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[ { "content": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.\n\n Glaucoma Overview Glaucoma is a group of eye conditions that damage the optic nerve, which is vital to good vision. This damage is often caused by an abnormally high pressure in your eye. Glaucoma is one of the leading causes of blindness in the United States. It can occur at any age but is more common in older adults. The most common form of glaucoma has no warning signs. The effect is so gradual that you may not notice a change in vision until the condition is at an advanced stage. Vision loss due to glaucoma can't be recovered. So it's important to have regular eye exams that include measurements of your eye pressure. If glaucoma is recognized early, vision loss can be slowed or prevented. If you have the condition, you'll generally need treatment for the rest of your life. Symptoms The signs and symptoms of glaucoma vary depending on the type and stage of your condition. For example: Open-angle glaucoma - Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes - Tunnel vision in the advanced stages Acute angle-closure glaucoma - Severe headache - Eye pain - Nausea and vomiting - Blurred vision - Halos around lights - Eye redness If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of people with glaucoma become blind in at least one eye within 20 years. When to see a doctor Seek immediate medical care Promptly go to an emergency room or an eye doctor's (ophthalmologist's) office if you experience some of the symptoms of acute angle-closure glaucoma, such as severe headache, eye pain and blurred vision. Schedule eye exams Open-angle glaucoma gives few warning signs until permanent damage has already occurred. Regular eye exams are the key to detecting glaucoma early enough to successfully slow or prevent vision loss. The American Academy of Ophthalmology recommends glaucoma screening: - Every four years beginning at age 40 if you don't have any glaucoma risk factors - Every two years if you're at high risk or over 65 Causes Glaucoma is the result of damage to the optic nerve. As this nerve gradually deteriorates, blind spots develop in your visual field. For reasons that doctors don't fully understand, this nerve damage is usually related to increased pressure in the eye. Elevated eye pressure is due to a buildup of a fluid (aqueous humor) that flows throughout your eye. This fluid normally drains into the front of the eye (anterior chamber) through tissue (trabecular meshwork) at the angle where the iris and cornea meet. When fluid is overproduced or the drainage system doesn't work properly, the fluid can't flow out at its normal rate and pressure builds up. Glaucoma tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage. The types of glaucoma include the following: Open-angle glaucoma Open-angle glaucoma is the most common form of the disease. The drainage angle formed by the cornea and iris remains open, but the trabecular meshwork is partially blocked. This causes pressure in the eye to gradually increase. This pressure damages the optic nerve. It happens so slowly that you may lose vision before you're even aware of a problem. Angle-closure glaucoma Angle-closure glaucoma, also called closed-angle glaucoma, occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and iris. As a result, fluid can't circulate through the eye and pressure increases. Some people have narrow drainage angles, putting them at increased risk of angle-closure glaucoma. Angle-closure glaucoma may occur suddenly (acute angle-closure glaucoma) or gradually (chronic angle-closure glaucoma). Acute angle glaucoma is a medical emergency. It can be triggered by sudden dilation of your pupils. Normal-tension glaucoma In normal-tension glaucoma, your optic nerve becomes damaged even though your eye pressure is within the normal range. No one knows the exact reason for this. You may have a sensitive optic nerve, or you may have less blood being supplied to your optic nerve. This limited blood flow could be caused by atherosclerosis - the buildup of fatty deposits (plaques) in the arteries - or other conditions that impair circulation. Glaucoma in children It's possible for infants and children to have glaucoma. It may be present from birth or developed in the first few years of life. The optic nerve damage may be caused by drainage blockages or an underlying medical condition. Pigmentary glaucoma In pigmentary glaucoma, pigment granules from your iris build up in the drainage channels, slowing or blocking fluid exiting your eye. Activities such as jogging sometimes stir up the pigment granules, depositing them on the trabecular meshwork and causing intermittent pressure elevations. Risk factors Because chronic forms of glaucoma can destroy vision before any signs or symptoms are apparent, be aware of these risk factors: - Having high internal eye pressure (intraocular pressure) - Being over age 60 - Being black or Hispanic - Having a family history of the condition - Having certain medical conditions, such as diabetes, heart disease, high blood pressure and sickle cell anemia - Having certain eye conditions, such as nearsightedness - Having had an eye injury or certain types of eye surgery - Early estrogen deficiency, such as can occur after removal of both ovaries (bilateral oophorectomy) before age 43 - Taking corticosteroid medications, especially eyedrops, for a long time Diagnosis Your doctor will review your medical history and conduct a comprehensive eye examination. He or she may perform several tests, including: - Measuring intraocular pressure (tonometry) - Testing for optic nerve damage - Checking for areas of vision loss (visual field test) - Measuring corneal thickness (pachymetry) - Inspecting the drainage angle (gonioscopy) Treatment The damage caused by glaucoma can't be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially in you catch the disease in its early stage. The goal of glaucoma treatment is to lower pressure in your eye (intraocular pressure). Depending on your situation, your options may include eyedrops, laser treatment or surgery. Eyedrops Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes. Prescription eyedrop medications include: - Prostaglandins. These increase the outflow of the fluid in your eye (aqueous humor) and reduce pressure in your eye. Examples include latanoprost (Xalatan) and bimatoprost (Lumigan). Possible side effects include mild reddening and stinging of the eyes, darkening of the iris, changes in the pigment of the eyelashes or eyelid skin, and blurred vision. - Beta blockers. These reduce the production of fluid in your eye, thereby lowering the pressure in your eye (intraocular pressure). Examples include timolol (Betimol, Timoptic) and betaxolol (Betoptic). Possible side effects include difficulty breathing, slowed heart rate, lower blood pressure, impotence and fatigue. - Alpha-adrenergic agonists. These reduce the production of aqueous humor and increase outflow of the fluid in your eye. Examples include apraclonidine (Iopidine) and brimonidine (Alphagan). Possible side effects include an irregular heart rate; high blood pressure; fatigue; red, itchy or swollen eyes; and dry mouth. - Carbonic anhydrase inhibitors. Rarely used for glaucoma, these drugs may reduce the production of fluid in your eye. Examples include dorzolamide (Trusopt) and brinzolamide (Azopt). Possible side effects include a metallic taste, frequent urination, and tingling in the fingers and toes. - Miotic or cholinergic agents. These increase the outflow of fluid from your eye. An example is pilocarpine (Isopto Carpine). Side effects include smaller pupils, possible blurred or dim vision, and nearsightedness. Oral medications If eyedrops alone don't bring your eye pressure down to the desired level, your doctor may also prescribe an oral medication, usually a carbonic anhydrase inhibitor. Possible side effects include frequent urination, tingling in the fingers and toes, depression, stomach upset, and kidney stones. Surgery and other therapies Other treatment options include laser therapy and various surgical procedures. Possible complications include pain, redness, infection, inflammation, bleeding, abnormally high or low eye pressure, and loss of vision. Some types of eye surgery may speed the development of cataracts. You'll need to see your doctor for follow-up exams. And you may eventually need to undergo additional procedures if your eye pressure begins to rise or other changes occur in your eye. The following techniques are intended to improve the drainage of fluid within the eye, lowering pressure: - Laser therapy. Laser trabeculoplasty (truh-BEK-u-low-plas-tee) is an option for people with open-angle glaucoma. It's done in your doctor's office. He or she uses a laser beam to open clogged channels in the trabecular meshwork. It may take a few weeks before the full effect of this procedure becomes apparent. - Filtering surgery. With a surgical procedure called a trabeculectomy (truh-bek-u-LEK-tuh-me), your surgeon creates an opening in the white of the eye (sclera) and removes part of the trabecular meshwork. - Drainage tubes. In this procedure, your eye surgeon inserts a small tube in your eye. - Electrocautery. Your doctor may suggest a minimally invasive procedure to remove tissue from the trabecular meshwork using a small electrocautery device called a Trabecutome. Treating acute angle-closure glaucoma Acute angle-closure glaucoma is a medical emergency. If you're diagnosed with this condition, you'll need urgent treatment to reduce the pressure in your eye. This generally will require both medication and laser or other surgical procedures. You may have a procedure called a laser peripheral iridotomy in which the doctor creates a small hole in your iris using a laser. This allows fluid (aqueous humor) to flow through it, relieving eye pressure. Emerging therapies Researchers are evaluating the effectiveness of new drugs, drug delivery methods, surgical procedures and devices (iStent, others). Lifestyle and home remedies These tips may help you control high eye pressure or promote eye health. - Eat a healthy diet. Eating a healthy diet can help you maintain your health, but it won't prevent glaucoma from worsening. Several vitamins and nutrients are important to eye health, including those found in dark, leafy greens and fish high in omega-3 fatty acids. - Exercise safely. Regular exercise may reduce eye pressure in open-angle glaucoma. Talk to your doctor about an appropriate exercise program. - Limit your caffeine. Drinking beverages with large amounts of caffeine may increase your eye pressure. - Sip fluids frequently. Drink only moderate amounts of fluids at any given time during the course of a day. Drinking a quart or more of any liquid within a short time may temporarily increase eye pressure. - Sleep with your head elevated. Using a wedge pillow that keeps your head slightly raised, about 20 degrees, has been shown to reduce intraocular eye pressure while you sleep. - Take prescribed medicine. Using your eyedrops or other medications as prescribed can help you get the best possible result from your treatment. Be sure to use the drops exactly as prescribed. Otherwise, your optic nerve damage could get even worse. Because some of the eyedrops are absorbed into your bloodstream, you may experience some side effects unrelated to your eyes. To minimize this absorption, close your eyes for one to two minutes after putting the drops in. Or press lightly at the corner of your eye near your nose to close the tear duct for one or two minutes. Wipe off any unused drops from your eyelid. Alternative medicine Some alternative medicine approaches may help your overall health but none are effective glaucoma remedies. Talk with your doctor about their possible benefits and risks. - Herbal remedies. A number of herbal supplements, such as bilberry and ginkgo, have been advertised as glaucoma remedies. But further study is needed to prove their effectiveness. Don't use herbal supplements in place of proven therapies. - Relaxation techniques. Stress may trigger an attack of acute angle-closure glaucoma. If you're at risk of this condition, find healthy ways to cope with stress. Meditation and other techniques may help. - Marijuana. Research shows that marijuana lowers eye pressure in people with glaucoma, but only for three to four hours. Other, standard treatments are more effective. The American Academy of Ophthalmology doesn't recommend marijuana for treating glaucoma. ", "role": "user" }, { "content": "Different types and stages of glaucoma have different symptoms. Open-angle glaucoma starts with patchy blind spots in peripheral or central vision, frequently in both eyes. In the advanced stages, the symptoms include tunnel vision. Open-angle glaucoma might have no symptoms until permanent damage has already occurred. Symptoms of acute angle-closure glaucoma include: severe headache, eye pain, nausea and vomiting, blurred vision, halos around lights, eye redness. Promptly go to an eye doctor if you experience some of the symptoms of acute angle-closure glaucoma, such as severe headache, eye pain and blurred vision. If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of people with glaucoma become blind in at least one eye within 20 years. Regular eye exams are the key to detecting glaucoma early enough to successfully slow or prevent vision loss.", "role": "assistant" } ]

