant filter wastes and extra water from the blood. One ectopic kidney, even when it has no function, will not cause kidney failure. The other kidney can usually perform the functions of two healthy kidneys. Total kidney failure happens only in rare cases when both kidneys are damaged.\n- Trauma. If the ectopic kidney is in the lower abdomen or pelvis, it may be susceptible to injury from blunt trauma. People with an ectopic kidney who want to participate in body contact sports may want to wear protective gear." } ]

[ { "from": "human", "value": "How to diagnose Ectopic Kidney?" }, { "from": "gpt", "value": "A health care provider may use one or more of the following imaging tests to diagnose an ectopic kidney:\n- Ultrasound. An 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 radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show the location of the kidneys.\n- Intravenous pyelogram (IVP). An IVP is an x ray of the urinary tract. A special dye, called contrast medium, is injected into a vein in the persons arm, travels through the body to the kidneys, and makes urine visible on the x ray. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician, and the images are interpreted by a radiologist; anesthesia is not needed. An IVP can show a blockage in the urinary tract. In children, ultrasounds are usually done instead of IVPs.\n- Voiding cystourethrogram (VCUG). A VCUG is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The bladder and urethra are filled with contrast medium to make the structures clearly visible on the x-ray images. The x-ray machine captures images of the contrast medium while the bladder is full and when the person urinates. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician supervised by a radiologist, who then interprets the images. Anesthesia is not needed, but sedation may be used for some people. The test can show abnormalities of the inside of the urethra and bladder and whether urine is backing up toward the kidneys during urination.\n- Radionuclide scan. A radionuclide scan is an imaging technique that relies on the detection of small amounts of radiation after injection of radioactive chemicals. Because the dose of the radioactive chemicals is small, the risk of causing damage to cells is low. Special cameras and computers are used to create images of the radioactive chemicals as they pass through the kidneys. 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. This test can show the location of an ectopic kidney and whether the ureters are blocked.\n- Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include the injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines are designed to allow the person to lie in a more open space. The procedure is performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed though light sedation may be used for people with a fear of confined spaces. MRIs can show the location of the kidneys.\nIn addition to imaging tests, blood tests may be done to determine how well the kidneys are working. These tests are almost always normal in people with an ectopic kidney, even if it is badly damaged, because the other kidney usually has completely normal function." } ]

[ { "from": "human", "value": "What are the treatments for Ectopic Kidney?" }, { "from": "gpt", "value": "No treatment for an ectopic kidney is needed if urinary function is normal and no blockage of the urinary tract is present.\nIf tests show an obstruction, surgery may be needed to correct the position of the kidney to allow for better drainage of urine. Reflux can be corrected by surgery to alter the ureter or injection of a gellike liquid into the bladder wall near the opening of the ureter.\nIf extensive kidney damage has occurred, surgery may be needed to remove the kidney. As long as the other kidney is working properly, losing one kidney should have no adverse health effects. More information is provided in the NIDDK health topic, Solitary Kidney.\nWith the right testing and treatment, if needed, an ectopic kidney should cause no serious long-term health problems." } ]

[ { "from": "human", "value": "What to do for Ectopic Kidney?" }, { "from": "gpt", "value": "Eating, diet, and nutrition have not been shown to play a role in causing or preventing an ectopic kidney." } ]

[ { "from": "human", "value": "What to do for Ectopic Kidney?" }, { "from": "gpt", "value": "- An ectopic kidney is a birth defect in which a kidney is located below, above, or on the opposite side of its usual position.\n- Factors that may lead to an ectopic kidney include- poor development of a kidney bud- a defect in the kidney tissue responsible for prompting the kidney to move to its usual position- genetic abnormalities- the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects- An ectopic kidney may not cause any symptoms and may function normally, even though it is not in its usual position.\n- Possible complications of an ectopic kidney include problems with urine drainage from that kidney. Abnormal urine flow and the placement of the ectopic kidney can lead to various problems such as infection, stones, kidney damage, and injury from trauma.\n- No treatment for an ectopic kidney is needed if urinary function is normal and no blockage of the urinary tract is present. Surgery or other treatment may be needed if there is an obstruction, reflux, or extensive damage to the kidney." } ]

[ { "from": "human", "value": "What is (are) Multiple Endocrine Neoplasia Type 1?" }, { "from": "gpt", "value": "MEN1 is an inherited disorder that causes tumors in the endocrine glands and the duodenum, the first part of the small intestine. MEN1 is sometimes called multiple endocrine adenomatosis or Wermer's syndrome, after one of the first doctors to recognize it. MEN1 is rare, occurring in about one in 30,000 people.1 The disorder affects both sexes equally and shows no geographical, racial, or ethnic preferences.\nEndocrine glands release hormones into the bloodstream. Hormones are powerful chemicals that travel through the blood, controlling and instructing the functions of various organs. Normally, the hormones released by endocrine glands are carefully balanced to meet the body's needs.\nIn people with MEN1, multiple endocrine glands form tumors and become hormonally overactive, often at the same time. The overactive glands may include the parathyroids, pancreas, or pituitary. Most people who develop overactivity of only one endocrine gland do not have MEN1." } ]

[ { "from": "human", "value": "What to do for Multiple Endocrine Neoplasia Type 1?" }, { "from": "gpt", "value": "- Multiple endocrine neoplasia type 1 (MEN1) is an inherited disorder that causes hormone-secreting tumors in the duodenum and the endocrine glands-most often the parathyroid, pancreas, and pituitary.\n- Overactive parathyroid glands can lead to tiredness, weakness, muscle or bone pain, constipation, indigestion, kidney stones, or thinning of bones.\n- Pancreatic and duodenal endocrine tumors called gastrinomas can cause dangerous stomach or intestinal ulcers.\n- Pituitary tumors called prolactinomas can cause excessive production of breast milk or interfere with fertility in women or with sex drive and fertility in men.\n- Although many tumors associated with MEN1 are benign, about half of people with MEN1 will eventually develop a cancerous tumor.\n- MEN1 carriers can be detected through gene testing or other laboratory tests.\n- MEN1 cannot be cured, but regular testing can detect the problems caused by MEN1 tumors many years before serious complications develop. Careful monitoring enables doctors to adjust an individual's treatment as needed." } ]

[ { "from": "human", "value": "What is (are) Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "Hematuria is blood in the urine. Two types of blood in the urine exist. Blood that can be seen in the urine is called gross hematuria. Blood that cannot be seen in the urine, except when examined with a microscope, is called microscopic hematuria." } ]

[ { "from": "human", "value": "What are the symptoms of Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "Most people with microscopic hematuria do not have symptoms. People with gross hematuria have urine that is pink, red, or cola-colored due to the presence of red blood cells (RBCs). Even a small amount of blood in the urine can cause urine to change color. In most cases, people with gross hematuria do not have other symptoms. However, people with gross hematuria that includes blood clots in the urine may have pain." } ]

