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[ { "from": "human", "value": "What are the symptoms of Hypothyroidism?" }, { "from": "gpt", "value": "Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism are\n- fatigue\n- weight gain\n- a puffy face\n- cold intolerance\n- joint and muscle pain\n- constipation\n- dry skin\n- dry, thinning hair\n- decreased sweating\n- heavy or irregular menstrual periods and impaired fertility\n- depression\n- slowed heart rate\nHowever, hypothyroidism develops slowly, so many people dont notice symptoms of the disease.\nSymptoms more specific to Hashimotos disease are a goiter and a feeling of fullness in the throat.\nHypothyroidism can contribute to high cholesterol, so people with high cholesterol should be tested for hypothyroidism. Rarely, severe, untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the bodys functions slow to the point that it becomes life threatening. Myxedema requires immediate medical treatment." } ]

[ { "from": "human", "value": "How to diagnose Hypothyroidism?" }, { "from": "gpt", "value": "Many symptoms of hypothyroidism are the same as those of other diseases, so hypothyroidism usually cannot be diagnosed based on symptoms alone. With suspected hypothyroidism, health care providers take a medical history and perform a thorough physical examination. Health care providers may then use several blood tests to confirm a diagnosis of hypothyroidism and find its cause:\nTSH test. The ultrasensitive TSH test is usually the first test a health care provider performs. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available. Generally, a TSH reading above normal means a person has hypothyroidism and a reading below normal means a person has hyperthyroidism.\nMildly elevated TSH without symptoms indicates subclinical hypothyroidism. Some health care providers treat subclinical hypothyroidism immediately. Others prefer to leave it untreated but monitor their patients for signs that the condition is worsening.\nHealth care providers may conduct additional tests to help confirm the diagnosis or determine the cause of hypothyroidism.\nT4 test. This test measures the actual amount of circulating thyroid hormone in the blood. In hypothyroidism, the level of T4 in the blood is lower than normal.\nThyroid autoantibody test. This test looks for the presence of thyroid autoantibodies. Most people with Hashimotos disease have these antibodies, but people whose hypothyroidism is caused by other conditions do not.\nMore information about testing for thyroid problems is provided in the NIDDK health topic, Thyroid Tests." } ]

[ { "from": "human", "value": "What are the treatments for Hypothyroidism?" }, { "from": "gpt", "value": "Health care providers treat hypothyroidism with synthetic thyroxine, a medication that is identical to the hormone T4. The exact dose will depend on the patients age and weight, the severity of the hypothyroidism, the presence of other health problems, and whether the person is taking other drugs that might interfere with how well the body uses thyroid hormone.\nHealth care providers test TSH levels about 6 to 8 weeks after a patient begins taking thyroid hormone and make any necessary adjustments to the dose. Each time the dose is adjusted, the blood is tested again. Once a stable dose is reached, blood tests are normally repeated in 6 months and then once a year.\nHypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed." } ]

[ { "from": "human", "value": "What to do for Hypothyroidism?" }, { "from": "gpt", "value": "Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition can be found on the National Agricultural Library website at www.nutrition.gov.\nDietary Supplements\nIodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hypothyroidism or hyperthyroidism. More information about iodine can be found in the National Library of Medicine fact sheet Iodine in diet, available at www.nlm.nih.gov/medlineplus/ency/article/002421.htm.\nWomen need more iodine when they are pregnantabout 250 micrograms a day because the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized salt salt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met.\nTo help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health." } ]

[ { "from": "human", "value": "What to do for Hypothyroidism?" }, { "from": "gpt", "value": "- Hypothyroidism is a disorder that occurs when the thyroid gland does not make enough thyroid hormone to meet the bodys needs. Thyroid hormone regulates metabolism. Without enough thyroid hormone, many of the bodys functions slow down.\n- Hypothyroidism has several causes, including- Hashimotos disease- thyroiditis- congenital hypothyroidism- surgical removal of part or all of the thyroid- radiation treatment of the thyroid- some medications- Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism are fatigue, weight gain, cold intolerance, constipation, impaired fertility, and depression.\n- Women are much more likely than men to develop hypothyroidism.\n- Women with hypothyroidism should discuss their condition with their health care provider before becoming pregnant.\n- Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed." } ]

[ { "from": "human", "value": "What is (are) Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Medullary sponge kidney, also known as Cacchi-Ricci disease, is a birth defect where changes occur in the tubules, or tiny tubes, inside a fetus kidneys.\nIn a normal kidney, urine flows through these tubules as the kidney is being formed during a fetus growth. In medullary sponge kidney, tiny, fluid-filled sacs called cysts form in the tubules within the medullathe inner part of the kidneycreating a spongelike appearance. The cysts keep urine from flowing freely through the tubules.\nSymptoms of medullary sponge kidney do not usually appear until the teenage years or the 20s. Medullary sponge kidney can affect one or both kidneys." } ]

[ { "from": "human", "value": "What are the complications of Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Complications of medullary sponge kidney include\n- hematuria, or blood in the urine\n- kidney stones\n- urinary tract infections (UTIs)\nMedullary sponge kidney rarely leads to more serious problems, such as chronic kidney disease or kidney failure." } ]

[ { "from": "human", "value": "What causes Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Scientists do not fully understand the cause of medullary sponge kidney or why cysts form in the tubules during fetal development. Even though medullary sponge kidney is present at birth, most cases do not appear to be inherited." } ]

[ { "from": "human", "value": "How many people are affected by Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Medullary sponge kidney affects about one person per 5,000 people in the United States. Researchers have reported that 12 to 20 percent of people who develop calcium-based kidney stones have medullary sponge kidney1." } ]

[ { "from": "human", "value": "What are the symptoms of Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Many people with medullary sponge kidney have no symptoms. The first sign that a person has medullary sponge kidney is usually a UTI or a kidney stone. UTIs and kidney stones share many of the same signs and symptoms:\n- burning or painful urination\n- pain in the back, lower abdomen, or groin\n- cloudy, dark, or bloody urine\n- foul-smelling urine\n- fever and chills\n- vomiting\nPeople who experience these symptoms should see or call a health care provider as soon as possible." } ]

[ { "from": "human", "value": "How to diagnose Medullary Sponge Kidney?" }, { "from": "gpt", "value": "A health care provider diagnoses medullary sponge kidney based on\n- a medical and family history\n- a physical exam\n- imaging studies\nMedical and Family History\nTaking a medical and family history can help diagnose medullary sponge kidney. A health care provider will suspect medullary sponge kidney when a person has repeated UTIs or kidney stones.\nPhysical Exam\nNo physical signs are usually present in a patient with medullary sponge kidney, except for blood in the urine. Health care providers usually confirm a diagnosis of medullary sponge kidney with imaging studies.\nImaging Studies\nImaging is the medical term for tests that use different methods to see bones, tissues, and organs inside the body. Health care providers commonly choose one or more of three imaging techniques to diagnose medullary sponge kidney:\n- intravenous pyelogram\n- computerized tomography (CT) scan\n- ultrasound\nA radiologista doctor who specializes in medical imaginginterprets the images from these studies, and patients do not need anesthesia.\nIntravenous Pyelogram\nIn an intravenous pyelogram, a health care provider injects a special dye, called contrast medium, into a vein in the patients arm. The contrast medium travels through the body to the kidneys. The kidneys excrete the contrast medium into urine, which makes the urine visible on an x-ray. An x-ray technician performs this procedure at a health care providers office, an outpatient center, or a hospital. An intravenous pyelogram can show any blockage in the urinary tract, and the cysts show up as clusters of light.\nComputerized Tomography Scans\nComputerized tomography scans use a combination of x-rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the x-rays are taken. An x-ray technician performs the procedure in an outpatient center or a hospital. CT scans can show expanded or stretched tubules.\nUltrasound\nUltrasound 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. Ultrasound can show kidney stones and calcium deposits within the kidney." } ]

[ { "from": "human", "value": "What are the treatments for Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Scientists have not discovered a way to reverse medullary sponge kidney. Once a health care provider is sure a person has medullary sponge kidney, treatment focuses on\n- curing an existing UTI\n- removing any kidney stones\nCuring an Existing Urinary Tract Infection\nTo treat a UTI, the health care provider may prescribe a medication called an antibiotic that kills bacteria. The choice of medication and length of treatment depend on the persons medical history and the type of bacteria causing the infection. More information is provided in the NIDDK health topic, Urinary Tract Infections in Adults.\nRemoving Kidney Stones\nTreatment for kidney stones usually depends on their size and what they are made of, as well as whether they are causing pain or obstructing the urinary tract. Kidney stones may be treated by a general practitioner or by a urologista doctor who specializes in the urinary tract.\nSmall stones usually pass through the urinary tract without treatment. Still, the person may need pain medication and should drink lots of liquids to help move the stone along. Pain control may consist of oral or intravenous (IV) medication, depending on the duration and severity of the pain. People may need IV fluids if they become dehydrated from vomiting or an inability to drink.\nA person with a larger stone, or one that blocks urine flow and causes great pain, may need more urgent treatment, such as\n- shock wave lithotripsy. A machine called a lithotripter is used to break up the kidney stone into smaller pieces to pass more easily through the urinary tract. The patient may need local or general anesthesia.\n- ureteroscopy. A ureteroscopea long, tubelike instrument with an eyepieceis used to find and retrieve the stone with a small basket or to break the stone up with laser energy. Local or general anesthesia may be required.\n- percutaneous nephrolithotomy. In this procedure, a wire-thin viewing instrument, called a nephroscope, is used to locate and remove the stones. During the procedure, which requires general anesthesia, a tube is inserted directly into the kidney through a small incision in the patients back.\nMore information is provided in the NIDDK health topic, Kidney Stones in Adults." } ]

[ { "from": "human", "value": "How to prevent Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Scientists have not yet found a way to prevent medullary sponge kidney. However, health care providers can recommend medications and dietary changes to prevent future UTIs and kidney stones." } ]

[ { "from": "human", "value": "How to prevent Medullary Sponge Kidney?" }, { "from": "gpt", "value": "Health care providers may prescribe certain medications to prevent UTIs and kidney stones:\n- A person with medullary sponge kidney may need to continue taking a low-dose antibiotic to prevent recurrent infections.\n- Medications that reduce calcium in the urine may help prevent calcium kidney stones. These medications may include- potassium citrate- thiazide" } ]

[ { "from": "human", "value": "What to do for Medullary Sponge Kidney?" }, { "from": "gpt", "value": "The following changes in diet may help prevent UTIs and kidney stone formation:\n- Drinking plenty of water and other liquids can help flush bacteria from the urinary tract and dilute urine so kidney stones cannot form. A person should drink enough liquid to produce about 2 to 2.5 quarts of urine every day.3\n- Reducing sodium intake, mostly from salt, may help prevent kidney stones. Diets high in sodium can increase the excretion of calcium into the urine and thus increase the chance of calciumcontaining kidney stones forming.\n- Foods rich in animal proteins such as meat, eggs, and fish can increase the chance of uric acid stones and calcium stones forming. People who form stones should limit their meat consumption to 6 to 8 ounces a day.4\n- People who are more likely to develop calcium oxalate stones should include 1,000 milligrams of calcium in their diet every day. Adults older than 50 years should consume 1,200 milligrams of calcium daily.3 Calcium in the digestive tract binds to oxalate from food and keeps it from entering the blood and the urinary tract, where it can form stones.\nPeople with medullary sponge kidney should talk with their health care provider or a dietitian before making any dietary changes. A dietitian can help a person plan healthy meals." } ]

[ { "from": "human", "value": "What to do for Medullary Sponge Kidney?" }, { "from": "gpt", "value": "- Medullary sponge kidney, also known as Cacchi-Ricci disease, is a birth defect where changes occur in the tubules, or tiny tubes, inside a fetus kidneys.\n- Symptoms of medullary sponge kidney do not usually appear until the teenage years or the 20s. Medullary sponge kidney can affect one or both kidneys.\n- Complications of medullary sponge kidney include- hematuria, or blood in the urine- kidney stones- urinary tract infections (UTIs)- Many people with medullary sponge kidney have no symptoms. The first sign that a person has medullary sponge kidney is usually a UTI or a kidney stone. UTIs and kidney stones share many of the same signs and symptoms:- burning or painful urination- pain in the back, lower abdomen, or groin- cloudy, dark, or bloody urine- foul-smelling urine- fever and chills- vomiting- Health care providers commonly choose one or more of three imaging techniques to diagnose medullary sponge kidney:- intravenous pyelogram- computerized tomography (CT) scan- ultrasound- Scientists have not discovered a way to reverse medullary sponge kidney. Once a health care provider is sure a person has medullary sponge kidney, treatment focuses on- curing an existing UTI- removing any kidney stones- Scientists have not yet found a way to prevent medullary sponge kidney. However, health care providers can recommend medications and dietary changes to prevent future UTIs and kidney stones." } ]

[ { "from": "human", "value": "What is (are) Lupus Nephritis?" }, { "from": "gpt", "value": "Lupus nephritis is kidney inflammation caused by systemic lupus erythematosus (SLE or lupus). SLE is an autoimmune diseasea disorder in which the bodys immune system attacks the bodys own cells and organs. Up to 60 percent of people with SLE are diagnosed with lupus nephritis, which can lead to significant illness and even death.1" } ]

[ { "from": "human", "value": "What is (are) Lupus Nephritis?" }, { "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 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 until releasing it through urination." } ]