[ { "content": "what are pancreatic enzymes?\n\nPancreatic cysts: Pancreatic cysts are saclike pockets of fluid on or in your pancreas, a large organ behind the stomach that produces hormones and enzymes that help digest food. Most pancreatic cysts aren't cancerous, and many don't cause symptoms. They're typically found during imaging testing for another problem. Some are actually noncancerous (benign) pockets of fluids lined with scar or inflammatory tissue, not the type of cells found in true cysts (pseudocysts). But some pancreatic cysts can be or can become cancerous. Your doctor might take a sample of the pancreatic cyst fluid to determine if cancer cells are present. Or your doctor might recommend monitoring a cyst over time for changes that indicate cancer. You may not have symptoms from pancreatic cysts, which are often found when imaging tests of the abdomen are done for another reason. When signs or symptoms of pancreatic cysts do occur, they typically include: - Persistent abdominal pain, which may radiate to your back - A mass you can feel in your upper abdomen - Nausea and vomiting When to see a doctor Rarely, cysts can become infected. See a doctor if you have a fever and persistent abdominal pain. A ruptured pseudocyst can be a medical emergency, but fortunately is rare. Fluid released by the pseudocyst can damage nearby blood vessels and cause massive bleeding. A ruptured pseudocyst can also cause infection of the abdominal cavity (peritonitis). Seek emergency medical treatment if you have signs or symptoms of internal bleeding and shock, including: - Fainting - Severe abdominal pain - Decreased consciousness - Weak and rapid heartbeat - Vomiting of blood The cause of most pancreatic cysts is unknown. Some cysts are associated with rare illnesses including von Hippel-Lindau disease, a genetic disorder that can affect the pancreas and other organs. Pseudocysts often follow a bout of a painful condition in which digestive enzymes become prematurely active and irritate the pancreas (pancreatitis). Pseudocysts can also result from injury to the abdomen, such as from a car accident. Heavy alcohol use and gallstones are risk factors for pancreatitis, and pancreatitis is a risk factor for pseudocysts. Abdominal injury is also a risk factor for pseudocysts. Pancreatic cysts are diagnosed more often than in the past because improved imaging technology finds them more readily. Many pancreatic cysts are found during abdominal scans for other problems. The main challenge in diagnosis is to determine whether the cyst might become cancerous. These procedures are often used to help with diagnosis and treatment planning: - Medical history. Previous abdominal injury or pancreatitis might indicate a pseudocyst. - CT scan. This imaging test can provide detailed information about the size and structure of a pancreatic cyst. - MRI scan. This imaging test can highlight subtle details of a pancreatic cyst, including whether it has any components that suggest a higher risk of cancer. - Endoscopic ultrasound. This test, like MRI, can provide a detailed image of the cyst. Also, fluid can be collected from the cyst for analysis in a laboratory for possible signs of cancer. The characteristics and location of the pancreatic cyst, with your age and sex, can help doctors pinpoint the type of cyst you have: - Serous cystadenoma can become large enough to displace nearby organs, causing abdominal pain and a feeling of fullness. Serous cystadenomas occur most frequently in women older than 60 and only rarely become cancerous. - Mucinous cystadenoma is usually situated in the body or tail of the pancreas and occurs most often in middle-aged women. Mucinous cystadenoma is precancerous, which means it might become cancer if left untreated. Larger cysts might already be cancerous when found. - Intraductal papillary mucinous neoplasm (IPMN) is a growth in the main pancreatic duct or one of its side branches. IPMN may be precancerous or cancerous. It occurs most often in men and women older than 50. Depending on its location and other factors, IPMN may require surgical removal. - Papillary cystic tumor is usually situated in the body or tail of the pancreas and occurs most often in women younger than 35. Also known as papillary cystic neoplasm, it's rare and usually cancerous. - Cystic islet cell tumor is mostly solid but can have cystlike components. Cystic islet cell tumors are rare. They can be confused with other pancreatic cysts and may be precancerous or cancerous. Watchful waiting or treatment depends on the type of cyst you have, its size, its characteristics and whether it's causing symptoms. Watchful waiting A benign pseudocyst, even a large one, can be left alone as long as it isn't bothering you. Serous cystadenoma rarely becomes cancerous, so it also can be left alone unless it causes symptoms or grows. But all pancreatic cysts should be monitored. Drainage A pseudocyst that is causing bothersome symptoms or growing larger can be drained. A small flexible tube (endoscope) is passed through your mouth to your stomach and small intestine. The endoscope is equipped with an ultrasound probe (endoscopic ultrasound) and a needle to drain the cyst. Sometimes drainage through the skin is necessary. Surgery Surgery might be needed to remove an enlarged pseudocyst or a serous cystadenoma that's causing pain or other symptoms. Other types of pancreatic cysts generally require surgical removal because of the risk of cancer. A pseudocyst may recur if you have ongoing pancreatitis.", "role": "user" }, { "content": "The pancreas is a large organ behind the stomach that produces hormones and enzymes that help digest food.", "role": "assistant" } ]

[ { "content": "what are some common symptoms of bulimia\n\nBulimia nervosa (Symptoms): Bulimia signs and symptoms may include: - Being preoccupied with your body shape and weight - Living in fear of gaining weight - Feeling that you can't control your eating behavior - Eating until the point of discomfort or pain - Eating much more food in a binge episode than in a normal meal or snack - Forcing yourself to vomit or exercise too much to keep from gaining weight after bingeing - Misusing laxatives, diuretics or enemas after eating - Restricting calories or avoiding certain foods between binges - Using dietary supplements or herbal products excessively for weight loss If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps to get successful bulimia treatment. If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to go along. Because most people with bulimia are normal weight or slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include: - Constantly worrying or complaining about being fat - Having a distorted, excessively negative body image - Repeatedly eating unusually large quantities of food in one sitting, especially foods the person would normally avoid - Not wanting to eat in public or in front of others - Going to the bathroom right after eating or during meals - Exercising too much - Having sores, scars or calluses on the knuckles or hands - Having damaged teeth and gums", "role": "user" }, { "content": "Bulimia signs and symptoms may include: - Being preoccupied with your body shape and weight - Living in fear of gaining weight - Feeling that you can't control your eating behavior - Eating until the point of discomfort or pain - Eating much more food in a binge episode than in a normal meal or snack - Forcing yourself to vomit or exercise too much to keep from gaining weight after bingeing - Misusing laxatives, diuretics or enemas after eating - Restricting calories or avoiding certain foods between binges - Using dietary supplements or herbal products excessively for weight loss If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust.", "role": "assistant" } ]

[ { "content": "how do people get diabetes\n\nDiabetes (Causes): Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested: - A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. - An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: - Their pancreas does not make enough insulin - Their cells do not respond to insulin normally - Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: - Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause is unknown. - Type 2 diabetes is much more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. - There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease.", "role": "user" }, { "content": "Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested: - A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. - An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: - Their pancreas does not make enough insulin - Their cells do not respond to insulin normally - Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: - Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause is unknown. - Type 2 diabetes is much more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. - There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease.", "role": "assistant" } ]