[ { "from": "human", "value": "What is (are) Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every day, the two kidneys process about 200 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra water. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder." } ]

[ { "from": "human", "value": "What causes Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "Hematuria can be caused by menstruation, vigorous exercise, sexual activity, viral illness, trauma, or infection, such as a urinary tract infection (UTI). More serious causes of hematuria include\n- cancer of the kidney or bladder\n- inflammation of the kidney, urethra, bladder, or prostatea walnut-shaped gland in men that surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen\n- polycystic kidney diseasean inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time, taking over and destroying working kidney tissue\n- blood clots\n- blood clotting disorders, such as hemophilia\n- sickle cell diseasean inherited disorder in which RBCs form an abnormal crescent shape, resulting in less oxygen delivered to the bodys tissues, clogging of small blood vessels, and disruption of healthy blood flow" } ]

[ { "from": "human", "value": "Who is at risk for Hematuria (Blood in the Urine)??" }, { "from": "gpt", "value": "Almost anyone, including children and teens, can have hematuria. Factors that increase the chance a person will have hematuria include\n- a family history of kidney disease\n- an enlarged prostate, which typically occurs in men age 50 or older\n- urinary stone disease\n- certain medications including aspirin and other pain relievers, blood thinners, and antibiotics\n- strenuous exercise such as long-distance running\n- a recent bacterial or viral infection" } ]

[ { "from": "human", "value": "How to diagnose Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "Hematuria is diagnosed with urinalysis, which is testing of a urine sample. The urine sample is collected in a special container in a health care providers office or commercial facility and can be tested in the same location or sent to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color when RBCs are present in urine. When blood is visible in the urine or a dipstick test of the urine indicates the presence of RBCs, a health care provider examines the urine with a microscope to make an initial diagnosis of hematuria. The next step is to diagnose the cause of the hematuria.\nThe health care provider will take a thorough medical history. If the history suggests a cause that does not require treatment, the urine should be tested again after 48 hours for the presence of RBCs. If two of three urine samples show too many RBCs when viewed with a microscope, more serious causes should be explored. The health care provider may order one or more of the following tests:\n- Urinalysis. Further testing of the urine may be done to check for problems that can cause hematuria, such as infection, kidney disease, and cancer. The presence of white blood cells signals a UTI. RBCs that are misshapen or clumped together to form little tubes, called casts, may indicate kidney disease. Large amounts of protein in the urine, called proteinuria, may also indicate kidney disease. The urine can also be tested for the presence of cancer cells.\n- Blood test. A blood test involves drawing blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. A blood test can show the presence of high levels of creatinine, a waste product of normal muscle breakdown, which may indicate kidney disease.\n- Biopsy. A biopsy is a procedure that involves taking a piece of kidney tissue for examination with a microscope. The biopsyis performed by a health care provider in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography (CT) scan to guide the biopsy needle into the kidney. The kidney tissue is examined in a lab by a pathologista doctor who specializes in diagnosing diseases. The test helps diagnose the type of kidney disease causing hematuria.\n- Cystoscopy. Cystoscopy is a procedure that uses a tubelike instrument to look inside the urethra and bladder. Cystoscopy is performed by a health care provider in the office, an outpatient facility, or a hospital with local anesthesia. However, in some cases, sedation and regional or general anesthesia are needed. Cystoscopy may be used to look for cancer cells in the bladder, particularly if cancer cells are found with urinalysis. More information is provided in the NIDDK health topic,Cystoscopy and Ureteroscopy.\n- Kidney imaging tests. Intravenous pyelogram (IVP) is an x ray of the urinary tract. A special dye, called contrast medium, is injected into a vein in the persons arm, travels through the body to the kidneys, and makes urine visible on the x ray. The contrast medium also shows any blockage in the urinary tract. When a small mass is found with IVP, another imaging test, such as an ultrasound, CT scan, or magnetic resonance imaging (MRI), can be used to further study the mass. Imaging tests are performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Anesthesia is not needed, though light sedation may be used in some cases. Imaging tests may show a tumor, a kidney or bladder stone, an enlarged prostate, or other blockage of the normal flow of urine. More information is provided in the NIDDK health topic, Imaging of the Urinary Tract." } ]

[ { "from": "human", "value": "What are the treatments for Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "Hematuria is treated by treating its underlying cause. If no serious condition is causing hematuria, no treatment is needed. Hematuria caused by a UTI is treated with antibiotics; urinalysis should be repeated 6 weeks after antibiotic treatment ends to be sure the infection has resolved." } ]

[ { "from": "human", "value": "What to do for Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "Eating, diet, and nutrition have not been shown to play a role in causing or preventing hematuria." } ]

[ { "from": "human", "value": "What to do for Hematuria (Blood in the Urine)?" }, { "from": "gpt", "value": "- Hematuria is blood in the urine.\n- Most people with microscopic hematuria do not have symptoms. People with gross hematuria have urine that is pink, red, or cola-colored due to the presence of red blood cells (RBCs).\n- Hematuria can be caused by menstruation, vigorous exercise, sexual activity, viral illness, trauma, or infection, such as a urinary tract infection (UTI). More serious causes of hematuria include- cancer of the kidney or bladder- inflammation of the kidney, urethra, bladder, or prostate- polycystic kidney disease- blood clots- blood clotting disorders, such as hemophilia- sickle cell disease- When blood is visible in the urine or a dipstick test of the urine indicates the presence of RBCs, the urine is examined with a microscope to make an initial diagnosis of hematuria. The next step is to diagnose the cause of the hematuria.\n- If a thorough medical history suggests a cause that does not require treatment, the urine should be tested again after 48 hours for the presence of RBCs. If two of three urine samples show too many RBCs when viewed with a microscope, more serious causes should be explored.\n- One or more of the following tests may be ordered: urinalysis, blood test, biopsy, cytoscopy, and kidney imaging tests.\n- Hematuria is treated by treating its underlying cause." } ]

[ { "from": "human", "value": "What is (are) Urine Blockage in Newborns?" }, { "from": "gpt", "value": "The urinary tract is the bodys drainage system for removing wastes and extra fluid. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. 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 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. The amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.\nThe kidneys and urinary system keep fluids and natural chemicals in the body balanced. While a baby is developing in the mothers womb, called prenatal development, the placentaa temporary organ joining mother and babycontrols much of that balance. The babys kidneys begin to produce urine at about 10 to 12 weeks after conception. However, the mothers placenta continues to do most of the work until the last few weeks of the pregnancy. Wastes and extra water are removed from the babys body through the umbilical cord. The babys urine is released into the amniotic sac and becomes part of the amniotic fluid. This fluid plays a role in the babys lung development." } ]