[ { "from": "human", "value": "What are the symptoms of Lupus Nephritis?" }, { "from": "gpt", "value": "The symptoms of lupus nephritis may include high blood pressure, foamy urine, and edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face.\nKidney problems often develop at the same time or shortly after lupus symptoms appear and can include\n- joint pain or swelling\n- muscle pain\n- fever with no known cause\n- red rashes, often on the face, which are also called butterfly rashes because of their shape" } ]

[ { "from": "human", "value": "How to diagnose Lupus Nephritis?" }, { "from": "gpt", "value": "Lupus nephritis is diagnosed through urine and blood tests and a kidney biopsy:\n- Urinalysis. Urinalysis is testing of a urine sample. The urine sample is collected in a special container in a health care providers office or commercial facility and can be tested in the same location or sent to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color when blood or protein is present. A high number of red blood cells or high levels of protein in the urine indicate kidney damage.\n- Blood test. A blood test involves drawing blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. The blood test can show high levels of creatinine, a waste product of normal muscle breakdown excreted by the kidneys, which increases when the kidneys are not functioning well.\n- Biopsy. A biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The biopsy is performed by a health care provider in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the kidney. The kidney tissue is examined in a lab by a pathologista doctor who specializes in diagnosing diseases. The test can confirm a diagnosis of lupus nephritis, determine how far the disease has progressed, and guide treatment. The American College of Rheumatology recommends biopsies for all people with evidence of active lupus nephritis that has not been previously treated." } ]

[ { "from": "human", "value": "What are the treatments for Lupus Nephritis?" }, { "from": "gpt", "value": "Lupus nephritis is treated with medications that suppress the immune system, so it stops attacking and damaging the kidneys. Standard treatment includes a corticosteroid, usually prednisone, to reduce inflammation in the kidneys. An immunosuppressive medication, such as cyclophosphamide or mycophenolate mofetil, is typically used with prednisone. These medicationswhen taken as prescribed by a health care providerfurther decrease the activity of the immune system and block the bodys immune cells from attacking the kidneys directly or making antibodies that attack the kidneys. Antibodies are proteins made by the immune system to protect the body from foreign substances such as bacteria or viruses. Hydroxychloroquine, a medication for treating SLE, should also be prescribed or continued for people with lupus nephritis.\nPeople with lupus nephritis that is causing high blood pressure may need to take medications that lower their 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 bodymay be prescribed. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed.\nBlood 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. High blood pressure is a systolic pressure of 140 or above or a diastolic pressure of 90 or above.2" } ]

[ { "from": "human", "value": "What are the complications of Lupus Nephritis?" }, { "from": "gpt", "value": "In many cases, treatment is effective in completely or partially controlling lupus nephritis, resulting in few, if any, further complications. However, even with treatment, 10 to 30 percent of people with lupus nephritis develop kidney failure, described as end-stage renal disease when treated with blood-filtering treatments called dialysis or a kidney transplant.3 Scientists cannot predict who will or will not respond to treatment. The most severe form of lupus nephritis is called diffuse proliferative nephritis. With this type of illness, the kidneys are inflamed, many white blood cells invade the kidneys, and kidney cells increase in number, which can cause such severe damage that scars form in the kidneys. Scars are difficult to treat, and kidney function often declines as more scars form. People with suspected lupus nephritis should get diagnosed and treated as early as possible to prevent such chronic, or long lasting, damage.\nPeople with lupus nephritis are at a high risk for cancer, primarily B-cell lymphomaa type of cancer that begins in the cells of the immune system. They are also at a high risk for heart and blood vessel problems." } ]

[ { "from": "human", "value": "What to do for Lupus Nephritis?" }, { "from": "gpt", "value": "Eating, diet, and nutrition have not been shown to play a role in causing or preventing lupus nephritis. People with kidney disease that progresses may need to talk with a health care provider about changes they may need to make to their diet. People with lupus nephritis and high blood pressure may benefit from reducing sodium intake, often from salt. More information about nutrition in people with kidney disease is provided in the NIDDK health topics, Nutrition for Early Chronic Kidney Disease in Adults and Nutrition for Advanced Chronic Kidney Disease in Adults." } ]

[ { "from": "human", "value": "What to do for Lupus Nephritis?" }, { "from": "gpt", "value": "- Lupus nephritis is kidney inflammation caused by systemic lupus erythematosus (SLE or lupus).\n- The symptoms of lupus nephritis may include high blood pressure, foamy urine, and edema.\n- Lupus nephritis is diagnosed through urine and blood tests and a kidney biopsy.\n- Lupus nephritis is treated with medications that suppress the immune system, so it stops attacking and damaging the kidneys. Standard treatment includes a corticosteroid, usually prednisone, to reduce inflammation in the kidneys. An immunosuppressive medication, such as cyclophosphamide or mycophenolate mofetil, is typically used with prednisone.\n- People with lupus nephritis that is causing high blood pressure may need to take medications that lower their blood pressure, which can also significantly slow the progression of kidney disease.\n- In many cases, treatment is effective in completely or partially controlling lupus nephritis, resulting in few, if any, further complications. However, even with treatment, 10 to 30 percent of people with lupus nephritis develop kidney failure." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Interstitial Cystitis/Painful Bladder Syndrome?" }, { "from": "gpt", "value": "Interstitial cystitis*painful bladder syndrome (IC/PBS) is one of several conditions that causes bladder pain and a need to urinate frequently and urgently. Some doctors have started using the term bladder pain syndrome (BPS) to describe this condition.\nYour bladder is a balloon-shaped organ where your body holds urine. When you have a bladder problem, you may notice certain signs or symptoms.\n*See Pronounciation Guide for tips on how to say the words in bold type." } ]

[ { "from": "human", "value": "What are the symptoms of What I need to know about Interstitial Cystitis/Painful Bladder Syndrome?" }, { "from": "gpt", "value": "Signs of bladder problems include\n-Urgency. The feeling that you need to go right now! Urgency is normal if you haven't been near a bathroom for a few hours or if you have been drinking a lot of fluids. But you may have a problem if you have strong urges before your bladder has had time to fill. All of a sudden, you feel a strong urge to go. At times, you may even have an accident because the urge strikes so quickly you don't have time to find a bathroom.\n- Frequency. The feeling that you need to go much more often than anyone else. Doctors and nurses use the term void, which means to empty the bladder. Most people void between four and seven times a day. Drinking large amounts of fluid can cause more frequent voiding. Taking blood pressure medicines called diuretics, or water pills, can also cause more frequent voiding. If you void more than eight times a day, and you dont take diuretics or drink large amounts of fluid, it may be the sign of a problem.\n- Pain. The feeling of more than discomfort when you need to go. Having a full bladder may be uncomfortable, but it should not be painful. You may have a problem if you feel burning or sharp pain in your bladder or urethrathe opening where urine leaves the body.\nSome people may have pain without urgency or frequency. Others have urgency and frequency without pain." } ]

[ { "from": "human", "value": "What causes What I need to know about Interstitial Cystitis/Painful Bladder Syndrome?" }, { "from": "gpt", "value": "Many different problems can cause urgency, frequency, and bladder pain. Just a few of them are\n- infections\n- bowel disorders\n- endometriosistissue that normally lines the womb that appears in other places outside of the womb\n- bladder cancer\nYour doctor will ask you questions and run tests to find the cause of your bladder problems. Usually, the doctor will find that you have either an infection or an overactive bladder. But urgency, frequency, and pain are not always caused by infection.\nSometimes the cause is hard to find. If all the test results are normal and all other diseases are ruled out, your doctor may find that you have IC/PBS." } ]

[ { "from": "human", "value": "Who is at risk for What I need to know about Interstitial Cystitis/Painful Bladder Syndrome??" }, { "from": "gpt", "value": "Both men and women can get IC/PBS, though twice as many women are affected as men. It can occur at any age, but it is most common in middle age.\nPeople with IC/PBS rarely have bladder pain all the time. The pain usually comes and goes as the bladder fills and then empties. The pain may go away for weeks or months and then return. People with IC/PBS sometimes refer to an attack of bladder pain as a flare or flare-up. Stress may bring on a flare-up of symptoms in someone who has IC/PBS. But stress does not cause a person to get IC/PBS." } ]

[ { "from": "human", "value": "How to diagnose What I need to know about Interstitial Cystitis/Painful Bladder Syndrome?" }, { "from": "gpt", "value": "Finding the cause of bladder pain may require several tests.\nWhile tests may aid your doctor in making a diagnosis of IC/PBS, a careful review of your symptoms and a physical exam in the office are generally the most important parts of the evaluation." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Interstitial Cystitis/Painful Bladder Syndrome?" }, { "from": "gpt", "value": "No one treatment for IC/PBS has been found that works for everyone. Your doctor or nurse will work with you to find a treatment plan that meets your special needs. The plan may include diet and lifestyle changes, bladder retraining, activity and exercise, physical therapy, and various types of medicines. You should expect some treatment failures along the way, but, with time, you and your doctor or nurse should find a treatment that gives you some relief and helps you cope with your disease.\nDiet and Lifestyle Changes\nSome people with IC/PBS find that certain foods or drinks bring on their symptoms. Others find no link between symptoms and what they eat.\nLearning what foods cause symptoms for you may require some trial and error. Keep a food diary and note the times you have bladder pain. The diary might reveal that your flare-ups always happen, for example, after you eat tomatoes or oranges.\nSome doctors recommend taking an antacid medicine with meals. The medicine reduces the amount of acid that gets into the urine.\nIf you make changes to your diet, remember to eat a variety of healthy foods.\nBladder Retraining\nBladder retraining is a way to help your bladder hold more urine. People with bladder pain often get in the habit of using the bathroom as soon as they feel pain or urgency. They then feel the need to go before the bladder is really full. The body may get used to frequent voiding. Bladder retraining helps your bladder hold more urine before signaling the urge to urinate.\nKeep a bladder diary to track how you are doing. Start by noting the times when you void. Note how much time goes by between voids. For example, you may find that you return to the bathroom every 40 minutes.\nTry to stretch out the time between voids. If you usually void every 40 minutes, try to wait at least 50 minutes before you go to the bathroom.\nIf your bladder becomes painful, you may use the bathroom. But you may find that your first urge to use the bathroom goes away if you ignore it. Find ways to relax or distract yourself when the first urge strikes.\nAfter a few days, you may be able to stretch the time out to 60 or 70 minutes, and you may find that the urge to urinate does not return as soon.\nActivity\nIf you have IC/PBS, you may feel the last thing you want to do is exercise. But many people feel that easy activities like walking or gentle stretching exercises help relieve symptoms.\nPhysical Therapy\nYour doctor or nurse may suggest pelvic exercises. The pelvic muscles hold the bladder in place and help control urination. The first step is to find the right muscle to squeeze. A doctor, nurse, or physical therapist can help you. One way to find the muscles is to imagine that you are trying to stop passing gas. Squeeze the muscles you would use. If you sense a \"pulling\" feeling, you have found the right muscles for pelvic exercises.\nYou may need exercises to strengthen those muscles so that it's easier to hold in urine. Or you may need to learn to relax your pelvic muscles if tense muscles are part of your bladder pain.\nSome physical therapists specialize in helping people with pelvic pain. Ask your doctor or nurse to help you find a professional trained in pelvic floor physical therapy.\nReducing Stress\nStress doesn't cause IC/PBS. But stress can trigger painful flare-ups in someone who has IC/PBS. Learning to reduce stress in your life by making time for relaxation every day may help control some symptoms of IC/PBS.\nOral Medicines\nPain pills like aspirin, ibuprofen, or acetominophen can help control mild bladder pain. Advil and Motrin are examples of ibuprofen. Tylenol is an example of acetominophen. Talk with your doctor if you feel you need a stronger pain medicine.\nYour doctor may recommend a medication, pentosan polysulfate sodium, sold as Elmiron, which is approved for treating the pain of IC/PBS. You may need to take this medicine for up to 6 months before you notice improvement. Elmiron does not work for everyone, but some people with IC/PBS have found relief taking it. You need a doctor's order for Elmiron. If you don't notice improvement of your symptoms in 6 months, this medicine is not likely to work.\nResearchers are also looking at other kinds of medicines. Medicines that treat heartburn might help bladder symptoms by reducing the amount of acid made in the body. Muscle relaxants can keep the bladder from squeezing at the wrong time. Keeping the bladder muscle relaxed helps ease the symptoms of IC/PBS.\nBladder Stretching\nThe doctor may stretch the bladder by filling it with liquid. You will be given an anesthetic to prevent pain and help relax your bladder muscles. Some patients have said their symptoms were helped after this treatment.\nBladder Medicines\nMany patients who have IC/PBS find relief after a treatment in which their bladders are filled with a liquid medicine. The doctor guides a tube into your bladder and slowly fills the bladder with a liquid that eases irritation of the bladder wall. The liquid may be a compound called DMSO or a solution that contains heparin and a pain medicine called lidocaine.\nYou will keep the liquid in your bladder for about 15 minutes and then release it. You can have this treatment once every week or every other week for 1 or 2 months. You may not feel any better until the third or fourth treatment.\nNerve Stimulation\nIf you have tried diet changes, exercise, and medicines and nothing seems to help, you may wish to think about nerve stimulation. This treatment sends mild electrical pulses to the nerves that control the bladder.\nAt first, you may try a system that sends the pulses through electrodes placed on your skin. If this therapy works for you, you may consider having a device put in your body. The device delivers small pulses of electricity to the nerves around the bladder.\nFor some patients, nerve stimulation relieves bladder pain as well as urinary frequency and urgency. For others, the treatment relieves frequency and urgency but not pain. For still other patients, it does not work.\nScientists are not sure why nerve stimulation works. Some believe that the electrical pulses block the pain signals carried in the nerves. If your brain doesn't receive the nerve signal, you don't feel the pain. Others believe that the electricity releases endorphins, which are hormones that block pain naturally.\nSurgery\nAs a last resort, your doctor might suggest surgery to remove part or all of the bladder. Surgery does not cure the pain of IC/PBS in all cases, but if you have tried every other option and your pain is still unbearable, surgery might be considered.\nTalk with your doctor and family about the possible benefits and side effects." } ]