[ { "content": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.\n\n Psoriasis What is it? Points To Remember About Psoriasis What is psoriasis? Psoriasis is an autoimmune disease that causes red, scaly skin.It is caused by genes, meaning it runs in families, but some outside factors can make it worse or trigger flares.Psoriasis can be hard to diagnose because it can look like other skin diseases.Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments.You may have to try a couple of different treatments before finding one that helps you.Joining a support group helps some people with psoriasis cope with the disease.Psoriasis is a skin disease that causes red, scaly skin that may feel painful, swollen or hot.If you have psoriasis, you are more likely to get some other conditions, including: Psoriatic arthritis, a condition that causes joint pain and swelling.Cardiovascular problems, which affect the heart and blood circulation system.Obesity.High blood pressure.Diabetes.Some treatments for psoriasis can have serious side effects, so be sure to talk about them with your doctor and keep all your appointments. Psoriasis is an autoimmune disease that causes red, scaly skin.It is caused by genes, meaning it runs in families, but some outside factors can make it worse or trigger flares.Psoriasis can be hard to diagnose because it can look like other skin diseases.Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments.You may have to try a couple of different treatments before finding one that helps you.Joining a support group helps some people with psoriasis cope with the disease. Psoriasis is an autoimmune disease that causes red, scaly skin.It is caused by genes, meaning it runs in families, but some outside factors can make it worse or trigger flares.Psoriasis can be hard to diagnose because it can look like other skin diseases.Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments.You may have to try a couple of different treatments before finding one that helps you.Joining a support group helps some people with psoriasis cope with the disease.Psoriasis is a skin disease that causes red, scaly skin that may feel painful, swollen or hot.If you have psoriasis, you are more likely to get some other conditions, including: Psoriatic arthritis, a condition that causes joint pain and swelling.Cardiovascular problems, which affect the heart and blood circulation system.Obesity.High blood pressure.Diabetes.Some treatments for psoriasis can have serious side effects, so be sure to talk about them with your doctor and keep all your appointments. Who gets it? Who gets psoriasis? Anyone can get psoriasis, but it is more common in adults. Certain genes have been linked to psoriasis, so you are more likely to get it if someone else in your family has it.Anyone can get psoriasis, but it is more common in adults. Certain genes have been linked to psoriasis, so you are more likely to get it if someone else in your family has it. What are the types? What are the types of psoriasis? There are several different types of psoriasis. Here are a few examples: Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales.Guttate psoriasis, which causes small, drop-shaped lesions on your trunk, limbs, and scalp. This type of psoriasis is most often triggered by upper respiratory infections, such as strep throat.Pustular psoriasis, which causes pus-filled blisters. Attacks or flares can be caused by medications, infections, stress, or certain chemicals.Inverse psoriasis, which causes smooth, red patches in folds of skin near the genitals, under the breasts or in the armpits. Rubbing and sweating can make this type of psoriasis worse.Erythrodermic psoriasis, which causes red and scaly skin over much of your body. This can be a reaction to a bad sunburn or taking certain medications, such as corticosteroids. It can also happen if you have a different type of psoriasis that is not well controlled. This type of psoriasis can be very serious, so if you have it, you should see a doctor immediately.There are several different types of psoriasis. Here are a few examples: Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales.Guttate psoriasis, which causes small, drop-shaped lesions on your trunk, limbs, and scalp. This type of psoriasis is most often triggered by upper respiratory infections, such as strep throat.Pustular psoriasis, which causes pus-filled blisters. Attacks or flares can be caused by medications, infections, stress, or certain chemicals.Inverse psoriasis, which causes smooth, red patches in folds of skin near the genitals, under the breasts or in the armpits. Rubbing and sweating can make this type of psoriasis worse.Erythrodermic psoriasis, which causes red and scaly skin over much of your body. This can be a reaction to a bad sunburn or taking certain medications, such as corticosteroids. It can also happen if you have a different type of psoriasis that is not well controlled. This type of psoriasis can be very serious, so if you have it, you should see a doctor immediately. What causes it? What causes psoriasis? Psoriasis is an autoimmune disease, which means that your body's immune system - which protects you from diseases - starts overacting and causing problems. If you have psoriasis, a type of white blood cells called the T cells become so active that they trigger other immune system responses, including swelling and fast turnover of skin cells.Your skin cells grow deep in the skin and rise slowly to the surface. This is called cell turnover, and it usually takes about a month. If you have psoriasis, though, cell turnover can take only a few days. Your skin cells rise too fast and pile up on the surface, causing your skin to look red and scaly.Some things may cause a flare, meaning your psoriasis becomes worse for a while, including: Infections.Stress.Changes in the weather that dry out your skin.Certain medicines.Cuts, scratches or sunburns.Certain genes have been linked to psoriasis, meaning it runs in families.Psoriasis is an autoimmune disease, which means that your body's immune system - which protects you from diseases - starts overacting and causing problems. If you have psoriasis, a type of white blood cells called the T cells become so active that they trigger other immune system responses, including swelling and fast turnover of skin cells.Your skin cells grow deep in the skin and rise slowly to the surface. This is called cell turnover, and it usually takes about a month. If you have psoriasis, though, cell turnover can take only a few days. Your skin cells rise too fast and pile up on the surface, causing your skin to look red and scaly.Some things may cause a flare, meaning your psoriasis becomes worse for a while, including: Infections.Stress.Changes in the weather that dry out your skin.Certain medicines.Cuts, scratches or sunburns.Certain genes have been linked to psoriasis, meaning it runs in families.Psoriasis is an autoimmune disease, which means that your body's immune system - which protects you from diseases - starts overacting and causing problems. If you have psoriasis, a type of white blood cells called the T cells become so active that they trigger other immune system responses, including swelling and fast turnover of skin cells.Your skin cells grow deep in the skin and rise slowly to the surface. This is called cell turnover, and it usually takes about a month. If you have psoriasis, though, cell turnover can take only a few days. Your skin cells rise too fast and pile up on the surface, causing your skin to look red and scaly.Some things may cause a flare, meaning your psoriasis becomes worse for a while, including: Infections.Stress.Changes in the weather that dry out your skin.Certain medicines.Cuts, scratches or sunburns.Certain genes have been linked to psoriasis, meaning it runs in families. Is there a test? Is there a test for psoriasis? Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor may look at a small sample of your skin under a microscope to help them figure out if psoriasis is causing your skin condition.Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor may look at a small sample of your skin under a microscope to help them figure out if psoriasis is causing your skin condition.Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor may look at a small sample of your skin under a microscope to help them figure out if psoriasis is causing your skin condition. How is it treated? How is psoriasis treated? There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: Topical treatment, which means putting creams on your skin.Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It's important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse.Systemic treatment, which can include taking prescription medicines or getting shots of medicine.There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: Topical treatment, which means putting creams on your skin.Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It's important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse.Systemic treatment, which can include taking prescription medicines or getting shots of medicine.There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: Topical treatment, which means putting creams on your skin.Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It's important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse.Systemic treatment, which can include taking prescription medicines or getting shots of medicine. Who treats it? Who treats psoriasis? Several types of health care professionals may treat you, including: Dermatologists, who treat skin problems.Internists, who diagnose and treat adults.Several types of health care professionals may treat you, including: Dermatologists, who treat skin problems.Internists, who diagnose and treat adults.Several types of health care professionals may treat you, including: Dermatologists, who treat skin problems.Internists, who diagnose and treat adults. Living With It Living with psoriasis Psoriasis is a chronic disease, which means it lasts a long time. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, here are some things you can try to help manage your symptoms: Keeping your skin well moisturized.Staying healthy overall.Joining support groups or counseling to help you realize you are not alone in dealing with psoriasis and to share ideas for coping with the disease.Psoriasis is a chronic disease, which means it lasts a long time. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, here are some things you can try to help manage your symptoms: Keeping your skin well moisturized.Staying healthy overall.Joining support groups or counseling to help you realize you are not alone in dealing with psoriasis and to share ideas for coping with the disease. ", "role": "user" }, { "content": "Your doctor may recommend creams, ultraviolet light therapy, prescription medications, shots, or some combination of these treatments. - You may have to try a couple of different treatments before finding one that helps you. - Joining a support group helps some people with psoriasis cope with the disease. There are several different types of treatment for psoriasis. Your doctor may recommend that you try one of these or a combination of them: - Topical treatment, which means putting creams on your skin. - Light therapy, which involves a doctor shining an ultraviolet light on your skin or getting more sunlight. It?s important that a doctor controls the amount of light you are getting from this therapy, because too much ultraviolet light may make your psoriasis worse. - Systemic treatment, which can include taking prescription medicines or getting shots of medicine. You can take an active role in treating your psoriasis. Besides going to your doctor regularly, here are some things you can try to help manage your symptoms: - Keeping your skin well moisturized. - Staying healthy overall. -", "role": "assistant" } ]