[ { "from": "human", "value": "What causes Urine Blockage in Newborns?" }, { "from": "gpt", "value": "Many types of defects in the urinary tract can cause urine blockage:\n- Vesicoureteral reflux (VUR). Most children with VUR are born with a ureter that did not grow long enough during development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine backs uprefluxesfrom the bladder to the ureter and eventually to the kidney. Severe reflux may prevent a kidney from developing normally and may increase the risk for damage from infections after birth. VUR usually affects only one ureter and kidney, though it can affect both ureters and kidneys.\n- Ureteropelvic junction (UPJ) obstruction. If urine is blocked where the ureter joins the kidney, only the kidney swells. The ureter remains a normal size. UPJ obstruction usually occurs in only one kidney.\n- Bladder outlet obstruction (BOO). BOO describes any blockage in the urethra or at the opening of the bladder.Posterior urethral valves (PUV), the most common form of BOO seen in newborns and during prenatal ultrasound exams, is a birth defect in boys in which an abnormal fold of tissue in the urethra keeps urine from flowing freely out of the bladder. This defect may cause swelling in the entire urinary tract, including the urethra, bladder, ureters, and kidneys.\n- Ureterocele. If the end of the ureter does not develop normally, it can bulge, creating a ureterocele. The ureterocele may obstruct part of the ureter or the bladder.\nSome babies are born with genetic conditions that affect several different systems in the body, including the urinary tract:\n- Prune belly syndrome (PBS). PBS is a group of birth defects involving poor development of the abdominal muscles, enlargement of the ureters and bladder, and both testicles remaining inside the body instead of descending into the scrotum. The skin over the abdomen is wrinkled, giving the appearance of a prune. PBS usually occurs in boys, and most children with PBS have hydronephrosisswelling in the kidneyand VUR.\n- Esophageal atresia (EA). EA is a birth defect in which the esophagusthe muscular tube that carries food and liquids from the mouth to the stomachlacks the opening for food to pass into the stomach. Babies born with EA may also have problems with their spinal columns, digestive systems, hearts, and urinary tracts.\n- Congenital heart defects. Heart defects range from mild to life threatening. Children born with heart defects also have a higher rate of problems in the urinary tract than children in the general population, suggesting that some types of heart and urinary defects may have a common genetic cause.\nUrine blockage can also be caused by spina bifida and other birth defects that affect the spinal cord. These defects may interrupt nerve signals between the bladder, spinal cord, and brain, which are needed for urination, and lead to urinary retentionthe inability to empty the bladder completelyin newborns. Urine that remains in the bladder can reflux into the ureters and kidneys, causing swelling." } ]

[ { "from": "human", "value": "What are the symptoms of Urine Blockage in Newborns?" }, { "from": "gpt", "value": "Before leaving the hospital, a baby with urine blockage may urinate only small amounts or may not urinate at all. As part of the routine newborn exam, the health care provider may feel an enlarged kidney or find a closed urethra, which may indicate urine blockage. Sometimes urine blockage is not apparent until a child develops symptoms of a urinary tract infection (UTI), including\n- fever\n- irritability\n- not eating\n- nausea\n- diarrhea\n- vomiting\n- cloudy, dark, bloody, or foul-smelling urine\n- urinating often\nIf these symptoms persist, the child should see a health care provider. A child 2 months of age or younger with a fever should see a health care provider immediately. The health care provider will ask for a urine sample to test for bacteria." } ]

[ { "from": "human", "value": "What are the complications of Urine Blockage in Newborns?" }, { "from": "gpt", "value": "When a defect in the urinary tract blocks the flow of urine, the urine backs up and causes the ureters to swell, called hydroureter, and hydronephrosis.\nHydronephrosis is the most common problem found during prenatal ultrasound of a baby in the womb. The swelling may be easy to see or barely detectable. The results of hydronephrosis may be mild or severe, yet the long-term outcome for the childs health cannot always be predicted by the severity of swelling. Urine blockage may damage the developing kidneys and reduce their ability to filter. In the most severe cases of urine blockage, where little or no urine leaves the babys bladder, the amount of amniotic fluid is reduced to the point that the babys lung development is threatened.\nAfter birth, urine blockage may raise a childs risk of developing a UTI. Recurring UTIs can lead to more permanent kidney damage." } ]

[ { "from": "human", "value": "How to diagnose Urine Blockage in Newborns?" }, { "from": "gpt", "value": "Defects of the urinary tract may be diagnosed before or after the baby is born.\nDiagnosis before Birth\nTests during pregnancy can help determine if the baby is developing normally in the womb.\n- Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A prenatal ultrasound can show internal organs within the baby. 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 radiologista doctor who specializes in medical imaging, or- an obstetriciana doctor who delivers babies\nThe images can show enlarged kidneys, ureters, or bladders in babies.\n- Amniocentesis. Amniocentesis is a procedure in which amniotic fluid is removed from the mothers womb for testing. The procedure can be performed in the health care providers office, and local anesthetic may be used. The health care provider inserts a thin needle through the abdomen into the uterus to obtain a small amount of amniotic fluid. Cells from the fluid are grown in a lab and then analyzed. The health care provider usually uses ultrasound to find the exact location of the baby. The test can show whether the baby has certain birth defects and how well the babys lungs are developing.\n- Chorionic villus sampling (CVS). CVS is the removal of a small piece of tissue from the placenta for testing. The procedure can be performed in the health care providers office; anesthesia is not needed. The health care provider uses ultrasound to guide a thin tube or needle through the vagina or abdomen into the placenta. Cells are removed from the placenta and then analyzed. The test can show whether the baby has certain genetic defects.\nMost healthy women do not need all of these tests. Ultrasound exams during pregnancy are routine. Amniocentesis and CVS are recommended only when a risk of genetic problems exists because of family history or a problem is detected during an ultrasound. Amniocentesis and CVS carry a slight risk of harming the baby and mother or ending the pregnancy in miscarriage, so the risks should be carefully considered.\nDiagnosis after Birth\nDifferent imaging techniques can be used in infants and children to determine the cause of urine blockage.\n- Ultrasound. Ultrasound can be used to view the childs urinary tract. For infants, the image is clearer than could be achieved while the baby was in the womb.\n- Voiding cystourethrogram (VCUG). VCUG is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The procedure is performed in an outpatient center or hospital by an x-ray technician supervised by a radiologist, who then interprets the images. While anesthesia is not needed, sedation may be used for some children. The bladder and urethra are filled with a special dye, called contrast medium, to make the structures clearly visible on the x-ray images. The x-ray machine captures images of the contrast medium while the bladder is full and when the child urinates. The test can show reflux or blockage of the bladder due to an obstruction, such as PUV.\n- Radionuclide scan. A radionuclide scan is an imaging technique that detects small amounts of radiation after a person is injected with radioactive chemicals. The dose of the radioactive chemicals is small; therefore, the risk of causing damage to cells is low. Radionuclide scans are performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist. Anesthesia is not needed. Special cameras and computers are used to create images of the radioactive chemicals as they pass through the kidneys. Radioactive chemicals injected into the blood can provide information about kidney function." } ]