[ { "from": "human", "value": "What to do for What I need to know about Interstitial Cystitis/Painful Bladder Syndrome?" }, { "from": "gpt", "value": "- Bladder problems have many possible causes.\n- Your doctor will need to do tests to find the cause of your bladder problems. If all the test results are normal, you may have IC/PBS.\n- No one treatment option for IC/PBS works for everybody.\n- Treatments for IC/PBS may include changing your diet and exercising.\n- Medicines for IC/PBS may be taken by mouth or put directly into the bladder through a tube by a doctor.\n- Nerve stimulation helps some people with IC/PBS.\n- Surgery is a last resort for treating IC/PBS." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Gestational* diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. Your body uses glucose for energy. Too much glucose in your blood is not good for you or your baby.\nGestational diabetes is usually diagnosed during late pregnancy. If you are diagnosed with diabetes earlier in your pregnancy, you may have had diabetes before you became pregnant.\nTreating gestational diabetes can help both you and your baby stay healthy. You can protect your baby and yourself by taking action right away to control your blood glucose levels.\nIf you have gestational diabetes, a health care team will likely be part of your care. In addition to your obstetrician-gynecologist, or OB/GYNthe doctor who will deliver your babyyour team might include a doctor who treats diabetes, a diabetes educator, and a dietitian to help you plan meals.\nFor Women with Type 1 or Type 2 Diabetes If you already have type 1 or type 2 diabetes and are thinking about having a baby, talk with your doctor before you get pregnant. Untreated or poorly controlled diabetes can cause serious problems for your baby. More information is provided in the NIDDK health topic, What I need to know about Preparing for Pregnancy if I Have Diabetes or call 18008608747 and request a copy.\n*See the Pronunciation Guide for tips on how to say the words in bold type." } ]

[ { "from": "human", "value": "What causes What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels.\nDuring pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body's cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body's need for insulin. If your pancreas can't make enough insulin, you will have gestational diabetes.\nAll pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.\nWhat are my chances of getting gestational diabetes? Your chances of getting gestational diabetes are higher if you\n- are overweight\n- have had gestational diabetes before\n- have given birth to a baby weighing more than 9 pounds\n- have a parent, brother, or sister with type 2 diabetes\n- have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes\n- are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American\n- have a hormonal disorder called polycystic ovary syndrome, also known as PCOS" } ]

[ { "from": "human", "value": "What is (are) What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Your chances of getting gestational diabetes are higher if you\n- are overweight\n- have had gestational diabetes before\n- have given birth to a baby weighing more than 9 pounds\n- have a parent, brother, or sister with type 2 diabetes\n- have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes\n- are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American\n- have a hormonal disorder called polycystic ovary syndrome, also known as PCOS" } ]

[ { "from": "human", "value": "How to diagnose What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Doctors use blood tests to diagnose gestational diabetes. All diabetes blood tests involve drawing blood at a doctor's office or a commercial facility. Blood samples are sent to a lab for analysis.\nScreening Glucose Challenge Test\nFor this test, you will drink a sugary beverage and have your blood glucose level checked an hour later. This test can be done at any time of the day. If the results are above normal, you may need to have an oral glucose tolerance test.\nOral Glucose Tolerance Test\nYou will need to fast for at least 8 hours before the test. Fasting means having nothing to eat or drink except water. Your doctor will give you other instructions to follow before the test.\nYour fasting blood glucose level will be checked before the test begins. Then you will drink a sugary beverage. Your blood glucose levels will be checked 1 hour, 2 hours, and possibly 3 hours later. Your doctor will use your test results to find out whether you have gestational diabetes." } ]

[ { "from": "human", "value": "How to diagnose What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "If you have gestational diabetes, your doctor may recommend that you have some extra tests to check your baby's health, such as\n- ultrasound exams, which use sound waves to make images that show your baby's growth and whether your baby is larger than normal\n- a nonstress test, which uses a monitor placed on your abdomen to check whether your baby's heart rate increases as it should when your baby is active\n- kick counts to check the time between your baby's movements" } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. Targets are numbers you aim for. Your doctor will help you set your targets. You will learn how to control your blood glucose using\n- healthy eating\n- physical activity\n- insulin shots, if needed" } ]

[ { "from": "human", "value": "What to do for What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Your health care team will help you make a healthy eating plan with food choices that are good for both you and your baby. These choices are good for you to follow throughout pregnancy and after, as you raise your family.\nUsing a healthy eating plan will help your blood glucose stay in your target range. The plan will help you know which foods to eat, how much to eat, and when to eat. Food choices, amounts, and timing are all important in keeping your blood glucose levels in your target range.\nMore information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes.\nPhysical Activity\nPhysical activity can help you reach your blood glucose targets. Talk with your doctor about the type of activity that is best for you. If you are already active, tell your doctor what you do. Being physically active will also help lower your chances of having type 2 diabetesand its problemsin the future. Now is the time to develop good habits for you and your baby.\nFor more information about physical activity and pregnancy, visit www.womenshealth.gov/pregnancy.\nInsulin Shots\nIf you have trouble meeting your blood glucose targets, you may need to take a medicine called insulin, along with following a healthy meal plan and being physically active. Your health care team will show you how to give yourself insulin shots. Insulin will not harm your baby." } ]

[ { "from": "human", "value": "How to diagnose What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "Your health care team may teach you how to test for chemicals called ketones in your morning urine or in your blood. High levels of ketones are a sign that your body is using your body fat for energy instead of the food you eat. Using fat for energy is not recommended during pregnancy. Ketones may be harmful for your baby.\nIf your ketone levels are high, your doctor may suggest that you change the type or amount of food you eat. Or you may need to change your meal or snack times." } ]

[ { "from": "human", "value": "How to prevent What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "You can do a lot to prevent or delay type 2 diabetes by making these lifestyle changes:\n- Reach and stay at a healthy weight. Try to reach your prepregnancy weight 6 to 12 months after your baby is born. Then, if you still weigh too much, work to lose at least 5 to 7 percent of your body weight and keep it off. For example, if you weigh 200 pounds, losing 10 to 14 pounds can greatly reduce your chance of getting diabetes.\n- Be physically active for at least 30 minutes most days of the week.\n- Follow a healthy eating plan. Eat more grains, fruits, and vegetables. Cut down on fat and calories. Your health care team can help you design a meal plan.\n- Ask your doctor if you should take the diabetes medicine metformin. Metformin can lower your chances of having type 2 diabetes, especially if you are younger and heavier and have prediabetes or if you have had gestational diabetes.\nThese changes can help you enjoy a longer, healthier life. Your health care team can give you information and support to help you make these changes.\nBy delaying or preventing type 2 diabetes, you will also lower your chances of having heart and blood vessel disease and other problems as you get older.\nTalk with your doctor if you are thinking about having another baby. For the safety of your baby, your blood glucose needs to be at healthy levels before you get pregnant again. Your doctor can help ensure you are ready for your next child." } ]

[ { "from": "human", "value": "What to do for What I need to know about Gestational Diabetes?" }, { "from": "gpt", "value": "- Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high.\n- Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels.\n- You will probably be tested for gestational diabetes between weeks 24 and 28 of your pregnancy. If you have a higher chance of getting gestational diabetes, your doctor may test you for diabetes during your first visit after you become pregnant.\n- If you have high blood glucose levels because your gestational diabetes is not under control, your baby will also have high blood glucose.\n- Untreated or uncontrolled gestational diabetes can cause problems for your baby.\n- Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range.\n- Even if your blood glucose levels return to normal after your pregnancy, your chances of getting diabetesusually type 2 diabeteslater in life are high. Therefore, you should be tested at least every 3 years for diabetes or prediabetes.\n- You can give your baby a healthy start by breastfeeding.\n- You can help your child be healthy by showing your child how to make healthy lifestyle choices, including being physically active, limiting screen time in front of the TV or video games, eating a healthy diet, and staying at a healthy weight." } ]

[ { "from": "human", "value": "What are the symptoms of Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease (For Health Care Professionals)?" }, { "from": "gpt", "value": "Dermatitis herpetiformis is characterized by small, clustered papules and vesicles that erupt symmetrically on the elbows, knees, buttocks, back, or scalp. The face and groin can also be involved. A burning sensation may precede lesion formation. Lesions are usually scratched off by the time a patient comes in for a physical exam, and the rash may appear as erosions and excoriations.\nPatients with DH may also experience dental enamel defects to permanent teeth, which is another manifestation of celiac disease. Less than 20 percent of people with DH have symptoms of celiac disease.3" } ]

[ { "from": "human", "value": "What causes Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease (For Health Care Professionals)?" }, { "from": "gpt", "value": "Dermatitis herpetiformis is caused by the deposit of immunoglobulin A (IgA) in the skin, which triggers further immunologic reactions resulting in lesion formation. DH is an external manifestation of an abnormal immune response to gluten, in which IgA antibodies form against the skin antigen epidermal transglutaminase.\nFamily studies show that 5 percent of first-degree relatives of a person with DH will also have DH. An additional 5 percent of first-degree relatives of a person with DH will have celiac disease.4 Various other autoimmune diseases are associated with DH, the most common being hypothyroidism." } ]

[ { "from": "human", "value": "How to diagnose Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease (For Health Care Professionals)?" }, { "from": "gpt", "value": "A skin biopsy is the first step in diagnosing DH. Direct immunofluorescence of clinically normal skin adjacent to a lesion shows granular IgA deposits in the upper dermis. Histology of lesional skin may show microabscesses containing neutrophils and eosinophils. However, histology may reveal only excoriation due to the intense itching that patients experience.\nBlood tests for antiendomysial or anti-tissue transglutaminase antibodies may also suggest celiac disease. Blood tests for epidermal transglutaminase antibodies are positive in more than 90 percent of cases.5 All of these tests will become negative with prolonged adherence to a gluten-free diet.\nA positive biopsy and serology confirm DH and should be taken as indirect evidence of small bowel damage. A biopsy of the small bowel is usually not needed for DH diagnosis. However, if clinical signs of gastrointestinal disease are evident on examination, further workup may be required.2 Whether or not intestinal damage is evident, a gluten-free diet should be implemented because the rash of DH is gluten sensitive.4" } ]

[ { "from": "human", "value": "What are the treatments for Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease (For Health Care Professionals)?" }, { "from": "gpt", "value": "The sulfone dapsone can provide immediate relief of symptoms. For patients who cannot tolerate dapsone, sulfapyridine or sulfamethoxypyridazine may be used, although these medications are less effective than dapsone. A strict gluten-free diet is the only treatment for the underlying disease. Even with a gluten-free diet, medication therapy may need to be continued from a few months to 2 years.\nDH can go into remission, which is defined as absence of skin lesions and symptoms of DH for more than 2 years while not taking sulfones or other treatments and not adhering to a gluten-free diet. Cohort studies showing DH remission provide support for reducing sulfone therapy and weaning from a gluten-free diet in patients with well-controlled DH.6" } ]

[ { "from": "human", "value": "What is (are) Your Guide to Diabetes: Type 1 and Type 2?" }, { "from": "gpt", "value": "Diabetes is when your blood glucose, also called blood sugar, is too high. Blood glucose is the main type of sugar found in your blood and your main source of energy. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries glucose to all of your bodys cells to use for energy.\nYour pancreasan organ, located between your stomach and spine, that helps with digestionreleases a hormone it makes, called insulin, into your blood. Insulin helps your blood carry glucose to all your bodys cells. Sometimes your body doesnt make enough insulin or the insulin doesnt work the way it should. Glucose then stays in your blood and doesnt reach your cells. Your blood glucose levels get too high and can cause diabetes or prediabetes.\nOver time, having too much glucose in your blood can cause health problems.\n*See the Pronunciation Guide for tips on how to say the the words in bold type." } ]

[ { "from": "human", "value": "What is (are) Your Guide to Diabetes: Type 1 and Type 2?" }, { "from": "gpt", "value": "Prediabetes is when the amount of glucose in your blood is above normal yet not high enough to be called diabetes. With prediabetes, your chances of getting type 2 diabetes, heart disease, and stroke are higher. With some weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. You can even return to normal glucose levels, possibly without taking any medicines." } ]

[ { "from": "human", "value": "What are the symptoms of Your Guide to Diabetes: Type 1 and Type 2?" }, { "from": "gpt", "value": "The signs and symptoms of diabetes are\n- being very thirsty\n- urinating often\n- feeling very hungry\n- feeling very tired\n- losing weight without trying\n- sores that heal slowly\n- dry, itchy skin\n- feelings of pins and needles in your feet\n- losing feeling in your feet\n- blurry eyesight\nSome people with diabetes dont have any of these signs or symptoms. The only way to know if you have diabetes is to have your doctor do a blood test." } ]

[ { "from": "human", "value": "What is (are) Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "A UTI is an infection in the urinary tract. Infections are caused by microbesorganisms too small to be seen without a microscopeincluding fungi, viruses, and bacteria. Bacteria are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are rapidly removed by the body before they cause symptoms. However, sometimes bacteria overcome the bodys natural defenses and cause infection. An infection in the urethra is called urethritis. A bladder infection is called cystitis. Bacteria may travel up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis." } ]