[ { "content": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you\n\n Williams Syndrome Definition Williams Syndrome (WS) is a rare genetic disorder characterized by mild to moderate delays in cognitive development or learning difficulties, a distinctive facial appearance, and a unique personality that combines over-friendliness and high levels of empathy with anxiety. The most significant medical problem associated with WS is cardiovascular disease caused by narrowed arteries. WS is also associated with elevated blood calcium levels in infancy. A random genetic mutation (deletion of a small piece of chromosome 7), rather than inheritance, most often causes the disorder. However, individuals who have WS have a 50 percent chance of passing it on if they decide to have children. The characteristic facial features of WS include puffiness around the eyes, a short nose with a broad nasal tip, wide mouth, full cheeks, full lips, and a small chin. People with WS are also likely to have a long neck, sloping shoulders, short stature, limited mobility in their joints, and curvature of the spine. Some individuals with WS have a star-like pattern in the iris of their eyes. Infants with WS are often irritable and colicky, with feeding problems that keep them from gaining weight. Chronic abdominal pain is common in adolescents and adults. By age 30, the majority of individuals with WS have diabetes or pre-diabetes and mild to moderate sensorineural hearing loss (a form of deafness due to disturbed function of the auditory nerve). For some people, hearing loss may begin as early as late childhood. WS also is associated with a characteristic “cognitive profile” of mental strengths and weaknesses composed of strengths in verbal short-term memory and language, combined with severe weakness in visuospatial construction (the skills used to copy patterns, draw, or write). Within language, the strongest skills are typically in concrete, practical vocabulary, which in many cases is in the low average to average range for the general population. Abstract or conceptual-relational vocabulary is much more limited. Most older children and adults with WS speak fluently and use good grammar. More than 50% of children with WS have attention deficit disorders (ADD or ADHD), and about 50% have specific phobias, such as a fear of loud noises. The majority of individuals with WS worry excessively. Treatment There is no cure for Williams syndrome, nor is there a standard course of treatment. Because WS is an uncommon and complex disorder, multidisciplinary clinics have been established at several centers in the United States. Treatments are based on an individual’s particular symptoms. People with WS require regular cardiovascular monitoring for potential medical problems, such as symptomatic narrowing of the blood vessels, high blood pressure, and heart failure. Prognosis The prognosis for individuals with WS varies. Some degree of impaired intellect is found in most people with the disorder. Some adults are able to function independently, complete academic or vocational school, and live in supervised homes or on their own; most live with a caregiver. Parents can increase the likelihood that their child will be able to live semi-independently by teaching self-help skills early. Early intervention and individualized educational programs designed with the distinct cognitive and personality profiles of WS in mind also help individuals maximize their potential. Medical complications associated with the disorder may shorten the lifespans of some individuals with WS. ", "role": "user" }, { "content": "There is no cure for Williams syndrome, nor is there a standard course of treatment. Because WS is an uncommon and complex disorder, multidisciplinary clinics have been established at several centers in the United States. Treatments are based on an individual?s particular symptoms. People with WS require regular cardiovascular monitoring for potential medical problems, such as symptomatic narrowing of the blood vessels, high blood pressure, and heart failure.", "role": "assistant" } ]

[ { "content": "how to deal with anxiety\n\nGeneralized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you. Then you can decide together if it is right for you.", "role": "user" }, { "content": "Generalized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you.", "role": "assistant" } ]

[ { "content": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?\n\n Bursitis of the heel Insertional heel pain Retrocalcaneal bursitis Summary Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone. Causes A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. It may be caused by too much walking, running, or jumping. This condition is very often linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis. Risks for this condition include: Starting a very intense workout schedule Suddenly increasing activity level without the right conditioning Changes in activity level History of arthritis that is caused by inflammation Symptoms Symptoms include: Pain in the heel, especially with walking, running, or when the area is touched Pain may get worse when rising on the toes (standing on tiptoes) Red, warm skin over the back of the heel Exams and Tests Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. An exam will be done to find the location of the pain. The provider will also look for tenderness and redness in the back of the heel. The pain may be worse when your ankle is bent upward (dorsiflex). Or, the pain may be worse when you rise on your toes. Most of the time, you will not need imaging studies such as x-ray and MRI at first. You may need these tests later if the first treatments DO NOT lead to improvement. Inflammation may show on a MRI. Treatment Your provider may recommend that you do the following: Avoid activities that cause pain. Put ice on the heel several times a day. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. Outlook (Prognosis) This condition most often gets better in several weeks with the proper treatment. When to Contact a Medical Professional Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest. Prevention Things you can do to prevent the problem include: Use proper form when exercising. Maintain as good flexibility and strength around the ankle to help prevent this condition. Stretch the Achilles tendon to help prevent injury. Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa. Review Date 9/22/2016 Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Your provider may recommend that you do the following: - Avoid activities that cause pain. - Put ice on the heel several times a day. - Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. - Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. - Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. This condition most often gets better in several weeks with the proper treatment. Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest. Things you can do to prevent the problem include: - Use proper form when exercising. - Maintain as good flexibility and strength around the ankle to help prevent this condition. - Stretch the Achilles tendon to help prevent injury. - Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa.", "role": "assistant" } ]

[ { "content": "could tetanus be a cause of death?\n\nTetanus (Complications): Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months. Complications of tetanus infection may include: - Broken bones. The severity of spasms may cause the spine and other bones to break. - Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches. - Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death.", "role": "user" }, { "content": "Complications of tetanus infection may include: -Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches. - Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death", "role": "assistant" } ]

[ { "content": "what are the causes of childhood obesity\n\nChildhood obesity (Causes): Lifestyle issues - too little activity and too many calories from food and drinks - are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well. For example, recent research has found that changes in digestive hormones can affect the signals that let you know you're full.", "role": "user" }, { "content": "Childhood obesity (Causes): Lifestyle issues - too little activity and too many calories from food and drinks - are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well.", "role": "assistant" } ]

[ { "content": "what the treatment for bronchitis\n\n Acute bronchitis Summary Acute bronchitis is swelling and inflamed tissue in the main passages that carry air to the lungs. This swelling narrows the airways, which makes it harder to breathe. Other symptoms of bronchitis are a cough and coughing up mucus. Acute means the symptoms have been present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a cold or flu-like illness. The bronchitis infection is caused by a virus. At first, it affects your nose, sinuses, and throat. Then it spreads to the airways that lead to your lungs. Sometimes, bacteria also infect your airways. This is more common in people with COPD. Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least 3 months. Symptoms Some symptoms of acute bronchitis are: Chest discomfort Cough that produces mucus -- the mucus may be clear or yellow-green Fatigue Fever -- usually low-grade Shortness of breath that gets worse with activity Wheezing, in people with asthma Even after acute bronchitis has cleared, you may have a dry, nagging cough that lasts for 1 to 4 weeks. Sometimes it can be hard to know if you have pneumonia or bronchitis. If you have pneumonia, you are more likely to have a high fever and chills, feel sicker, or be more short of breath. Exams and Tests Your health care provider will listen to the breathing sounds in your lungs with a stethoscope. Your breathing may sound abnormal or rough. Tests may include: Chest x-ray, if your provider suspects pneumonia Pulse oximetry, a painless test that helps determine the amount of oxygen in your blood by using a device placed on the end of your finger Treatment Most people DO NOT need antibiotics for acute bronchitis caused by a virus. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better: Drink plenty of fluids. If you have asthma or another chronic lung condition, use your inhaler. Get plenty of rest. Take aspirin or acetaminophen if you have a fever. DO NOT give aspirin to children. Breathe moist air by using a humidifier or steaming up the bathroom. Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word \"guaifenesin\" on the label. Ask the pharmacist for help finding it. If your symptoms do not improve or if you are wheezing, your provider may prescribe an inhaler to open your airways. If your provider thinks you also have bacteria in your airways, they may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. Your provider may also prescribe corticosteroid medicine to reduce swelling in your lungs. If you have the flu and it is caught in the first 48 hours after getting sick, your provider might also prescribe antiviral medicine. Other tips include: DO NOT smoke. Avoid secondhand smoke and air pollution. Wash your hands (and your children's hands) often to avoid spreading viruses and other germs. Outlook (Prognosis) Except for the cough, symptoms usually go away in 7 to 10 days if you do not have a lung disorder. When to Contact a Medical Professional Call your provider if you: Have a cough on most days, or have a cough that keeps returning Are coughing up blood Have a high fever or shaking chills Have a low-grade fever for 3 or more days Have thick, yellow-green mucus, especially if it has a bad smell Feel short of breath or have chest pain Have a chronic illness, like heart or lung disease Review Date 2/18/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Most people DO NOT need antibiotics for acute bronchitis. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better: - Drink plenty of fluids. - Get plenty of rest. - Take aspirin or acetaminophen (Tylenol and other brands) if you have a fever. - Use a humidifier or steam in the bathroom. Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word \"guaifenesin\" on the label. If your symptoms do not improve or if you are wheezing, your doctor may prescribe an inhaler to open your airways. If your doctor thinks you also have bacteria in your airways, he or she may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. Sometimes, bacteria may infect the airways along with the virus. If your doctor thinks this has happened, you may be prescribed antibiotics. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs. Other tips include: - Do not smoke. - Avoid secondhand smoke and air pollution. - Wash your hands ... often to avoid spreading viruses and other germs.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary hypertension (Summary): Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal.", "role": "user" }, { "content": "Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal.", "role": "assistant" } ]