[ { "from": "human", "value": "What are the treatments for Urine Blockage in Newborns?" }, { "from": "gpt", "value": "Treatment for urine blockage depends on the cause and severity of the blockage. Hydronephrosis discovered before the baby is born rarely requires immediate action, especially if it is only on one side. The condition often goes away without any treatment before or after birth. The health care provider should keep track of the condition with frequent ultrasounds.\nSurgery\nIf the urine blockage threatens the life of the unborn baby, a fetal surgeon may recommend surgery to insert a shunt or correct the problem causing the blockage. A shunt is a small tube that can be inserted into the babys bladder to release urine into the amniotic sac. The procedure is similar to amniocentesis, in that a needle is inserted through the mothers abdomen. Ultrasound guides placement of the shunt, which is attached to the end of the needle. Alternatively, an endoscopea small, flexible tube with a lightcan be used to place a shunt or to repair the problem causing the blockage. Fetal surgery carries many risks, so it is performed only in special circumstances, such as when the amniotic fluid is absent and the babys lungs are not developing or when the kidneys are severely damaged.\nIf the urinary defect does not correct itself after the child is born, and the child continues to have urine blockage, surgery may be needed to remove the obstruction and restore urine flow. The decision to operate depends on the degree of blockage. After surgery, a small tube, called a stent, may be placed in the ureter or urethra to keep it open temporarily while healing occurs.\nAntibiotics\nAntibiotics are bacteria-fighting medications. A child with possible urine blockage or VUR may be given antibiotics to prevent UTIs from developing until the urinary defect corrects itself or is corrected with surgery.\nIntermittent Catheterization\nIntermittent catheterization may be used for a child with urinary retention due to a nerve disease. The parent or guardian, and later the child, is taught to drain the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder. Emptying the bladder in this way helps to decrease kidney damage, urine leakage, and UTIs." } ]

[ { "from": "human", "value": "What to do for Urine Blockage in Newborns?" }, { "from": "gpt", "value": "Researchers have not found that a mothers eating, diet, and nutrition play a role in causing or preventing urine blockage in newborns." } ]

[ { "from": "human", "value": "What to do for Urine Blockage in Newborns?" }, { "from": "gpt", "value": "- Many types of defects in the urinary tract can cause urine blockage:- vesicoureteral reflux (VUR)- ureteropelvic junction (UPJ) obstruction- bladder outlet obstruction (BOO), such as posterior urethral valves (PUV)- ureterocele- Some babies are born with genetic conditions that affect several different systems in the body, including the urinary tract:- prune belly syndrome (PBS)- esophageal atresia (EA)- congenital heart defects- Urine blockage can also be caused by spina bifida and other birth defects that affect the spinal cord.\n- Before leaving the hospital, a baby with urine blockage may urinate only small amounts or may not urinate at all. As part of the routine newborn exam, the health care provider may feel an enlarged kidney or find a closed urethra, which may indicate urine blockage. Sometimes urine blockage is not apparent until a child develops symptoms of a urinary tract infection (UTI).\n- When a defect in the urinary tract blocks the flow of urine, the urine backs up and causes the ureters to swell, called hydroureter, and hydronephrosis.\n- Defects of the urinary tract may be discovered before or after the baby is born.\n- Prenatal tests include ultrasound, amniocentesis, and chorionic villus sampling (CVS).\n- Different imaging techniques, including ultrasound, voiding cystourethrogram (VCUG), and radionuclide scan, can be used in infants and children to determine the cause of urine blockage.\n- Treatment for urine blockage depends on the cause and severity of the blockage. Hydronephrosis discovered before the baby is born rarely requires immediate action, especially if it is only on one side. Treatments for more serious conditions include- surgery- antibiotics- intermittent catheterization" } ]

[ { "from": "human", "value": "What is (are) What I need to know about Bladder Control for Women?" }, { "from": "gpt", "value": "Not all bladder control problems are alike. Some problems are caused by weak muscles, while others are caused by damaged nerves. Sometimes the cause may be a medicine that dulls the nerves.\nTo help solve your problem, your doctor or nurse will try to identify the type of incontinence you have. It may be one or more of the following six types." } ]