[ { "from": "human", "value": "What is (are) Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "The urinary tract is the body's drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean-shaped organs, each about the size of a fist and located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine a person produces each day. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder and emptied through the urethra, a tube at the bottom of the bladder.\nWhen the bladder empties, a muscle called the sphincter relaxes and urine flows out of the body through the urethra. The opening of the urethra is at the end of the penis in males and in front of the vagina in females." } ]

[ { "from": "human", "value": "What causes Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "Most UTIs are caused by bacteria that live in the bowel. The bacterium Escherichia coli (E. coli) causes the vast majority of UTIs. Microbes called Chlamydia and Mycoplasma can infect the urethra and reproductive system but not the bladder. Chlamydia and Mycoplasma infections may be sexually transmitted and require treatment of sexual partners.\nThe urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act like one-way valves to prevent urine from backing up toward the kidneys, and urination washes microbes out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. But despite these safeguards, infections still occur. Certain bacteria have a strong ability to attach themselves to the lining of the urinary tract." } ]

[ { "from": "human", "value": "How many people are affected by Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "Urinary tract infections are the second most common type of infection in the body, accounting for about 8.1 million visits to health care providers each year.1 Women are especially prone to UTIs for anatomical reasons. One factor is that a womans urethra is shorter, allowing bacteria quicker access to the bladder. Also, a womans urethral opening is near sources of bacteria from the anus and vagina. For women, the lifetime risk of having a UTI is greater than 50 percent.2 UTIs in men are not as common as in women but can be serious when they occur." } ]

[ { "from": "human", "value": "Who is at risk for Urinary Tract Infection In Adults??" }, { "from": "gpt", "value": "Although everyone has some risk, some people are more prone to getting UTIs than others. People with spinal cord injuries or other nerve damage around the bladder have difficulty emptying their bladder completely, allowing bacteria to grow in the urine that stays in the bladder. Anyone with an abnormality of the urinary tract that obstructs the flow of urinea kidney stone or enlarged prostate, for exampleis at risk for a UTI. People with diabetes or problems with the bodys natural defense system are more likely to get UTIs.\nSexual activity can move microbes from the bowel or vaginal cavity to the urethral opening. If these microbes have special characteristics that allow them to live in the urinary tract, it is harder for the body to remove them quickly enough to prevent infection. Following sexual intercourse, most women have a significant number of bacteria in their urine, but the body normally clears them within 24 hours. However, some forms of birth control increase the risk of UTI. In some women, certain spermicides may irritate the skin, increasing the risk of bacteria invading surrounding tissues. Using a diaphragm may slow urinary flow and allow bacteria to multiply. Condom use is also associated with increased risk of UTIs, possibly because of the increased trauma that occurs to the vagina during sexual activity. Using spermicides with diaphragms and condoms can increase risk even further.\nAnother common source of infection is catheters, or tubes, placed in the urethra and bladder. Catheters interfere with the bodys ability to clear microbes from the urinary tract. Bacteria travel through or around the catheter and establish a place where they can thrive within the bladder. A person who cannot urinate in the normal way or who is unconscious or critically ill often needs a catheter for more than a few days. The Infectious Diseases Society of America recommends using catheters for the shortest time possible to reduce the risk of a UTI.3\nRecurrent Infections\nMany women suffer from frequent UTIs. About 20 percent of young women with a first UTI will have a recurrent infection.4 With each UTI, the risk that a woman will continue having recurrent UTIs increases.5 Some women have three or more UTIs a year. However, very few women will have frequent infections throughout their lives. More typically, a woman will have a period of 1 or 2 years with frequent infections, after which recurring infections cease.\nMen are less likely than women to have a first UTI. But once a man has a UTI, he is likely to have another because bacteria can hide deep inside prostate tissue. Anyone who has diabetes or a problem that makes it hard to urinate may have repeat infections.\nResearch funded by the National Institutes of Health (NIH) suggests that one factor behind recurrent UTIs may be the ability of bacteria to attach to cells lining the urinary tract. One NIH-funded study found that bacteria formed a protective film on the inner lining of the bladder in mice.6 If a similar process can be demonstrated in humans, the discovery may lead to new treatments to prevent recurrent UTIs. Another line of research has indicated that women who are nonsecretors of certain blood group antigens may be more prone to recurrent UTIs because the cells lining the vagina and urethra may allow bacteria to attach more easily. A nonsecretor is a person with an A, B, or AB blood type who does not secrete the normal antigens for that blood type in bodily fluids, such as fluids that line the bladder wall.7\nInfections during Pregnancy\nPregnant women seem no more prone to UTIs than other women. However, when a UTI does occur in a pregnant woman, it is more likely to travel to the kidneys. According to some reports, about 4 to 5 percent of pregnant women develop a UTI.8 Scientists think that hormonal changes and shifts in the position of the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys and cause infection. For this reason, health care providers routinely screen pregnant women for bacteria in the urine during the first 3 months of pregnancy." } ]

[ { "from": "human", "value": "What are the symptoms of Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "Symptoms of a UTI vary by age, gender, and whether a catheter is present. Among young women, UTI symptoms typically include a frequent and intense urge to urinate and a painful, burning feeling in the bladder or urethra during urination. The amount of urine may be very small. Older women and men are more likely to be tired, shaky, and weak and have muscle aches and abdominal pain. Urine may look cloudy, dark, or bloody or have a foul smell. In a person with a catheter, the only symptom may be fever that cannot be attributed to any other cause. Normally, UTIs do not cause fever if they are in the bladder. A fever may mean the infection has reached the kidneys or has penetrated the prostate. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, and vomiting." } ]

[ { "from": "human", "value": "How to diagnose Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "To find out whether a person has a UTI, the health care provider will ask about urinary symptoms and then test a sample of urine for the presence of bacteria and white blood cells, which are produced by the body to fight infection. Because bacteria can be found in the urine of healthy individuals, a UTI is diagnosed based both on symptoms and a laboratory test. The person will be asked to give a clean catch urine sample by washing the genital area and collecting a midstream sample of urine in a sterile container. This method of collecting urine helps prevent bacteria around the genital area from getting into the sample and confusing the test results. Usually, the sample is sent to a laboratory, although some health care providers offices are equipped to do the testing. For people with recurring infections and patients in the hospital, the urine may be cultured. The culture is performed by placing part of the urine sample in a tube or dish with a substance that encourages any bacteria present to grow. Once the bacteria have multiplied, which usually takes 1 to 3 days, they can be identified. The health care provider may also order a sensitivity test, which tests the bacteria for sensitivity to different antibiotics to see which medication is best for treating the infection.\nIf a person has recurrent UTIs, the health care provider may order some additional tests to determine if the persons urinary tract is normal.\nKidney and bladder ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show abnormalities in the kidneys and bladder. However, this test cannot reveal all important urinary abnormalities or measure how well the kidneys work.\nVoiding cystourethrogram. This test is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. As the person lies on the x-ray table, a health care provider inserts the tip of a thin, flexible tube called a catheter through the urethra into the bladder. The bladder and urethra are filled with a special dye called contrast medium, to make the structures clearly visible on the x-ray images. The x rays are taken from various angles while the bladder is full of contrast medium. The catheter is then removed and x-ray images are taken during urination. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician. The technician is supervised by a radiologist while the images are taken. The radiologist then interprets the images. Anesthesia is not needed, but light sedation may be used for some people. This test can show abnormalities of the inside of the urethra and bladder. The test can also determine whether the flow of urine is normal when the bladder empties.\nComputerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. A CT scan may include the injection of contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. 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. CT scans can provide clearer, more detailed images to help the health care provider understand the problem.\nMagnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include an injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines are designed to allow the person to lie in a more open space. The procedure is performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed though light sedation may be used for people with a fear of confined spaces. Like CT scans, MRIs can provide clearer, more detailed images.\nRadionuclide scan. A radionuclide scan is an imaging technique that relies on the detection of small amounts of radiation after injection of radioactive chemicals. Because the dose of the radioactive chemicals is small, the risk of causing damage to cells is low. Special cameras and computers are used to create images of the radioactive chemicals as they pass through the kidneys. Radionuclide scans are performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. Radioactive chemicals injected into the blood can provide information about kidney function. Radioactive chemicals can also be put into the fluids used to fill the bladder and urethra for x ray, MRI, and CT imaging.\nUrodynamics. Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most of these tests are performed in the office of a urologista doctor who specializes in urinary problemsby a urologist, physician assistant, or nurse practitioner. Some procedures may require light sedation to keep a person calm. Most urodynamic tests focus on the bladders ability to hold urine and empty steadily and completely. Urodynamic tests can also show whether the bladder is having abnormal contractions that cause leakage. A health care provider may order these tests if there is evidence that the person has some kind of nerve damage.\nCystoscopy. Cystoscopy is a procedure that uses a tubelike instrument to look inside the urethra and bladder. Cystoscopy is performed by a doctor in a health care providers office, outpatient facility, or hospital with local anesthesia. However, in some cases, sedation and regional or general anesthesia are needed. Cystoscopy may be used to look for swelling, redness, and other signs of infection." } ]

[ { "from": "human", "value": "What are the treatments for Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "Most UTIs are caused by bacteria, which are treated with bacteria-fighting medications called antibiotics or antimicrobials. The choice of medication and length of treatment depend on the patients history and the type of bacteria causing the infection. Some antibiotics may be ruled out if a person has allergies to them. The sensitivity test takes 48 hours to complete and is especially useful in helping the health care provider select the antibiotic most likely to be effective in treating an infection. Longer treatment may be needed if the first antibiotic given is not effective.\nWhen a UTI occurs in a healthy person with a normal, unobstructed urinary tract, the term uncomplicated is used to describe the infection. Most young women who have UTIs have uncomplicated UTIs, which can be cured with 2 or 3 days of treatment. Single-dose treatment is less effective. Longer treatment causes more side effects and is not more effective. A follow-up urinalysis helps to confirm the urinary tract is infection-free. Taking the full course of treatment is important because symptoms may disappear before the infection is fully cleared.\nComplicated UTIs occur when a personfor example, a pregnant woman or a transplant patientis weakened by another condition. A UTI is also complicated when the person has a structural or functional abnormality of the urinary tract, such as an obstructive kidney stone or prostate enlargement that squeezes the urethra. Health care providers should assume that men and boys have a complicated UTI until proven otherwise.\nSeverely ill patients with kidney infections may be hospitalized until they can take fluids and needed medications on their own. Kidney infections may require several weeks of antibiotic treatment. Kidney infections in adults rarely lead to kidney damage or kidney failure unless they go untreated or are associated with urinary tract obstruction.\nBladder infections are generally self-limiting, but antibiotic treatment significantly shortens the duration of symptoms. People usually feel better within a day or two of treatment. Symptoms of kidney and prostate infections last longer. Drinking lots of fluids and urinating frequently will speed healing. If needed, various medications are available to relieve the pain of a UTI. A heating pad on the back or abdomen may also help.\nRecurrent Infections in Women\nHealth care providers may advise women who have recurrent UTIs to try one of the following treatment options:\n- Take low doses of the prescribed antibiotic daily for 6 months or longer. If taken at bedtime, the medication remains in the bladder longer and may be more effective. NIH-supported research has shown this therapy to be effective without causing serious side effects.\n- Take a single dose of an antibiotic after sexual intercourse.\n- Take a short course2 or 3 daysof an antibiotic when symptoms appear.\nTo try to prevent an infection, health care providers may suggest women\n- drink plenty of water every day\n- urinate when the need arises and avoid resisting the urge to urinate\n- urinate after sexual intercourse\n- switch to a different method of birth control if recurring UTIs are a problem\nInfections during Pregnancy\nDuring pregnancy, bacterial infection of the urineeven in the absence of symptomscan pose risks to both the mother and the baby. Some antibiotics are not safe to take during pregnancy. In selecting the best treatments, health care providers consider various factors such as the medications effectiveness, the stage of pregnancy, the mothers health, and potential effects on the fetus.\nComplicated Infections\nCuring infections that stem from a urinary obstruction or other systemic disorder depends on finding and correcting the underlying problem, sometimes with surgery. If the root cause goes untreated, this group of patients is at risk for kidney damage. Also, such infections tend to arise from a wider range of bacteria and sometimes from more than one type of bacteria at a time.\nInfections in Men\nUrinary tract infections in men are often the result of an obstructionfor example, a urinary stone or enlarged prostateor are from a catheter used during a medical procedure. The first step in treating such an infection is to identify the infecting organism and the medications to which it is sensitive.\nProstate infectionschronic bacterial prostatitisare harder to cure because antibiotics may be unable to penetrate infected prostate tissue effectively. For this reason, men with bacterial prostatitis often need long-term treatment with a carefully selected antibiotic. UTIs in men are frequently associated with acute bacterial prostatitis, which can be life threatening if not treated urgently." } ]