[ { "content": "I have been suffering from lichen planus since last four years. Some time it reduces the red sign and sometime it increases and I cannot take spicy food or hot food. Could you please suggest the remedies. I had consulted the dermatologist also .He gave me some ointment named as clone taxol for applying towards the read area. Awaiting your valuable advise I this behalf. With kind regards. Sent from my iPad\n\nWhat are the treatments for Lichen planus?: The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, you may not need treatment. Treatments may include: - Antihistamines - Medicines that calm down the immune system (in severe cases) - Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) - Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses - Corticosteroid shots into a sore - Vitamin A as a cream or taken by mouth - Other medicines that are applied to the skin - Dressings placed over your skin with medicines to keep you from scratching - Ultraviolet light therapy", "role": "user" }, { "content": "Treatments for Lichen planus may include: antihistamines (in severe cases) that calm down the immune system; lidocaine mouthwashes for mouth sores, to numb the area and make eating more comfortable; topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses; corticosteroid shots into a sore, vitamin A as a cream or taken by mouth; dressings placed over your skin with medicines to keep you from scratching, and ultraviolet light therapy.", "role": "assistant" } ]

[ { "content": "what blood tests confirm celiac disease\n\nCeliac Disease (What tests do doctors use to diagnose celiac disease?): A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.4 You are very unlikely to have celiac disease if these gene variants are not present. Having these variants alone is not enough to diagnose celiac disease because they also are common in people without the disease. In fact, most people with these genes will never get celiac disease.If blood tests suggest you have celiac disease, your doctor will perform a biopsy to be sure. During a biopsy, the doctor takes a small piece of tissue from your small intestine during a procedure called an upper GI endoscopy.If a doctor suspects you have dermatitis herpetiformis, he or she will perform a skin biopsy. For a skin biopsy, the doctor removes tiny pieces of skin tissue to examine with a microscope.A doctor examines the skin tissue and checks the tissue for antibodies common in celiac disease. If the skin tissue has the antibodies, a doctor will perform blood tests to confirm celiac disease. If the skin biopsy and blood tests both suggest celiac disease, you may not need an intestinal biopsy.", "role": "user" }, { "content": "A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.", "role": "assistant" } ]

[ { "content": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.\n\n Kartagener syndrome Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Primary ciliary dyskinesia, Kartagener type Dextrocardia-bronchiectasis-sinusitis syndrome Primary ciliary dyskinesia and situs inversus See More Summary Kartagener syndrome is a type of p that is also characterized by situs inversus totalis (mirror-image reversal of internal organs ). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility. [1] [2] [3] It can be cause by changes ( mutations ) in many different genes that are inherited in an autosomal recessive manner. Although scientists have identified many of the genes associated with Kartagener syndrome, the genetic cause of some cases is unknown. [4] [2] There is no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person but may include airway clearance therapy and antibiotics . [1] [2] [3] Symptoms Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. [1] [2] The signs and symptoms of primary ciliary dyskinesia vary, but may include: [1] [2] [3] Neonatal respiratory distress Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility Cause Kartagener syndrome can be caused by changes ( mutations ) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . The coordinated movement of cilia in wave-like motions is important to the normal functioning of certain organs and tissues throughout the body and ensures the proper placement of organs in the developing embryo. Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. [1] [4] [3] Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. [1] [4] [3] Inheritance Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. Diagnosis Kartagener syndrome is typically suspected based on the presence of characteristic signs and symptoms. A diagnosis can be confirmed by examining a small sample of tissue ( biopsy ) from an area of the body known to have cilia such as the sinus cavities or the airway. Abnormalities in the structure of cilia, as seen in people affected by Kartagener syndrome, can be observed under a special microscope (called an electron microscope). If the disease-causing change ( mutation ) is known, genetic testing can also be used to confirm the diagnosis. [1] [2] [3] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Treatment There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. Surgery to insert ear tubes may be recommended in children with chronic ear infections that are resistant to antibiotics. In people with severe lung disease, lung transplantation may be an option. [1] [2] [3] For more information on the treatment and management of Kartagener syndrome, please click here. Prognosis The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. Chronic childhood infections can be very debilitating. However, with appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided. [3] [2] [5] ", "role": "user" }, { "content": "Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. The signs and symptoms of primary ciliary dyskinesia vary, but may include: ... Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility", "role": "assistant" } ]

[ { "content": "what are the causes of headaches\n\n Headaches - danger signs Migraine headache - danger signs Tension headache - danger signs Cluster headache - danger signs Vascular headache - danger signs Summary A headache is a pain or discomfort in the head, scalp, or neck. Common types of headaches include tension headaches, migraine or cluster headaches, sinus headaches, and headaches that begin in your neck. You may have a mild headache with a cold, the flu, or other viral illnesses when you also have a low fever. Most people with headaches feel better by making lifestyle changes, such as learning ways to relax. Taking certain medicines, such as pain medicine, may also help. Emergency Causes of Headaches Problems with blood vessels and bleeding in the brain can cause a headache. These problems include: Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. Blood flow to part of the brain stops. This is called a stroke. Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. Bleeding in the brain. This is called an intracerebral hematoma. Bleeding around the brain. This can be a subarachnoid hemorrhage, a subdural hematoma, or an epidural hematoma. Other causes of headaches that should be checked by a health care provider right away include: Acute hydrocephalus, which results from an interruption of cerebrospinal fluid flow. Blood pressure that is very high. Brain tumor. Brain swelling (brain edema) from altitude sickness, carbon monoxide poisoning, or acute brain injury. Buildup of pressure inside the skull that appears to be, but is not, a tumor (pseudotumor cerebri). Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess. Swollen, inflamed artery that supplies blood to part of the head, temple, and neck area (temporal arteritis). When to Call the Doctor If you cannot see your provider right away, go to the emergency room or call 911 if: This is the first severe headache you have ever had in your life and it interferes with your daily activities. You develop a headache right after activities such as weightlifting, aerobics, jogging, or sex. Your headache comes on suddenly and is explosive or violent. Your headache is \"the worst ever,\" even if you regularly get headaches. You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache. Your headache gets worse over 24 hours. You also have fever, stiff neck, nausea, and vomiting with your headache. Your headache occurs with a head injury. Your headache is severe and just in one eye, with redness in that eye. You just started getting headaches, especially if your are older than 50. You have headaches along with vision problems and pain while chewing, or weight loss. You have a history of cancer and develop a new headache. Your immune system is weakened by disease (such as HIV infection) or by medicines (such as chemotherapy drugs and steroids). See your provider soon if: Your headaches wake you up from sleep. A headache lasts more than a few days. Headaches are worse in the morning. You have a history of headaches but they have changed in pattern or intensity . You have headaches often and there is no known cause. Review Date 11/22/2017 Updated by: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery at Providence Medical Center, Medford OR; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Maxillofacial Surgery at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Some headaches can be dangerous, if they are related to problems with blood vessels and bleeding in the brain. These types of headaches may be caused by abnormal connection between the arteries and veins in the brain that usually forms before birth. Other possible causes include a stroke, a brain aneurysm, high blood pressure, or carbon monoxide poisoning.", "role": "assistant" } ]

[ { "content": "How bad can endometriosis get?\n\nEndometriosis (When to Contact a Medical Professional): Call your provider if: - You have symptoms of endometriosis - Back pain or other symptoms reoccurring after endometriosis is treated You may want to get screened for endometriosis if: - Your mother or sister has the disease - You are unable to become pregnant after trying for 1 year", "role": "user" }, { "content": "Contact your doctor if experience back pain after endometriosis is treated. Get screened for endometriosis if your mother or sister has it or if you are unable to become pregnant after trying for 1 year", "role": "assistant" } ]

[ { "content": "how often do you need a pap smear\n\nCervical cancer - screening and prevention (Pap Smears): Cervical cancer usually develops slowly. It starts as precancerous changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear. Dysplasia is fully treatable. That is why it is important for women to get regular Pap smears, so that precancerous cells can be removed before they can become cancer. Pap smear screening should start at age 21. After the first test: - Women ages 21 through 29 should have a Pap smear every 3 years. - Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years. - If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. - Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years. - Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer. Talk with your provider about how often you should have a Pap smear.", "role": "user" }, { "content": "Cervical cancer usually develops slowly. It starts as precancerous changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear. Dysplasia is fully treatable. That is why it is important for women to get regular Pap smears, so that precancerous cells can be removed before they can become cancer. Pap smear screening should start at age 21. After the first test: - Women ages 21 through 29 should have a Pap smear every 3 years. - Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years. - If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. - Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years. - Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer. Talk with your provider about how often you should have a Pap smear.", "role": "assistant" } ]