[ { "from": "human", "value": "What causes What I need to know about Bladder Control for Women?" }, { "from": "gpt", "value": "Urine leakage has many possible causes." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Bladder Control for Women?" }, { "from": "gpt", "value": "Talking about bladder control problems is not easy for some people. You may feel embarrassed to tell your doctor. But talking about the problem is the first step in finding an answer. Also, you can be sure your doctor has heard it all before. You will not shock or embarrass your doctor or nurse.\nMedical History\nYou can prepare for your visit to the doctor's office by gathering the information your doctor will need to understand your problem. Make a list of the medicines you are taking. Include prescription medicines and those you buy over the counter, like aspirin or antacid. List the fluids you drink regularly, including sodas, coffee, tea, and alcohol. Tell the doctor how much of each drink you have in an average day.\nFinding a Doctor\nYou will need to find a doctor who is skilled in helping women with urine leakage. If your primary doctor shrugs off your problem as normal aging, for example, ask for a referral to a specialist-a urogynecologist or a urologist who specializes in treating female urinary problems. You may need to be persistent, or you may need to look to organizations to help locate a doctor in your area. See For More Information for a list of organizations.\nMake a note of any recent surgeries or illnesses you have had. Let the doctor know how many children you have had. These events may or may not be related to your bladder control problem.\nFinally, keep track of the times when you have urine leakage. Note what you were doing at the time. Were you coughing, laughing, sneezing, or exercising? Did you have an uncontrollable urge to urinate when you heard running water?\nYou can use What Your Doctor Needs to Know (Item A) and Your Daily Bladder Diary (Item B) to prepare for your appointment.\nPhysical Exam\nThe doctor will give you a physical exam to look for any health issues that may be causing your bladder control problem. Checking your reflexes can show possible nerve damage. You will give a urine sample so the doctor can check for a urinary tract infection. For women, the exam may include a pelvic exam. Tests may also include taking an ultrasound picture of your bladder. Or the doctor may examine the inside of your bladder using a cystoscope, a long, thin tube that slides up into the bladder through the urethra.\nBladder Function Tests\nAny medical test can be uncomfortable. Bladder testing may sound embarrassing, but the health professionals who perform the tests will try to make you feel comfortable and give you as much privacy as possible." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Bladder Control for Women?" }, { "from": "gpt", "value": "Your doctor will likely offer several treatment choices. Some treatments are as simple as changing some daily habits. Other treatments require taking medicine or using a device. If nothing else seems to work, surgery may help a woman with stress incontinence regain her bladder control.\nTalk with your doctor about which treatments might work best for you.\nPelvic Muscle Strengthening\nMany women prefer to try the simplest treatment choices first. Kegel exercises strengthen the pelvic muscles and don't require any equipment. Once you learn how to \"Kegel,\" you can Kegel anywhere. The trick is finding the right muscles to squeeze. Your doctor or nurse can help make sure you are squeezing the right muscles. Your doctor may refer you to a specially trained physical therapist who will teach you to find and strengthen the sphincter muscles. Learning when to squeeze these muscles can also help stop the bladder spasms that cause urge incontinence. After about 6 to 8 weeks, you should notice that you have fewer leaks and more bladder control. Use the pelvic muscle exercise log included with the Kegel Exercise Tips sheet (Item C) to keep track of your progress.\nChanging Habits\nTimed voiding. By keeping track of the times you leak urine, you may notice certain times of day when you are most likely to have an accident. You can use that information to make planned trips to the bathroom ahead of time to avoid the accident. Once you have established a safe pattern, you can build your bladder control by stretching out the time between trips to the bathroom. By forcing your pelvic muscles to hold on longer, you make those muscles stronger.\nDiet changes. You may notice that certain foods and drinks cause you to urinate more often. You may find that avoiding caffeinated drinks like coffee, tea, or cola helps your bladder control. You can choose the decaf version of your favorite drink. Make sure you are not drinking too much fluid because that will cause you to make a large amount of urine. If you are bothered by nighttime urination, drink most of your fluids during the day and limit your drinking after dinner. You should not, however, avoid drinking fluids for fear of having an accident. Some foods may irritate your bladder and cause urgency. Talk with your doctor about diet changes that might affect your bladder.\nWeight loss. Extra body weight puts extra pressure on your bladder. By losing weight, you may be able to relieve some of that pressure and regain your bladder control.\nMedicines\nNo medications are approved to treat stress urinary incontinence. But if you have an overactive bladder, your doctor may prescribe a medicine that can calm muscles and nerves. Medicines for overactive bladder come as pills, liquid, or a patch.\nMedicines to treat overactive bladder can cause your eyes to become dry. These medicines can also cause dry mouth and constipation. If you take medicine to treat an overactive bladder, you may need to take steps to deal with the side effects.\n- Use eye drops to keep your eyes moist.\n- Chew gum or suck on hard candy if dry mouth bothers you. Make it sugarless gum or candy to avoid tooth decay.\n- Take small sips of water throughout the day.\nMedicines for other conditions also can affect the nerves and muscles of the urinary tract in different ways. Pills to treat swelling-edema-or high blood pressure may increase urine output and contribute to bladder control problems.\nTalk with your doctor; you may find that taking a different medicine solves the problem without adding another prescription. The list of Medicines for Bladder Control (Item D) will give you more information about specific medicines.\nPessaries\nA pessary is a plastic ring, similar to a contraceptive diaphragm, that is worn in the vagina. It will help support the walls of the vagina, lifting the bladder and nearby urethra, leading to less stress leakage. A doctor or nurse can fit you with the best shape and size pessary for you and teach you how to care for it. Many women use a pessary only during exercise while others wear their pessary all day to reduce stress leakage. If you use a pessary, you should see your doctor regularly to check for small scrapes in the vagina that can result from using the device.\nNerve Stimulation\nElectrical stimulation of the nerves that control the bladder can improve symptoms of urgency, frequency, and urge incontinence, as well as bladder emptying problems, in some people. This treatment is usually offered to patients who cannot tolerate or do not benefit from medications. At first, your doctor will use a device outside your body to deliver stimulation through a wire implanted under your skin to see if the treatment relieves your symptoms. If the temporary treatment works well for you, you may be able to have a permanent device implanted that delivers stimulation to the nerves in your back, much like a pacemaker. The electrodes in the permanent device are placed in your lower back through a minor surgical procedure. You may need to return to the doctor for adjustments to find the right setting that controls your bladder symptoms.\nSurgery\nDoctors may suggest surgery to improve bladder control if other treatments have failed. Surgery helps only stress incontinence. It won't work for urge incontinence. Many surgical options have high rates of success.\nMost stress incontinence problems are caused by the bladder neck dropping toward the vagina. To correct this problem, the surgeon raises the bladder neck or urethra and supports it with a ribbon-like sling or web of strings attached to a muscle or bone. The sling holds up the bottom of the bladder and the top of the urethra to stop leakage.\nCatheterization\nIf your bladder does not empty well as a result of nerve damage, you might leak urine. This condition is called overflow incontinence. You might use a catheter to empty your bladder. A catheter is a thin tube you can learn to insert through the urethra into the bladder to drain urine. You may use a catheter once in a while, a few times a day, or all of the time. If you use the catheter all the time, it will drain urine from your bladder into a bag you can hang from your leg. If you use a catheter all the time, you should watch for possible infections." } ]

[ { "from": "human", "value": "What is (are) Glomerular Diseases?" }, { "from": "gpt", "value": "The two kidneys are bean-shaped organs located just below the rib cage, one on each side of the spine. Everyday, 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.\nBlood enters the kidneys through arteries that branch inside the kidneys into tiny clusters of looping blood vessels. Each cluster is called a glomerulus, which comes from the Greek word meaning filter. The plural form of the word is glomeruli. There are approximately 1 million glomeruli, or filters, in each kidney. The glomerulus is attached to the opening of a small fluid-collecting tube called a tubule. Blood is filtered in the glomerulus, and extra fluid and wastes pass into the tubule and become urine. Eventually, the urine drains from the kidneys into the bladder through larger tubes called ureters.\nEach glomerulus-and-tubule unit is called a nephron. Each kidney is composed of about 1 million nephrons. In healthy nephrons, the glomerular membrane that separates the blood vessel from the tubule allows waste products and extra water to pass into the tubule while keeping blood cells and protein in the bloodstream." } ]

[ { "from": "human", "value": "What are the symptoms of Glomerular Diseases?" }, { "from": "gpt", "value": "The signs and symptoms of glomerular disease include\n- albuminuria: large amounts of protein in the urine\n- hematuria: blood in the urine\n- reduced glomerular filtration rate: inefficient filtering of wastes from the blood\n- hypoproteinemia: low blood protein\n- edema: swelling in parts of the body\nOne or more of these symptoms can be the first sign of kidney disease. But how would you know, for example, whether you have proteinuria? Before seeing a doctor, you may not. But some of these symptoms have signs, or visible manifestations:\n- Proteinuria may cause foamy urine.\n- Blood may cause the urine to be pink or cola-colored.\n- Edema may be obvious in hands and ankles, especially at the end of the day, or around the eyes when awakening in the morning, for example." } ]

