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[ { "from": "human", "value": "What are the symptoms of Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes?" }, { "from": "gpt", "value": "The signs and symptoms of type 2 diabetes can be so mild that you might not even notice them. Nearly 7 million people in the United States have type 2 diabetes and dont know they have the disease. Many have no signs or symptoms. Some people have symptoms but do not suspect diabetes.\nSymptoms include\n- increased thirst\n- increased hunger\n- fatigue\n- increased urination, especially at night\n- unexplained weight loss\n- blurred vision\n- numbness or tingling in the feet or hands\n- sores that do not heal\nMany people do not find out they have the disease until they have diabetes problems, such as blurred vision or heart trouble. If you find out early that you have diabetes, you can get treatment to prevent damage to your body." } ]

[ { "from": "human", "value": "Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes??" }, { "from": "gpt", "value": "To find out your risk for type 2 diabetes, check each item that applies to you.\n- I am age 45 or older.\n- I am overweight or obese.\n- I have a parent, brother, or sister with diabetes.\n- My family background is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American.\n- I have had gestational diabetes.\n- I gave birth to at least one baby weighing more than 9 pounds.\n- My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure.\n- My cholesterol levels are higher than normal. My HDL, or good, cholesterol is below 35, or my triglyceride level is above 250.\n- I am fairly inactive.\n- I have polycystic ovary syndrome, also called PCOS.\n- On previous testing, I had prediabetesan A1C level of 5.7 to 6.4 percent, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT).\n- I have other clinical conditions associated with insulin resistance, such as a condition called acanthosis nigricans, characterized by a dark, velvety rash around my neck or armpits.\n- I have a history of cardiovascular disease.\nThe more items you checked, the higher your risk.\nDoes sleep matter? Yes. Studies show that untreated sleep problems, especially sleep apnea, can increase the risk of type 2 diabetes. Sleep apnea is a common disorder in which you have pauses in breathing or shallow breaths while you sleep. Most people who have sleep apnea dont know they have it and it often goes undiagnosed. Night shift workers who have problems with sleepiness may also be at increased risk for obesity and type 2 diabetes. If you think you might have sleep problems, ask your doctor for help. More information about sleep problems is available from the National Heart Lung and Blood Institute at http://www.nhlbi.nih.gov/health/resources/sleep." } ]

[ { "from": "human", "value": "Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes??" }, { "from": "gpt", "value": "You can do a lot to reduce your risk of getting type 2 diabetes. Being more physically active, reducing fat and calorie intake, and losing a little weight can help you lower your chances of developing type 2 diabetes. Taking the diabetes medicine metformin can also reduce risk, particularly in younger and heavier people with prediabetes and women who have had gestational diabetes. Lowering blood pressure and cholesterol levels also helps you stay healthy.\nIf you are overweight, then take these steps:\n- Reach and maintain a reasonable body weight. Even a 10 or 15 pound weight loss makes a big difference.\n- Make wise food choices most of the time.\n- Be physically active every day.\nIf you are fairly inactive, then take this step:\n- Be physically active every day.\nIf your blood pressure is too high, then take these steps:\n- Reach and maintain a reasonable body weight.\n- Make wise food choices most of the time.\n- Reduce your sodium and alcohol intake.\n- Be physically active every day.\n- Talk with your doctor about whether you need medicine to control your blood pressure.\nIf your cholesterol or triglyceride levels are too high, then take these steps:\n- Make wise food choices most of the time.\n- Be physically active every day.\n- Talk with your doctor about whether you need medicine to control your cholesterol levels." } ]

[ { "from": "human", "value": "Who is at risk for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes??" }, { "from": "gpt", "value": "Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:\n- Make a plan to change behavior.\n- Decide exactly what you will do and give yourself a time frame.\n- Plan what you need to get ready.\n- Track your goals and activity on a food and activity tracker, available at http://www.niddk.nih.gov/health-information/health-communication-programs/ndep/health-care-professionals/game-plan/small-steps/Documents/GP_FoodActTracker.pdf (PDF, 349 KB)\n- Think about what might prevent you from reaching your goals.\n- Find family and friends who will support and encourage you.\n- Decide how you will reward yourselfa shopping trip, movie tickets, an afternoon in the parkwhen you do what you have planned.\nYour doctor, a dietitian, or a counselor can help you make a plan.\nBe Physically Active Every Day\nRegular physical activity tackles several risk factors at once. Activity helps you lose weight; keeps your blood glucose, blood pressure, and cholesterol under control; and helps your body use insulin. People in the DPP who were physically active for 30 minutes a day, 5 days a week, reduced their risk of type 2 diabetes. Many chose brisk walking as their physical activity.\nIf you are not fairly active, you should start slowly. First, talk with your doctor about what kinds of physical activity are safe for you. Make a plan to increase your activity level toward the goal of being active at least 30 minutes a day most days of the week. You can increase your level of physical activity in two main ways:\n1. Start an exercise program. 2. Increase your daily activity.\nStart an exercise program. Pick exercises that suit you. Find a friend to walk with you or join an exercise class that will help you keep going.\n- Do aerobic activities, which use your large muscles to make your heart beat faster. The large muscles are those of the upper and lower arms; upper and lower legs; and those that control head, shoulder, and hip movements.\n- Do activities to strengthen muscles and bone, such as lifting weights or sit-ups, two to three times a week. Find helpsuch as a video or a classto learn how to do these exercises properly.\nIncrease your daily activity. Choose activities you enjoy. You can work extra activity into your daily routine by doing the following:\n- Increase daily activity by decreasing time spent watching TV or at the computer. Set up a reminder on your computer to take an activity break.\n- Take the stairs rather than an elevator or escalator.\n- Park at the far end of the parking lot and walk.\n- Get off the bus a few stops early and walk the rest of the way.\n- Walk or bicycle whenever you can.\nTake Your Prescribed Medicines\nSome people need medicine to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor if you should take metformin to prevent type 2 diabetes. Metformin is a medicine that makes insulin work better and can reduce the risk of type 2 diabetes." } ]

[ { "from": "human", "value": "What to do for Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes?" }, { "from": "gpt", "value": "Your eating, diet, and nutrition choices play an important role in preventing or delaying diabetes. Follow the suggestions below to reach and maintain a reasonable weight and make wise food choices most of the time. Remember that it can take time to change your habits and be patient with yourself. You can also get help from a dietitian or join a weight-loss program to support you while you reach your goals.\nReach and Maintain a Reasonable Body Weight\nYour weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. Excess body weight can also cause high blood pressure. Every pound you lose lowers your risk of getting diabetes.\nIn addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a persons risk for type 2 diabetes. This is true even if your BMI falls within the normal range.\nFind Your BMI\nThe BMI is a measure of body weight relative to height. The BMI can help you find out whether you are normal weight, overweight, or obese. Use the table on pages 24 and 25 to find your BMI.\n- Find your height in the left-hand column.\n- Move across in the same row to the number closest to your weight.\n- The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.\nThe BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle.\nThe BMI for children and teens must be determined based on age, height, weight, and sex. The Centers for Disease Control and Prevention (CDC) has information about BMI in children and teens, including a BMI calculator, at www.cdc.gov/nccdphp/dnpa/bmi. The CDC website also has a BMI calculator for adults. A BMI calculator from the NIH is available at www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.\nThe NIH also has a free smartphone app for calculating BMI. You can search My BMI Calculator on your phone to find the app. The app also provides links to information about steps you can take to bring your BMI into a healthy range." } ]

[ { "from": "human", "value": "What is (are) Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.\nInsulin plays a major role in metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy.\nInsulin's Role in Blood Glucose Control\nWhen blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body.\n- Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels.\n- Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen.\n- Insulin also lowers blood glucose levels by reducing glucose production in the liver.\nIn a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range." } ]

[ { "from": "human", "value": "What is (are) Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Insulin resistance is a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes.\nMost people with insulin resistance don't know they have it for many yearsuntil they develop type 2 diabetes, a serious, lifelong disease. The good news is that if people learn they have insulin resistance early on, they can often prevent or delay diabetes by making changes to their lifestyle.\nInsulin resistance can lead to a variety of serious health disorders. The section \"What is metabolic syndrome?\" provides more information about other health disorders linked to insulin resistance." } ]

[ { "from": "human", "value": "What causes Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Although the exact causes of insulin resistance are not completely understood, scientists think the major contributors to insulin resistance are excess weight and physical inactivity.\nExcess Weight\nSome experts believe obesity, especially excess fat around the waist, is a primary cause of insulin resistance. Scientists used to think that fat tissue functioned solely as energy storage. However, studies have shown that belly fat produces hormones and other substances that can cause serious health problems such as insulin resistance, high blood pressure, imbalanced cholesterol, and cardiovascular disease (CVD).\nBelly fat plays a part in developing chronic, or long-lasting, inflammation in the body. Chronic inflammation can damage the body over time, without any signs or symptoms. Scientists have found that complex interactions in fat tissue draw immune cells to the area and trigger low-level chronic inflammation. This inflammation can contribute to the development of insulin resistance, type 2 diabetes, and CVD. Studies show that losing the weight can reduce insulin resistance and prevent or delay type 2 diabetes.\nPhysical Inactivity\nMany studies have shown that physical inactivity is associated with insulin resistance, often leading to type 2 diabetes. In the body, more glucose is used by muscle than other tissues. Normally, active muscles burn their stored glucose for energy and refill their reserves with glucose taken from the bloodstream, keeping blood glucose levels in balance.\nStudies show that after exercising, muscles become more sensitive to insulin, reversing insulin resistance and lowering blood glucose levels. Exercise also helps muscles absorb more glucose without the need for insulin. The more muscle a body has, the more glucose it can burn to control blood glucose levels.\nOther Causes\nOther causes of insulin resistance may include ethnicity; certain diseases; hormones; steroid use; some medications; older age; sleep problems, especially sleep apnea; and cigarette smoking.\nDoes sleep matter? Yes. Studies show that untreated sleep problems, especially sleep apnea, can increase the risk of obesity, insulin resistance, and type 2 diabetes. Night shift workers may also be at increased risk for these problems. Sleep apnea is a common disorder in which a person's breathing is interrupted during sleep. People may often move out of deep sleep and into light sleep when their breathing pauses or becomes shallow. This results in poor sleep quality that causes problem sleepiness, or excessive tiredness, during the day. Many people aren't aware of their symptoms and aren't diagnosed. People who think they might have sleep problems should talk with their health care provider. More information about sleep problems is available from the National Heart, Lung, and Blood Institute at http://www.nhlbi.nih.gov/health/resources/sleep." } ]

[ { "from": "human", "value": "What is (are) Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes. Prediabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that at least 86 million U.S. adults ages 20 or older had prediabetes in 2012.1 People with prediabetes are at increased risk of developing type 2 diabetes and CVD, which can lead to heart attack or stroke." } ]

[ { "from": "human", "value": "What are the symptoms of Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Insulin resistance and prediabetes usually have no symptoms. People may have one or both conditions for several years without knowing they have them. Even without symptoms, health care providers can identify people at high risk by their physical characteristics, also known as risk factors. The section \"Who should be tested for prediabetes?\" lists these risk factors.\nPeople with a severe form of insulin resistance may have dark patches of skin, usually on the back of the neck. Sometimes people have a dark ring around their neck. Dark patches may also appear on elbows, knees, knuckles, and armpits. This condition is called acanthosis nigricans." } ]

[ { "from": "human", "value": "What is (are) Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both CVD and type 2 diabetes. Metabolic syndrome is defined* as the presence of any three of the following2:\n- large waist sizewaist measurement of 40 inches or more for men and 35 inches or more for women\n- high triglycerides in the bloodtriglyceride level of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride level\n- abnormal levels of cholesterol in the bloodHDL, or good, cholesterol level below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL\n- high blood pressureblood pressure level of 130/85 or above, or taking medication for elevated blood pressure\n- higher than normal blood glucose levelsfasting blood glucose level of 100 mg/dL or above, or taking medication for elevated blood glucose\nIn addition to type 2 diabetes, metabolic syndrome has been linked to the following health disorders:\n- obesity\n- CVD\n- PCOS\n- nonalcoholic fatty liver disease\n- chronic kidney disease\nHowever, not everyone with these disorders has insulin resistance, and some people may have insulin resistance without getting these disorders.\nPeople who are obese or who have metabolic syndrome, insulin resistance, type 2 diabetes, or prediabetes often also have low-level inflammation throughout the body and blood clotting defects that increase the risk of developing blood clots in the arteries. These conditions contribute to increased risk for CVD.\n*Similar definitions have been developed by the World Health Organization and the American Association of Clinical Endocrinologists." } ]

[ { "from": "human", "value": "How to diagnose Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Health care providers use blood tests to determine whether a person has prediabetes, but they do not usually test specifically for insulin resistance. Insulin resistance can be assessed by measuring the level of insulin in the blood.\nHowever, the test that most accurately measures insulin resistance, called the euglycemic clamp, is too costly and complicated to be used in most health care providers' offices. The clamp is a research tool used by scientists to learn more about glucose metabolism. Research has shown that if blood tests indicate prediabetes, insulin resistance most likely is present.\nBlood Tests for Prediabetes\nAll blood tests involve drawing blood at a health care provider's office or commercial facility and sending the sample to a lab for analysis. Lab analysis of blood is needed to ensure test results are accurate. Glucose measuring devices used in a health care provider's office, such as finger-stick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose.\nPrediabetes can be detected with one of the following blood tests:\n- the A1C test\n- the fasting plasma glucose (FPG) test\n- the oral glucose tolerance test (OGTT)\nA1C test. Sometimes called hemoglobin A1c, HbA1c, or glycohemoglobin test, this test reflects average blood glucose levels over the past 3 months. This test is the most reliable test for prediabetes, but it is not as sensitive as the other tests. In some individuals, it may miss prediabetes that could be caught by glucose tests.\nAlthough some health care providers can quickly measure A1C in their office, that type of measurementcalled a point-of-care testis not considered reliable for diagnosis. For diagnosis of prediabetes, the A1C test should be analyzed in a laboratory using a method that is certified by the NGSP.\nThe A1C test can be unreliable for diagnosing prediabetes in people with certain conditions that are known to interfere with the results. Interference should be suspected when A1C results seem very different from the results of a blood glucose test. People of African, Mediterranean, or Southeast Asian descent, or people with family members with sickle cell anemia or a thalassemia, are particularly at risk of interference. People in these groups may have a less common type of hemoglobin, known as a hemoglobin variant, that can interfere with some A1C tests.\nAn A1C of 5.7 to 6.4 percent indicates prediabetes.\nMore information about the A1C test is provided in the NIDDK health topic, The A1C Test and Diabetes.\nFasting plasma glucose test. This test measures blood glucose in people who have not eaten anything for at least 8 hours. This test is most reliable when done in the morning. Prediabetes found with this test is called IFG.\nFasting glucose levels of 100 to 125 mg/dL indicate prediabetes.\nOGTT. This test measures blood glucose after people have not eaten for at least 8 hours and 2 hours after they drink a sweet liquid provided by a health care provider or laboratory. Prediabetes found with this test is called IGT.\nA blood glucose level between 140 and 199 mg/dL indicates prediabetes.\nThe following table lists the blood test levels for a diagnosis of prediabetes." } ]