[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\n Obesity Morbid obesity Fat - obese Summary Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height. Causes Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: Eating more food than your body can use Drinking too much alcohol Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. Many people feel they do not have time to plan and make healthy meals. More people today work desk jobs compared to more active jobs in the past. People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: Underactive thyroid (hypothyroidism) Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: Quitting smoking -- Many people who quit smoking gain 4 to 10 pounds (lb) or 2 to 5 kilograms (kg) in the first 6 months after quitting. Stress, anxiety, feeling sad, or not sleeping well. Menopause -- Women may gain 12 to 15 lb (5.5 to 7 kg) during menopause. Pregnancy -- Women may not lose the weight they gained during pregnancy. Exams and Tests The health care provider will perform a physical exam and ask about your medical history, eating habits, and exercise routine. The two most common ways to assess your weight and measure health risks related to your weight are: Body mass index (BMI) Waist circumference (your waist measurement in inches or centimeters) BMI is calculated using height and weight. You and your provider can use your BMI to estimate how much body fat you have. Your waist measurement is another way to estimate how much body fat you have. Extra weight around your middle or stomach area increases your risk for type 2 diabetes, heart disease, and stroke. People with \"apple-shaped\" bodies (meaning they tend to store fat around their waist and have a slim lower body) also have an increased risk for these diseases. Skin fold measurements may be taken to check your body fat percentage. Blood tests may be done to look for thyroid or hormone problems that could lead to weight gain. Treatment CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop weight slowly and steadily, you are more likely to keep it off. Your dietitian can teach you about: Healthy food choices at home and in restaurants Healthy snacks Reading nutrition labels and healthy grocery shopping New ways to prepare food Portion sizes Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your provider. Many people lose at least 5 lb (2 kg) by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: Arthritis Diabetes Heart disease High blood pressure Sleep apnea Some cancers Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your provider to learn if surgery is a good option for you. Weight-loss surgeries include: Laparoscopic gastric banding Gastric bypass surgery Sleeve gastrectomy Duodenal switch Support Groups Many people find it easier to follow a diet and exercise program if they join a group of people with similar problems. Possible Complications Obesity is a major health threat. The extra weight creates many risks to your health. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1100 calories per day) are not thought to be safe or to work very well. You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch", "role": "assistant" } ]

[ { "content": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks\n\nAbetalipoproteinemia: Abetalipoproteinemia is a condition characterized by the inability to fully absorb dietary fats, cholesterol and fat-soluble vitamins. [1] Signs and symptoms appear in the first few months of life and can include failure to thrive; diarrhea; acanthocytosis; and stool abnormalities. Other features develop later in childhood and often impair the function of the nervous system, potentially causing slower intellectual development; poor muscle coordination; progressive ataxia ; and an eye disorder called retinitis pigmentosa. [1] [2] Most of the symptoms are due to defects in the absorption and transport of vitamin E. [2] Abetalipoproteinemia is caused by mutations in the MTTP gene and is inherited in an autosomal recessive manner. [3] Early diagnosis, high-dose vitamin E therapy, and medium-chain fatty acid supplements may slow the progression of the nervous system abnormalities. Long-term outlook is reasonably good for most affected people who are diagnosed early. If left untreated, the condition can result in early death. [2] The signs and symptoms of abetalipoproteinemia usually appear in the first few months of life. They can include: failure to thrive in infancy digestive symptoms such as diarrhea and steatorrhea (foul-smelling stools) abnormal, star-shaped red blood cells (acanthocytosis) nervous system (neurologic) symptoms beginning in childhood such as slower intellectual development; peripheral neuropathy ; poor muscle coordination; ataxia ; and intention tremors eye (ophthalmologic) symptoms such as decreased night and color vision; retinitis pigmentosa in adolescence; and gradual deterioration of vision, often leading to blindness in the fourth decade of life[1][2] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Malabsorption Very frequent Abnormality of movement Frequent Abnormality of retinal pigmentation Frequent Ataxia Frequent Muscular hypotonia Frequent Visual impairment Occasional Abetalipoproteinemia - Acanthocytosis - Autosomal recessive inheritance - CNS demyelination - Fat malabsorption - Peripheral demyelination - Pigmentary retinal degeneration - Retinopathy - View complete list of signs and symptoms... Abetalipoproteinemia is caused by changes ( mutations ) in the MTTP gene . The MTTP gene gives the body instructions to make a protein needed for creating beta-lipoproteins. These lipoproteins are necessary for the body to absorb fats, cholesterol, and fat-soluble vitamins (vitamins A, D, E and K), and for transporting these substances in the blood. Mutations in the MTTP result in a lack of beta-lipoproteins, leading to an inability to absorb and transport these substances. This in turn leads to the nutritional and neurologic problems in affected people. [1] Abetalipoproteinemia is inherited in an  autosomal recessive  manner. [4] This means that to be affected, a person must have a  mutation  in both copies of the responsible  gene  in each cell . Affected people inherit one mutated copy of the gene from each parent, who is referred to as a  carrier . Carriers of an autosomal recessive condition typically do not have any signs or symptoms (they are unaffected). When 2 carriers of an autosomal recessive condition have children, each child has a: 25% (1 in 4) chance to be affected 50% (1 in 2) chance to be an unaffected carrier like each parent 25% chance to be unaffected and not be a carrier The Genetic Testing Registry (GTR) provides information about the genetic tests available for abetalipoproteinemia. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Prenatal testing may be available for pregnancies at increased risk if the mutations in the family have been identified. A nutritionist or other qualified medical professional should be consulted for specific dietary instruction in people with abetalipoproteinemia. Treatment involves very large doses of vitamin E, as well as large doses of vitamin supplements containing other fat-soluble vitamins (vitamin A, vitamin D, and vitamin K). Linoleic acid supplements are also recommended. [3] [2] Several diet changes and/or restrictions are also needed to prevent stomach problems. A low-fat diet may help with digestive symptoms; medium chain triglycerides may be used (under supervision of a specialist) as a source of fat in the diet. [3] Management in adults typically focuses on specific complications associated with the disorder, and depends on the signs and symptoms present. Affected people may need consultations with several other types of specialists, including a lipidologist, gastroenterologist , hepatologist , ophthalmologist , and neurologist . [2] The long-term outlook ( prognosis ) is reasonably good for most people who are diagnosed and treated early. [2] However, how well each person does depends on the amount of brain and nervous system problems. [3] Therefore, the prognosis can vary. [5] People with prolonged vitamin deficiency, especially of vitamin E, may develop very limiting ataxia and gait disturbances. Some people may develop retinal degeneration and blindness. [2] The following diseases are related to Abetalipoproteinemia. If you have a question about any of these diseases, you can contact GARD. Familial hypobetalipoproteinemia", "role": "user" }, { "content": "Treatment involves very large doses of vitamin E, as well as large doses of vitamin supplements containing other fat-soluble vitamins (vitamin A, vitamin D, and vitamin K). Linoleic acid supplements are also recommended. Several diet changes and/or restrictions are also needed to prevent stomach problems. A low-fat diet may help with digestive symptoms; medium chain triglycerides may be used (under supervision of a specialist) as a source of fat in the diet. Management in adults typically focuses on specific complications associated with the disorder, and depends on the signs and symptoms present. Affected people may need consultations with several other types of specialists, including a lipidologist, gastroenterologist , hepatologist , ophthalmologist , and neurologist .", "role": "assistant" } ]

[ { "content": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?\n\nWhat are the treatments for Generalized anxiety disorder - self-care?: Taking medicine and going to talk therapy can get you started on the road to feeling better. It can also help you take care of your body and relationships. To help improve your condition: - Get enough sleep. - Eat healthy foods. - Keep a regular daily schedule. - Get out of the house every day. - Exercise every day. Even a little bit of exercise, such as a 15-minute walk, can help. - Stay away from alcohol and street drugs. - Talk with family or friends when you feel nervous or frightened. - Find out about different types of group activities you can join.", "role": "user" }, { "content": "Generalized anxiety disorder may be helped by talk therapy, medications, and better care for your body and relationships. It is important to get enough sleep, eat right, keep regular daily schedule, exercise and get out of the house every day, and stay away from alcohol and street drugs. Talking with family or friends and joining group activities when you get nervous could be helpful.", "role": "assistant" } ]