[ { "from": "human", "value": "How to prevent Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "Changing some daily habits may help a person prevent recurrent UTIs.\nEating, Diet, and Nutrition\nDrinking lots of fluid can help flush bacteria from the system. Water is best. Most people should try for six to eight, 8-ounce glasses a day. Talk with your health care provider if you cant drink the recommended amount due to other health problems, such as urinary incontinence, urinary frequency, or kidney failure.\nUrination Habits\nA person should urinate often and when the urge arises. Bacteria can grow when urine stays in the bladder too long. Women and men should urinate shortly after sex to flush away bacteria that might have entered the urethra during sex. Drinking a glass of water will also help flush bacteria away.\nAfter using the toilet, women should wipe from front to back. This step is most important after a bowel movement to keep bacteria from getting into the urethra.\nClothing\nCotton underwear and loose-fitting clothes should be worn, so air can keep the area around the urethra dry. Tight-fitting jeans and nylon underwear should be avoided because they can trap moisture and help bacteria grow.\nBirth Control\nFor women, using a diaphragm or spermicide for birth control can lead to UTIs by increasing bacteria growth. A woman who has trouble with UTIs should try switching to a new form of birth control. Unlubricated condoms or spermicidal condoms increase irritation, which may help bacteria grow. Switching to lubricated condoms without spermicide or using a nonspermicidal lubricant may help prevent UTIs." } ]

[ { "from": "human", "value": "What to do for Urinary Tract Infection In Adults?" }, { "from": "gpt", "value": "- Most urinary tract infections (UTIs) arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the bowel.\n- Symptoms of a UTI in adults may include the following:- a frequent and intense urge to urinate- a painful, burning feeling in the bladder or urethra during urination- feeling tired, shaky, and weak- muscle aches- abdominal pain- only small amounts of urine passed, despite a strong urge to urinate- cloudy, dark, or bloody urine or urine that has a foul smell- pain in the back or side below the ribs- nausea and vomiting- Fever may indicate a kidney or prostate infection.\n- Because bacteria can be found in the urine of healthy individuals, a UTI is diagnosed based both on symptoms and a laboratory test.\n- UTIs are treated with bacteria-fighting medications called antibiotics or antimicrobials." } ]

[ { "from": "human", "value": "What is (are) Pregnancy and Thyroid Disease?" }, { "from": "gpt", "value": "Thyroid disease is a disorder that affects the thyroid gland. Sometimes the body produces too much or too little thyroid hormone. Thyroid hormones regulate metabolismthe way the body uses energyand affect nearly every organ in the body. Too much thyroid hormone is called hyperthyroidism and can cause many of the bodys functions to speed up. Too little thyroid hormone is called hypothyroidism and can cause many of the bodys functions to slow down.\nThyroid hormone plays a critical role during pregnancy both in the development of a healthy baby and in maintaining the health of the mother.\nWomen with thyroid problems can have a healthy pregnancy and protect their fetuses health by learning about pregnancys effect on the thyroid, keeping current on their thyroid function testing, and taking the required medications." } ]

[ { "from": "human", "value": "What is (are) Pregnancy and Thyroid Disease?" }, { "from": "gpt", "value": "The thyroid is a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on either side of the windpipe. The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce, store, and release hormones into the bloodstream. The hormones then travel through the body and direct the activity of the bodys cells.\nThe thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is the active hormone and is made from T4. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.\nThyroid hormone production is regulated by thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production." } ]

[ { "from": "human", "value": "What to do for Pregnancy and Thyroid Disease?" }, { "from": "gpt", "value": "During pregnancy, the body requires higher amounts of some nutrients to support the health of the mother and growing baby. Experts recommend pregnant women maintain a balanced diet and take a prenatal multivitamin and mineral supplement containing iodine to receive most nutrients necessary for thyroid health. More information about diet and nutrition during pregnancy is provided by the National Agricultural Library available at www.choosemyplate.gov/nutritional-needs-during-pregnancy.\nDietary Supplements\nBecause the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for a mother during pregnancy. During pregnancy, the baby gets iodine from the mothers diet. Women need more iodine when they are pregnantabout 250 micrograms a day. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met.\nHowever, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism and hypothyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet.\nTo help ensure coordinated and safe care, people should discuss their use of dietary supplements with their health care provider. Tips for talking with health care providers are available at the National Center for Complementary and Integrative Health's Time to Talk campaign." } ]

[ { "from": "human", "value": "What to do for Pregnancy and Thyroid Disease?" }, { "from": "gpt", "value": "- Thyroid disease is a disorder that results when the thyroid gland produces more or less thyroid hormone than the body needs.\n- Pregnancy causes normal changes in thyroid function but can also lead to thyroid disease.\n- Uncontrolled hyperthyroidism during pregnancy can lead to serious health problems in the mother and the unborn baby.\n- During pregnancy, mild hyperthyroidism does not require treatment. More severe hyperthyroidism is treated with antithyroid medications, which act by interfering with thyroid hormone production.\n- Uncontrolled hypothyroidism during pregnancy can lead to serious health problems in the mother and can affect the unborn babys growth and brain development.\n- Hypothyroidism during pregnancy is treated with synthetic thyroid hormone, thyroxine (T4).\n- Postpartum thyroiditisinflammation of the thyroid glandcauses a brief period of hyperthyroidism, often followed by hypothyroidism that usually goes away within a year. Sometimes the hypothyroidism is permanent." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "Crohn's disease is a disease that causes inflammation,* or swelling, and irritation of any part of the digestive tractalso called the gastrointestinal (GI) tract. The part most commonly affected is the end part of the small intestine, called the ileum.\n*See the Pronunciation Guide for tips on how to say the words in bold type.\nCrohns disease is one of two main forms of diseases of the GI tract named inflammatory bowel disease (IBD). The other form, called ulcerative colitis, affects the large intestine, which includes the colon and the rectumthe lower end of the large intestine, leading to the anus.\nWith Crohns disease, chronicor long lastinginflammation may cause scar tissue to form in the lining of the intestine. When scar tissue builds up, the passage can become narrow, causing food and stool to move through the GI tract more slowlywhich can lead to pain, cramps, and diarrhea." } ]

[ { "from": "human", "value": "Who is at risk for What I need to know about Crohn's Disease??" }, { "from": "gpt", "value": "Both men and women can get Crohn's disease, and it can run in families. People with Crohns disease may have a blood relative with the disease or another type of IBD. Crohns disease most commonly starts between the ages of 13 and 30." } ]

[ { "from": "human", "value": "What causes What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "Researchers are studying the possible causes of Crohns disease. Your bodys natural defense system, called the immune system, protects you from infection by fighting against bacteria, viruses, and other things that can make you sick. Researchers believe that with Crohns disease, the immune system attacks harmless bacteria and viruses. During the attack, white blood cells gather in the intestinal lining. The white blood cells cause chronic inflammation, which leads to ulcers, or sores, and damage to the intestines.\nOther factors associated with Crohns disease are\n- genesthe traits passed down from your parents\n- unknown triggers caused by the environment" } ]

[ { "from": "human", "value": "What are the symptoms of What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "Crohn's disease symptoms can be different for each person. The most common symptoms of Crohns disease are\n- abdominal painoften in the lower right area of the abdomen\n- diarrhea\n- bleeding in the rectum, which can be seen in a persons underwear, in the toilet, or in a bowel movement; rectal bleeding can be serious and may not stop without medical help\n- weight loss\n- fever" } ]

[ { "from": "human", "value": "How to diagnose What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "A doctor will perform a physical exam and tests to diagnose Crohns disease. During your visit, the doctor will ask about your symptoms and medical history.\nThe doctor may order blood tests, which involve drawing blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. Blood tests can show anemia caused by bleeding. Anemia is a condition in which red blood cells are fewer or smaller than normal, which means less oxygen is carried to the bodys cells. Blood tests can also show a high white blood cell count, a sign of chronic inflammation.\nYou may also be asked for a stool sample. A stool test is commonly used to rule out other causes of GI diseases, such as infections. The doctor will give you a container for catching and storing the stool. The sample is returned to the doctor or a commercial facility and sent to a lab for analysis. A stool sample can also be used to check if you have bleeding or inflammation.\nOther tests may be needed to diagnose Crohn's disease. The following tests are all performed at a hospital or outpatient center.\n- Colonoscopy. Colonoscopy is the most commonly used test to specifically diagnose Crohns disease. This test is used to look inside your rectum, entire colon, and ileum. The health care provider will give you written bowel prep instructions to follow at home before the test. You may need to follow a clear liquid diet for 1 to 3 days before the test. You will need to take laxatives and enemas the evening before the test, and you will likely have one or more enemas about 2 hours before the test. A laxative is medicine that loosens stool and increases bowel movements. An enema involves flushing water, laxative, or sometimes a mild soap solution into the anus using a special squirt bottle. For the test, you will lie on a table while the doctor inserts a flexible tube into your anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The doctor can see inflammation, ulcers, or bleeding. The doctor may also perform a biopsy. The doctor will look at the tissue with a microscope to confirm the diagnosis of Crohns disease. In most cases, youll be given a light sedative, and possibly pain medicine, to help you relax. You will not feel the biopsy. Cramping or bloating may occur during the first hour after the test. Driving is not permitted for 24 hours after the test to allow the sedative time to wear off. Before the appointment, you should make plans for a ride home. By the next day, you should fully recover and go back to your normal diet.\n- Flexible sigmoidoscopy. This test is used to look inside the rectum and lower colon. The health care provider will give you written bowel prep instructions to follow at home before the test. You may need to follow a clear liquid diet for 1 to 3 days before the test. You may also need a laxative or enema the night before the test. And youll have one or more enemas about 2 hours before the procedure. For the test, you will lie on a table while the doctor inserts a flexible tube into your anus. You will not need a sedative for the test. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The doctor can see inflammation, ulcers, or bleeding. The doctor may also perform a biopsy by snipping a bit of tissue from the intestinal lining. The doctor will look at the tissue with a microscope to confirm the diagnosis of Crohns disease. You will not feel the biopsy. You can usually go back to your normal diet after the test, though you may have cramping or bloating during the first hour after the test.\n- Computerized tomography (CT) scan. A CT scan uses x rays and computers to create images of the inside of the body. For the test, you will lie on a table that slides into a tunnel-shaped device where the x rays are taken. The technician may give you a solution to drink and an injection of a special dye through a needle inserted into an arm vein. You will not need a sedative for the test. CT scans can be used to help diagnose Crohn's disease.\n- Upper GI series (x rays). An upper GI series may be done to look at the small intestine. No eating or drinking is allowed for 8 hours before the procedure. You will not need a sedative for the test. During the procedure, you will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. The barium coats the small intestine, making signs of the disease show up more clearly on x rays. After the test, you may go back to your normal diet, though you may have nausea or bloating for a short time. Traces of barium in the GI tract cause stools to be white or light colored for a few days after the test.\n- Lower GI series (x rays). A lower GI series may be done to look at the large intestine. The health care provider will give you written bowel prep instructions to follow at home before the test. You will be asked to follow a clear liquid diet for 1 to 3 days before the test. A laxative or enema is usually used the evening before a lower GI series. Enemas are sometimes repeated the morning of the test. For the test, you will lie on a table while the doctor inserts a flexible tube into your anus. You will not need a sedative for the test. The large intestine is filled with barium, making signs of the disease show up more clearly on x rays. After the test, you may go back to your normal diet, though you may have bloating. You also may have some soreness of the anus. Traces of barium in the GI tract cause stools to be white or light colored for a few days after the test." } ]

[ { "from": "human", "value": "What is (are) What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "Intestinal blockage can occur in people with Crohns disease when scar tissue blocks the intestinal passage. A narrow intestinal passage is called a stricture. When the passage blocks completely, food and stool stop moving, causing abdominal cramps and vomiting. If you have these symptoms, you should see a health care provider right away.\nUlcers from Crohns disease can cause tunnels to form through the inflamed areas, or even the healthy parts, of the intestine. These tunnels are called fistulas. Fistulas are seen most often in the areas around the rectum and anus. Sometimes a pocket of infection, called an abscess, can form in and around the fistulas. Most fistulas can be treated with medicines, but sometimes surgery is needed.\nPeople with Crohns disease often have anemia, which can be caused by the disease itself or by iron deficiency. Anemia may make a person feel tired.\nPeople with Crohns disease, particularly if they have been treated with steroid medicines, may have weakness of their bonescalled osteoporosis or osteomalacia.\nPeople with Crohns disease may also have arthritis, skin problems, swelling in the eyes or mouth, kidney stones, gallstones, and liver problems. Some people with Crohns disease may have restless legs syndromeextreme leg discomfort the person feels while sitting or lying down. These problems may go away during treatment, but some must be treated with medicines.\nPeople who have Crohns disease may not get enough nutrition, such as protein, vitamins, or calories, because they\n- have an upset stomach that keeps them from eating enough calories\n- may not be able to absorb nutrients in the intestine\nChildren with Crohns disease may fail to grow normally and may have low height for their age." } ]