[ { "from": "human", "value": "What to do for Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.\nIn general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.\nThe DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/health-topics/topics/dash.\nThe U.S. Dietary Guidelines for Americans also offers healthy eating advice and tools for changing eating habits at www.choosemyplate.gov.\nDietary Supplements\nVitamin D studies show a link between people's ability to maintain healthy blood glucose levels and having enough vitamin D in their blood. However, studies to determine the proper vitamin D levels for preventing diabetes are ongoing; no special recommendations have been made about vitamin D levels or supplements for people with prediabetes.\nCurrently, the Institute of Medicine (IOM), the agency that recommends supplementation levels based on current science, provides the following guidelines for daily vitamin D intake:\n- People ages 1 to 70 years may require 600 International Units (IUs).\n- People ages 71 and older may require as much as 800 IUs.\nThe IOM also recommended that no more than 4,000 IUs of vitamin D be taken per day.\nTo help ensure coordinated and safe care, people should discuss use of complementary and alternative medicine practices, including the use of dietary supplements, with their health care provider.\nMore information about using dietary supplements to help with diabetes is provided in the NIDDK health topic, Complementary and Alternative Medical Therapies for Diabetes.\nPhysical Activity\nRegular physical activity tackles several risk factors at once. Regular physical activity helps the body use insulin properly.\nRegular physical activity also helps a person\n- lose weight\n- control blood glucose levels\n- control blood pressure\n- control cholesterol levels\nPeople in the DPP who were physically active for 30 minutes a day, 5 days a week, reduced their risk of type 2 diabetes. Many chose brisk walking as their physical activity.\nMost people should aim for at least 30 minutes of exercise most days of the week. For best results, people should do both aerobic activities, which use large muscle groups and make the heart beat faster, and muscle strengthening activities.\nAerobic activities include brisk walking, climbing stairs, swimming, dancing, and other activities that increase the heart rate.\nMuscle strengthening activities include lifting weights and doing sit-ups or push-ups.\nPeople who haven't been physically active recently should talk with their health care provider about which activities are best for them and have a checkup before starting an exercise program.\nNot Smoking\nThose who smoke should quit. A health care provider can help people find ways to quit smoking. Studies show that people who get help have a better chance of quitting.\nFor more information about how to reverse insulin resistance and prediabetes with diet and increased physical activity, see the following National Diabetes Education Program publications at www.yourdiabetesinfo.org:- Get Real! You Don't Have to Knock Yourself Out to Prevent Diabetes!\n- More Than 50 Ways to Prevent Diabetes\n- Small Steps. Big Rewards. Your Game Plan to Prevent Type 2 Diabetes.\nMedication\nThe medication metformin is recommended for treatment of some individuals at very high risk of developing type 2 diabetes. In the DPP, metformin was shown to be most effective in preventing or delaying the development of type 2 diabetes in younger, heavier people with prediabetes. In general, metformin is recommend for those who are younger than age 60 and have\n- combined IGT and IFG\n- A1C above 6 percent\n- low HDL cholesterol\n- elevated triglycerides\n- a parent or sibling with diabetes\n- a BMI of at least 35\nMetformin also lowers the risk of diabetes in women who have had gestational diabetes. People at high risk should ask their health care provider if they should take metformin to prevent type 2 diabetes.\nSeveral medications have been shown to reduce type 2 diabetes risk to varying degrees, but the only medication recommended by the ADA for type 2 diabetes prevention is metformin. Other medications that have delayed diabetes have side effects or haven't shown long-lasting benefits. No medication, including metformin, is approved by the U.S. Food and Drug Administration to treat insulin resistance or prediabetes or to prevent type 2 diabetes." } ]

[ { "from": "human", "value": "What to do for Insulin Resistance and Prediabetes?" }, { "from": "gpt", "value": "- Insulin is a hormone that helps cells throughout the body absorb glucose and use it for energy. Insulin resistance is a condition in which the body produces insulin but does not use it effectively.\n- Insulin resistance increases the risk of developing type 2 diabetes and prediabetes.\n- The major contributors to insulin resistance are excess weight, especially around the waist, and physical inactivity.\n- Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes.\n- The Diabetes Prevention Program (DPP) study and its follow-up study, the Diabetes Prevention Program Outcomes Study (DPPOS), confirmed that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity.\n- By losing weight and being more physically active, people can reverse insulin resistance and prediabetes, thus preventing or delaying type 2 diabetes.\n- People with insulin resistance and prediabetes can decrease their risk for diabetes by eating a healthy diet and reaching and maintaining a healthy weight, increasing physical activity, not smoking, and taking medication.\n- The DPP showed the diabetes medication metformin to be most effective in preventing or delaying the development of type 2 diabetes in younger and heavier people with prediabetes and women who have had gestational diabetes." } ]

[ { "from": "human", "value": "What is (are) I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians?" }, { "from": "gpt", "value": "Diabetes causes blood glucose levels to be above normal. People with diabetes have problems converting food to energy. After food is eaten, it is broken down into a sugar called glucose. Glucose is then carried by the blood to cells throughout the body. The hormone insulin, made in the pancreas, helps the body change blood glucose into energy. People with diabetes, however, either no longer make enough insulin, or their insulin doesn't work properly, or both.\nType 2 diabetes\nType 2 diabetes is the most common type in American Indians. This type of diabetes can occur at any age, even during childhood. People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the body cannot make enough insulin. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, blindness, kidney failure, and amputation.\nOther kinds of diabetes\nType 1 diabetes\nType 1 diabetes is rare in American Indians. People develop type 1 diabetes when their bodies no longer make any insulin. Type 1 is usually first diagnosed in children or young adults but can develop at any age.\nGestational diabetes\nGestational diabetes is first diagnosed during pregnancy. It occurs when the body doesn't use insulin properly. Having an American Indian family background raises the risk of developing gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life." } ]

[ { "from": "human", "value": "What are the symptoms of I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians?" }, { "from": "gpt", "value": "Many people have no visible signs or symptoms of diabetes. Symptoms can also be so mild that you might not notice them. More than 5 million people in the United States have type 2 diabetes and do not know it.\n- increased thirst\n- increased hunger\n- fatigue\n- increased urination, especially at night\n- unexplained weight loss\n- blurred vision\n- sores that do not heal" } ]

[ { "from": "human", "value": "Who is at risk for I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians??" }, { "from": "gpt", "value": "- My mother had diabetes when I was born.\n- I am overweight.\n- I have a parent, brother, or sister with diabetes.\n- My family background is American Indian.\n- I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.\n- My blood pressure is 140/90 mmHg or higher, or I have been told that I have high blood pressure.\n- My cholesterol levels are higher than normal. My HDL cholesterol\"good\" cholesterolis below 35 mg/dL, or my triglyceride level is above 250 mg/dL.\n- I am fairly inactive. I exercise fewer than three times a week." } ]

[ { "from": "human", "value": "Who is at risk for I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians??" }, { "from": "gpt", "value": "- Reach and maintain a reasonable body weight.\n- Make wise food choices most of the time.\n- Be physically active every day.\n- Take your prescribed medicines.\nDoing these things can reduce your risk of developing type 2 diabetes. Keeping your blood pressure and cholesterol on target also helps you stay healthy.\nIf you are pregnant, plan to breastfeed your baby. Ask your health care provider for the names of people to call for help learning to breastfeed. Besides being good for your baby, breastfeeding is good for you. Studies done with the help of Pima Indian volunteers have shown that breastfeeding may lower the baby's risk of becoming overweight and getting diabetes.\nGetting Started.\nMaking changes in your life such as eating less can be hard. You can make the changes easier by taking these steps:\n- Make a plan to change something that you do.\n- Decide exactly what you will do and when you will do it.\n- Plan what you need to get ready.\n- Think about what might prevent you from reaching your goal.\n- Find family and friends who will support and encourage you.\n- Decide how you will reward yourselfwith a nonfood itemor activitywhen you do what you have planned.\nYour health care provider, a registered dietitian, or a counselor can help you make a plan.\nReach and Maintain a Reasonable Body Weight.\nYour weight affects your health in many ways. Being overweight can keep your body from making and using insulin correctly. The extra weight may also cause high blood pressure. The DPP study showed that losing even a few pounds can help lower your risk of developing type 2 diabetes, because weight loss helps your body use insulin more effectively. Every pound you lose lowers your risk of getting diabetes. In the DPP, people who lost 5 to 7 percent of their body weight lowered their risk of developing type 2 diabetes. They had less than half the risk of developing diabetes as people who didn't make lifestyle changes. A 5- to 7-percent weight loss for a 150-pound person, for example, would be about 7 to 10 pounds. If you're overweight, choose sensible ways to lose weight.\n- Don't use crash diets. Instead, eat smaller servings of the foods you usually have, and limit the amount of fat you eat.\n- Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week. Do something you enjoy, like biking or walking with a friend.\n- Set a reasonable weight-loss goal, such as losing about a pound a week. Aim for a long-term goal of losing the number of pounds that's right for you.\nChoosing My Weight Loss Goal.\nLosing 5 to 7 percent of your total weight can help lower your risk of getting type 2 diabetes. You are more likely to lose weight if:\n- you're physically active\n- you cut down on fat and calories\n- Use these steps to choose a goal. Talk with your health care provider and your dietitian about your goal and how to reach it.\nTo find your weight loss goal for losing about 5 to 7 percent of your weight, find the weight closest to yours on the chart below. Follow the row across to see how many pounds you need to lose.\nYour weight in pounds5 percent loss in pounds*7 percent loss in pounds**1508111759122001014225111625013182751419300152132516233501825\n*To find your exact weight loss goal in pounds for a 5 percent loss, multiply your weight by .05.\n**To find your exact weight loss goal in pounds for a 7 percent loss, multiply your weight by .07.\nWrite your weight loss goal here:\nTo lower my risk of getting type 2 diabetes, my goal is to lose about ___________ pounds.\nWrite down what you will do to lose weight. I will:\nChoose a date to start your plan for losing weight and write it here:\nStart date: ___________________\nLook ahead to when you think you can meet your goal. Allow about a week for each pound or half-pound you'd like to lose. Write the date for meeting your goal here:\nEnd date: ___________________\nMake Wise Food Choices Most of The Time\nWhat you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood glucose, blood pressure, and cholesterol.\n- Keep track of what you eat and drink. People who keep track are more successful in losing weight. You can use the Daily Food and Drink Tracker to write down what you eat and drink.\n- Take a look at the serving sizes of the foods you eat. Reduce serving sizes of main courses, meat, desserts, and other foods high in fat. Increase the amount of fruits and vegetables at every meal. Below is a chart for choosing sensible serving sizes using your hand as a measuring guide. Because your hand is proportioned to the rest of your body, it can be used to measure a healthy serving size for your body. Remember, the chart is only a guide. Choose your serving sizes and foods wisely.\n- Limit your fat intake to about 25 percent of your total calories. Your health care provider or dietitian can help you figure out how many grams of fat to have every day. You can check food labels for fat content. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. See Ways to Lower The Amount of Fat in Your Meals and Snacks.\n- Cut down on calories by eating smaller servings and by cutting back on fat. People in the DPP lifestyle change group lowered their daily calorie total by an average of about 450 calories. Your health care provider or dietitian can work with you to develop a meal plan that helps you lose weight.\n- Choose healthy commodity foods (items provided by the government to help people consume a nutritious diet), including those lower in fat.\n- When you meet your goal, reward yourself with something special, like a new outfit or a movie.\nChoose Sensible Serving Sizes\nAmount of foodTypes of foodSize of one serving (the same size as:)3 ouncesmeat, chicken, turkey, or fishthe palm of a hand or a deck of cards1 cupcooked vegetables salads casseroles or stews, such as chili with beans milkan average-sized fist1/2 cupfruit or fruit juice starchy vegetables, such as potatoes or corn pinto beans and other dried beans rice or noodles cerealhalf of an average-sized fist1 ouncesnack foodone handful1 Tablespoonsalad dressingthe tip of a thumb1 teaspoonmargarinea fingertip\nWays to Lower The Amount of Fat in Your Meals and Snacks\n- Choose lower-fat foods. Example: Instead of sunflower seeds (20 grams of fat), choose pretzels (1 gram). Savings: 19 grams.\n- Use low-fat versions of foods. Example: Instead of regular margarine (5 grams of fat), use low-fat margarine (2 grams). Savings: 3 grams.\n- Use low-fat seasonings. Example: Instead of putting butter and sour cream on your baked potato (20 grams of fat), have salsa (0 grams). Savings: 20 grams.\n- Cook with less fat. Example: Instead of making fried chicken (31 grams of fat), roast or grill the chicken (9 grams). Savings: 22 grams.\nRemember that low-fat or fat-free products still contain calories. Be careful about how much you eat. In fact, some low-fat or fat-free products are high in calories. Check the food label\nBe Physically Active Every Day\n- Keep track of what you do for exercise and how long you do it. Use the Daily Physical Activity Tracker to keep track of your physical activity.\n- Aim for at least 30 minutes of physical activity a day most days of the week.\n- Incorporate physical activity into plans with family and friends. Set a good example for your children. Play softball on weekends. Go on a family hike.\n- Be active every day. For example, walk to the store, clean the house, or work in the garden, rather than watch TV.\nGetting Started on a Walking Routine\nWalking is a great way to be physically active. Before you get started, talk with your health care provider about whether it's OK for you to walk for exercise. Then get comfortable shoes that provide good support. You can use the Daily Physical Activity Tracker to start your routine gradually. Try to walk at least 5 times a week. Build up little by little to 30 minutes a day of brisk walking.\nMy Walking Program\nWeek numberWarm-up time (minutes) Walk slowlyFast walk time (minutes) Walk brisklyCool-down time (minutes) Walk slowlyTotal (minutes)1555152585183511521451452455175276520530752353385265369+530540\nTake Your Prescribed Medicines\nDaily Food and Drink Tracker\nUse the Daily Food and Drink Tracker to keep track of everything you eat and drink. Make a copy of the form for each day. Write down the time, the name of the food or drink, and how much you had. For a free booklet with information on fat grams and calories, call the National Diabetes Education Program at 1888693NDEP (18886936337) and request a copy of the Game Plan Fat and Calorie Counter(PDF, 405.05 KB).\nSample\nDaily Food and Drink TrackerDate: _____________\nTimeNameAmountFat GramsCalories8:00 amoatmeal1/2 cup180fat-free milk1 cup090\nDaily Physical Activity Tracker\nUse the Daily Physical Activity Tracker to keep track of your physical activity. Make a copy of the form for each day. Write down what you do and for how long.\nSample\nDaily Physical Activity TrackerDate: _____________\nType of ActivityMinutesWalking20Gardening10\nDaily Food and Drink TrackerDate: _____________\nTimeNameAmountFat GramsCaloriesTOTALS\nDaily Physical Activity TrackerDate: _____________Type of ActivityMinutesTOTAL" } ]

[ { "from": "human", "value": "What is (are) Renal Artery Stenosis?" }, { "from": "gpt", "value": "Renal artery stenosis is the narrowing of one or both renal arteries. Renal means kidney and stenosis means narrowing. The renal arteries are blood vessels that carry blood to the kidneys from the aortathe main blood vessel that carries blood from the heart to arteries throughout the body.\nRVH is high blood pressure caused by RAS. Blood pressure is written with two numbers separated by a slash, 120/80, and is said as 120 over 80. The top number is called the systolic pressure and represents the pressure as the heart beats and pushes blood through the blood vessels. The bottom number is called the diastolic pressure and represents the pressure as blood vessels relax between heartbeats. A persons blood pressure is considered normal if it stays at or below 120/80. High blood pressure is a systolic pressure of 140 or above or a diastolic pressure of 90 or above.1" } ]

[ { "from": "human", "value": "What is (are) Renal Artery Stenosis?" }, { "from": "gpt", "value": "The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid." } ]

[ { "from": "human", "value": "What causes Renal Artery Stenosis?" }, { "from": "gpt", "value": "About 90 percent of RAS is caused by atherosclerosisclogging, narrowing, and hardening of the renal arteries.2 In these cases, RAS develops when plaquea sticky substance made up of fat, cholesterol, calcium, and other material found in the bloodbuilds up on the inner wall of one or both renal arteries. Plaque buildup is what makes the artery wall hard and narrow.\nMost other cases of RAS are caused by fibromuscular dysplasia (FMD)the abnormal development or growth of cells on the renal artery wallswhich can cause blood vessels to narrow. Rarely, RAS is caused by other conditions." } ]

[ { "from": "human", "value": "Who is at risk for Renal Artery Stenosis??" }, { "from": "gpt", "value": "People at risk for artherosclerosis are also at risk for RAS. Risk factors for RAS caused by artherosclerosis include\n- high blood cholesterol levels\n- high blood pressure\n- smoking\n- insulin resistance\n- diabetes\n- being overweight or obese\n- lack of physical activity\n- a diet high in fat, cholesterol, sodium, and sugar\n- being a man older than 45 or a woman older than 55\n- a family history of early heart disease\nThe risk factors for RAS caused by FMD are unknown, but FMD is most common in women and people 25 to 50 years of age.3 FMD can affect more than one person in a family, indicating that it may be caused by an inherited gene." } ]

[ { "from": "human", "value": "What are the symptoms of Renal Artery Stenosis?" }, { "from": "gpt", "value": "In many cases, RAS has no symptoms until it becomes severe.\nThe signs of RAS are usually either high blood pressure or decreased kidney function, or both, but RAS is often overlooked as a cause of high blood pressure. RAS should be considered as a cause of high blood pressure in people who\n- are older than age 50 when they develop high blood pressure or have a marked increase in blood pressure\n- have no family history of high blood pressure\n- cannot be successfully treated with at least three or more different types of blood pressure medications\nSymptoms of a significant decrease in kidney function include\n- increase or decrease in urination\n- edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face\n- drowsiness or tiredness\n- generalized itching or numbness\n- dry skin\n- headaches\n- weight loss\n- appetite loss\n- nausea\n- vomiting\n- sleep problems\n- trouble concentrating\n- darkened skin\n- muscle cramps" } ]

[ { "from": "human", "value": "What are the complications of Renal Artery Stenosis?" }, { "from": "gpt", "value": "People with RAS are at increased risk for complications resulting from loss of kidney function or atherosclerosis occurring in other blood vessels, such as\n- chronic kidney disease (CKD)reduced kidney function over a period of time\n- coronary artery diseasenarrowing and hardening of arteries that supply blood to the heart\n- strokebrain damage caused by lack of blood flow to the brain\n- peripheral vascular diseaseblockage of blood vessels that restricts flow of blood from the heart to other parts of the body, particularly the legs\nRAS can lead to kidney failure, described as end-stage renal disease when treated with blood-filtering treatments called dialysis or a kidney transplant, though this is uncommon in people who receive ongoing treatment for RAS." } ]