[ { "content": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc etc. Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?\n\n Polymicrogyria Summary Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Specifically, the surface of the brain develops too many folds which are unusually small. The signs and symptoms associated with the condition vary based on how much of the brain and which areas of the brain are affected; however, affected people may experience recurrent seizures ( epilepsy ); delayed development; crossed eyes ; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms (affecting both sides of the brain) tend to cause more severe neurological problems. Polymicrogyria can result from both genetic and environmental causes. It may occur as an isolated finding or as part of a syndrome . Treatment is based on the signs and symptoms present in each person. [1] [2] Symptoms A wide variety of symptoms may be observed in people with polymicrogyria, depending on the areas of the brain implicated and whether or not it is part of a larger syndrome . Signs and symptoms may include: [3] [4] Developmental delay Crossed eyes Epilepsy Paralysis of the face, throat, and tongue Difficulty with speech and swallowing Drooling Diagnosis The diagnosis of polymicrogyria is made by imaging brain structures using MRI . Typical findings include areas of the cerebral cortex with a complex set of small gyri that appear fused to each other and separated by shallow sulci. These findings may be isolated to one side of the brain (unilateral) or may involve both sides of the brain (bilateral). [3] [4] ", "role": "user" }, { "content": "Polymicrogyria is a condition characterized by abnormal development of the brain before birth. The signs and symptoms associated with the condition vary based on how much of the brain and which areas of the brain are affected; however, affected people may experience recurrent seizures ( epilepsy ); delayed development; crossed eyes ; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms (affecting both sides of the brain) tend to cause more severe neurological problems.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\n Anal fissure Overview An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter). Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery. Symptoms Signs and symptoms of an anal fissure include: - Pain, sometimes severe, during bowel movements - Pain after bowel movements that can last up to several hours - Bright red blood on the stool or toilet paper after a bowel movement - Itching or irritation around the anus - A visible crack in the skin around the anus - A small lump or skin tag on the skin near the anal fissure When to see a doctor See your doctor if you have pain during bowel movements or notice blood on stools or toilet paper after a bowel movement. Causes Common causes of anal fissure include: - Passing large or hard stools - Constipation and straining during bowel movements - Chronic diarrhea - Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease - Childbirth Less common causes of anal fissures include: - Anal cancer - HIV - Tuberculosis - Syphilis - Herpes Risk factors Factors that may increase your risk of developing an anal fissure include: - Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why. - Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area. - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing. - Childbirth. Anal fissures are more common in women after they give birth. - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing. - Anal intercourse. Complications Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. Diagnosis If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has the tear, as well as two separate lumps or tags of skin, one internal (sentinel pile) and one external (hypertrophied papilla). The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition: - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer. - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea. Treatment Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Lifestyle and home remedies Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences: - Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually. - Drink adequate fluids. Fluids help prevent constipation. - Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. - Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your child's doctor. ", "role": "user" }, { "content": "An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. ... Once you've experienced an anal fissure, you are prone to having another one. .. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure.", "role": "assistant" } ]

[ { "content": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?\n\nHow to prevent Dengue fever?: Clothing, mosquito repellent, and netting can help reduce the risk of mosquito bites that can spread dengue fever and other infections. Limit outdoor activity during mosquito season, especially when they are most active, at dawn and dusk.", "role": "user" }, { "content": "Clothing, mosquito repellent, and netting can help reduce the risk of mosquito bites that can spread dengue fever. Limit outdoor activity during mosquito season, especially when they are most active, at dawn and dusk.", "role": "assistant" } ]

[ { "content": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?\n\n Frozen shoulder Adhesive capsulitis Shoulder pain - frozen Summary Frozen shoulder is a condition in which the shoulder is painful and loses motion because of inflammation. Causes The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: Diabetes Thyroid problems Changes in your hormones, such as during menopause Shoulder injury Shoulder surgery Open heart surgery Cervical disk disease of the neck Women 40 to 70 years old are most affected Symptoms Main symptoms of a frozen shoulder are: Decreased motion of the shoulder Pain Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. Exams and Tests Your health care provider will ask about your symptoms and examine your shoulder. A diagnosis is often made when you are not able to rotate your shoulder. You may have x-rays of the shoulder. This is to make sure there is no other problem, such as arthritis or calcium deposits. Sometimes, an MRI exam shows inflammation, but these types of imaging tests are not needed to diagnose frozen shoulder. Treatment Pain is treated with NSAIDs and steroid injections. Steroid injections and physical therapy can improve your motion. It can take a few weeks to see progress. It may take as long as 6 to 9 months for complete recovery. Physical therapy is intense and needs to be done every day. Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated. Surgery is recommended if nonsurgical treatment is not effective. This procedure (shoulder arthroscopy) is done under anesthesia. During surgery the scar tissue is released (cut) by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks (shots) so you can do physical therapy. Follow instructions on caring for your shoulder at home. Outlook (Prognosis) Treatment with physical therapy and NSAIDs often restores motion and function of the shoulder within a year. Even untreated, the shoulder may get better by itself in 2 years. After surgery restores motion, you must continue physical therapy for several weeks or months. This is to prevent the frozen shoulder from returning. If you do not keep up with physical therapy, the frozen shoulder may come back. Possible Complications Complications may include: Stiffness and pain continue even with therapy The arm can break if the shoulder is moved forcefully during surgery When to Contact a Medical Professional If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your provider for referral and treatment. Prevention Early treatment may help prevent stiffness. Call your provider if you develop shoulder pain that limits your range of motion for an extended period. People who have diabetes or thyroid problems will be less likely to get frozen shoulder if they keep their condition under control. Review Date 11/27/2016 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck - Women 40 to 70 years old are most affected Main symptoms of a frozen shoulder are: - Decreased motion of the shoulder - Pain - Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. ... Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated.", "role": "assistant" } ]