[ { "from": "human", "value": "How to diagnose Glomerular Diseases?" }, { "from": "gpt", "value": "Patients with glomerular disease have significant amounts of protein in the urine, which may be referred to as \"nephrotic range\" if levels are very high. Red blood cells in the urine are a frequent finding as well, particularly in some forms of glomerular disease. Urinalysis provides information about kidney damage by indicating levels of protein and red blood cells in the urine. Blood tests measure the levels of waste products such as creatinine and urea nitrogen to determine whether the filtering capacity of the kidneys is impaired. If these lab tests indicate kidney damage, the doctor may recommend ultrasound or an x ray to see whether the shape or size of the kidneys is abnormal. These tests are called renal imaging. But since glomerular disease causes problems at the cellular level, the doctor will probably also recommend a kidney biopsya procedure in which a needle is used to extract small pieces of tissue for examination with different types of microscopes, each of which shows a different aspect of the tissue. A biopsy may be helpful in confirming glomerular disease and identifying the cause." } ]

[ { "from": "human", "value": "What causes Glomerular Diseases?" }, { "from": "gpt", "value": "A number of different diseases can result in glomerular disease. It may be the direct result of an infection or a drug toxic to the kidneys, or it may result from a disease that affects the entire body, like diabetes or lupus. Many different kinds of diseases can cause swelling or scarring of the nephron or glomerulus. Sometimes glomerular disease is idiopathic, meaning that it occurs without an apparent associated disease.\nThe categories presented below can overlap: that is, a disease might belong to two or more of the categories. For example, diabetic nephropathy is a form of glomerular disease that can be placed in two categories: systemic diseases, since diabetes itself is a systemic disease, and sclerotic diseases, because the specific damage done to the kidneys is associated with scarring.\nAutoimmune Diseases\nWhen the body's immune system functions properly, it creates protein-like substances called antibodies and immunoglobulins to protect the body against invading organisms. In an autoimmune disease, the immune system creates autoantibodies, which are antibodies or immunoglobulins that attack the body itself. Autoimmune diseases may be systemic and affect many parts of the body, or they may affect only specific organs or regions.\nSystemic lupus erythematosus (SLE) affects many parts of the body: primarily the skin and joints, but also the kidneys. Because women are more likely to develop SLE than men, some researchers believe that a sex-linked genetic factor may play a part in making a person susceptible, although viral infection has also been implicated as a triggering factor. Lupus nephritis is the name given to the kidney disease caused by SLE, and it occurs when autoantibodies form or are deposited in the glomeruli, causing inflammation. Ultimately, the inflammation may create scars that keep the kidneys from functioning properly. Conventional treatment for lupus nephritis includes a combination of two drugs, cyclophosphamide, a cytotoxic agent that suppresses the immune system, and prednisolone, a corticosteroid used to reduce inflammation. A newer immunosuppressant, mychophenolate mofetil (MMF), has been used instead of cyclophosphamide. Preliminary studies indicate that MMF may be as effective as cyclophosphamide and has milder side effects.\nGoodpasture's Syndrome involves an autoantibody that specifically targets the kidneys and the lungs. Often, the first indication that patients have the autoantibody is when they cough up blood. But lung damage in Goodpasture's Syndrome is usually superficial compared with progressive and permanent damage to the kidneys. Goodpasture's Syndrome is a rare condition that affects mostly young men but also occurs in women, children, and older adults. Treatments include immunosuppressive drugs and a blood-cleaning therapy called plasmapheresis that removes the autoantibodies.\nIgA nephropathy is a form of glomerular disease that results when immunoglobulin A (IgA) forms deposits in the glomeruli, where it creates inflammation. IgA nephropathy was not recognized as a cause of glomerular disease until the late 1960s, when sophisticated biopsy techniques were developed that could identify IgA deposits in kidney tissue.\nThe most common symptom of IgA nephropathy is blood in the urine, but it is often a silent disease that may go undetected for many years. The silent nature of the disease makes it difficult to determine how many people are in the early stages of IgA nephropathy, when specific medical tests are the only way to detect it. This disease is estimated to be the most common cause of primary glomerulonephritisthat is, glomerular disease not caused by a systemic disease like lupus or diabetes mellitus. It appears to affect men more than women. Although IgA nephropathy is found in all age groups, young people rarely display signs of kidney failure because the disease usually takes several years to progress to the stage where it causes detectable complications.\nNo treatment is recommended for early or mild cases of IgA nephropathy when the patient has normal blood pressure and less than 1 gram of protein in a 24-hour urine output. When proteinuria exceeds 1 gram/day, treatment is aimed at protecting kidney function by reducing proteinuria and controlling blood pressure. Blood pressure medicinesangiotensinconverting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs)that block a hormone called angiotensin are most effective at achieving those two goals simultaneously.\nHereditary NephritisAlport Syndrome\nThe primary indicator of Alport syndrome is a family history of chronic glomerular disease, although it may also involve hearing or vision impairment. This syndrome affects both men and women, but men are more likely to experience chronic kidney disease and sensory loss. Men with Alport syndrome usually first show evidence of renal insufficiency while in their twenties and reach total kidney failure by age 40. Women rarely have significant renal impairment, and hearing loss may be so slight that it can be detected only through testing with special equipment. Usually men can pass the disease only to their daughters. Women can transmit the disease to either their sons or their daughters. Treatment focuses on controlling blood pressure to maintain kidney function.\nInfection-related Glomerular Disease\nGlomerular disease sometimes develops rapidly after an infection in other parts of the body. Acute post-streptococcal glomerulonephritis (PSGN) can occur after an episode of strep throat or, in rare cases, impetigo (a skin infection). The Streptococcus bacteria do not attack the kidney directly, but an infection may stimulate the immune system to overproduce antibodies, which are circulated in the blood and finally deposited in the glomeruli, causing damage. PSGN can bring on sudden symptoms of swelling (edema), reduced urine output (oliguria), and blood in the urine (hematuria). Tests will show large amounts of protein in the urine and elevated levels of creatinine and urea nitrogen in the blood, thus indicating reduced kidney function. High blood pressure frequently accompanies reduced kidney function in this disease.\nPSGN is most common in children between the ages of 3 and 7, although it can strike at any age, and it most often affects boys. It lasts only a brief time and usually allows the kidneys to recover. In a few cases, however, kidney damage may be permanent, requiring dialysis or transplantation to replace renal function.\nBacterial endocarditis, infection of the tissues inside the heart, is also associated with subsequent glomerular disease. Researchers are not sure whether the renal lesions that form after a heart infection are caused entirely by the immune response or whether some other disease mechanism contributes to kidney damage. Treating the heart infection is the most effective way of minimizing kidney damage. Endocarditis sometimes produces chronic kidney disease (CKD).\nHIV, the virus that leads to AIDS, can also cause glomerular disease. Between 5 and 10 percent of people with HIV experience kidney failure, even before developing full-blown AIDS. HIV-associated nephropathy usually begins with heavy proteinuria and progresses rapidly (within a year of detection) to total kidney failure. Researchers are looking for therapies that can slow down or reverse this rapid deterioration of renal function, but some possible solutions involving immunosuppression are risky because of the patients' already compromised immune system.\nSclerotic Diseases\nGlomerulosclerosis is scarring (sclerosis) of the glomeruli. In several sclerotic conditions, a systemic disease like lupus or diabetes is responsible. Glomerulosclerosis is caused by the activation of glomerular cells to produce scar material. This may be stimulated by molecules called growth factors, which may be made by glomerular cells themselves or may be brought to the glomerulus by the circulating blood that enters the glomerular filter.\nDiabetic nephropathy is the leading cause of glomerular disease and of total kidney failure in the United States. Kidney disease is one of several problems caused by elevated levels of blood glucose, the central feature of diabetes. In addition to scarring the kidney, elevated glucose levels appear to increase the speed of blood flow into the kidney, putting a strain on the filtering glomeruli and raising blood pressure.\nDiabetic nephropathy usually takes many years to develop. People with diabetes can slow down damage to their kidneys by controlling their blood glucose through healthy eating with moderate protein intake, physical activity, and medications. People with diabetes should also be careful to keep their blood pressure at a level below 140/90 mm Hg, if possible. Blood pressure medications called ACE inhibitors and ARBs are particularly effective at minimizing kidney damage and are now frequently prescribed to control blood pressure in patients with diabetes and in patients with many forms of kidney disease.\nFocal segmental glomerulosclerosis (FSGS) describes scarring in scattered regions of the kidney, typically limited to one part of the glomerulus and to a minority of glomeruli in the affected region. FSGS may result from a systemic disorder or it may develop as an idiopathic kidney disease, without a known cause. Proteinuria is the most common symptom of FSGS, but, since proteinuria is associated with several other kidney conditions, the doctor cannot diagnose FSGS on the basis of proteinuria alone. Biopsy may confirm the presence of glomerular scarring if the tissue is taken from the affected section of the kidney. But finding the affected section is a matter of chance, especially early in the disease process, when lesions may be scattered.\nConfirming a diagnosis of FSGS may require repeat kidney biopsies. Arriving at a diagnosis of idiopathic FSGS requires the identification of focal scarring and the elimination of possible systemic causes such as diabetes or an immune response to infection. Since idiopathic FSGS is, by definition, of unknown cause, it is difficult to treat. No universal remedy has been found, and most patients with FSGS progress to total kidney failure over 5 to 20 years. Some patients with an aggressive form of FSGS reach total kidney failure in 2 to 3 years. Treatments involving steroids or other immunosuppressive drugs appear to help some patients by decreasing proteinuria and improving kidney function. But these treatments are beneficial to only a minority of those in whom they are tried, and some patients experience even poorer kidney function as a result. ACE inhibitors and ARBs may also be used in FSGS to decrease proteinuria. Treatment should focus on controlling blood pressure and blood cholesterol levels, factors that may contribute to kidney scarring.\nOther Glomerular Diseases\nMembranous nephropathy, also called membranous glomerulopathy, is the second most common cause of the nephrotic syndrome (proteinuria, edema, high cholesterol) in U.S. adults after diabetic nephropathy. Diagnosis of membranous nephropathy requires a kidney biopsy, which reveals unusual deposits of immunoglobulin G and complement C3, substances created by the body's immune system. Fully 75 percent of cases are idiopathic, which means that the cause of the disease is unknown. The remaining 25 percent of cases are the result of other diseases like systemic lupus erythematosus, hepatitis B or C infection, or some forms of cancer. Drug therapies involving penicillamine, gold, or captopril have also been associated with membranous nephropathy. About 20 to 40 percent of patients with membranous nephropathy progress, usually over decades, to total kidney failure, but most patients experience either complete remission or continued symptoms without progressive kidney failure. Doctors disagree about how aggressively to treat this condition, since about 20 percent of patients recover without treatment. ACE inhibitors and ARBs are generally used to reduce proteinuria. Additional medication to control high blood pressure and edema is frequently required. Some patients benefit from steroids, but this treatment does not work for everyone. Additional immunosuppressive medications are helpful for some patients with progressive disease.\nMinimal change disease (MCD) is the diagnosis given when a patient has the nephrotic syndrome and the kidney biopsy reveals little or no change to the structure of glomeruli or surrounding tissues when examined by a light microscope. Tiny drops of a fatty substance called a lipid may be present, but no scarring has taken place within the kidney. MCD may occur at any age, but it is most common in childhood. A small percentage of patients with idiopathic nephrotic syndrome do not respond to steroid therapy. For these patients, the doctor may recommend a low-sodium diet and prescribe a diuretic to control edema. The doctor may recommend the use of nonsteroidal anti-inflammatory drugs to reduce proteinuria. ACE inhibitors and ARBs have also been used to reduce proteinuria in patients with steroid-resistant MCD. These patients may respond to larger doses of steroids, more prolonged use of steroids, or steroids in combination with immunosuppressant drugs, such as chlorambucil, cyclophosphamide, or cyclosporine." } ]