[ { "from": "human", "value": "How to diagnose Renal Artery Stenosis?" }, { "from": "gpt", "value": "A health care provider can diagnose RAS by listening to the abdomen with a stethoscope and performing imaging tests. When blood flows through a narrow artery, it sometimes makes a whooshing sound, called a bruit. The health care provider may place a stethoscope on the front or the side of the abdomen to listen for this sound. The absence of this sound, however, does not exclude the possibility of RAS.\nIn some cases, RAS is found when a person has a test for another reason. For example, a health care provider may find RAS during a coronary angiogram for diagnosis of heart problems. A coronary angiogram is a procedure that uses a special dye, called contrast medium, and x rays to see how blood flows through the heart.\nThe following imaging tests are used to diagnose RAS:\n- Duplex ultrasound. Duplex ultrasound combines traditional ultrasound with Doppler ultrasonography. Traditional ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. Doppler ultrasonography records sound waves reflected off of moving objects, such as blood, to measure their speed and other aspects of how they flow. 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 blockage in the renal artery or blood moving through nearby arteries at a lower-than-normal speed. Ultrasound is noninvasive and low cost.\n- Catheter angiogram. A catheter angiogram, also called a traditional angiogram, is a special kind of x ray in which a thin, flexible tube called a catheter is threaded through the large arteries, often from the groin, to the artery of interestin this case, the renal artery. The procedure is performed in a hospital or outpatient center by a radiologist. Anesthesia is not needed though a sedative may be given to lessen anxiety during the procedure. Contrast medium is injected through the catheter so the renal artery shows up more clearly on the x ray. Catheter angiogram is the gold standard for diagnosing RAS due to the high quality of the image produced. In addition, severe RAS can be treated during the same visit. However, a catheter angiogram is an invasive procedure, and a person may have side effects from the sedative or contrast medium or may have bleeding or injury to the artery from the catheter. The procedure is also more expensive than other imaging tests.\n- Computerized tomographic angiography (CTA) scan. CTA scans use a combination of x rays and computer technology to create images. The procedure is performed in an outpatient center or hospital by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. Contrast medium is injected into a vein in the persons arm to better see the structure of the arteries. CTA scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. CTA scans are less invasive than catheter angiograms and take less time. However, the risks from the x-ray radiation still exist, and the test often requires more contrast medium than a catheter angiogram, so it may not be recommended for a person with poor kidney function.\n- Magnetic resonance angiogram (MRA). MRA uses radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. The procedure is performed in an outpatient center or hospital by an x-ray 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. Contrast medium may be injected into a vein in the persons arm to better see the structure of the arteries. With most MRA scans, 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. In addition to providing high-quality images noninvasively, MRA can provide a functional assessment of blood flow and organ function. However, the use of contrast medium for an MRA is not advised for people with poor kidney function because of the risk of complications to the skin and other organs if the kidneys do not remove the contrast medium well enough." } ]

[ { "from": "human", "value": "What are the treatments for Renal Artery Stenosis?" }, { "from": "gpt", "value": "Treatment for RAS includes lifestyle changes, medications, and surgery and aims to\n- prevent RAS from getting worse\n- treat RVH\n- relieve the blockage of the renal arteries\nRAS that has not led to RVH or caused a significant blockage of the artery may not need treatment. RAS that needs to be treated, also called critical RAS, is defined by the American Heart Association as a reduction by more than 60 percent in the diameter of the renal artery.1 However, health care providers are not exactly sure what degree of blockage will cause significant problems.\nLifestyle Changes\nThe first step in treating RAS is making lifestyle changes that promote healthy blood vessels throughout the body, including the renal arteries. The best ways to keep plaque from building up in the arteries are to exercise, maintain a healthy body weight, and choose healthy foods. People who smoke should quit to help protect their kidneys and other internal organs.\nMedications\nPeople with RVH may need to take medications thatwhen taken as prescribed by their health care providerlower blood pressure and can also significantly slow the progression of kidney disease. Two types of blood pressure-lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretica medication that helps the kidneys remove fluid from the bloodmay be prescribed. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed. Some people with RAS cannot take an ACE inhibitor or ARB due to the effects on the kidneys. People with RAS who are prescribed an ACE inhibitor or ARB should have their kidney function checked within a few weeks of starting the medication.\nA cholesterol-lowering medication to prevent plaque from building up in the arteries and a blood-thinner, such as aspirin, to help the blood flow more easily through the arteries may also be prescribed.\nSurgery\nAlthough surgery has been used in the past for treatment of RAS due to atherosclerosis, recent studies have not shown improved outcomes with surgery compared with medication. However, surgery may be recommended for people with RAS caused by FMD or RAS that does not improve with medication. Different types of surgery for RAS include the following. The procedures are performed in a hospital by a vascular surgeona doctor who specializes in repairing blood vessels. Anesthesia is needed.\n- Angioplasty and stenting. Angioplasty is a procedure in which a catheter is put into the renal artery, usually through the groin, just as in a catheter angiogram. In addition, for angioplasty, a tiny balloon at the end of the catheter can be inflated to flatten the plaque against the artery wall. A small mesh tube, called a stent, may then be positioned inside the artery to keep plaque flattened and the artery open. People with RAS caused by FMD may be successfully treated with angioplasty alone, while angioplasty with stenting has a better outcome for people with RAS caused by atherosclerosis.\n- Endarterectomy or bypass surgery. In an endarterectomy, the plaque is cleaned out of the artery, leaving the inside lining smooth and clear. To create a bypass, a vein or synthetic tube is used to connect the kidney to the aorta. This new path serves as an alternate route for blood to flow around the blocked artery into the kidney. These procedures are not performed as often as in the past due to a high risk of complications during and after the procedure." } ]

[ { "from": "human", "value": "What to do for Renal Artery Stenosis?" }, { "from": "gpt", "value": "Limiting intake of fats, cholesterol, sodium, and sugar can help prevent atherosclerosis, which can lead to RAS. Most sodium in the diet comes from salt. A healthy diet that prevents people from becoming overweight or obese can also help prevent atherosclerosis. People with RAS that has caused decreased kidney function should limit their intake of protein, cholesterol, sodium, and potassium to slow the progression of kidney failure. More information about nutrition for CKD is provided in the NIDDK health topics, Nutrition for Early Chronic Kidney Disease in Adults and Nutrition for Advanced Chronic Kidney Disease in Adults. People should talk with their health care provider about what diet is right for them." } ]

[ { "from": "human", "value": "What to do for Renal Artery Stenosis?" }, { "from": "gpt", "value": "- Renal artery stenosis (RAS) is the narrowing of one or both renal arteries. The renal arteries are blood vessels that carry blood to the kidneys from the aortathe main blood vessel that carries blood from the heart to arteries throughout the body.\n- Renovascular hypertension (RVH) is high blood pressure caused by RAS.\n- About 90 percent of RAS is caused by atherosclerosis. Most other cases of RAS are caused by fibromuscular dysplasia (FMD), which can cause blood vessels to narrow.\n- RAS often has no symptoms until it becomes severe. The first symptoms of RAS are usually either high blood pressure or decreased kidney function, or both, but RAS is often overlooked as a cause of high blood pressure.\n- People with RAS are at increased risk for chronic kidney disease (CKD), coronary artery disease, stroke, and peripheral vascular disease.\n- Imaging tests used to diagnose RAS include duplex ultrasound, catheter angiogram, computerized tomographic angiography (CTA) scan, and magnetic resonance angiogram (MRA).\n- Treatment for RAS includes lifestyle changes, medications, and surgery." } ]

[ { "from": "human", "value": "What is (are) Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "Amyloidosis is a rare disease that occurs when amyloid proteins are deposited in tissues and organs. Amyloid proteins are abnormal proteins that the body cannot break down and recycle, as it does with normal proteins. When amyloid proteins clump together, they form amyloid deposits. The buildup of these deposits damages a persons organs and tissues. Amyloidosis can affect different organs and tissues in different people and can affect more than one organ at the same time. Amyloidosis most frequently affects the kidneys, heart, nervous system, liver, and digestive tract. The symptoms and severity of amyloidosis depend on the organs and tissues affected." } ]

[ { "from": "human", "value": "What is (are) Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men, the urethra is long, while in women it is short." } ]

[ { "from": "human", "value": "What is (are) Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys.\nPrimary Amyloidosis of the Kidneys\nThe kidneys are the organs most commonly affected by primary amyloidosis. Amyloid deposits damage the kidneys and make it harder for them to filter wastes and break down proteins. When the kidneys become too damaged, they may no longer be able to function well enough to maintain health, resulting in kidney failure. Kidney failure can lead to problems such as high blood pressure, bone disease, and anemiaa condition in which the body has fewer red blood cells than normal.\nDialysis-related Amyloidosis\nPeople who suffer from kidney failure and have been on long-term dialysis may develop dialysis-related amyloidosis. This type of amyloidosis occurs when a certain protein, called beta-2 microglobulin, builds up in the blood because dialysis does not remove it completely. The two types of dialysis are\n- hemodialysis. Hemodialysis uses a special filter called a dialyzer to remove wastes and extra fluid from the blood.\n- peritoneal dialysis. Peritoneal dialysis uses the lining of the abdominal cavitythe space in the body that holds organs such as the stomach, intestines, and liverto filter the blood.\nDialysis-related amyloidosis is a complication of kidney failure because neither hemodialysis nor peritoneal dialysis effectively filters beta-2 microglobulin from the blood. As a result, elevated amounts of beta-2 microglobulin remain in the blood. Dialysis-related amyloidosis is relatively common in people with kidney failure, especially adults older than 60 years of age, who have been on dialysis for more than 5 years.1\nMore information is provided in the NIDDK health topics:\n- Treatment Methods for Kidney Failure: Hemodialysis\n- Treatment Methods for Kidney Failure: Peritoneal Dialysis" } ]

[ { "from": "human", "value": "What are the symptoms of Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "The most common sign of primary amyloidosis of the kidneys is nephrotic syndromea collection of signs that indicate kidney damage. The signs of nephrotic syndrome include\n- albuminuriaan increased amount of albumin, a protein, in the urine. A person with nephrotic syndrome excretes more than half a teaspoon of albumin per day.\n- hyperlipidemiaa condition in which a persons blood has more-than-normal amounts of fats and cholesterol.\n- edemaswelling, typically in a persons legs, feet, or ankles and less often in the hands or face.\n- hypoalbuminemiaa condition in which a persons blood has less-than-normal amounts of albumin.\nMore information is provided in the NIDDK health topic, Nephrotic Syndrome in Adults.\nOther signs and symptoms of primary amyloidosis may include\n- fatigue, or feeling tired\n- shortness of breath\n- low blood pressure\n- numbness, tingling, or a burning sensation in the hands or feet\n- weight loss" } ]

[ { "from": "human", "value": "What are the symptoms of Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "The symptoms of dialysis-related amyloidosis may include\n- pain, stiffness, and fluid in the joints.\n- abnormal, fluid-containing sacs, called cysts, in some bones.\n- carpal tunnel syndrome, caused by unusual buildup of amyloid proteins in the wrists. The symptoms of carpal tunnel syndrome include numbness or tingling, sometimes associated with muscle weakness, in the fingers and hands.\nDialysis-related amyloidosis most often affects bones, joints, and the tissues that connect muscle to bone, called tendons. The disease may also affect the digestive tract and organs such as the heart and lungs. Bone cysts caused by dialysis-related amyloidosis can lead to bone fractures. Dialysis-related amyloidosis can also cause tears in tendons and ligaments. Ligaments are tissues that connect bones to other bones." } ]

[ { "from": "human", "value": "How to diagnose Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "A health care provider diagnoses primary amyloidosis of the kidneys with\n- a medical and family history\n- a physical exam\n- urinalysis\n- blood tests\n- a kidney biopsy\nMedical and Family History\nTaking a medical and family history may help a health care provider diagnose amyloidosis of the kidneys. He or she will ask the patient to provide a medical and family history.\nPhysical Exam\nA physical exam may help diagnose primary amyloidosis of the kidneys. During a physical exam, a health care provider usually\n- examines a patients body to check for swelling\n- uses a stethoscope to listen to the lungs\n- taps on specific areas of the patients body\nUrinalysis\nA health care provider may use urinalysisthe testing of a urine sampleto check for albumin and amyloid proteins in urine. The patient provides a urine sample in a special container at a health care providers office or a commercial facility. A nurse or technician can test the sample in the same location or send it to a lab for analysis. More-than-normal amounts of albumin in urine may indicate kidney damage due to primary amyloidosis. Amyloid proteins in urine may indicate amyloidosis.\nBlood Tests\nThe health care provider may use blood tests to see how well the kidneys are working and to check for amyloid proteins and hyperlipidemia. A blood test involves drawing a patients blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. Blood tests for kidney function measure the waste products in the blood that healthy kidneys normally filter out. Hyperlipidemia may indicate nephrotic syndrome. Amyloid proteins in blood may indicate amyloidosis.\nKidney Biopsy\nOnly a biopsy can show the amyloid protein deposits in the kidneys. A health care provider may recommend a kidney biopsy if other tests show kidney damage. A kidney biopsy is a procedure that involves taking a piece of kidney tissue for examination with a microscope. A health care provider performs a kidney biopsy 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 and take the tissue sample. A pathologista doctor who specializes in diagnosing diseasesexamines the tissue in a lab for amyloid proteins and kidney damage.\nThe biopsy results can help the health care provider determine the best course of treatment. More information is provided in the NIDDK health topic, Kidney Biopsy." } ]

[ { "from": "human", "value": "How to diagnose Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "A health care provider diagnoses dialysis-related amyloidosis with\n- urinalysis\n- blood tests\n- imaging tests\nA health care provider can use urinalysis and blood tests to detect the amount of amyloid proteins in urine and blood. Imaging tests, such as x-rays and CT scans, can provide pictures of bone cysts and amyloid deposits in bones, joints, tendons, and ligaments. An x-ray technician performs imaging tests in a health care providers office, an outpatient center, or a hospital. A radiologista doctor who specializes in medical imaginginterprets the images. A patient does not require anesthesia." } ]

[ { "from": "human", "value": "What are the treatments for Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "A health care provider treats primary amyloidosis of the kidneys with the following:\n- medication therapy, including chemotherapy\n- a stem cell transplant\n- treating other conditions\nMedication therapy. The goal of medication therapy, including chemotherapy, is to reduce amyloid protein levels in the blood. Many health care providers recommend combination medication therapy such as\n- melphalan (Alkeran), a type of chemotherapy\n- dexamethasone (Decadron), an anti-inflammatory steroid medication\nThese medications can stop the growth of the cells that make amyloid proteins. These medications may cause hair loss and serious side effects, such as nausea, vomiting, and fatigue.\nStem cell transplant. A stem cell transplant is a procedure that replaces a patients damaged stem cells with healthy ones. Stem cells are found in the bone marrow and develop into three types of blood cells the body needs. To prepare for a stem cell transplant, the patient receives high doses of chemotherapy. The actual transplant is like a blood transfusion. The transplanted stem cells travel to the bone marrow to make healthy new blood cells. The chemotherapy a patient receives to prepare for the transplant can have serious side effects, so it is important to talk with the health care provider about the risks of this procedure.\nRead more in What Is a Blood and Marrow Stem Cell Transplant? at www.nhlbi.nih.gov/health/health-topics/topics/bmsct.\nTreating other conditions. Primary amyloidosis has no cure, so treating some of the side effects and other conditions seen with the disease is essential. Other conditions may include\n- anemiatreatment may include medications\n- depressiontreatment may include talking with a mental health counselor and taking medications\n- fatiguetreatment may include changes in diet and activity level\n- kidney diseasetreatment may include medications to help maintain kidney function or slow the progression of kidney disease\nA patient and his or her family should talk with the health care provider about resources for support and treatment options.\nMore information about kidney disease is provided in the NIDDK health topic, niddk-kidney disease." } ]

[ { "from": "human", "value": "What are the treatments for Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "A health care provider treats dialysis-related amyloidosis with\n- medication therapy\n- newer, more effective hemodialysis filters\n- surgery\n- a kidney transplant\nThe goal of medication therapy and the use of newer, more effective hemodialysis filters is to reduce amyloid protein levels in the blood. Medication therapy can help reduce symptoms such as pain and inflammation. A health care provider may treat a person with dialysis-related amyloidosis who has bone, joint, and tendon problems, such as bone cysts and carpal tunnel syndrome, using surgery.\nDialysis-related amyloidosis has no cure; however, a successful kidney transplant may stop the disease from progressing.\nMore information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Transplantation." } ]