[ { "from": "human", "value": "What are the treatments for What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "Treatment for Crohns disease depends on\n- where the disease is located in the GI tract\n- what problems you already have from the disease\n- what past treatments you have had for the disease\nThe goals of treatment are to\n- decrease the inflammation\n- relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding\n- correct nutritional problems\nTreatment may include\n- medicines\n- surgery\n- eating, diet, and nutrition\nMedicines\nOne or more of the following medicines may be used to treat Crohns disease:\n- Anti-inflammation medicines may be used first to treat your Crohn's disease. These medicines help lower inflammation in the intestine and relieve the pain and diarrhea. Sometimes anti-inflammation medicines cause side effects, so you should talk with your health care provider about what to expect.\n- Steroids also help lower inflammation. Steroids are similar to natural chemicals in the body. However, steroids are used only for a short time because long-term use can lead to serious side effects.\n- Immune system suppressors. Azathioprine and 6-mercaptopurine work by keeping your immune system from attacking harmless foreign substances. Immune system suppressors also cause side effects, so you should talk with your health care provider about what to expect.\n- Biological therapies. Biological therapies are medicines that are given by an injection in the vein, infliximab (Remicade), or an injection in the skin, adalimumab (HUMIRA). Your health care provider may treat you with these medicines if others are not helping to decrease inflammation, or if you have fistulas with abscesses. The goals for using these medicines are to get you better, keep you better, and avoid long-term steroid use.\n- Antibiotics. Antibiotics are used to treat bacterial overgrowth in the small intestine caused by stricture, fistulas, or surgery. For this common problem, the doctor may prescribe one or more of the following antibiotics: ampicillin, sulfonamide, cephalosporin, tetracycline, or metronidazole.\n- Anti-diarrheal medicines and fluid replacements. Diarrhea and abdominal cramps are often relieved when the inflammation improves, but more medicine may be needed. Anti-diarrheal medicines include diphenoxylate, loperamide, and codeine. People with diarrhea should drink plenty of fluids to prevent dehydrationloss of fluids from the body. If diarrhea does not improve, the person should see the doctor promptly for possible treatment with fluids given through a small tube inserted into an arm vein.\nSurgery\nSome people with Crohns disease need surgery if medicines are no longer working to control blockage, fistulas, abscesses, and bleeding. A surgeon performs the procedure in a hospital, where you will receive medicine to make you sleep during the surgery.\nOne or more of the following surgeries may be needed:\n- Intestinal resection. The surgeon removes the diseased section of intestine and puts the ends of the intestine back together.\n- Proctocolectomy. Proctocolectomy is surgery to remove the rectum and part or all of the colon. An ileostomy is performed with a proctocolectomy.\n- Ileostomy. Ileostomy is an operation to create an openingcalled a stomafor the stool to exit the body when the ends of the intestine cannot be put back together. To create a stoma, an end of the intestine is brought out through a small opening made on the lower right part of the abdomen near the beltline. The stoma is about the size of a quarter. An ostomy pouch is worn outside the body over the stoma to collect waste, and it is emptied several times a day. Your health care provider may refer you to an ostomy nursea specialist who cares for people with an ostomy pouch.\nSurgery usually does not cure Crohn's disease forever. Sometimes you need to have more than one surgery because the disease returns next to where the intestine was removed. Because Crohns disease can return after surgery, you can talk with your health care provider and other patients to get as much information as possible before having surgery." } ]

[ { "from": "human", "value": "What to do for What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "Your health care provider may start you on a special diet, so you get extra nutrition and calories. High-calorie liquid supplements are often used to give you the extra calories and right amount of vitamins and minerals to keep you healthy. During acute phases of the disease, you may need to receive intravenous nutrition to give the intestine a rest.\nNo foods are known to cause injury or inflammation to the intestine. But foods such as hot spices, alcohol, greasy foods, and milk products may make diarrhea and cramping worse. You should eat a healthy diet and avoid foods that make symptoms worse. Your health care provider may refer you to a dietitian to help you with meal planning." } ]

[ { "from": "human", "value": "What to do for What I need to know about Crohn's Disease?" }, { "from": "gpt", "value": "- Crohn's disease is a disease that causes inflammation, or swelling, and irritation of any part of the digestive tractalso called the gastrointestinal (GI) tract.\n- People with Crohns disease may have a blood relative with the disease or another type of inflammatory bowel disease (IBD).\n- Symptoms of Crohns disease include abdominal pain, diarrhea, bleeding, weight loss, and fever.\n- A physical exam, blood tests, stool tests, and other tests are needed to diagnose Crohns disease.\n- Problems of Crohns disease include intestinal blockage, fistulas, abscesses, anemia, and slower growth in children.\n- Doctors treat Crohns disease with medicines, surgery, diet, and nutrition.\n- People with Crohns disease should eat a healthy diet and avoid foods that make symptoms worse.\n- Quitting smoking can help make Crohns disease less severe. Ask your health care provider if you need help quitting smoking.\n- Support groups may help lower stress for people with Crohns disease.\n- Most people with Crohns disease are able to work, raise families, and live full lives.\n- Many women with Crohns disease can become pregnant and have a baby. You should talk with your health care provider before getting pregnant." } ]

[ { "from": "human", "value": "What is (are) Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more than 4 weeks. Children with chronic diarrhea may have loose, watery stools continually, or diarrhea may come and go. Chronic diarrhea may go away without treatment, or it may be a symptom of a chronic disease or disorder. Treating the disease or disorder can relieve chronic diarrhea.\nChronic diarrhea can affect children of any age:\n- infantsages 0 to 12 months\n- toddlersages 1 to 3 years\n- preschool-age childrenages 3 to 5 years\n- grade school-age childrenages 5 to 12 years\n- adolescentsages 12 to 18 years\nDiarrhea that lasts only a short time is called acute diarrhea. Acute diarrhea, a common problem, usually lasts a few days and goes away on its own. More information about acute diarrhea is provided in the NIDDK health topics:\n- Diarrhea\n- What I need to know about Diarrhea" } ]

[ { "from": "human", "value": "What causes Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "Many diseases and disorders can cause chronic diarrhea in children. Common causes include\n- infections\n- functional gastrointestinal (GI) disorders\n- food allergies and intolerances\n- inflammatory bowel disease (IBD)\nInfections, food allergies and intolerances, and IBD may cause chronic diarrhea along with malabsorption, meaning the small intestine does not absorb nutrients from food. If children do not absorb enough nutrients from the food they eat, they may become malnourished. Functional GI disorders do not cause malabsorption.\nInfections\nInfections from viruses, bacteria, or parasites sometimes lead to chronic diarrhea. After an infection, some children have problems digesting carbohydrates, such as lactose, or proteins, such as milk or soy proteins. These problems can cause prolonged diarrheaoften for up to 6 weeksafter an infection. Also, some bacteria and parasite infections that cause diarrhea do not go away quickly without treatment.\nMore information about infections that cause diarrhea is provided in the NIDDK health topics:\n- Viral Gastroenteritis\n- Foodborne Illnesses\nSmall intestinal bacterial overgrowth may also cause chronic diarrhea. Normally, few bacteria live in the small intestine, and many bacteria live in the large intestine. Small intestinal bacterial overgrowth is an increase in the number of bacteria or a change in the type of bacteria in the small intestine. These bacteria can cause diarrhea, gas, cramping, and weight loss. Small intestinal bacterial overgrowth is often related to diseases or disorders that damage the digestive system or affect how it works, such as Crohns disease or diabetes. Small intestinal bacterial overgrowth is also more common in people who have had abdominal surgery or who have slow-moving intestines.\nFunctional Gastrointestinal Disorders\nIn functional GI disorders, symptoms are caused by changes in how the GI tract works. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anusthe opening through which stool leaves the body. The GI tract digests, or breaks down, food and processes solid waste.\nChildren with a functional GI disorder have frequent symptoms, yet the GI tract does not become damaged. Functional GI disorders are not diseases; they are groups of symptoms that occur together.\nTwo functional GI disorders that cause chronic diarrhea in children are toddlers diarrhea and irritable bowel syndrome (IBS).\nToddlers diarrhea. Toddlers diarrheaalso called functional diarrhea or chronic nonspecific diarrhea of childhoodis a common cause of chronic diarrhea in toddlers and preschool-age children. Children with this disorder pass three or more loose stools a day and do not have any other symptoms. They typically are growing well and gaining weight, and are healthy.\nToddlers diarrhea develops between the ages of 6 months and 3 years, and it usually goes away on its own by the time children begin grade school. Researchers think a diet with too much sugarsuch as the sugar found in fruit juicerelative to the amount of fat and fiber may cause toddlers diarrhea.\nIBS. The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with changes in bowel habits, such as diarrhea. The pain or discomfort of IBS typically gets better with the passage of stool or gas. IBS does not cause symptoms such as weight loss, vomiting, or blood in the stool.\nPossible causes include problems with nerves in the intestines, problems with nerve signals between the brain and the intestines, changes in how food moves through the intestines, and hypersensitivity to pain. Psychological problems, such as anxiety and depression, or food sensitivity may also play a role.\nIBS is a common cause of chronic diarrhea in grade school-age children and adolescents. Health care providers rarely diagnose IBS in younger children because younger children are not able to report symptoms of pain or discomfort. More information is provided in the NIDDK health topics:\n- Irritable Bowel Syndrome\n- Irritable Bowel Syndrome in Children\nFood Allergies and Intolerances\nFood allergies, celiac disease, lactose intolerance, and dietary fructose intolerance are common causes of chronic diarrhea.\nFood allergies. A food allergy is a reaction by the immune system, the bodys natural defense system, to one or more proteins in certain foods. The immune system normally protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances that can cause illness. In food allergies, however, the immune system responds abnormally to certain foods.\nCows milk and soy allergies are the most common food allergies that affect the GI tract in children. Food allergies usually appear in the first year of life. Many children outgrow cows milk and soy allergies by age 3. Allergies to other foods, such as cereal grains, eggs, or seafood, may also affect the GI tract.\nSymptoms of food allergies may include diarrhea, vomiting, and weight loss or poor weight gain. Some children have mild symptoms, while others have severe or life-threatening symptoms. For example, some children have severe vomiting and diarrhea that lead to dehydration, which means the body lacks enough fluid and electrolytesminerals in salts, including sodium, potassium, and chlorideto function properly.\nCeliac disease. Celiac disease is an autoimmune disease in which people cannot tolerate gluten. A chronic reaction to gluten damages the lining of their small intestine and prevents absorption of nutrients. Gluten is a protein found in wheat, rye, and barley and in vitamin and nutrient supplements, lip balms, communion wafers, and certain medications.\nChildren of any age can experience digestive symptoms of celiac disease or have symptoms in other parts of the body. Digestive symptoms can include\n- chronic diarrhea\n- abdominal bloating\n- stomach pain\n- gas\n- vomiting\n- constipation\n- pale, foul-smelling, or fatty stool\nMalabsorption of nutrients during the years when nutrition is critical to a childs normal growth and development can result in other health problems. These problems may include\n- failure to thrive in infants\n- slowed growth and short stature\n- weight loss\n- irritability or mood changes\n- delayed puberty\n- dental enamel defects of the permanent teeth\n- anemia, a condition in which red blood cells are fewer or smaller than normal, which prevents the bodys cells from getting enough oxygen\n- low levels of important nutrients such as iron and calcium\nMore information is provided in the NIDDK health topics:\n- Celiac Disease\n- What I need to know about Celiac Disease\nLactose intolerance. Lactose intolerance is a condition in which people have digestive symptomssuch as bloating, gas, and diarrheaafter consuming milk or milk products. Lactose is a sugar found in milk or milk products. Lactase, an enzyme produced by the small intestine, breaks down lactose into two simpler forms of sugar: glucose and galactose. The bloodstream then absorbs these simpler sugars.\nSome children have a lactase deficiency, meaning the small intestine produces low levels of lactase and cannot digest much lactose. Lactase deficiency may cause lactose malabsorption. In children with lactose malabsorption, undigested lactose passes to the colon, where bacteria break down the lactose and create fluid and gas.\nNot all children with lactase deficiency and lactose malabsorption have digestive symptoms. Experts use the term lactose intolerance when lactase deficiency and lactose malabsorption cause digestive symptoms.\nThe most common type of lactase deficiency develops over time, beginning after about age 2, when the body begins to produce less lactase. Children who have lactase deficiency may not experience symptoms of lactose intolerance until late adolescence or adulthood.\nInfants rarely have lactose intolerance at birth. People sometimes mistake cows milk allergy, which can cause diarrhea in infants, for lactose intolerance. Congenital lactase deficiencyan extremely rare inherited genetic disorder in which the small intestine produces little or no lactase enzyme at birthcan cause lactose intolerance in infants. Premature infants may experience lactose intolerance for a short time after birth. Children of any age may develop temporary lactose intolerance after a viral diarrheal episode or other infection.\nMore information is provided in the NIDDK health topics:\n- Lactose Intolerance\n- What I need to know about Lactose Intolerance\nDietary fructose intolerance. Dietary fructose intolerance is a condition in which people have digestive symptomssuch as bloating, gas, and diarrheaafter consuming foods that contain fructose. Fructose is a sugar found in fruits, fruit juices, and honey. Fructose is also added to many foods and soft drinks as a sweetener called high fructose corn syrup.\nFructose malabsorption causes dietary fructose intolerance. The small intestine absorbs fructose, and, when a person consumes more fructose than the small intestine can absorb, fructose malabsorption results. Unabsorbed fructose passes to the colon, where bacteria break down the fructose and create fluid and gas.\nThe amount of fructose that a childs small intestine can absorb varies. The capacity of the small intestine to absorb fructose increases with age. Some children may be able to tolerate more fructose as they get older.\nAnother type of fructose intolerance, hereditary fructose intolerance, is not related to fructose malabsorption. Hereditary fructose intolerance is an extremely rare inherited genetic disorder. Children with this disorder lack an enzyme needed to break down fructose. Symptoms of hereditary fructose intolerance may include abdominal pain, vomiting, and diarrhea. This disorder can also damage the liver and kidneys.\nInflammatory Bowel Disease\nInflammatory bowel disease causes irritation and inflammation in the intestines. The two main types of IBD are ulcerative colitis and Crohns disease. These disorders can affect children at any age; however, they commonly begin in the grade school years or in adolescence. The causes of IBD are unknown. Researchers believe they result from an abnormal immune system reaction.\nUlcerative colitis. Ulcerative colitis is a disease that causes inflammation, or swelling, and ulcers in the inner lining of the large intestine. The large intestine includes the colon and the rectumthe lower end of the large intestine leading to the anus. Normally, the large intestine absorbs water from stool and changes it from a liquid to a solid. In ulcerative colitis, the inflammation causes loss of the lining of the large intestine, leading to bleeding, production of pus, diarrhea, and abdominal discomfort.\nMore information is provided in the NIDDK health topic, Ulcerative Colitis.\nCrohns disease. Crohns disease is a disease that causes inflammation and irritation of any part of the GI tract. The end part of the small intestine, called the ileum, is most commonly affected. In Crohns disease, inflammation can extend through the entire wall of the GI tract, leading to possible complications. Swelling can cause pain and can make the intestine empty frequently, resulting in diarrhea.\nMore information is provided in the NIDDK health topics:\n- Crohns Disease\n- What I need to know about Crohns Disease" } ]