[ { "from": "human", "value": "What is (are) Glomerular Diseases?" }, { "from": "gpt", "value": "Renal failure is any acute or chronic loss of kidney function and is the term used when some kidney function remains. Total kidney failure, sometimes called end-stage renal disease (ESRD), indicates permanent loss of kidney function. Depending on the form of glomerular disease, renal function may be lost in a matter of days or weeks or may deteriorate slowly and gradually over the course of decades.\nAcute Renal Failure\nA few forms of glomerular disease cause very rapid deterioration of kidney function. For example, PSGN can cause severe symptoms (hematuria, proteinuria, edema) within 2 to 3 weeks after a sore throat or skin infection develops. The patient may temporarily require dialysis to replace renal function. This rapid loss of kidney function is called acute renal failure (ARF). Although ARF can be life-threatening while it lasts, kidney function usually returns after the cause of the kidney failure has been treated. In many patients, ARF is not associated with any permanent damage. However, some patients may recover from ARF and subsequently develop CKD.\nChronic Kidney Disease\nMost forms of glomerular disease develop gradually, often causing no symptoms for many years. CKD is the slow, gradual loss of kidney function. Some forms of CKD can be controlled or slowed down. For example, diabetic nephropathy can be delayed by tightly controlling blood glucose levels and using ACE inhibitors and ARBs to reduce proteinuria and control blood pressure. But CKD cannot be cured. Partial loss of renal function means that some portion of the patient's nephrons have been scarred, and scarred nephrons cannot be repaired. In many cases, CKD leads to total kidney failure.\nTotal Kidney Failure\nTo stay alive, a patient with total kidney failure must go on dialysishemodialysis or peritoneal dialysisor receive a new kidney through transplantation. Patients with CKD who are approaching total kidney failure should learn as much about their treatment options as possible so they can make an informed decision when the time comes. With the help of dialysis or transplantation, many people continue to lead full, productive lives after reaching total kidney failure." } ]