[ { "from": "human", "value": "What to do for Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "Researchers have not found that eating, diet, and nutrition play a role in causing or preventing primary amyloidosis of the kidneys or dialysis-related amyloidosis. People with nephrotic syndrome may make dietary changes such as\n- limiting dietary sodium, often from salt, to help reduce edema and lower blood pressure\n- decreasing liquid intake to help reduce edema and lower blood pressure\n- eating a diet low in saturated fat and cholesterol to help control more-than-normal amounts of fats and cholesterol in the blood\nHealth care providers may recommend that people with kidney disease eat moderate or reduced amounts of protein. Proteins break down into waste products that the kidneys filter from the blood. Eating more protein than the body needs may burden the kidneys and cause kidney function to decline faster. However, protein intake that is too low may lead to malnutrition, a condition that occurs when the body does not get enough nutrients.\nPeople with kidney disease on a restricted protein diet should receive blood tests that can show low nutrient levels. People with primary amyloidosis of the kidneys or dialysis-related amyloidosis should talk with a health care provider about dietary restrictions to best manage their individual needs." } ]

[ { "from": "human", "value": "What to do for Amyloidosis and Kidney Disease?" }, { "from": "gpt", "value": "- Amyloidosis is a rare disease that occurs when amyloid proteins are deposited in tissues and organs.\n- Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys.\n- The most common sign of primary amyloidosis of the kidneys is nephrotic syndrome.\n- The signs of nephrotic syndrome include- albuminuriaan elevated amount of albumin in the urine. A person with nephrotic syndrome excretes more than half a teaspoon of albumin per day.\n- hyperlipidemiaa condition in which a persons blood has more-than-normal amounts of fats and cholesterol.\n- edemaswelling, typically in a persons legs, feet, or ankles and less often in the hands or face.\n- hypoalbuminemiaa condition in which a persons blood has less-than-normal amounts of albumin.\n- Other signs and symptoms of primary amyloidosis may include- fatigue, or feeling tired- shortness of breath- low blood pressure- numbness, tingling, or a burning sensation in the hands or feet- weight loss- The symptoms of dialysis-related amyloidosis may include- pain, stiffness, and fluid in the joints.\n- abnormal, fluid-containing sacs, called cysts, in some bones.\n- carpal tunnel syndrome, caused by unusual buildup of amyloid proteins in the wrists. The symptoms of carpal tunnel syndrome include numbness or tingling, sometimes associated with muscle weakness, in the fingers and hands.\n- A health care provider diagnoses primary amyloidosis of the kidneys with- a medical and family history- a physical exam- urinalysis- blood tests- a kidney biopsy- A health care provider diagnoses dialysis-related amyloidosis with- urinalysis- blood tests- imaging tests- A health care provider treats primary amyloidosis of the kidneys with the following:- medication therapy, including chemotherapy- a stem cell transplant- treating other conditions- A health care provider treats dialysis-related amyloidosis with- medication therapy- newer, more effective hemodialysis filters- surgery- a kidney transplant" } ]

[ { "from": "human", "value": "What is (are) Amyloidosis and Kidney Disease?" }, { "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: Glenn Chertow, M.D., University of California at San Francisco; William J. Stone, M.D., Vanderbilt University; Morie A. Gertz, M.D., Mayo Clinic\nThis information is not copyrighted. The NIDDK encourages people to share this content freely.\nSeptember 2014" } ]

[ { "from": "human", "value": "What is (are) Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "Primary biliary cirrhosis is a chronic, or long lasting, disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear.\nThe bile ducts carry a fluid called bile from the liver to the gallbladder, where it is stored. When food enters the stomach after a meal, the gallbladder contracts, and the bile ducts carry bile to the duodenum, the first part of the small intestine, for use in digestion. The liver makes bile, which is made up of bile acids, cholesterol, fats, and fluids. Bile helps the body absorb fats, cholesterol, and fat-soluble vitamins. Bile also carries cholesterol, toxins, and waste products to the intestines, where the body removes them. When chronic inflammation, or swelling, damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue.\nThis damage to the liver tissue can lead to cirrhosis, a condition in which the liver slowly deteriorates and is unable to function normally. In cirrhosis, scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.\nThe liver is the bodys largest internal organ. The liver is called the bodys metabolic factory because of the important role it plays in metabolismthe way cells change food into energy after food is digested and absorbed into the blood. The liver has many functions, including\n- taking up, storing, and processing nutrients from foodincluding fat, sugar, and proteinand delivering them to the rest of the body when needed\n- making new proteins, such as clotting factors and immune factors\n- producing bile\n- removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications\nA healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete, and the liver creates scar tissue. Scarring of the liver may lead to cirrhosis.\nThe buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail. Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively replace damaged cells.\nPrimary biliary cirrhosis usually occurs between the ages of 30 and 65 and affects women more often than men.1" } ]

[ { "from": "human", "value": "What causes Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "The causes of primary biliary cirrhosis are unknown. Most research suggests it is an autoimmune disease. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. An autoimmune disease is a disorder in which the bodys immune system attacks the bodys own cells and organs. In primary biliary cirrhosis, the immune system attacks the small bile ducts in the liver.\nGenetics, or inherited genes, can make a person more likely to develop primary biliary cirrhosis. Primary biliary cirrhosis is more common in people who have a parent or siblingparticularly an identical twinwith the disease. In people who are genetically more likely to develop primary biliary cirrhosis, environmental factors may trigger or worsen the disease, including\n- exposure to toxic chemicals\n- smoking\n- infections\nGenetics can also make some people more likely to develop other autoimmune diseases, such as\n- autoimmune hepatitis, a disease in which the bodys immune system attacks liver cells\n- Sjgrens syndrome, a condition in which the immune system attacks the glands that produce tears and saliva\n- autoimmune thyroid dysfunctions, conditions in which the immune system attacks the thyroid gland" } ]

[ { "from": "human", "value": "What are the symptoms of Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "The first and most common symptoms of primary biliary cirrhosis are\n- fatigue, or feeling tired\n- itching skin, and darkened skin in itching areas due to scratching\n- dry eyes and mouth\nSome people may have jaundice, a condition that causes the skin and whites of the eyes to turn yellow. Health care providers diagnose up to 60 percent of people with primary biliary cirrhosis before symptoms begin.2 Routine blood tests showing abnormal liver enzyme levels may lead a health care provider to suspect that a person without symptoms has primary biliary cirrhosis." } ]

[ { "from": "human", "value": "What are the complications of Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "Most complications of primary biliary cirrhosis are related to cirrhosis and start after primary biliary cirrhosis progresses to cirrhosis. In some cases, portal hypertension and esophageal varices may develop before cirrhosis.\nPortal hypertension. The portal vein carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver. In cirrhosis, scar tissue partially blocks the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension. Portal hypertension is a common complication of cirrhosis. This condition may lead to other complications, such as\n- edemaswelling due to a buildup of fluidin the feet, ankles, or legs, and ascitesa buildup of fluid in the abdomen\n- enlarged blood vessels, called varices, in the esophagus, stomach, or both\n- an enlarged spleen, called splenomegaly\n- mental confusion due to a buildup of toxins that are ordinarily removed by the liver, a condition called hepatic encephalopathy\nEdema and ascites. Liver failure causes fluid buildup that results in edema and ascites. Ascites can lead to spontaneous bacterial peritonitis, a serious infection that requires immediate medical attention.\nVarices. Portal hypertension may cause enlarged blood vessels in the esophagus, stomach, or both. These enlarged blood vessels, called esophageal or gastric varices, cause the vessel walls to become thin and blood pressure to increase, making the blood vessels more likely to burst. If they burst, serious bleeding can occur in the esophagus or upper stomach, requiring immediate medical attention.\nSplenomegaly. Portal hypertension may cause the spleen to enlarge and retain white blood cells and platelets, reducing the numbers of these cells and platelets in the blood. A low platelet count may be the first evidence that a person has developed cirrhosis.\nHepatic encephalopathy. A failing liver cannot remove toxins from the blood, so they eventually accumulate in the brain. The buildup of toxins in the brain is called hepatic encephalopathy. This condition can decrease mental function and cause stupor and even coma. Stupor is an unconscious, sleeplike state from which a person can only be aroused briefly by a strong stimulus, such as a sharp pain. Coma is an unconscious, sleeplike state from which a person cannot be aroused. Signs of decreased mental function include\n- confusion\n- personality changes\n- memory loss\n- trouble concentrating\n- a change in sleep habits\nMetabolic bone diseases. Some people with cirrhosis develop a metabolic bone disease, which is a disorder of bone strength usually caused by abnormalities of vitamin D, bone mass, bone structure, or minerals, such as calcium and phosphorous. Osteopenia is a condition in which the bones become less dense, making them weaker. When bone loss becomes more severe, the condition is referred to as osteoporosis. People with these conditions are more likely to develop bone fractures.\nGallstones and bile duct stones. If cirrhosis prevents bile from flowing freely to and from the gallbladder, the bile hardens into gallstones. Symptoms of gallstones include abdominal pain and recurrent bacterial cholangitisirritated or infected bile ducts. Stones may also form in and block the bile ducts, causing pain, jaundice, and bacterial cholangitis.\nSteatorrhea. Steatorrhea is a condition in which the body cannot absorb fat, causing a buildup of fat in the stool and loose, greasy, and foul-smelling bowel movements. Steatorrhea may be caused by impairment of bile delivery to the small intestine or by the pancreas not producing enough digestive enzymes.\nLiver cancer. Liver cancer is common in people with cirrhosis. Liver cancer has a high mortality rate. Current treatments are limited and only fully successful if a health care provider detects the cancer early, before the tumor is too large. For this reason, health care providers should check people with cirrhosis for signs of liver cancer every 6 to 12 months. Health care providers use blood tests, ultrasound, or both to check for signs of liver cancer." } ]

[ { "from": "human", "value": "How to diagnose Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "A health care provider may use the following tests to diagnose primary biliary cirrhosis:\n- a medical and family history\n- a physical exam\n- blood tests\n- imaging tests\n- a liver biopsy\nA health care provider usually bases a diagnosis of primary biliary cirrhosis on two out of three of the following criteria:\n- a blood test showing elevated liver enzymes\n- a blood test showing the presence of anti-mitochondrial antibodies (AMA)\n- a liver biopsy showing signs of the disease\nHealth care providers may order additional tests to rule out other causes of symptoms. Health care providers diagnose the majority of people with primary biliary cirrhosis early in the course of the disease.\nMedical and family history. Taking a medical and family history is one of the first things a health care provider may do to help diagnose primary biliary cirrhosis. He or she will ask a patient to provide a medical and family history.\nPhysical exam. A physical exam may help diagnose primary biliary cirrhosis. During a physical exam, a health care provider usually\n- examines a patients body\n- uses a stethoscope to listen to sounds in the abdomen\n- taps on specific areas of the patients body\nThe health care provider will perform a physical exam to look for signs of the disease. For example, the liver may feel hard or ascites may cause the abdomen to enlarge.\nBlood test. A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. The blood test can show elevated levels of liver enzymes, such as alkaline phosphatase. A routine blood test may show high levels of the liver enzyme alkaline phosphatase in people who have primary biliary cirrhosis and are not yet showing symptoms.\nThe health care provider will perform an AMA blood test to help confirm the diagnosis. A blood test will detect the presence of AMA in 90 to 95 percent of people with primary biliary cirrhosis.3\nImaging tests. A health care provider may use the following imaging tests to examine the bile ducts. These tests can distinguish between primary biliary cirrhosis and other conditions that affect the bile ducts.\n- Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and a radiologista doctor who specializes in medical imaging interprets the images. A patient does not need anesthesia. In addition to showing problems with the bile ducts, the images can show signs of advanced cirrhosis or complications.\n- Magnetic resonance cholangiopancreatography uses magnetic resonance imaging (MRI) to examine the bile ducts. MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. A specially trained technician performs magnetic resonance cholangiopancreatography in an outpatient center or a hospital, and a radiologist interprets the images. A patient does not need anesthesia, though a health care provider may use light sedation for patients with a fear of confined spaces. With most MRI machines, the patient lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some machines allow the patient to lie in a more open space.\n- Endoscopic retrograde cholangiopancreatography uses an x ray to look at the bile ducts. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. After lightly sedating the patient, the gastroenterologist inserts an endoscopea small, flexible tube with a light and a camera on the endthrough the mouth into the duodenum and bile ducts. The endoscope is connected to a computer and video monitor. The gastroenterologist injects a special dye, called contrast medium, through the tube into the bile ducts, which makes the ducts show up on the monitor. This test is more invasive than other imaging tests, and health care providers do not routinely need the test to make the diagnosis of primary biliary cirrhosis. A health care provider uses the test selectively when he or she is concerned that the blockage of the bile ducts has another cause, such as a gallstone or a narrowing of the large bile ducts due to inflammation or cancer. Patients may have pain, nausea, or vomiting after the test or may develop bacterial cholangitis or pancreatitisinflammation of the pancreas.\nLiver biopsy. A liver biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to stop taking certain medications temporarily before the liver biopsy. The health care provider may ask the patient to fast for 8 hours before the procedure.\nDuring the procedure, the patient lies on a table, right hand resting above the head. The health care provider applies a local anesthetic to the area where he or she will insert the biopsy needle. If needed, a health care provider will also give sedatives and pain medication. The health care provider uses a needle to take a small piece of liver tissue. He or she may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home.\nA health care provider performs a liver biopsy at a hospital or an outpatient center. The health care provider sends the liver sample to a pathology lab, where the pathologista doctor who specializes in diagnosing diseaseslooks at the tissue with a microscope and sends a report to the patients health care provider.\nA liver biopsy can confirm the diagnosis of primary biliary cirrhosis; however, a person does not always need this test. A health care provider will perform a biopsy if the AMA blood test is negative and the person shows other signs of primary biliary cirrhosis. Sometimes a health care provider finds a cause of liver damage other than primary biliary cirrhosis during biopsy." } ]

[ { "from": "human", "value": "What are the treatments for Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "Treatment for primary biliary cirrhosis depends on how early a health care provider diagnoses the disease and whether complications are present. In the early stages of primary biliary cirrhosis, treatment can slow the progression of liver damage to cirrhosis. In the early stages of cirrhosis, the goals of treatment are to slow the progression of tissue scarring in the liver and prevent complications. As cirrhosis progresses, a person may need additional treatments and hospitalization to manage complications.\nMedications\nHealth care providers prescribe ursodiol (Actigall, Urso) to treat primary biliary cirrhosis. Ursodiol is a nontoxic bile acid that people can take orally. Ursodiol replaces the bile acids that are normally produced by the liver, which are more toxic and can harm the liver. Treatment with ursodiol can reduce levels of bilirubin and liver enzymes in the blood. Early treatment with this medication reduces the likelihood of needing a liver transplant and improves survival.3 Early treatment provides the most benefit; however, ursodiol treatment late in the course of the disease can still slow the progression of liver damage. While ursodiol treatment improves the outcome of primary biliary cirrhosis, it does not cure the disease.\nResearchers are studying the effects of several other medications on the progression of primary biliary cirrhosis. To date, none has shown the positive effects of ursodiol.\nAvoiding Alcohol and Other Substances\nPeople with cirrhosis should not drink any alcohol or take any illegal substances, as both will cause more liver damage. People with cirrhosis should avoid complementary and alternative medications, such as herbs. People with cirrhosis should be careful about starting new medications and should consult a health care provider before taking prescription medications, over-the-counter medications, or vitamins. Many vitamins and prescription and over-the-counter medications can affect liver function.\nTreatment of Symptoms and Complications\nHealth care providers treat symptoms and complications as follows:\nItching. Antihistamines may help with mild itching. However, antihistamines often cause drowsiness, and a person should take antihistamines just before bedtime to help with nighttime itching. A health care provider will treat more problematic itching with cholestyramine (Locholest, Questran), which reduces cholesterol in the blood. Experts believe high levels of cholesterol let substances that cause itching build up in tissues.\nDry eyes and mouth. Health care providers usually treat dry eyes and mouth with artificial tears and saliva substitutes, respectively. These products are available without a prescription. A health care provider may treat people whose symptoms do not improve with pilocarpine (Salagen) or cevimeline (Evoxac). People who have difficulty with dry eyes should see an ophthalmologista doctor who diagnoses and treats all eye diseases and eye disordersregularly. People with dry mouth should have regular dental exams.\nPortal hypertension. A health care provider may prescribe a beta-blocker or nitrate to treat portal hypertension. Beta-blockers lower blood pressure by helping the heart beat slower and with less force, and nitrates relax and widen blood vessels to let more blood flow to the heart and reduce the hearts workload.\nVarices. Beta-blockers can lower the pressure in varices and reduce the likelihood of bleeding. Bleeding in the stomach or esophagus requires an immediate upper endoscopy. This procedure involves using an endoscope to look for varices. The health care provider may use the endoscope to perform a band ligation, a procedure that involves placing a special rubber band around the varices that causes the tissue to die and fall off. A gastroenterologist performs the procedure at a hospital or an outpatient center. People who have had varices in the past may need to take medication to prevent future episodes.\nEdema and ascites. Health care providers prescribe diureticsmedications that remove fluid from the bodyto treat edema and ascites. A health care provider may remove large amounts of ascitic fluid from the abdomen and check for spontaneous bacterial peritonitis. A health care provider may prescribe bacteria-fighting medications called antibiotics to prevent infection. He or she may prescribe oral antibiotics; however, severe infection with ascites requires intravenous (IV) antibiotics.\nHepatic encephalopathy. A health care provider will treat hepatic encephalopathy by cleansing the bowel with lactulose, a laxative given orally or as an enemaa liquid put into the rectum. A health care provider may also add antibiotics to the treatment. Hepatic encephalopathy may improve as other complications of cirrhosis are controlled.\nOsteoporosis. A health care provider may prescribe bisphosphonate medications to improve bone density.\nGallstones and bile duct stones. A health care provider may use surgery to remove gallstones. He or she may use endoscopic retrograde cholangiopancreatography, which uses balloons and basketlike devices, to retrieve the bile duct stones.\nLiver cancer. A health care provider may recommend screening tests every 6 to 12 months to check for signs of liver cancer. Screening tests can find cancer before the person has symptoms of the disease. Cancer treatment is usually more effective when the health care provider finds the disease early. Health care providers use blood tests, ultrasound, or both to screen for liver cancer in people with cirrhosis. He or she may treat cancer with a combination of surgery, radiation, and chemotherapy." } ]