[ { "from": "human", "value": "What are the symptoms of Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "Symptoms that accompany chronic diarrhea in children depend on the cause of the diarrhea. Symptoms can include\n- cramping\n- abdominal pain\n- nausea or vomiting\n- fever\n- chills\n- bloody stools\nChildren with chronic diarrhea who have malabsorption can experience\n- bloating and swelling, also called distention, of the abdomen\n- changes in appetite\n- weight loss or poor weight gain\nConsult a Health Care Provider A childs parent or caretaker should consult a health care provider if the child\n- has diarrhea for more than 24 hours\n- is younger than 6 months old\n- has received treatment and the diarrhea persistsChildren with any of the following symptoms should see a health care provider right away:\n- signs of malabsorptionbloating and swelling of the abdomen, changes in appetite, and weight loss or poor weight gain\n- severe abdominal or rectal pain\n- a fever of 102 degrees or higher\n- stools containing blood or pusMore information is provided in the NIDDK health topics:\n- Diarrhea\n- What I need to know about Diarrhea" } ]

[ { "from": "human", "value": "What causes Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "To determine the cause of chronic diarrhea in children, the health care provider will take a complete medical and family history and conduct a physical exam, and may perform tests.\nMedical and family history. Taking a medical and family history is one of the first things a health care provider may do to help determine the cause of chronic diarrhea. He or she will ask for information about symptoms, such as\n- how long the child has had diarrhea\n- the amount of stool passed\n- the frequency of diarrhea\n- the appearance of the stool\n- the presence of other symptoms that accompany diarrhea\nThe health care provider will ask about the childs diet and may recommend keeping a diary of the childs diet and bowel habits. If the health care provider suspects a food allergy or intolerance, he or she may recommend changing the childs diet to see if symptoms improve.\nThe health care provider may also ask about family medical history. Some of the conditions that cause chronic diarrhea, such as celiac disease and lactose intolerance, run in families.\nPhysical exam. After taking a medical history, a health care provider will perform a physical exam, which may help determine the cause of chronic diarrhea. During a physical exam, a health care provider usually\n- examines a childs body\n- uses a stethoscope to listen to bodily sounds\n- taps on specific areas of the childs body\nTests. The health care provider may perform one or more of the following tests:\n- Stool test. A stool test is the analysis of a sample of stool. The health care provider will give the parent or caretaker a container for catching and storing the stool. The parent or caretaker returns the sample to the health care provider or a commercial facility that will send the sample to a lab for analysis. Stool tests can show the presence of blood, bacteria, or parasites or signs of diseases and disorders. The health care provider may also do a rectal exam, sometimes during the physical exam. For a rectal exam, the health care provider inserts a gloved, lubricated finger into the rectum to check for blood in the stool.\n- Blood 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 signs of certain diseases and disorders that can cause chronic diarrhea in children, including- high levels of white blood cells, which may be a sign of inflammation or infection somewhere in the body- anemia, which may be a sign of bleeding in the GI tract or of malabsorption- the presence of certain antibodiesproteins that react against the bodys own cells or tissueswhich may be a sign of celiac disease- Hydrogen breath test. This test measures the amount of hydrogen in a childs breath. Normally, only a small amount of hydrogen is detectable in the breath. However, bacteria break down sugarssuch as lactose and fructosethat are not digested by the small intestine and produce high levels of hydrogen. In small intestinal bacterial overgrowth, bacteria break down sugars in the small intestine and produce hydrogen. For this test, the child breathes into a balloonlike container that measures hydrogen. Then, the child drinks a lactose-loaded beverage, and the childs breath is analyzed at regular intervals to measure the amount of hydrogen. In most cases, a health care provider performs this test at a hospital, on an outpatient basis. A health care provider may use a hydrogen breath test to check for signs of lactose intolerance, fructose intolerance, or small intestinal bacterial overgrowth.\n- Upper GI endoscopy. This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract, which includes the esophagus, stomach, and duodenum, the first part of the small intestine. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A child may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. A health care provider will place an intravenous (IV) needle in a vein in the arm if general anesthesia is given. The health care provider may use instruments passed through the endoscope to perform a biopsy or collect fluid. A biopsy is a procedure that involves taking a piece of tissue for examination with a microscope. A pathologista doctor who specializes in diagnosing diseasesexamines the tissues in a lab. This test can show problems in the upper GI tract that may cause chronic diarrhea. For example, a biopsy of the small intestine can show signs of celiac disease. A health care provider may use a fluid sample from the small intestine to check for bacteria to diagnose small intestinal bacterial overgrowth.\n- Flexible sigmoidoscopy or colonoscopy. While these tests are similar, a health care provider uses a colonoscopy to view the rectum and entire colon and a flexible sigmoidoscopy to view just the rectum and lower colon. A gastroenterologist performs these tests at a hospital or an outpatient center. For both tests, the health care provider will give written bowel prep instructions for the child to follow at home. The health care provider may ask that the child follow a clear liquid diet the day before either test. The child may require a laxative for 4 days before either test or only the day before either test. The child may require an enema the day before either test. These medications cause diarrhea, so the child should stay close to a bathroom during the bowel prep. In most cases, light anesthesia, and possibly pain medication, helps the child relax. For either test, the child will lie on a table while the gastroenterologist inserts a flexible tube into the anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The gastroenterologist may also perform a biopsy by taking a small piece of tissue from the intestinal lining. The child will not feel the biopsy. These tests can show problems in the rectum or colon, such as signs of IBD. Cramping or bloating may occur during the first hour after these tests. The child should recover fully by the next day and be able to return to a normal diet." } ]

[ { "from": "human", "value": "What are the treatments for Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "The treatment for chronic diarrhea will depend on the cause. Some common causes of chronic diarrhea are treated as follows:\n- Infections. If a child has prolonged problems digesting certain carbohydrates or proteins after an acute infection, a health care provider may recommend changes in diet. A child may need antibiotics or medications that target parasites to treat infections that do not go away on their own. A health care provider may also prescribe antibiotics to treat small intestinal bacterial overgrowth.\n- Functional GI disorders. For toddlers diarrhea, treatment is usually not needed. Most children outgrow toddlers diarrhea by the time they start school. In many children, limiting fruit juice intake and increasing the amount of fiber and fat in the diet may improve symptoms of toddlers diarrhea. A health care provider may treat IBS with- changes in diet.\n- medication.\n- probioticslive microorganisms, usually bacteria, that are similar to microorganisms normally found in the GI tract. Studies have found that probiotics, specifically Bifidobacteria and certain probiotic combinations, improve symptoms of IBS when taken in large enough amounts. However, researchers are still studying the use of probiotics to treat IBS.\n- psychological therapy.\nTo help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/probiotics.\n- Food allergies and intolerances. A health care provider will recommend changes in diet to manage symptoms of food allergies and intolerances. To treat food allergies, the childs parent or caretaker should remove the food that triggers the allergy from the childs diet. For children with celiac disease, following a gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further damage. The childs parent or caretaker can manage the symptoms of lactose intolerance with changes in the childs diet and by using products that contain the lactase enzyme. Most children with lactose intolerance can tolerate some amount of lactose in their diet. The amount of change needed in the diet depends on how much lactose a child can consume without symptoms. For children with dietary fructose intolerance, reducing the amount of fructose in the diet can relieve symptoms.\n- IBD. A health care provider may use medications, surgery, and changes in diet to treat IBD." } ]

[ { "from": "human", "value": "What to do for Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "A health care provider may recommend changing a childs diet to treat the cause of chronic diarrhea. Making sure that children receive proper nutrition is important for growth and development. A childs parent or caretaker should talk with a health care provider about changing the childs diet to treat chronic diarrhea." } ]

[ { "from": "human", "value": "What to do for Chronic Diarrhea in Children?" }, { "from": "gpt", "value": "- Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more than 4 weeks.\n- Many diseases and disorders can cause chronic diarrhea in children. Common causes include infections, functional gastrointestinal (GI) disorders, food allergies and intolerances, and inflammatory bowel disease (IBD).\n- Symptoms that accompany chronic diarrhea in children depend on the cause of the diarrhea. Symptoms can include cramping, abdominal pain, nausea or vomiting, fever, chills, or bloody stools.\n- Children with chronic diarrhea who have malabsorption can experience bloating and swelling of the abdomen, changes in appetite, or weight loss or poor weight gain.\n- Children with any of the following symptoms should see a health care provider right away: signs of malabsorption, severe abdominal or rectal pain, a fever of 102 degrees or higher, or stools containing blood or pus.\n- To determine the cause of chronic diarrhea, the health care provider will take a complete medical and family history and conduct a physical exam, and may perform tests.\n- The treatment for chronic diarrhea will depend on the cause.\n- A childs parent or caretaker should talk with a health care provider about changing the childs diet to treat chronic diarrhea." } ]

[ { "from": "human", "value": "What is (are) Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "Anemia is a condition in which the body has fewer red blood cells than normal. Red blood cells carry oxygen to tissues and organs throughout the body and enable them to use energy from food. With anemia, red blood cells carry less oxygen to tissues and organsparticularly the heart and brainand those tissues and organs may not function as well as they should." } ]

[ { "from": "human", "value": "What is (are) Anemia in Chronic 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 kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine.\nHealthy kidneys produce a hormone called erythropoietin (EPO). A hormone is a chemical produced by the body and released into the blood to help trigger or regulate particular body functions. EPO prompts the bone marrow to make red blood cells, which then carry oxygen throughout the body." } ]

[ { "from": "human", "value": "What causes Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "When kidneys are diseased or damaged, they do not make enough EPO. As a result, the bone marrow makes fewer red blood cells, causing anemia. When blood has fewer red blood cells, it deprives the body of the oxygen it needs.\nOther common causes of anemia in people with kidney disease include blood loss from hemodialysis and low levels of the following nutrients found in food:\n- iron\n- vitamin B12\n- folic acid\nThese nutrients are necessary for red blood cells to make hemoglobin, the main oxygen-carrying protein in the red blood cells.\nIf treatments for kidney-related anemia do not help, the health care provider will look for other causes of anemia, including\n- other problems with bone marrow\n- inflammatory problemssuch as arthritis, lupus, or inflammatory bowel diseasein which the bodys immune system attacks the bodys own cells and organs\n- chronic infections such as diabetic ulcers\n- malnutrition" } ]

[ { "from": "human", "value": "What are the symptoms of Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "The signs and symptoms of anemia in someone with CKD may include\n- weakness\n- fatigue, or feeling tired\n- headaches\n- problems with concentration\n- paleness\n- dizziness\n- difficulty breathing or shortness of breath\n- chest pain\nAnyone having difficulty breathing or with shortness of breath should seek immediate medical care. Anyone who has chest pain should call 911." } ]

[ { "from": "human", "value": "What are the complications of Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "Heart problems are a complication of anemia and may include\n- an irregular heartbeat or an unusually fast heartbeat, especially when exercising.\n- the harmful enlargement of muscles in the heart.\n- heart failure, which does not mean the heart suddenly stops working. Instead, heart failure is a long-lasting condition in which the heart cant pump enough blood to meet the bodys needs." } ]

[ { "from": "human", "value": "How to diagnose Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "A health care provider diagnoses anemia based on\n- a medical history\n- a physical exam\n- blood tests\nMedical History\nTaking a medical history is one of the first things a health care provider may do to diagnose anemia. He or she will usually ask about the patients symptoms.\nPhysical Exam\nA physical exam may help diagnose anemia. During a physical exam, a health care provider usually examines a patients body, including checking for changes in skin color.\nBlood Tests\nTo diagnose anemia, a health care provider may order a complete blood count, which measures the type and number of blood cells in the body. A blood test involves drawing a patients blood at a health care providers office or a commercial facility. A health care provider will carefully monitor the amount of hemoglobin in the patients blood, one of the measurements in a complete blood count.\nThe Kidney Disease: Improving Global Outcomes Anemia Work Group recommends that health care providers diagnose anemia in males older than age 15 when their hemoglobin falls below 13 grams per deciliter (g/dL) and in females older than 15 when it falls below 12 g/dL.2 If someone has lost at least half of normal kidney function and has low hemoglobin, the cause of anemia may be decreased EPO production.\nTwo other blood tests help measure iron levels:\n- The ferritin level helps assess the amount of iron stored in the body. A ferritin score below 200 nanograms (ng) per liter may mean a person has iron deficiency that requires treatment.2\n- The transferrin saturation score indicates how much iron is available to make red blood cells. A transferrin saturation score below 30 percent can also mean low iron levels that require treatment.2\nIn addition to blood tests, the health care provider may order other tests, such as tests for blood loss in stool, to look for other causes of anemia." } ]