[ { "from": "human", "value": "What to do for Glomerular Diseases?" }, { "from": "gpt", "value": "- The kidneys filter waste and extra fluid from the blood.\n- The filtering process takes place in the nephron, where microscopic blood vessel filters, called glomeruli, are attached to fluid-collecting tubules.\n- A number of different disease processes can damage the glomeruli and thereby cause kidney failure. Glomerulonephritis and glomerulosclerosis are broad terms that include many forms of damage to the glomeruli.\n- Some forms of kidney failure can be slowed down, but scarred glomeruli can never be repaired.\n- Treatment for the early stages of kidney failure depends on the disease causing the damage.\n- Early signs of kidney failure include blood or protein in the urine and swelling in the hands, feet, abdomen, or face. Kidney failure may be silent for many years.\nThe Nephrotic Syndrome\n- The nephrotic syndrome is a condition marked by very high levels of protein in the urine; low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol.\n- The nephrotic syndrome is a set of symptoms, not a disease in itself. It can occur with many diseases, so prevention relies on controlling the diseases that cause it.\n- Treatment of the nephrotic syndrome focuses on identifying and treating the underlying cause, if possible, and reducing high cholesterol, blood pressure, and protein in the urine through diet, medication, or both.\n- The nephrotic syndrome may go away once the underlying cause, if known, is treated. However, often a kidney disease is the underlying cause and cannot be cured. In these cases, the kidneys may gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the patient will need to be on dialysis or have a kidney transplant." } ]

[ { "from": "human", "value": "What is (are) Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes?" }, { "from": "gpt", "value": "Type 2 diabetes, formerly called adult-onset diabetes, is the most common type of diabetes. About 95 percent of people with diabetes have type 2. People can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes develops most often in middle-aged and older people. People who are overweight and inactive are also more likely to develop type 2 diabetes.\nIn type 2 and other types of diabetes, you have too much glucose, also called sugar, in your blood. People with diabetes have problems converting food to energy. After a meal, food is broken down into glucose, which is carried by your blood to cells throughout your body. With the help of the hormone insulin, cells absorb glucose from your blood and use it for energy. Insulin is made in the pancreas, an organ located behind the stomach.\nType 2 diabetes usually begins with insulin resistance, a condition linked to excess weight in which your bodys cells do not use insulin properly. As a result, your body needs more insulin to help glucose enter cells. At first, your pancreas keeps up with the added demand by producing more insulin. But in time, your pancreas loses its ability to produce enough insulin, and blood glucose levels rise.\nOver time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other problems of diabetes may include increased risk of getting other diseases, loss of mobility with aging, depression, and pregnancy problems.\nTreatment includes taking diabetes medicines, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and for some, taking aspirin daily." } ]

[ { "from": "human", "value": "How to prevent Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes?" }, { "from": "gpt", "value": "Yes. The results of the Diabetes Prevention Program (DPP) proved that weight loss through moderate diet changes and physical activity can delay or prevent type 2 diabetes. The DPP was a federally funded study of 3,234 people at high risk for diabetes. This study showed that a 5-to 7-percent weight loss, which for a 200-pound person would be 10 to 14 pounds, slowed development of type 2 diabetes.\nPeople at High Risk for Diabetes\nDPP study participants were overweight and had higher than normal levels of blood glucose, a condition called prediabetes. Many had family members with type 2 diabetes. Prediabetes, obesity, and a family history of diabetes are strong risk factors for type 2 diabetes. About half of the DPP participants were from minority groups with high rates of diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans.\nDPP participants also included others at high risk for developing type 2 diabetes, such as women with a history of gestational diabetes and people age 60 and older.\nApproaches to Preventing Diabetes\nThe DPP tested three approaches to preventing diabetes:\n- Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.\n- Taking the diabetes medicine metformin. Those who took metformin also received information about physical activity and diet.\n- Receiving education about diabetes. The third group only received information about physical activity and diet and took a placeboa pill without medicine in it.\nPeople in the lifestyle change group showed the best outcomes. But people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years. Lifestyle change was even more effective in those age 60 and older. People in this group reduced their risk by 71 percent. But people in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under National Institutes of Health (NIH) clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dpp.\nLasting Results\nThe Diabetes Prevention Program Outcomes Study (DPPOS) has shown that the benefits of weight loss and metformin last for at least 10 years. The DPPOS has continued to follow most DPP participants since the DPP ended in 2001. The DPPOS showed that 10 years after enrolling in the DPP,\n- people in the lifestyle change group reduced their risk for developing diabetes by 34 percent\n- those in the lifestyle change group age 60 or older had even greater benefit, reducing their risk of developing diabetes by 49 percent\n- participants in the lifestyle change group also had fewer heart and blood vessel disease risk factors, including lower blood pressure and triglyceride levels, even though they took fewer medicines to control their heart disease risk\n- the metformin group reduced the risk of developing diabetes by 18 percent\nEven though controlling your weight with lifestyle changes is challenging, it produces long-term health rewards by lowering your risk for type 2 diabetes, lowering your blood glucose levels, and reducing other heart disease risk factors. More information about the DPPOS, funded under NIH clinical trial number NCT00038727, can be found at www.bsc.gwu.edu/dpp.\nOther Types of Diabetes In addition to type 2, the other main types of diabetes are type 1 diabetes and gestational diabetes. Type 1 Diabetes Type 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. In this type of diabetes, your pancreas can no longer make insulin because your bodys immune system has attacked and destroyed the cells that make it. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and, for some, taking aspirin daily. Gestational Diabetes Gestational diabetes is a type of diabetes that develops only during pregnancy. Hormones produced by your placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If your pancreas cant produce enough insulin, gestational diabetes occurs. As with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk. Gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Although gestational diabetes usually goes away after the baby is born, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes as they grow up." } ]

[ { "from": "human", "value": "What is (are) Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes?" }, { "from": "gpt", "value": "In addition to type 2, the other main types of diabetes are type 1 diabetes and gestational diabetes.\nType 1 Diabetes\nType 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. In this type of diabetes, your pancreas can no longer make insulin because your bodys immune system has attacked and destroyed the cells that make it. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and, for some, taking aspirin daily.\nGestational Diabetes\nGestational diabetes is a type of diabetes that develops only during pregnancy. Hormones produced by your placenta and other pregnancy-related factors contribute to insulin resistance, which occurs in all women during late pregnancy. Insulin resistance increases the amount of insulin needed to control blood glucose levels. If your pancreas cant produce enough insulin, gestational diabetes occurs.\nAs with type 2 diabetes, excess weight is linked to gestational diabetes. Overweight or obese women are at particularly high risk for gestational diabetes because they start pregnancy with a higher need for insulin due to insulin resistance. Excessive weight gain during pregnancy may also increase risk. Gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes.\nAlthough gestational diabetes usually goes away after the baby is born, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes as they grow up." } ]