[ { "from": "human", "value": "What to do for Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "A healthy diet is important in all stages of cirrhosis because malnutrition is common in people with this disease. Malnutrition is a condition that occurs when the body does not get enough nutrients. Cirrhosis may lead to malnutrition because it can cause\n- people to eat less because of symptoms such as loss of appetite\n- changes in metabolism\n- reduced absorption of vitamins and minerals\nHealth care providers can recommend a meal plan that is well balanced and provides enough calories and protein. If ascites develops, a health care provider or dietitian may recommend a sodium-restricted diet. To improve nutrition, the health care provider may prescribe a liquid supplement. A person may take the liquid by mouth or through a nasogastric tubea tiny tube inserted through the nose and throat that reaches into the stomach.\nA person with cirrhosis should not eat raw shellfish, which can contain a bacterium that causes serious infection. Cirrhosis affects the immune system, making people with cirrhosis more likely than healthy people to develop an infection after eating shellfish that contain this bacterium.\nA health care provider may recommend calcium and vitamin D supplements to help prevent osteoporosis." } ]

[ { "from": "human", "value": "What to do for Primary Biliary Cirrhosis?" }, { "from": "gpt", "value": "- Primary biliary cirrhosis is a chronic disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear.\n- When chronic inflammation damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue. This damage to the liver tissue can lead to cirrhosis.\n- The causes of primary biliary cirrhosis are unknown. Most research suggests it is an autoimmune disease.\n- Primary biliary cirrhosis is more common in people who have a parent or siblingparticularly an identical twinwith the disease.\n- The first and most common symptoms of primary biliary cirrhosis are fatigue, itching, and dry eyes and mouth. Some people may have jaundice, a condition that causes the skin and whites of the eyes to turn yellow. Health care providers diagnose up to 60 percent of people with primary biliary cirrhosis before symptoms begin.\n- Most complications of primary biliary cirrhosis are related to cirrhosis and start after primary biliary cirrhosis progresses to cirrhosis.\n- A health care provider may use the following tests to diagnose primary biliary cirrhosis:- a medical and family history- a physical exam- blood tests- imaging tests- a liver biopsy- Health care providers prescribe ursodiol (Actigall, Urso) to treat primary biliary cirrhosis. Early treatment with this medication reduces the likelihood of needing a liver transplant and improves survival.\n- A health care provider may consider a liver transplant when cirrhosis leads to liver failure or treatment for complications is ineffective." } ]

[ { "from": "human", "value": "What is (are) Proteinuria?" }, { "from": "gpt", "value": "Proteinuriaalso called albuminuria or urine albuminis a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body.\nAs blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys' filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged.\nProteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease. If CKD progresses, it can lead to end-stage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular blood-cleansing treatments called dialysis." } ]

[ { "from": "human", "value": "Who is at risk for Proteinuria??" }, { "from": "gpt", "value": "People with diabetes, hypertension, or certain family backgrounds are at risk for proteinuria. In the United States, diabetes is the leading cause of ESRD.1 In both type 1 and type 2 diabetes, albumin in the urine is one of the first signs of deteriorating kidney function. As kidney function declines, the amount of albumin in the urine increases.\nAnother risk factor for developing proteinuria is hypertension, or high blood pressure. Proteinuria in a person with high blood pressure is an indicator of declining kidney function. If the hypertension is not controlled, the person can progress to full kidney failure.\nAfrican Americans are more likely than Caucasians to have high blood pressure and to develop kidney problems from it, even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertension-related kidney failure.2\nOther groups at risk for proteinuria are American Indians, Hispanics/Latinos, Pacific Islander Americans, older adults, and overweight people. These at-risk groups and people who have a family history of kidney disease should have their urine tested regularly." } ]

[ { "from": "human", "value": "What are the symptoms of Proteinuria?" }, { "from": "gpt", "value": "Proteinuria has no signs or symptoms in the early stages. Large amounts of protein in the urine may cause it to look foamy in the toilet. Also, because protein has left the body, the blood can no longer soak up enough fluid, so swelling in the hands, feet, abdomen, or face may occur. This swelling is called edema. These are signs of large protein loss and indicate that kidney disease has progressed. Laboratory testing is the only way to find out whether protein is in a persons urine before extensive kidney damage occurs.\nSeveral health organizations recommend regular urine checks for people at risk for CKD. A 1996 study sponsored by the National Institutes of Health determined that proteinuria is the best predictor of progressive kidney failure in people with type 2 diabetes. The American Diabetes Association recommends regular urine testing for proteinuria for people with type 1 or type 2 diabetes. The National Kidney Foundation recommends that routine checkups include testing for excess protein in the urine, especially for people in high-risk groups." } ]

[ { "from": "human", "value": "How to diagnose Proteinuria?" }, { "from": "gpt", "value": "Until recently, an accurate protein measurement required a 24-hour urine collection. In a 24-hour collection, the patient urinates into a container, which is kept refrigerated between trips to the bathroom. The patient is instructed to begin collecting urine after the first trip to the bathroom in the morning. Every drop of urine for the rest of the day is to be collected in the container. The next morning, the patient adds the first urination after waking and the collection is complete.\nIn recent years, researchers have found that a single urine sample can provide the needed information. In the newer technique, the amount of albumin in the urine sample is compared with the amount of creatinine, a waste product of normal muscle breakdown. The measurement is called a urine albumin-to-creatinine ratio (UACR). A urine sample containing more than 30 milligrams of albumin for each gram of creatinine (30 mg/g) is a warning that there may be a problem. If the laboratory test exceeds 30 mg/g, another UACR test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, the person has persistent proteinuria, a sign of declining kidney function, and should have additional tests to evaluate kidney function." } ]

[ { "from": "human", "value": "How to diagnose Proteinuria?" }, { "from": "gpt", "value": "Tests that measure the amount of creatinine in the blood will show whether a persons kidneys are removing wastes efficiently. Having too much creatinine in the blood is a sign that a person has kidney damage. The doctor can use the creatinine measurement to estimate how efficiently the kidneys are filtering the blood. This calculation is called the estimated glomerular filtration rate, or eGFR. CKD is present when the eGFR is less than 60 milliliters per minute (mL/min)." } ]

[ { "from": "human", "value": "What to do for Proteinuria?" }, { "from": "gpt", "value": "- Proteinuria is a condition in which urine contains a detectable amount of protein.\n- Proteinuria is a sign of chronic kidney disease (CKD).\n- Groups at risk for proteinuria include African Americans, American Indians, Hispanics/Latinos, Pacific Islander Americans, older people, overweight people, people with diabetes or hypertension, and people who have a family history of kidney disease.\n- Proteinuria may have no signs or symptoms. Laboratory testing is the only way to find out whether protein is in a person's urine.\n- Several health organizations recommend regular checks for proteinuria so kidney disease can be detected and treated before it progresses.\n- A person with diabetes, hypertension, or both should work to control blood glucose and blood pressure." } ]

[ { "from": "human", "value": "What is (are) Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "Benign prostatic hyperplasiaalso called BPHis a condition in men in which the prostate gland is enlarged and not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction.\nThe prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a mans life. Benign prostatic hyperplasia often occurs with the second growth phase.\nAs the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retentionthe inability to empty the bladder completelycause many of the problems associated with benign prostatic hyperplasia." } ]

[ { "from": "human", "value": "What is (are) Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. Prostate fluid is essential for a mans fertility. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis." } ]

[ { "from": "human", "value": "What causes Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.\nThroughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.\nAnother theory focuses on dihydrotestosterone (DHT), a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia." } ]

[ { "from": "human", "value": "How many people are affected by Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "Benign prostatic hyperplasia is the most common prostate problem for men older than age 50. In 2010, as many as 14 million men in the United States had lower urinary tract symptoms suggestive of benign prostatic hyperplasia.1 Although benign prostatic hyperplasia rarely causes symptoms before age 40, the occurrence and symptoms increase with age. Benign prostatic hyperplasia affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80.2" } ]

[ { "from": "human", "value": "What are the symptoms of Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include\n- urinary frequencyurination eight or more times a day\n- urinary urgencythe inability to delay urination\n- trouble starting a urine stream\n- a weak or an interrupted urine stream\n- dribbling at the end of urination\n- nocturiafrequent urination during periods of sleep\n- urinary retention\n- urinary incontinencethe accidental loss of urine\n- pain after ejaculation or during urination\n- urine that has an unusual color or smell\nSymptoms of benign prostatic hyperplasia most often come from\n- a blocked urethra\n- a bladder that is overworked from trying to pass urine through the blockage\nThe size of the prostate does not always determine the severity of the blockage or symptoms. Some men with greatly enlarged prostates have little blockage and few symptoms, while other men who have minimally enlarged prostates have greater blockage and more symptoms. Less than half of all men with benign prostatic hyperplasia have lower urinary tract symptoms.3\nSometimes men may not know they have a blockage until they cannot urinate. This condition, called acute urinary retention, can result from taking over-the-counter cold or allergy medications that contain decongestants, such as pseudoephedrine and oxymetazoline. A potential side effect of these medications may prevent the bladder neck from relaxing and releasing urine. Medications that contain antihistamines, such as diphenhydramine, can weaken the contraction of bladder muscles and cause urinary retention, difficulty urinating, and painful urination. When men have partial urethra blockage, urinary retention also can occur as a result of alcohol consumption, cold temperatures, or a long period of inactivity." } ]

[ { "from": "human", "value": "What are the complications of Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "The complications of benign prostatic hyperplasia may include\n- acute urinary retention\n- chronic, or long lasting, urinary retention\n- blood in the urine\n- urinary tract infections (UTIs)\n- bladder damage\n- kidney damage\n- bladder stones\nMost men with benign prostatic hyperplasia do not develop these complications. However, kidney damage in particular can be a serious health threat when it occurs.\nWhen to Seek Medical Care A person may have urinary symptoms unrelated to benign prostatic hyperplasia that are caused by bladder problems, UTIs, or prostatitisinflammation of the prostate. Symptoms of benign prostatic hyperplasia also can signal more serious conditions, including prostate cancer. Men with symptoms of benign prostatic hyperplasia should see a health care provider. Men with the following symptoms should seek immediate medical care:\n- complete inability to urinate\n- painful, frequent, and urgent need to urinate, with fever and chills\n- blood in the urine\n- great discomfort or pain in the lower abdomen and urinary tract" } ]

[ { "from": "human", "value": "How to diagnose Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "A health care provider diagnoses benign prostatic hyperplasia based on\n- a personal and family medical history\n- a physical exam\n- medical tests\nPersonal and Family Medical History\nTaking a personal and family medical history is one of the first things a health care provider may do to help diagnose benign prostatic hyperplasia. A health care provider may ask a man\n- what symptoms are present\n- when the symptoms began and how often they occur\n- whether he has a history of recurrent UTIs\n- what medications he takes, both prescription and over the counter\n- how much liquid he typically drinks each day\n- whether he consumes caffeine and alcohol\n- about his general medical history, including any significant illnesses or surgeries\nPhysical Exam\nA physical exam may help diagnose benign prostatic hyperplasia. During a physical exam, a health care provider most often\n- examines a patients body, which can include checking for- discharge from the urethra- enlarged or tender lymph nodes in the groin- a swollen or tender scrotum- taps on specific areas of the patients body\n- performs a digital rectal exam\nA digital rectal exam, or rectal exam, is a physical exam of the prostate. To perform the exam, the health care provider asks the man to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to the rectum. The man may feel slight, brief discomfort during the rectal exam. A health care provider most often performs a rectal exam during an office visit, and men do not require anesthesia. The exam helps the health care provider see if the prostate is enlarged or tender or has any abnormalities that require more testing.\nMany health care providers perform a rectal exam as part of a routine physical exam for men age 40 or older, whether or not they have urinary problems.\nMedical Tests\nA health care provider may refer men to a urologista doctor who specializes in urinary problems and the male reproductive systemthough the health care provider most often diagnoses benign prostatic hyperplasia on the basis of symptoms and a digital rectal exam. A urologist uses medical tests to help diagnose lower urinary tract problems related to benign prostatic hyperplasia and recommend treatment. Medical tests may include\n- urinalysis\n- a prostate-specific antigen (PSA) blood test\n- urodynamic tests\n- cystoscopy\n- transrectal ultrasound\n- biopsy\nUrinalysis. Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container in a health care providers office or a commercial facility. A health care provider tests the sample during an office visit or sends it 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 to indicate signs of infection in urine.\nPSA blood test. A health care provider may draw blood for a PSA test during an office visit or in a commercial facility and send the sample to a lab for analysis. Prostate cells create a protein called PSA. Men who have prostate cancer may have a higher amount of PSA in their blood. However, a high PSA level does not necessarily indicate prostate cancer. In fact, benign prostatic hyperplasia, prostate infections, inflammation, aging, and normal fluctuations often cause high PSA levels. Much remains unknown about how to interpret a PSA blood test, the tests ability to discriminate between cancer and prostate conditions such as benign prostatic hyperplasia, and the best course of action to take if the PSA level is high.\nUrodynamic tests. Urodynamic tests include a variety of procedures that look at how well the bladder and urethra store and release urine. A health care provider performs urodynamic tests during an office visit or in an outpatient center or a hospital. Some urodynamic tests do not require anesthesia; others may require local anesthesia. Most urodynamic tests focus on the bladders ability to hold urine and empty steadily and completely and may include the following:\n- uroflowmetry, which measures how rapidly the bladder releases urine\n- postvoid residual measurement, which evaluates how much urine remains in the bladder after urination\n- reduced urine flow or residual urine in the bladder, which often suggests urine blockage due to benign prostatic hyperplasia\nMore information is provided in the NIDDK health topic, Urodynamic Testing.\nCystoscopy. Cystoscopy is a procedure that uses a tubelike instrument, called a cystoscope, to look inside the urethra and bladder. A urologist inserts the cystoscope through the opening at the tip of the penis and into the lower urinary tract. A urologist performs cystoscopy during an office visit or in an outpatient center or a hospital. The urologist will give the patient local anesthesia; however, in some cases, the patient may require sedation and regional or general anesthesia. A urologist may use cystoscopy to look for blockage or stones in the urinary tract.\nMore information is provided in the NIDDK health topic, Cystoscopy and Ureteroscopy.\nTransrectal ultrasound. Transrectal ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The health care provider can move the transducer to different angles to make it possible to examine different organs. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images; the patient does not require anesthesia. Urologists most often use transrectal ultrasound to examine the prostate. In a transrectal ultrasound, the technician inserts a transducer slightly larger than a pen into the mans rectum, next to the prostate. The ultrasound image shows the size of the prostate and any abnormalities, such as tumors. Transrectal ultrasound cannot reliably diagnose prostate cancer.\nBiopsy. Biopsy is a procedure that involves taking a small piece of prostate tissue for examination with a microscope. A urologist performs the biopsy in an outpatient center or a hospital. The urologist will give the patient light sedation and local anesthetic; however, in some cases, the patient will require general anesthesia. The urologist uses imaging techniques such as ultrasound, a computerized tomography scan, or magnetic resonance imaging to guide the biopsy needle into the prostate. A pathologista doctor who specializes in examining tissues to diagnose diseasesexamines the prostate tissue in a lab. The test can show whether prostate cancer is present.\nMore information is provided in the NIDDK health topic, Medical Tests for Prostate Problems." } ]