[ { "from": "human", "value": "What are the treatments for Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "Depending on the cause, a health care provider treats anemia with one or more of the following treatments:\nIron\nThe first step in treating anemia is raising low iron levels. Iron pills may help improve iron and hemoglobin levels. However, for patients on hemodialysis, many studies show pills do not work as well as iron given intravenously.2\nErythropoietin\nIf blood tests indicate kidney disease as the most likely cause of anemia, treatment can include injections of a genetically engineered form of EPO. A health care provider, often a nurse, injects the patient with EPO subcutaneously, or under the skin, as needed. Some patients learn how to inject the EPO themselves. Patients on hemodialysis may receive EPO intravenously during hemodialysis.\nStudies have shown the use of EPO increases the chance of cardiovascular events, such as heart attack and stroke, in people with CKD. The health care provider will carefully review the medical history of the patient and determine if EPO is the best treatment for the patients anemia. Experts recommend using the lowest dose of EPO that will reduce the need for red blood cell transfusions. Additionally, health care providers should consider the use of EPO only when a patients hemoglobin level is below 10 g/dL. Health care providers should not use EPO to maintain a patients hemoglobin level above 11.5 g/dL.2 Patients who receive EPO should have regular blood tests to monitor their hemoglobin so the health care provider can adjust the EPO dose when the level is too high or too low.2 Health care providers should discuss the benefits and risks of EPO with their patients.\nMany people with kidney disease need iron supplements and EPO to raise their red blood cell count to a level that will reduce the need for red blood cell transfusions. In some people, iron supplements and EPO will improve the symptoms of anemia.\nRed Blood Cell Transfusions\nIf a patients hemoglobin falls too low, a health care provider may prescribe a red blood cell transfusion. Transfusing red blood cells into the patients vein raises the percentage of the patients blood that consists of red blood cells, increasing the amount of oxygen available to the body.\nVitamin B12 and Folic Acid Supplements\nA health care provider may suggest vitamin B12 and folic acid supplements for some people with CKD and anemia. Using vitamin supplements can treat low levels of vitamin B12 or folic acid and help treat anemia. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements, with their health care provider.\nRead more about vitamin B12 and folic acid on the MedlinePlus website at www.nlm.nih.gov/medlineplus. Read more about complementary and alternative medicine at www.nccam.nih.gov." } ]

[ { "from": "human", "value": "What to do for Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "A health care provider may advise people with kidney disease who have anemia caused by iron, vitamin B12, or folic acid deficiencies to include sources of these nutrients in their diets. Some of these foods are high in sodium or phosphorus, which people with CKD should limit in their diet. Before making any dietary changes, people with CKD should talk with their health care provider or with a dietitian who specializes in helping people with kidney disease. A dietitian can help a person plan healthy meals.\nRead more about nutrition for people with CKD on the National Kidney Disease Education Program website.\nThe following chart illustrates some good dietary sources of iron, vitamin B12, and folic acid.\nFoodServing SizeIronVitamin B12Folic AcidRecommended Daily Value18 mg6 mcg400 mcg100 percent fortified breakfast cerealcup (1 oz)18 mg6 mcg394 mcgbeans, baked1 cup (8 oz)8 mg0 mcg37 mcgbeef, ground3 oz2 mg2 mcg8 mcgbeef liver3 oz5 mg67 mcg211 mcgclams, fried4 oz3 mg1 mcg66 mcgspinach, boiled1 cup (3 oz)2 mg0 mcg115 mcgspinach, fresh1 cup (1 oz)1 mg0 mcg58 mcgtrout3 oz0 mg5 mcg16 mcgtuna, canned3 oz1 mg1 mcg2 mcg" } ]

[ { "from": "human", "value": "What to do for Anemia in Chronic Kidney Disease?" }, { "from": "gpt", "value": "- Anemia is a condition in which the body has fewer red blood cells than normal. Red blood cells carry oxygen to tissues and organs throughout the body and enable them to use energy from food.\n- Anemia commonly occurs in people with chronic kidney disease (CKD)the permanent, partial loss of kidney function. Most people who have total loss of kidney function, or kidney failure, have anemia.\n- When kidneys are diseased or damaged, they do not make enough erythropoietin (EPO). As a result, the bone marrow makes fewer red blood cells, causing anemia.\n- Other common causes of anemia in people with kidney disease include blood loss from hemodialysis and low levels of the following nutrients found in food:- iron- vitamin B12- folic acid- The first step in treating anemia is raising low iron levels.\n- If blood tests indicate kidney disease as the most likely cause of anemia, treatment can include injections of a genetically engineered form of EPO.\n- Many people with kidney disease need iron supplements and EPO to raise their red blood cell count to a level that will reduce the need for red blood cell transfusions.\n- A health care provider may suggest vitamin B12 and folic acid supplements for some people with CKD and anemia.\n- A health care provider may advise people with kidney disease who have anemia caused by iron, vitamin B12, or folic acid deficiencies to include sources of these nutrients in their diets." } ]

[ { "from": "human", "value": "What is (are) Anemia in Chronic 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- 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- Treatment Methods for Kidney Failure: 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: John C. Stivelman, M.D., Emory University School of Medicine; Kerri Cavanaugh, M.D., M.H.S., Vanderbilt University\nThis information is not copyrighted. The NIDDK encourages people to share this content freely.\nJuly 2014" } ]

[ { "from": "human", "value": "What is (are) Vesicoureteral Reflux?" }, { "from": "gpt", "value": "Vesicoureteral reflux is the abnormal flow of urine from the bladder to the upper urinary tract. The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. Blood flows through the kidneys, and the kidneys filter out wastes and extra water, making urine. The urine travels down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.\nIn VUR, urine may flow backrefluxinto one or both ureters and, in some cases, to one or both kidneys. VUR that affects only one ureter and kidney is called unilateral reflux, and VUR that affects both ureters and kidneys is called bilateral reflux." } ]

[ { "from": "human", "value": "Who is at risk for Vesicoureteral Reflux??" }, { "from": "gpt", "value": "Vesicoureteral reflux is more common in infants and young children, but older children and even adults can be affected. About 10 percent of children have VUR.1 Studies estimate that VUR occurs in about 32 percent of siblings of an affected child. This rate may be as low as 7 percent in older siblings and as high as 100 percent in identical twins. These findings indicate that VUR is an inherited condition.2" } ]

[ { "from": "human", "value": "What is (are) Vesicoureteral Reflux?" }, { "from": "gpt", "value": "The two types of VUR are primary and secondary. Most cases of VUR are primary and typically affect only one ureter and kidney. With primary VUR, a child is born with a ureter that did not grow long enough during the childs development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine refluxes from the bladder to the ureter and eventually to the kidney. This type of VUR can get better or disappear as a child gets older. As a child grows, the ureter gets longer and function of the valve improves.\nSecondary VUR occurs when a blockage in the urinary tract causes an increase in pressure and pushes urine back up into the ureters. Children with secondary VUR often have bilateral reflux. VUR caused by a physical defect typically results from an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder.\nVUR is usually classified as grade I through V, with grade I being the least severe and grade V being the most severe." } ]

[ { "from": "human", "value": "What are the symptoms of Vesicoureteral Reflux?" }, { "from": "gpt", "value": "In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI). VUR can lead to infection because urine that remains in the childs urinary tract provides a place for bacteria to grow. Studies estimate that 30 percent of children and up to 70 percent of infants with a UTI have VUR.2" } ]

[ { "from": "human", "value": "What are the complications of Vesicoureteral Reflux?" }, { "from": "gpt", "value": "When a child with VUR gets a UTI, bacteria can move into the kidney and lead to scarring. Scarring of the kidney can be associated with high blood pressure and kidney failure. However, most children with VUR who get a UTI recover without long-term complications." } ]

[ { "from": "human", "value": "How to diagnose Vesicoureteral Reflux?" }, { "from": "gpt", "value": "The most common tests used to diagnose VUR include\n- Voiding cystourethrogram (VCUG). VCUG is an x-ray image of the bladder and urethra taken during urination, also called voiding. The bladder and urethra are filled with a special dye, called contrast medium, to make the urethra clearly visible. The x-ray machine captures a video of the contrast medium when the child urinates. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician supervised by a radiologista doctor who specializes in medical imagingwho then interprets the images. Anesthesia is not needed, but sedation may be used for some children. This test can show abnormalities of the inside of the urethra and bladder.\n- Radionuclide cystogram (RNC). RNC is a type of nuclear scan that involves placing radioactive material into the bladder. A scanner then detects the radioactive material as the child urinates or after the bladder is empty. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist. Anesthesia is not needed, but sedation may be used for some children. RNC is more sensitive than VCUG but does not provide as much detail of the bladder anatomy.\n- Abdominal ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract, including the kidneys and bladder. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. Ultrasound may be used before VCUG or RNC if the childs family or health care provider wants to avoid exposure to x-ray radiation or radioactive material.\nTesting is usually done on\n- infants diagnosed during pregnancy with urine blockage affecting the kidneys\n- children younger than 5 years of age with a UTI\n- children with a UTI and fever, called febrile UTI, regardless of age\n- males with a UTI who are not sexually active, regardless of age or fever\n- children with a family history of VUR, including an affected sibling\nMore information about urine blockage in infants is provided in the NIDDK health topic, Urine Blockage in Newborns.\nVUR is an unlikely cause of UTI in some children, so these tests are not done until other causes of UTI are ruled out for\n- children 5 years of age and older with a UTI\n- children with a UTI but no fever\n- sexually active males with a UTI" } ]

[ { "from": "human", "value": "How to diagnose Vesicoureteral Reflux?" }, { "from": "gpt", "value": "Following diagnosis, children with VUR should have a general medical evaluation that includes blood pressure measurement, as high blood pressure is an indicator of kidney damage. If both kidneys are affected, a childs blood should be tested for creatininea waste product of normal muscle breakdown. Healthy kidneys remove creatinine from the blood; when the kidneys are damaged, creatinine builds up in the blood. The urine may be tested for the presence of protein and bacteria. Protein in the urine is another indication of damaged kidneys.\n- having to urinate often or suddenly\n- long periods of time between bathroom visits\n- daytime wetting\n- pain in the penis or perineumthe area between the anus and genitals\n- posturing to prevent wetting\n- constipationa condition in which a child has fewer than two bowel movements in a week; the bowel movements may be painful\n- fecal incontinenceinability to hold stool in the colon and rectum, which are parts of the large intestine" } ]

[ { "from": "human", "value": "What are the treatments for Vesicoureteral Reflux?" }, { "from": "gpt", "value": "The standard treatment for primary VUR has included prompt treatment of UTIs and long-term use of antibiotics to prevent UTIs, also called antimicrobial prophylaxis, until VUR goes away on its own. Antibiotics are bacteria-fighting medications. Surgery has also been used in certain cases.\nSeveral studies have raised questions about long-term use of antibiotics for prevention of UTIs. The studies found little or no effect on prevention of kidney damage. Long-term use may also make the child resistant to the antibiotic, meaning the medication does not work as well, and the child may be sicker longer and may need to take medications that are even stronger.\n- children younger than 1 year of age continuous antibiotics should be used if a child has a history of febrile UTI or VUR grade III through V that was identified through screening\n- children older than 1 year of age with BBDcontinuous antibiotics should be used while BBD is being treated\n- children older than 1 year of age without BBDcontinuous antibiotics can be used at the discretion of the health care provider but is not automatically recommended; however, UTIs should be promptly treated\nDeflux, a gellike liquid containing complex sugars, is an alternative to surgery for treatment of VUR. A small amount of Deflux is injected into the bladder wall near the opening of the ureter. This injection creates a bulge in the tissue that makes it harder for urine to flow back up the ureter. The health care provider uses a special tube to see inside the bladder during the procedure. Deflux injection is an outpatient procedure done under general anesthesia, so the child can go home the same day." } ]

[ { "from": "human", "value": "What are the treatments for Vesicoureteral Reflux?" }, { "from": "gpt", "value": "Secondary VUR is treated by removing the blockage causing the reflux. Treatment may involve\n- surgery\n- antibiotics\n- intermittent catheterizationdraining the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder" } ]

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

[ { "from": "human", "value": "What to do for Vesicoureteral Reflux?" }, { "from": "gpt", "value": "- Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder to the upper urinary tract.\n- VUR is more common in infants and young children, but older children and even adults can be affected. About 10 percent of children have VUR.\n- In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI).\n- When a child with VUR gets a UTI, bacteria can move into the kidney and lead to scarring. Scarring of the kidney can be associated with high blood pressure and kidney failure.\n- Voiding cystourethrogram (VCUG), radionuclide cystogram (RNC), and abdominal ultrasound are used to diagnose VUR.\n- Children with VUR should also be assessed for bladder/bowel dysfunction (BBD). Children who have VUR along with any BBD symptoms are at greater risk of kidney damage due to infection.\n- The standard treatment for primary VUR has included prompt treatment of UTIs and long-term use of antibiotics to prevent UTIs, also called antimicrobial prophylaxis, until VUR goes away on its own. Surgery has also been used in certain cases.\n- Secondary VUR is treated by removing the blockage causing the reflux." } ]

[ { "from": "human", "value": "What is (are) Diabetic Kidney Disease?" }, { "from": "gpt", "value": "Diabetic kidney disease, also called diabetic nephropathy, is kidney disease caused by diabetes. Even when well controlled, diabetes can lead to chronic kidney disease (CKD) and kidney failure, described as end-stage kidney disease or ESRD when treated with a kidney transplant or blood-filtering treatments called dialysis.\nDiabetes affects 25.8 million people of all ages in the United States.1 As many as 40 percent of people who have diabetes are expected to develop CKD.2 Diabetes, the most common cause of kidney failure in the United States, accounts for nearly 44 percent of new cases of kidney failure, as illustrated in Figure 1.3" } ]