[ { "from": "human", "value": "What are the treatments for Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "Treatment options for benign prostatic hyperplasia may include\n- lifestyle changes\n- medications\n- minimally invasive procedures\n- surgery\nA health care provider treats benign prostatic hyperplasia based on the severity of symptoms, how much the symptoms affect a mans daily life, and a mans preferences.\nMen may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life. In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia symptoms become bothersome or present a health risk, a urologist most often recommends treatment.\nLifestyle Changes\nA health care provider may recommend lifestyle changes for men whose symptoms are mild or slightly bothersome. Lifestyle changes can include\n- reducing intake of liquids, particularly before going out in public or before periods of sleep\n- avoiding or reducing intake of caffeinated beverages and alcohol\n- avoiding or monitoring the use of medications such as decongestants, antihistamines, antidepressants, and diuretics\n- training the bladder to hold more urine for longer periods\n- exercising pelvic floor muscles\n- preventing or treating constipation\nMedications\nA health care provider or urologist may prescribe medications that stop the growth of or shrink the prostate or reduce symptoms associated with benign prostatic hyperplasia:\n- alpha blockers\n- phosphodiesterase-5 inhibitors\n- 5-alpha reductase inhibitors\n- combination medications\nAlpha blockers. These medications relax the smooth muscles of the prostate and bladder neck to improve urine flow and reduce bladder blockage:\n- terazosin (Hytrin)\n- doxazosin (Cardura)\n- tamsulosin (Flomax)\n- alfuzosin (Uroxatral)\n- silodosin (Rapaflo)\nPhosphodiesterase-5 inhibitors. Urologists prescribe these medications mainly for erectile dysfunction. Tadalafil (Cialis) belongs to this class of medications and can reduce lower urinary tract symptoms by relaxing smooth muscles in the lower urinary tract. Researchers are working to determine the role of erectile dysfunction drugs in the long-term treatment of benign prostatic hyperplasia.\n5-alpha reductase inhibitors. These medications block the production of DHT, which accumulates in the prostate and may cause prostate growth:\n- finasteride (Proscar)\n- dutasteride (Avodart)\nThese medications can prevent progression of prostate growth or actually shrink the prostate in some men. Finasteride and dutasteride act more slowly than alpha blockers and are useful for only moderately enlarged prostates.\nCombination medications. Several studies, such as the Medical Therapy of Prostatic Symptoms (MTOPS) study, have shown that combining two classes of medications, instead of using just one, can more effectively improve symptoms, urinary flow, and quality of life. The combinations include\n- finasteride and doxazosin\n- dutasteride and tamsulosin (Jalyn), a combination of both medications that is available in a single tablet\n- alpha blockers and antimuscarinics\nA urologist may prescribe a combination of alpha blockers and antimuscarinics for patients with overactive bladder symptoms. Overactive bladder is a condition in which the bladder muscles contract uncontrollably and cause urinary frequency, urinary urgency, and urinary incontinence. Antimuscarinics are a class of medications that relax the bladder muscles.\nMinimally Invasive Procedures\nResearchers have developed a number of minimally invasive procedures that relieve benign prostatic hyperplasia symptoms when medications prove ineffective. These procedures include\n- transurethral needle ablation\n- transurethral microwave thermotherapy\n- high-intensity focused ultrasound\n- transurethral electrovaporization\n- water-induced thermotherapy\n- prostatic stent insertion\nMinimally invasive procedures can destroy enlarged prostate tissue or widen the urethra, which can help relieve blockage and urinary retention caused by benign prostatic hyperplasia.\nUrologists perform minimally invasive procedures using the transurethral method, which involves inserting a cathetera thin, flexible tubeor cystoscope through the urethra to reach the prostate. These procedures may require local, regional, or general anesthesia. Although destroying troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue destruction does not cure benign prostatic hyperplasia. A urologist will decide which procedure to perform based on the mans symptoms and overall health.\nTransurethral needle ablation. This procedure uses heat generated by radiofrequency energy to destroy prostate tissue. A urologist inserts a cystoscope through the urethra to the prostate. A urologist then inserts small needles through the end of the cystoscope into the prostate. The needles send radiofrequency energy that heats and destroys selected portions of prostate tissue. Shields protect the urethra from heat damage.\nTransurethral microwave thermotherapy. This procedure uses microwaves to destroy prostate tissue. A urologist inserts a catheter through the urethra to the prostate, and a device called an antenna sends microwaves through the catheter to heat selected portions of the prostate. The temperature becomes high enough inside the prostate to destroy enlarged tissue. A cooling system protects the urinary tract from heat damage during the procedure.\nHigh-intensity focused ultrasound. For this procedure, a urologist inserts a special ultrasound probe into the rectum, near the prostate. Ultrasound waves from the probe heat and destroy enlarged prostate tissue.\nTransurethral electrovaporization. For this procedure, a urologist inserts a tubelike instrument called a resectoscope through the urethra to reach the prostate. An electrode attached to the resectoscope moves across the surface of the prostate and transmits an electric current that vaporizes prostate tissue. The vaporizing effect penetrates below the surface area being treated and seals blood vessels, which reduces the risk of bleeding.\nWater-induced thermotherapy. This procedure uses heated water to destroy prostate tissue. A urologist inserts a catheter into the urethra so that a treatment balloon rests in the middle of the prostate. Heated water flows through the catheter into the treatment balloon, which heats and destroys the surrounding prostate tissue. The treatment balloon can target a specific region of the prostate, while surrounding tissues in the urethra and bladder remain protected.\nProstatic stent insertion. This procedure involves a urologist inserting a small device called a prostatic stent through the urethra to the area narrowed by the enlarged prostate. Once in place, the stent expands like a spring, and it pushes back the prostate tissue, widening the urethra. Prostatic stents may be temporary or permanent. Urologists generally use prostatic stents in men who may not tolerate or be suitable for other procedures.\nSurgery\nFor long-term treatment of benign prostatic hyperplasia, a urologist may recommend removing enlarged prostate tissue or making cuts in the prostate to widen the urethra. Urologists recommend surgery when\n- medications and minimally invasive procedures are ineffective\n- symptoms are particularly bothersome or severe\n- complications arise\nAlthough removing troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue removal does not cure benign prostatic hyperplasia.\nSurgery to remove enlarged prostate tissue includes\n- transurethral resection of the prostate (TURP)\n- laser surgery\n- open prostatectomy\n- transurethral incision of the prostate (TUIP)\nA urologist performs these surgeries, except for open prostatectomy, using the transurethral method. Men who have these surgical procedures require local, regional, or general anesthesia and may need to stay in the hospital.\nThe urologist may prescribe antibiotics before or soon after surgery to prevent infection. Some urologists prescribe antibiotics only when an infection occurs.\nImmediately after benign prostatic hyperplasia surgery, a urologist may insert a special catheter, called a Foley catheter, through the opening of the penis to drain urine from the bladder into a drainage pouch.\nTURP. With TURP, a urologist inserts a resectoscope through the urethra to reach the prostate and cuts pieces of enlarged prostate tissue with a wire loop. Special fluid carries the tissue pieces into the bladder, and the urologist flushes them out at the end of the procedure. TURP is the most common surgery for benign prostatic hyperplasia and considered the gold standard for treating blockage of the urethra due to benign prostatic hyperplasia.\nLaser surgery. With this surgery, a urologist uses a high-energy laser to destroy prostate tissue. The urologist uses a cystoscope to pass a laser fiber through the urethra into the prostate. The laser destroys the enlarged tissue. The risk of bleeding is lower than in TURP and TUIP because the laser seals blood vessels as it cuts through the prostate tissue. However, laser surgery may not effectively treat greatly enlarged prostates.\nOpen prostatectomy. In an open prostatectomy, a urologist makes an incision, or cut, through the skin to reach the prostate. The urologist can remove all or part of the prostate through the incision. This surgery is used most often when the prostate is greatly enlarged, complications occur, or the bladder is damaged and needs repair. Open prostatectomy requires general anesthesia, a longer hospital stay than other surgical procedures for benign prostatic hyperplasia, and a longer rehabilitation period. The three open prostatectomy procedures are retropubic prostatectomy, suprapubic prostatectomy, and perineal prostatectomy. The recovery period for open prostatectomy is different for each man who undergoes the procedure. However, it typically takes anywhere from 3 to 6 weeks.4\nTUIP. A TUIP is a surgical procedure to widen the urethra. During a TUIP, the urologist inserts a cystoscope and an instrument that uses an electric current or a laser beam through the urethra to reach the prostate. The urologist widens the urethra by making a few small cuts in the prostate and in the bladder neck. Some urologists believe that TUIP gives the same relief as TURP except with less risk of side effects.\nAfter surgery, the prostate, urethra, and surrounding tissues may be irritated and swollen, causing urinary retention. To prevent urinary retention, a urologist inserts a Foley catheter so urine can drain freely out of the bladder. A Foley catheter has a balloon on the end that the urologist inserts into the bladder. Once the balloon is inside the bladder, the urologist fills it with sterile water to keep the catheter in place. Men who undergo minimally invasive procedures may not need a Foley catheter.\nThe Foley catheter most often remains in place for several days. Sometimes, the Foley catheter causes recurring, painful, difficult-to-control bladder spasms the day after surgery. However, these spasms will eventually stop. A urologist may prescribe medications to relax bladder muscles and prevent bladder spasms. These medications include\n- oxybutynin chloride (Ditropan)\n- solifenacin (VESIcare)\n- darifenacin (Enablex)\n- tolterodine (Detrol)\n- hyoscyamine (Levsin)\n- propantheline bromide (Pro-Banthine)" } ]

[ { "from": "human", "value": "What are the treatments for Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "The complications of benign prostatic hyperplasia treatment depend on the type of treatment.\nMedications\nMedications used to treat benign prostatic hyperplasia may have side effects that sometimes can be serious. Men who are prescribed medications to treat benign prostatic hyperplasia should discuss possible side effects with a health care provider before taking the medications. Men who experience the following side effects should contact a health care provider right away or get emergency medical care:\n- hives\n- rash\n- itching\n- shortness of breath\n- rapid, pounding, or irregular heartbeat\n- painful erection of the penis that lasts for hours\n- swelling of the eyes, face, tongue, lips, throat, arms, hands, feet, ankles, or lower legs\n- difficulty breathing or swallowing\n- chest pain\n- dizziness or fainting when standing up suddenly\n- sudden decrease or loss of vision\n- blurred vision\n- sudden decrease or loss of hearing\n- chest pain, dizziness, or nausea during sexual activity\nThese side effects are mostly related to phosphodiesterase-5 inhibitors. Side effects related to alpha blockers include\n- dizziness or fainting when standing up suddenly\n- decreased sexual drive\n- problems with ejaculation\nMinimally Invasive Procedures\nComplications after minimally invasive procedures may include\n- UTIs\n- painful urination\n- difficulty urinating\n- an urgent or a frequent need to urinate\n- urinary incontinence\n- blood in the urine for several days after the procedure\n- sexual dysfunction\n- chronic prostatitislong-lasting inflammation of the prostate\n- recurring problems such as urinary retention and UTIs\nMost of the complications of minimally invasive procedures go away within a few days or weeks. Minimally invasive procedures are less likely to have complications than surgery.\nSurgery\nComplications after surgery may include\n- problems urinating\n- urinary incontinence\n- bleeding and blood clots\n- infection\n- scar tissue\n- sexual dysfunction\n- recurring problems such as urinary retention and UTIs\nProblems urinating. Men may initially have painful urination or difficulty urinating. They may experience urinary frequency, urgency, or retention. These problems will gradually lessen and, after a couple of months, urination will be easier and less frequent.\nUrinary incontinence. As the bladder returns to normal, men may have some temporary problems controlling urination. However, long-term urinary incontinence rarely occurs. The longer urinary problems existed before surgery, the longer it takes for the bladder to regain its full function after surgery.\nBleeding and blood clots. After benign prostatic hyperplasia surgery, the prostate or tissues around it may bleed. Blood or blood clots may appear in urine. Some bleeding is normal and should clear up within several days. However, men should contact a health care provider right away if\n- they experience pain or discomfort\n- their urine contains large clots\n- their urine is so red it is difficult to see through\nBlood clots from benign prostatic hyperplasia surgery can pass into the bloodstream and lodge in other parts of the bodymost often the legs. Men should contact a health care provider right away if they experience swelling or discomfort in their legs.\nInfection. Use of a Foley catheter after benign prostatic hyperplasia surgery may increase the risk of a UTI. Anesthesia during surgery may cause urinary retention and also increase the risk of a UTI. In addition, the incision site of an open prostatectomy may become infected. A health care provider will prescribe antibiotics to treat infections.\nScar tissue. In the year after the original surgery, scar tissue sometimes forms and requires surgical treatment. Scar tissue may form in the urethra and cause it to narrow. A urologist can solve this problem during an office visit by stretching the urethra. Rarely, the opening of the bladder becomes scarred and shrinks, causing blockage. This problem may require a surgical procedure similar to TUIP.\nSexual dysfunction. Some men may experience temporary problems with sexual function after benign prostatic hyperplasia surgery. The length of time for restored sexual function depends on the type of benign prostatic hyperplasia surgery performed and how long symptoms were present before surgery. Many men have found that concerns about sexual function can interfere with sex as much as the benign prostatic hyperplasia surgery itself. Understanding the surgical procedure and talking about concerns with a health care provider before surgery often help men regain sexual function earlier. Many men find it helpful to talk with a counselor during the adjustment period after surgery. Even though it can take a while for sexual function to fully return, with time, most men can enjoy sex again.\nMost health care providers agree that if men with benign prostatic hyperplasia were able to maintain an erection before surgery, they will probably be able to have erections afterward. Surgery rarely causes a loss of erectile function. However, benign prostatic hyperplasia surgery most often cannot restore function that was lost before the procedure. Some men find a slight difference in the quality of orgasm after surgery. However, most report no difference.\nProstate surgery may make men sterile, or unable to father children, by causing retrograde ejaculationthe backward flow of semen into the bladder. Men flush the semen out of the bladder when they urinate. In some cases, medications such as pseudoephedrine, found in many cold medications, or imipramine can treat retrograde ejaculation. These medications improve muscle tone at the bladder neck and keep semen from entering the bladder.\nRecurring problems. Men may require further treatment if prostate problems, including benign prostatic hyperplasia, return. Problems may arise when treatments for benign prostatic hyperplasia leave a good part of the prostate intact. About 10 percent of men treated with TURP or TUIP require additional surgery within 5 years. About 2 percent of men who have an open prostatectomy require additional surgery within 5 years.2\nIn the years after benign prostatic hyperplasia surgery or treatment, men should continue having a digital rectal exam once a year and have any symptoms checked by a health care provider. In some cases, the health care provider may recommend a digital rectal exam and checkup more than once a year." } ]

[ { "from": "human", "value": "How to prevent Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "Researchers have not found a way to prevent benign prostatic hyperplasia. Men with risk factors for benign prostatic hyperplasia should talk with a health care provider about any lower urinary tract symptoms and the need for regular prostate exams. Men can get early treatment and minimize benign prostatic hyperplasia effects by recognizing lower urinary tract symptoms and identifying an enlarged prostate." } ]

[ { "from": "human", "value": "What to do for Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "Researchers have not found that eating, diet, and nutrition play a role in causing or preventing benign prostatic hyperplasia. However, a health care provider can give information about how changes in eating, diet, or nutrition could help with treatment. Men should talk with a health care provider or dietitian about what diet is right for them." } ]

[ { "from": "human", "value": "What to do for Prostate Enlargement: Benign Prostatic Hyperplasia?" }, { "from": "gpt", "value": "- Benign prostatic hyperplasiaalso called BPHis a condition in men in which the prostate gland is enlarged and not cancerous.\n- The prostate is a walnut-shaped gland that is part of the male reproductive system.\n- The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men.\n- Benign prostatic hyperplasia is the most common prostate problem for men older than age 50.\n- Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include- urinary frequencyurination eight or more times a day- urinary urgencythe inability to delay urination- trouble starting a urine stream- a weak or an interrupted urine stream- dribbling at the end of urination- nocturiafrequent urination during periods of sleep- urinary retentionthe inability to empty the bladder completely- urinary incontinencethe accidental loss of urine- pain after ejaculation or during urination- urine that has an unusual color or smell- The complications of benign prostatic hyperplasia may include- acute urinary retention- chronic, or long lasting, urinary retention- blood in the urine- urinary tract infections (UTIs)- bladder damage- kidney damage- bladder stones- A health care provider diagnoses benign prostatic hyperplasia based on- a personal and family medical history- a physical exam- medical tests- Treatment options for benign prostatic hyperplasia may include- lifestyle changes- medications- minimally invasive procedures- surgery- The complications of benign prostatic hyperplasia treatment depend on the type of treatment.\n- Researchers have not found a way to prevent benign prostatic hyperplasia.\n- Researchers have not found that eating, diet, and nutrition play a role in causing or preventing benign prostatic hyperplasia." } ]

[ { "from": "human", "value": "What is (are) Dumping Syndrome?" }, { "from": "gpt", "value": "Dumping syndrome occurs when food, especially sugar, moves too fast from the stomach to the duodenumthe first part of the small intestinein the upper gastrointestinal (GI) tract. This condition is also called rapid gastric emptying. Dumping syndrome has two forms, based on when symptoms occur:\n- early dumping syndromeoccurs 10 to 30 minutes after a meal\n- late dumping syndromeoccurs 2 to 3 hours after a meal" } ]

[ { "from": "human", "value": "What is (are) Dumping Syndrome?" }, { "from": "gpt", "value": "The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anusthe opening where stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. The upper GI tract includes the mouth, esophagus, stomach, duodenum, and small intestine. The esophagus carries food and liquids from the mouth to the stomach. The stomach slowly pumps the food and liquids into the intestine, which then absorbs needed nutrients. Two digestive organs, the liver and the pancreas, produce digestive juices that reach the small intestine through small tubes called ducts.\nThe last part of the GI tractcalled the lower GI tractconsists of the large intestine and anus. The large intestine is about 5 feet long in adults and absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine then changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is located between the last part of the coloncalled the sigmoid colonand the anus. The rectum stores stool prior to a bowel movement. During a bowel movement, stool moves from the rectum to the anus." } ]

[ { "from": "human", "value": "What causes Dumping Syndrome?" }, { "from": "gpt", "value": "Dumping syndrome is caused by problems with the storage of food particles in the stomach and emptying of particles into the duodenum. Early dumping syndrome results from rapid movement of fluid into the intestine following a sudden addition of a large amount of food from the stomach. Late dumping syndrome results from rapid movement of sugar into the intestine, which raises the body's blood glucose level and causes the pancreas to increase its release of the hormone insulin. The increased release of insulin causes a rapid drop in blood glucose levels, a condition known as hypoglycemia, or low blood sugar." } ]

[ { "from": "human", "value": "What are the symptoms of Dumping Syndrome?" }, { "from": "gpt", "value": "The symptoms of early and late dumping syndrome are different and vary from person to person. Early dumping syndrome symptoms may include\n- nausea\n- vomiting\n- abdominal pain and cramping\n- diarrhea\n- feeling uncomfortably full or bloated after a meal\n- sweating\n- weakness\n- dizziness\n- flushing, or blushing of the face or skin\n- rapid or irregular heartbeat\n- hypoglycemia\n- sweating\n- weakness\n- rapid or irregular heartbeat\n- flushing\n- dizziness\nAbout 75 percent of people with dumping syndrome report symptoms of early dumping syndrome and about 25 percent report symptoms of late dumping syndrome. Some people have symptoms of both types of dumping syndrome.1" } ]

[ { "from": "human", "value": "How to diagnose Dumping Syndrome?" }, { "from": "gpt", "value": "A health care provider will diagnose dumping syndrome primarily on the basis of symptoms. A scoring system helps differentiate dumping syndrome from other GI problems. The scoring system assigns points to each symptom and the total points result in a score. A person with a score above 7 likely has dumping syndrome.\nThe following tests may confirm dumping syndrome and exclude other conditions with similar symptoms:\n- A modified oral glucose tolerance test checks how well insulin works with tissues to absorb glucose. A health care provider performs the test during an office visit or in a commercial facility and sends the blood samples to a lab for analysis. The person should fasteat or drink nothing except waterfor at least 8 hours before the test. The health care provider will measure blood glucose concentration, hematocritthe amount of red blood cells in the bloodpulse rate, and blood pressure before the test begins. After the initial measurements, the person drinks a glucose solution. The health care provider repeats the initial measurements immediately and at 30-minute intervals for up to 180 minutes. A health care provider often confirms dumping syndrome in people with- low blood sugar between 120 and 180 minutes after drinking the solution- an increase in hematocrit of more than 3 percent at 30 minutes- a rise in pulse rate of more than 10 beats per minute after 30 minutes- A gastric emptying scintigraphy test involves eating a bland mealsuch as eggs or an egg substitutethat contains a small amount of radioactive material. A specially trained technician performs this test in a radiology center or hospital, and a radiologista doctor who specializes in medical imaginginterprets the results. Anesthesia is not needed. An external camera scans the abdomen to locate the radioactive material. The radiologist measures the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. The test can help confirm a diagnosis of dumping syndrome.\n- An upper GI endoscopy involves using an endoscopea small, flexible tube with a lightto see the upper GI tract. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. The gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive general anesthesia or a liquid anesthetic that is gargled or sprayed on the back of the throat. If the person receives general anesthesia, a health care provider will place an intravenous (IV) needle in a vein in the arm. The test may show ulcers, swelling of the stomach lining, or cancer.\n- An upper GI series examines the small intestine. An x-ray technician performs the test at a hospital or an outpatient center and a radiologist interprets the images. Anesthesia is not needed. No eating or drinking is allowed before the procedure, as directed by the health care staff. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of a blockage or other complications of gastric surgery show up more clearly on x rays." } ]

[ { "from": "human", "value": "What are the treatments for Dumping Syndrome?" }, { "from": "gpt", "value": "Treatment for dumping syndrome includes changes in eating, diet, and nutrition; medication; and, in some cases, surgery. Many people with dumping syndrome have mild symptoms that improve over time with simple dietary changes." } ]

[ { "from": "human", "value": "What to do for Dumping Syndrome?" }, { "from": "gpt", "value": "The first step to minimizing symptoms of dumping syndrome involves changes in eating, diet, and nutrition, and may include\n- eating five or six small meals a day instead of three larger meals\n- delaying liquid intake until at least 30 minutes after a meal\n- increasing intake of protein, fiber, and complex carbohydratesfound in starchy foods such as oatmeal and rice\n- avoiding simple sugars such as table sugar, which can be found in candy, syrup, sodas, and juice beverages\n- increasing the thickness of food by adding pectin or guar gumplant extracts used as thickening agents\nSome people find that lying down for 30 minutes after meals also helps reduce symptoms.\nMedication\nA health care provider may prescribe octreotide acetate (Sandostatin) to treat dumping syndrome symptoms. The medication works by slowing gastric emptying and inhibiting the release of insulin and other GI hormones. Octreotide comes in short- and long-acting formulas. The short-acting formula is injected subcutaneouslyunder the skinor intravenouslyinto a veintwo to four times a day. A health care provider may perform the injections or may train the patient or patient's friend or relative to perform the injections. A health care provider injects the long-acting formula into the buttocks muscles once every 4 weeks. Complications of octreotide treatment include increased or decreased blood glucose levels, pain at the injection site, gallstones, and fatty, foul-smelling stools.\nSurgery\nA person may need surgery if dumping syndrome is caused by previous gastric surgery or if the condition is not responsive to other treatments. For most people, the type of surgery depends on the type of gastric surgery performed previously. However, surgery to correct dumping syndrome often has unsuccessful results." } ]

[ { "from": "human", "value": "What to do for Dumping Syndrome?" }, { "from": "gpt", "value": "- Dumping syndrome occurs when food, especially sugar, moves too fast from the stomach to the duodenumthe first part of the small intestinein the upper gastrointestinal (GI) tract.\n- Dumping syndrome has two forms, based on when symptoms occur:- early dumping syndromeoccurs 10 to 30 minutes after a meal- late dumping syndromeoccurs 2 to 3 hours after a meal- People who have had surgery to remove or bypass a significant part of the stomach are more likely to develop dumping syndrome. Other conditions that impair how the stomach stores and empties itself of food, such as nerve damage caused by esophageal surgery, can also cause dumping syndrome.\n- Early dumping syndrome symptoms include- nausea- vomiting- abdominal pain and cramping- diarrhea- feeling uncomfortably full or bloated after a meal- sweating- weakness- dizziness- flushing, or blushing of the face or skin- rapid or irregular heartbeat- The symptoms of late dumping syndrome include- hypoglycemia- sweating- weakness- rapid or irregular heartbeat- flushing- dizziness- Treatment for dumping syndrome includes changes in eating, diet, and nutrition; medication; and, in some cases, surgery. Many people with dumping syndrome have mild symptoms that improve over time with simple dietary changes." } ]

[ { "from": "human", "value": "What is (are) Renal Tubular Acidosis?" }, { "from": "gpt", "value": "Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic. Without proper treatment, chronic acidity of the blood leads to growth retardation, kidney stones, bone disease, chronic kidney disease, and possibly total kidney failure.\nThe body's cells use chemical reactions to carry out tasks such as turning food into energy and repairing tissue. These chemical reactions generate acids. Some acid in the blood is normal, but too much acidacidosiscan disturb many bodily functions. Healthy kidneys help maintain acid-base balance by excreting acids into the urine and returning bicarbonatean alkaline, or base, substanceto the blood. This \"reclaimed\" bicarbonate neutralizes much of the acid that is created when food is broken down in the body. The movement of substances like bicarbonate between the blood and structures in the kidneys is called transport.\nOne researcher has theorized that Charles Dickens may have been describing a child with RTA in the character of Tiny Tim from A Christmas Carol. Tiny Tim's small stature, malformed limbs, and periods of weakness are all possible consequences of the chemical imbalance caused by RTA.1 In the story, Tiny Tim recovers when he receives medical treatment, which would likely have included sodium bicarbonate and sodium citrate, alkaline agents to neutralize acidic blood. The good news is that medical treatment can indeed reverse the effects of RTA." } ]

[ { "from": "human", "value": "How to diagnose Renal Tubular Acidosis?" }, { "from": "gpt", "value": "To diagnose RTA, doctors check the acid-base balance in blood and urine samples. If the blood is more acidic than it should be and the urine less acidic than it should be, RTA may be the reason, but additional information is needed to rule out other causes. If RTA is the reason, additional information about the sodium, potassium, and chloride levels in the urine and the potassium level in the blood will help identify which type of RTA a person has. In all cases, the first goal of therapy is to neutralize acid in the blood, but different treatments may be needed to address the different underlying causes of acidosis." } ]

[ { "from": "human", "value": "What is (are) Renal Tubular Acidosis?" }, { "from": "gpt", "value": "Type 1: Classical Distal RTA\nType 1 is also called classical distal RTA. \"Distal,\" which means distant, refers to the point in the urine-forming tube of the kidney where the defect occursrelatively distant from the point where fluid from the blood enters the tiny tube, or tubule, that collects fluid and wastes to form urine.\nThis disorder may be inherited as a primary disorder or may be one symptom of a disease that affects many parts of the body. Researchers have discovered abnormal genes responsible for the inherited forms of the disease. More often, however, classical distal RTA occurs as a result of systemic diseasesdiseases that affect many organ systemslike the autoimmune disorders Sjgren's syndrome and lupus, which also attack the distal tubule.\nOther diseases and conditions associated with classical distal RTA include sickle cell anemia, hyperparathyroidism, hyperthyroidism, chronic active hepatitis, primary biliary cirrhosis, a hereditary form of deafness, analgesic nephropathy, rejection of a transplanted kidney, renal medullary cystic disease, obstructive uropathy, and chronic urinary tract infections. Many of these conditions cause abnormal calcium deposits to build up in the kidney and impair distal tubule function.\nA major consequence of classical distal RTA is a low blood potassium level. The level drops if the kidneys excrete too much potassium into urine instead of returning it to the blood supply. Because potassium helps regulate nerve and muscle health and heart rate, low levels can cause extreme weakness, irregular heartbeat, paralysis, and even death.\nUntreated classical distal RTA causes growth retardation in children and progressive kidney and bone disease in adults. Restoring normal growth and preventing kidney stones are the major goals of therapy. If acidosis is corrected with sodium bicarbonate or sodium citrate, then low blood-potassium, salt depletion, and calcium leakage into urine will be corrected. This alkali therapy also helps decrease the development of kidney stones and stabilizes kidney function so kidney failure does not progress. Infants may need potassium supplements, but older children and adults rarely do because alkali therapy prevents the kidney from excreting potassium into the urine.\nType 2: Proximal RTA\nType 2 is also called proximal RTA. The word \"proximal,\" which means near, indicates that the defect is closer to the point where fluid and wastes from the blood enter the tubule.\nThis form of RTA occurs most frequently in children as part of a disorder called Fanconi's syndrome. The features of Fanconi's syndrome include the abnormal excretion of glucose, amino acids, citrate, and phosphate into the urine, as well as vitamin D deficiency and low blood-potassium.\nProximal RTA can also result from inherited disorders that disrupt the body's normal breakdown and use of nutrients. Examples include the rare disease cystinosis, in which cystine crystals are deposited in bones and other tissues; hereditary fructose intolerance; and Wilson disease.\nProximal RTA also occurs in patients treated with ifosfamide, a drug used in chemotherapy. A few older drugssuch as acetazolamide or outdated tetracyclinecan also cause proximal RTA. In adults, proximal RTA may complicate diseases like multiple myeloma, or it may occur in people who experience chronic rejection of a transplanted kidney.\nWhen possible, identifying and correcting the underlying causes are important steps in treating the acquired forms of proximal RTA. The diagnosis is based on the chemical analysis of blood and urine samples. Children with this disorder would likely receive large doses of an oral alkali, such as sodium bicarbonate or potassium citrate, to treat acidosis and prevent bone disorders, kidney stones, and growth failure. Correcting acidosis and low potassium levels restores normal growth patterns, allowing bone to mature while preventing further renal disease. Vitamin D supplements may also be needed to help prevent bone problems.\nType 3\nType 3 is rarely used as a classification because it is now thought to be a combination of type 1 and type 2.\nType 4: Hyperkalemic RTA\nType 4 is also called hyperkalemic RTA and is caused by a generalized transport abnormality of the distal tubule. The transport of electrolytes such as sodium, chloride, and potassium that normally occurs in the distal tubule is impaired. This form is distinguished from classical distal RTA and proximal RTA because it results in high levels of potassium in the blood instead of low levels. Either low potassiumhypokalemiaor high potassiumhyperkalemiacan be a problem because potassium is important in regulating heart rate.\nType 4 RTA occurs when blood levels of the hormone aldosterone are low or when the kidneys do not respond to it. Aldosterone directs the kidneys to regulate the levels of sodium, potassium, and chloride in the blood. Type 4 RTA also occurs when the tubule transport of electrolytes such as sodium, chloride, and potassium is impaired due to an inherited disorder or the use of certain drugs.\nDrugs that may cause type 4 RTA include\n- diuretics used to treat congestive heart failure such as spironolactone or eplerenone\n- blood pressure drugs called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)\n- the antibiotic trimethoprim\n- the antibiotic pentamidine, which is used to treat pneumonia\n- an agent called heparin that keeps blood from clotting\n- a class of painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs)\n- some immunosuppressive drugs used to prevent rejection\nType 4 RTA may also result from diseases that alter kidney structure and function such as diabetic nephropathy, HIV/AIDS, Addison's disease, sickle cell disease, urinary tract obstruction, lupus, amyloidosis, removal or destruction of both adrenal glands, and kidney transplant rejection.\nFor people who produce aldosterone but cannot use it, researchers have identified the genetic basis for their body's resistance to the hormone. To treat type 4 RTA successfully, patients may require alkaline agents to correct acidosis and medication to lower the potassium in their blood.\nIf treated early, most people with any type of RTA will not develop permanent kidney failure. Therefore, the goal is early recognition and adequate therapy, which will need to be maintained and monitored throughout the person's lifetime." } ]

[ { "from": "human", "value": "What to do for Renal Tubular Acidosis?" }, { "from": "gpt", "value": "- Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic.\n- Without proper treatment, chronic acidity of the blood leads to growth retardation, kidney stones, bone disease, chronic kidney disease, and possibly total kidney failure.\n- If RTA is suspected, additional information about the sodium, potassium, and chloride levels in the urine and the potassium level in the blood will help identify which type of RTA a person has.\n- In all cases, the first goal of therapy is to neutralize acid in the blood, but different treatments may be needed to address the different underlying causes of acidosis." } ]

[ { "from": "human", "value": "What is (are) Kidney Dysplasia?" }, { "from": "gpt", "value": "Kidney dysplasia is a condition in which the internal structures of one or both of a fetus kidneys do not develop normally while in the womb. During normal development, two thin tubes of muscle called ureters grow into the kidneys and branch out to form a network of tiny structures called tubules. The tubules collect urine as the fetus grows in the womb. In kidney dysplasia, the tubules fail to branch out completely. Urine that would normally flow through the tubules has nowhere to go. Urine collects inside the affected kidney and forms fluid-filled sacs called cysts. The cysts replace normal kidney tissue and prevent the kidney from functioning.\nKidney dysplasia can affect one kidney or both kidneys. Babies with severe kidney dysplasia affecting both kidneys generally do not survive birth. Those who do survive may need the following early in life:\n- blood-filtering treatments called dialysis\n- a kidney transplant\nChildren with dysplasia in only one kidney have normal kidney function if the other kidney is unaffected. Those with mild dysplasia of both kidneys may not need dialysis or a kidney transplant for several years.\nKidney dysplasia is also called renal dysplasia or multicystic dysplastic kidney." } ]

[ { "from": "human", "value": "What is (are) Kidney Dysplasia?" }, { "from": "gpt", "value": "The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, which is composed of wastes and extra fluid. Children produce less urine than adultsthe amount they produce depends on their age. The urine flows from the kidneys to the bladder through the two ureters, one on each side of the bladder. The bladder stores urine. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder.\nThe kidneys, ureters, bladder, and urethra are parts of the urinary tract. More information is provided in the NIDDK health topics, the kidneys and the urinary tract." } ]

[ { "from": "human", "value": "What causes Kidney Dysplasia?" }, { "from": "gpt", "value": "Genetic factors can cause kidney dysplasia. Genes pass information from both parents to the child and determine the childs traits. Sometimes, parents may pass a gene that has changed, or mutated, causing kidney dysplasia.\nGenetic syndromes that affect multiple body systems can also cause kidney dysplasia. A syndrome is a group of symptoms or conditions that may seem unrelated yet are thought to have the same genetic cause. A baby with kidney dysplasia due to a genetic syndrome might also have problems of the digestive tract, nervous system, heart and blood vessels, muscles and skeleton, or other parts of the urinary tract.\nA baby may also develop kidney dysplasia if his or her mother takes certain prescription medications during pregnancy, such as some used to treat seizures and high blood pressure. A mothers use of illegal drugs, such as cocaine, during pregnancy may also cause kidney dysplasia in her unborn child." } ]

[ { "from": "human", "value": "How many people are affected by Kidney Dysplasia?" }, { "from": "gpt", "value": "Kidney dysplasia is a common condition. Scientists estimate that kidney dysplasia affects about one in 4,000 babies.1 This estimate may be low because some people with kidney dysplasia are never diagnosed with the condition. About half of the babies diagnosed with this condition have other urinary tract defects.2" } ]

[ { "from": "human", "value": "What are the symptoms of Kidney Dysplasia?" }, { "from": "gpt", "value": "Many babies with kidney dysplasia in only one kidney have no signs of the condition. In some cases, the affected kidney may be enlarged at birth and may cause pain." } ]

[ { "from": "human", "value": "What are the complications of Kidney Dysplasia?" }, { "from": "gpt", "value": "The complications of kidney dysplasia can include\n- hydronephrosis of the working kidney. A baby with kidney dysplasia in only one kidney might have other urinary tract defects. When other defects in the urinary tract block the flow of urine, the urine backs up and causes the kidneys and ureters to swell, a condition called hydronephrosis. If left untreated, hydronephrosis can damage the working kidney and reduce its ability to filter blood. Kidney damage may lead to chronic kidney disease (CKD) and kidney failure.\n- a urinary tract infection (UTI). A urine blockage may increase a babys chance of developing a UTI. Recurring UTIs can also lead to kidney damage.\n- high blood pressure.\n- a slightly increased chance of developing kidney cancer.\nMore information is provided in the NIDDK health topics, urine blockage in newbornsand UTIs in children." } ]

[ { "from": "human", "value": "How to diagnose Kidney Dysplasia?" }, { "from": "gpt", "value": "Health care providers may be able to diagnose kidney dysplasia during a womans pregnancy using a fetal ultrasound, also called a fetal sonogram. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. Fetal ultrasound is a test done during pregnancy to create images of the fetus in the womb. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and an obstetrician or a radiologist interprets the images. An obstetrician is a doctor who specializes in pregnancy and childbirth. A radiologist is a doctor who specializes in medical imaging. The patientin this case, the fetus motherdoes not need anesthesia for this procedure. The images can show defects in the fetus kidneys and other parts of the urinary tract.\nHealth care providers do not always diagnose kidney dysplasia before a baby is born. After birth, health care providers often diagnose kidney dysplasia during an evaluation of the child for a UTI or another medical condition. A health care provider uses ultrasound to diagnose kidney dysplasia after the baby is born." } ]

[ { "from": "human", "value": "What are the treatments for Kidney Dysplasia?" }, { "from": "gpt", "value": "If the condition is limited to one kidney and the baby has no signs of kidney dysplasia, no treatment may be necessary. However, the baby should have regular checkups that include\n- checking blood pressure.\n- testing blood to measure kidney function.\n- testing urine for albumin, a protein most often found in blood. Albumin in the urine may be a sign of kidney damage.\n- performing periodic ultrasounds to monitor the damaged kidney and to make sure the functioning kidney continues to grow and remains healthy." } ]

[ { "from": "human", "value": "How to prevent Kidney Dysplasia?" }, { "from": "gpt", "value": "Researchers have not found a way to prevent kidney dysplasia caused by genetic factors or certain genetic syndromes. Pregnant women can prevent kidney dysplasia by avoiding the use of certain prescription medications or illegal drugs during pregnancy. Pregnant women should talk with their health care provider before taking any medications during pregnancy." } ]

[ { "from": "human", "value": "What is the outlook for Kidney Dysplasia?" }, { "from": "gpt", "value": "The long-term outlook for a child with kidney dysplasia in only one kidney is generally good. A person with one working kidney, a condition called solitary kidney, can grow normally and may have few, if any, health problems.\nThe affected kidney may shrink as the child grows. By age 10,3 the affected kidney may no longer be visible on x-ray or ultrasound. Children and adults with only one working kidney should have regular checkups to test for high blood pressure and kidney damage. A child with urinary tract problems that lead to failure of the working kidney may eventually need dialysis or a kidney transplant.\nMore information is provided in the NIDDK health topics, solitary kidney, dialysis, and kidney transplants." } ]

[ { "from": "human", "value": "What is the outlook for Kidney Dysplasia?" }, { "from": "gpt", "value": "The long-term outlook for a child with kidney dysplasia in both kidneys is different from the long-term outlook for a child with one dysplastic kidney. A child with kidney dysplasia in both kidneys\n- is more likely to develop CKD.\n- needs close follow-up with a pediatric nephrologista doctor who specializes in caring for children with kidney disease. Children who live in areas that dont have a pediatric nephrologist available can see a nephrologist who cares for both children and adults.\n- may eventually need dialysis or a kidney transplant." } ]

[ { "from": "human", "value": "What to do for Kidney Dysplasia?" }, { "from": "gpt", "value": "Researchers have not found that eating, diet, and nutrition play a role in causing or preventing kidney dysplasia." } ]

[ { "from": "human", "value": "What to do for Kidney Dysplasia?" }, { "from": "gpt", "value": "- Kidney dysplasia is a condition in which the internal structures of one or both of a fetus kidneys do not develop normally while in the womb.\n- Genetic factors can cause kidney dysplasia.\n- Genetic syndromes that affect multiple body systems can also cause kidney dysplasia.\n- A baby may also develop kidney dysplasia if his or her mother takes certain prescription medications during pregnancy, such as some used to treat seizures and high blood pressure.\n- Many babies with kidney dysplasia in only one kidney have no signs of the condition.\n- Health care providers may be able to diagnose kidney dysplasia during a womans pregnancy using a fetal ultrasound, also called a fetal sonogram.\n- Health care providers do not always diagnose kidney dysplasia before a baby is born.\n- If the condition is limited to one kidney and the baby has no signs of kidney dysplasia, no treatment may be necessary.\n- Researchers have not found a way to prevent kidney dysplasia caused by genetic factors or certain genetic syndromes.\n- Pregnant women can prevent kidney dysplasia by avoiding the use of certain prescription medications or illegal drugs during pregnancy.\n- The long-term outlook for a child with kidney dysplasia in only one kidney is generally good.\n- The long-term outlook for a child with kidney dysplasia in both kidneys is different from the long-term outlook for a child with one dysplastic kidney. A child with kidney dysplasia in both kidneys- is more likely to develop chronic kidney disease (CKD)- needs close follow-up with a pediatric nephrologist- may eventually need dialysis or a kidney transplant" } ]

[ { "from": "human", "value": "What is (are) Viral Gastroenteritis?" }, { "from": "gpt", "value": "Viral gastroenteritis is inflammation of the lining of the stomach, small intestine, and large intestine. Several different viruses can cause viral gastroenteritis, which is highly contagious and extremely common. Viral gastroenteritis causes millions of cases of diarrhea each year.\nAnyone can get viral gastroenteritis and most people recover without any complications, unless they become dehydrated." } ]

[ { "from": "human", "value": "What are the symptoms of Viral Gastroenteritis?" }, { "from": "gpt", "value": "The main symptoms of viral gastroenteritis are\n- watery diarrhea\n- vomiting\nOther symptoms include\n- headache\n- fever\n- chills\n- abdominal pain\nSymptoms usually appear within 12 to 48 hours after exposure to a gastroenteritis-causing virus and last for 1 to 3 days. Some viruses cause symptoms that last longer." } ]

[ { "from": "human", "value": "What are the complications of Viral Gastroenteritis?" }, { "from": "gpt", "value": "Dehydration is the most common complication of viral gastroenteritis. When someone does not drink enough fluids to replace those that are lost through vomiting and diarrhea, dehydration can result. When dehydrated, the body does not have enough fluids to keep the proper balance of important salts or minerals, known as electrolytes. Infants, young children, older adults, and people with weak immune systems have the greatest risk of becoming dehydrated.\nThe signs of dehydration in adults are\n- excessive thirst\n- infrequent urination\n- dark-colored urine\n- dry skin\n- lethargy, dizziness, or faintness\nSigns of dehydration in babies and young children are\n- dry mouth and tongue\n- lack of tears when crying\n- no wet diapers for 3 hours or more\n- high fever\n- unusually cranky or drowsy behavior\n- sunken eyes, cheeks, or soft spot in the skull\nAlso, when people are dehydrated, their skin does not flatten back to normal right away after being gently pinched and released.\nPeople should talk with a health care provider if they have\n- blood in their stool, which may indicate a bacterial infection\n- symptoms that are severe or last more than a few days\n- symptoms of dehydration\nSevere dehydration may require intravenous fluids and hospitalization. Untreated severe dehydration can cause serious health problems such as organ damage, shock, or comaa sleeplike state in which a person is not conscious." } ]

[ { "from": "human", "value": "What causes Viral Gastroenteritis?" }, { "from": "gpt", "value": "Four types of viruses cause most cases of viral gastroenteritis.\nRotavirus\nRotavirus is the leading cause of gastroenteritis among infants and young children. Rotavirus infections are most common in infants 3 to 15 months old. Symptoms usually appear 1 to 3 days after exposure. Rotavirus typically causes vomiting and watery diarrhea for 3 to 7 days, along with fever and abdominal pain. Rotavirus can also infect adults who are in close contact with infected children, but the symptoms in adults are milder.\nCaliciviruses\nCaliciviruses cause infection in people of all ages. Norovirus is the most common calicivirus and the most common cause of viral gastroenteritis in adults. Norovirus is usually responsible for epidemics of viral gastroenteritis. Norovirus outbreaks occur all year but are more frequent from October to April. People infected with norovirus typically experience nausea, vomiting, diarrhea, abdominal cramps, fatigue, headache, and muscle aches. The symptoms usually appear 1 to 2 days after exposure to the virus and last for 1 to 3 days.\nAdenovirus\nAdenovirus mainly infects children younger than 2 years old. Of the 49 types of adenoviruses, one strain affects the gastrointestinal tract, causing vomiting and diarrhea. Symptoms typically appear 8 to 10 days after exposure and last 5 to 12 days. Adenovirus infections occur year-round.\nAstrovirus\nAstrovirus primarily infects infants and young children, but adults may also be infected. This virus causes vomiting and watery diarrhea. Symptoms usually appear 3 to 4 days after exposure and last 2 to 7 days. The symptoms are milder than the symptoms of norovirus or rotavirus infections. Infections occur year-round, but the virus is most active during the winter months.\nViral gastroenteritis is often mistakenly called stomach flu, but it is not caused by the influenza virus. Some forms of gastroenteritis are caused by bacteria or parasites rather than viruses. More information about bacterial infections is provided in the NIDDK health topic, Foodborne Illnesses fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)." } ]

[ { "from": "human", "value": "How to diagnose Viral Gastroenteritis?" }, { "from": "gpt", "value": "Viral gastroenteritis is usually diagnosed based on symptoms alone. People who have symptoms that are severe or last for more than a few days may want to see a health care provider for additional tests. A health care provider may ask for a stool sample to test for rotavirus or norovirus or to rule out bacteria or parasites as the cause of the gastroenteritis.\nDuring an epidemic of viral gastroenteritis, health care providers or public health officials may test stool samples to find out which virus is responsible for the outbreak." } ]

[ { "from": "human", "value": "What are the treatments for Viral Gastroenteritis?" }, { "from": "gpt", "value": "Most cases of viral gastroenteritis resolve over time without specific treatment. Antibiotics are not effective against viral infections. The primary goal of treatment is to reduce symptoms and prevent complications.\nOver-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) can help relieve symptoms in adults. These medicines are not recommended for children." } ]

[ { "from": "human", "value": "What to do for Viral Gastroenteritis?" }, { "from": "gpt", "value": "The following steps may help relieve the symptoms of viral gastroenteritis in adults:\n- drinking plenty of liquids such as fruit juices, sports drinks, caffeine-free soft drinks, and broths to replace fluids and electrolytes\n- sipping small amounts of clear liquids or sucking on ice chips if vomiting is still a problem\n- gradually reintroducing food, starting with bland, easy-to-digest foods such as rice, potatoes, toast or bread, cereal, lean meat, applesauce, and bananas\n- avoiding fatty foods, sugary foods, dairy products, caffeine, and alcohol until recovery is complete\n- getting plenty of rest\nChildren present special concerns. Because of their smaller body size, infants and children are likely to become dehydrated more quickly from diarrhea and vomiting. The following steps may help relieve symptoms of viral gastroenteritis and prevent dehydration in children:\n- giving oral rehydration solutions such as Pedialyte, Naturalyte, Infalyte, and CeraLyte\n- giving food as soon as the child is hungry\n- giving infants breast milk or full strength formula, as usual, along with oral rehydration solutions\nOlder adults and adults with weak immune systems should also drink oral rehydration solutions to prevent dehydration." } ]

[ { "from": "human", "value": "How to prevent Viral Gastroenteritis?" }, { "from": "gpt", "value": "People can reduce their chances of getting or spreading viral gastroenteritis if they\n- wash their hands thoroughly with soap and warm water for 20 seconds after using the bathroom or changing diapers and before eating or handling food\n- disinfect contaminated surfaces such as countertops and baby changing tables with a mixture of 2 cups of household bleach and 1 gallon of water\n- avoid foods and drinks that might be contaminated\nThe U.S. Food and Drug Administration has approved two vaccines to protect children from rotavirus infections: rotavirus vaccine, live, oral, pentavalent (RotaTeq); and rotavirus vaccine, live, oral (Rotarix). RotaTeq is given to infants in three doses at 2, 4, and 6 months of age. Rotarix is given in two doses. The first dose is given when the infant is 6 weeks old, and the second is given at least 4 weeks later but before the infant is 24 weeks old.\nParents of infants should discuss rotavirus vaccination with a health care provider. For more information, parents can visit the Centers for Disease Control and Prevention rotavirus vaccination webpage at www.cdc.gov/vaccines/vpd-vac/rotavirus.\nIn the past, rotavirus infections were most common from November to April in the United States. However, recently widespread vaccination slowed the transmission of the virus, delaying rotavirus activity until late February. Overall rates of infection have also been lower than in previous years." } ]

[ { "from": "human", "value": "What to do for Viral Gastroenteritis?" }, { "from": "gpt", "value": "- Viral gastroenteritis is inflammation of the lining of the stomach, small intestine, and large intestine. Several different viruses can cause viral gastroenteritis, which is highly contagious and extremely common.\n- The main symptoms of viral gastroenteritis are watery diarrhea and vomiting.\n- Dehydration is the most common complication of viral gastroenteritis.\n- When someone does not drink enough fluids to replace those that are lost through vomiting and diarrhea, dehydration can result. Signs of dehydration in adults are excessive thirst, infrequent urination, dark-colored urine, dry skin, and lethargy, dizziness, or faintness.\n- Infants, young children, older adults, and people with weak immune systems have the greatest risk of becoming dehydrated.\n- Viral gastroenteritis is transmitted from person to person.\n- Diagnosis of viral gastroenteritis is usually based on symptoms alone.\n- Most cases of viral gastroenteritis resolve over time without specific treatment. Antibiotics are not effective against viral infections. The primary goal of treatment is to reduce symptoms.\n- Adults with viral gastroenteritis should drink plenty of liquids such as fruit juices, sports drinks, caffeine-free soft drinks, and broths to replace fluids and electrolytes.\n- Children with viral gastroenteritis should be given oral rehydration solutions to prevent dehydration.\n- People can reduce their chances of getting or spreading viral gastroenteritis if they wash their hands thoroughly with soap and warm water for 20 seconds after using the bathroom or changing diapers and before eating or handling food, disinfect contaminated surfaces, and avoid foods or liquids that might be contaminated." } ]