[ { "content": "how do you get pulmonary hypertension\n\n Pulmonary Hypertension What Is... Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity. Overview To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum. Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen. The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich blood from your lungs. The blood is then pumped into the lower left chamber of your heart, the left ventricle. From the left ventricle, the blood is pumped to the rest of your body through an artery called the aorta. For more information about the heart and lungs, go to the Diseases and Conditions Index How the Heart Works and How the Lungs Work articles. PH begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. As a result, the pressure in your arteries rises. Also, because your heart is working harder than normal, your right ventricle becomes strained and weak. Your heart may become so weak that it can't pump enough blood to your lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH. PH is divided into five groups based on its causes. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Other diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition (that is, their parents pass the genes for PH on to them). In some cases, the cause isn't known. Outlook PH has no cure. However, research for new treatments is ongoing. The earlier PH is treated, the easier it is to control. Treatments include medicines, procedures, and other therapies. These treatments can relieve PH symptoms and slow the progress of the disease. Lifestyle changes also can help control symptoms. Types The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease. Other Names Group 1 pulmonary arterial hypertension (PAH) that occurs without a known cause often is called primary PAH or idiopathic (id-ee-o-PATH-ick) PAH. Group 1 PAH that occurs with a known cause often is called associated PAH. For example, PAH that occurs in a person who has scleroderma might be called \"PAH occurring in association with scleroderma,\" or simply \"scleroderma-associated PAH.\" Groups 2–5 pulmonary hypertension (PH) sometimes are called secondary PH. Causes Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\" Who Is at Risk The exact number of people who have pulmonary hypertension (PH) isn't known. Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight. PH that occurs with another disease or condition is more common. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include: Those who have a family history of the condition. Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to \"Types of Pulmonary Hypertension.\") Those who use street drugs (such as cocaine) or certain diet medicines. Those who live at high altitudes. Signs & Symptoms Signs and symptoms of pulmonary hypertension (PH) may include: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin Diagnosis Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the condition has no early signs or symptoms. When symptoms do occur, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose. Medical and Family Histories Your doctor may ask about your signs and symptoms and how and when they began. He or she also may ask whether you have other medical conditions that can cause PH. Your doctor will want to know whether you have any family members who have or have had PH. People who have a family history of PH are at higher risk for the condition. Physical Exam During the physical exam, your doctor will listen to your heart and lungs with a stethoscope. He or she also will check your ankles and legs for swelling and your lips and skin for a bluish color. These are signs of PH. Diagnostic Tests and Procedures Your doctor may recommend tests and procedures to confirm a diagnosis of PH and to look for its underlying cause. Your doctor also will use test results to find out the severity of your PH. Tests and Procedures To Confirm a Diagnosis Echocardiography. Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, uses sound waves to create a moving picture of your heart. This test can estimate the pressure in your pulmonary arteries. Echo also can show the size and thickness of your right ventricle and how well it's working. Chest x ray. A chest x ray takes pictures of the structures in your chest, such as your heart, lungs, and blood vessels. This test can show whether your pulmonary arteries and right ventricle are enlarged. The pulmonary arteries and right ventricle may get larger if the right ventricle has to work hard to pump blood through the pulmonary arteries. A chest x ray also may show signs of an underlying lung disease that's causing or contributing to PH. EKG (electrocardiogram). An EKG is a simple, painless test that records the heart's electrical activity. This test also shows whether your heart's rhythm is steady or irregular. An EKG may show whether your right ventricle is enlarged or strained. Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization (KATH-e-ter-ih-ZA-shun) can find any leaks between the left and right side of the heart. During this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your groin (upper thigh) or neck. The tube is threaded into the right side of your heart and into the pulmonary arteries. Through the tube, your doctor can do tests and treatments on your heart. Tests To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause. Chest CT scan. A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. These pictures can show signs of PH or a condition that may be causing PH. Chest MRI. Chest magnetic resonance imaging, or chest MRI, shows how your right ventricle is working. The test also shows blood flow in your lungs. Chest MRI also can help detect signs of PH or an underlying condition causing PH. Lung function tests. Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can help detect a lung disease that may be causing PH. Polysomnogram (PSG). This test records brain activity, eye movements, heart rate, and blood pressure while you sleep. A PSG also measures the level of oxygen in your blood. A low oxygen level during sleep is common in PH, and it can make the condition worse. A PSG usually is done while you stay overnight at a sleep center. For more information about this test, go to the Diseases and Conditions Index Sleep Studies article. Lung ventilation/perfusion (VQ) scan. A lung VQ scan measures air and blood flow in your lungs. This test can help detect blood clots in your lung's blood vessels. Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases (such as rheumatoid arthritis). Finding Out the Severity of Pulmonary Hypertension Exercise testing is used to find out the severity of PH. This testing consists of either a 6-minute walk test or a cardiopulmonary exercise test. A 6-minute walk test measures the distance you can quickly walk in 6 minutes. A cardiopulmonary exercise test measures how well your lungs and heart work while you exercise on a treadmill or bicycle. During exercise testing, your doctor will rate your activity level. Your level is linked to the severity of your PH. The rating system ranges from class 1 to class 4. Class 1 has no limits. You can do regular physical activities, such as walking or climbing stairs. These activities don't cause PH symptoms, such as tiredness, shortness of breath, or chest pain. Class 2 has slight or mild limits. You're comfortable while resting, but regular physical activity causes PH symptoms. Class 3 has marked or noticeable limits. You're comfortable while resting. However, walking even one or two blocks or climbing one flight of stairs can cause PH symptoms. Class 4 has severe limits. You're not able to do any physical activity without discomfort. You also may have PH symptoms while at rest. Over time, you may need more exercise tests to find out how well your treatments are working. Each time testing is done, your doctor will compare your activity level with the previous one. Treatment Pulmonary hypertension (PH) has no cure. However, treatment may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and its severity. (For more information, go to \"Types of Pulmonary Hypertension.\") Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH that's inherited, that has no known cause, or that's caused by certain drugs or conditions. Treatments for group 1 PAH include medicines and medical procedures. Medicines Your doctor may prescribe medicines to relax the blood vessels in your lungs and reduce excess cell growth in the blood vessels. As the blood vessels relax, more blood can flow through them. Your doctor may prescribe medicines that are taken by mouth, inhaled, or injected. Examples of medicines for group 1 PAH include: Phosphodiesterase-5 inhibitors, such as sildenafil Prostanoids, such as epoprostenol Endothelin receptor antagonists, such as bosentan and ambrisentan Calcium channel blockers, such as diltiazem Your doctor may prescribe one or more of these medicines. To find out which of these medicines works best, you'll likely have an acute vasoreactivity test. This test shows how the pressure in your pulmonary arteries reacts to certain medicines. The test is done during right heart catheterization. Medical and Surgical Procedures If you have group 1 PAH, your doctor may recommend one or more of the following procedures. Atrial septostomy (sep-TOS-toe-me). For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your leg and threaded to your heart. The tube is then put through the wall that separates your right and left atria (the upper chambers of your heart). This wall is called the septum. A tiny balloon on the tip of the tube is inflated. This creates an opening between the atria. This procedure relieves the pressure in the right atria and increases blood flow. Atrial septostomy is rarely done in the United States. Lung transplant. A lung transplant is surgery to replace a person's diseased lung with a healthy lung from a deceased donor. This procedure may be used for people who have severe lung disease that's causing PAH. Heart–lung transplant. A heart–lung transplant is surgery in which both the heart and lung are replaced with healthy organs from a deceased donor. Group 2 Pulmonary Hypertension Conditions that affect the left side of the heart, such as mitral valve disease, can cause group 2 PH. Treating the underlying condition will help treat PH. Treatments may include lifestyle changes, medicines, and surgery. Group 3 Pulmonary Hypertension Lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial lung disease, can cause group 3 PH. Certain sleep disorders, such as sleep apnea, also can cause group 3 PH. If you have this type of PH, you may need oxygen therapy. This treatment raises the level of oxygen in your blood. You'll likely get the oxygen through soft, plastic prongs that fit into your nose. Oxygen therapy can be done at home or in a hospital. Your doctor also may recommend other treatments if you have an underlying lung disease. Group 4 Pulmonary Hypertension Blood clots in the lungs or blood clotting disorders can cause group 4 PH. If you have this type of PH, your doctor will likely prescribe blood-thinning medicines. These medicines prevent clots from forming or getting larger. Sometimes doctors use surgery to remove scarring in the pulmonary arteries due to old blood clots. Group 5 Pulmonary Hypertension Various diseases and conditions, such as thyroid disease and sarcoidosis, can cause group 5 PH. An object, such as a tumor, pressing on the pulmonary arteries also can cause group 5 PH. Group 5 PH is treated by treating its cause. All Types of Pulmonary Hypertension Several treatments may be used for all types of PH. These treatments include: Diuretics, also called water pills. These medicines help reduce fluid buildup in your body, including swelling in your ankles and feet. Blood-thinning medicines. These medicines help prevent blood clots from forming or getting larger. Digoxin. This medicine helps the heart beat stronger and pump more blood. Digoxin sometimes is used to control the heart rate if abnormal heart rhythms, such as atrial fibrillation or atrial flutter, occur. Oxygen therapy. This treatment raises the level of oxygen in your blood. Physical activity. Regular activity may help improve your ability to be active. Talk with your doctor about a physical activity plan that's safe for you. Research is ongoing for better PH treatments. These treatments offer hope for the future. Living With Pulmonary hypertension (PH) has no cure. However, you can work with your doctor to manage your symptoms and slow the progress of the disease. Ongoing Care Follow your treatment plan as your doctor advises. Call your doctor if your PH symptoms worsen or change. The earlier symptoms are addressed, the easier it is to treat them. Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care. Also, talk with your doctor before taking any over-the-counter medicines. Some medicines can make your PH worse or interfere with the medicines you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot. You may have a complex schedule for taking medicines. Call your doctor or nurse if you're having problems with this schedule. Knowing the names of your medicines and how they work is helpful. Keep a list of your medicines with you. Don't stop or change medicines unless you talk with your doctor first. Pay careful attention to your weight. You may want to keep a daily record of your weight. You should weigh yourself at the same time each day. If you notice a rapid weight gain (2 or more pounds in 1 day or 5 or more pounds in 1 week), call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky for women who have PH. Consider using birth control if there is a chance you may become pregnant. Ask your doctor which birth control methods are safe for you. Lifestyle Changes Making lifestyle changes can help you manage your symptoms. These changes will depend on the type of PH you have. Talk with your doctor about which lifestyle changes can help you. Quit Smoking If you smoke, quit. Smoking makes PH symptoms worse. Ask your doctor about programs and products that can help you quit. Also, avoid exposure to secondhand smoke. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) \"Your Guide to a Healthy Heart.\" Although these resources focus on heart health, they both include general information about how to quit smoking. Follow a Healthy Diet Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, \"Your Guide to a Healthy Heart,\" and \"Your Guide to Lowering Your Blood Pressure With DASH.\" All of these resources include general advice about healthy eating. The DASH eating plan focuses on reduced-sodium foods, which may be helpful if your doctor advises you to limit the salt in your diet. Be Physically Active Physical activity is an important part of a healthy lifestyle. Try to do physical activity, such as walking, regularly. This will keep your muscles strong and help you stay active. Ask your doctor how much activity is safe for you. Your doctor may tell you to limit or avoid certain activities, such as: Those that cause straining, such as lifting heavy objects or weights. Sitting in a hot tub or sauna or taking long baths. These activities can lower your blood pressure too much. Flying in an airplane or traveling to high-altitude areas. Your doctor may ask you to use extra oxygen during air travel. Avoid activities that cause breathing problems, dizziness, or chest pain. If you have any of these symptoms, seek care right away. Emotional Issues and Support Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. ", "role": "user" }, { "content": "Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. These changes make it more difficult for your heart to push blood through your pulmonary arteries. This causes the pressure in your arteries to rise, causing PH.", "role": "assistant" } ]

[ { "content": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.\n\n Breath odor Bad breath Halitosis Malodor Summary Breath odor is the scent of the air you breathe out of your mouth. Unpleasant breath odor is commonly called bad breath. Considerations Bad breath is usually related to poor dental hygiene. Not brushing and flossing regularly causes sulfur compounds to be released by bacteria in the mouth. Some disorders will produce distinct breath odors. Some examples are: A fruity odor to the breath is a sign of ketoacidosis, which may occur in diabetes. It is a potentially life-threatening condition. Breath that smells like feces can occur with prolonged vomiting, especially when there is a bowel obstruction. It may also occur temporarily if a person has a tube placed through the nose or mouth to drain their stomach. The breath may have an ammonia-like odor (also described as urine-like or \"fishy\") in people with chronic kidney failure. Causes Bad breath may be caused by: Abscessed tooth Gum surgery Alcoholism Cavities Dentures Eating certain foods, such as cabbage, garlic, or raw onions Coffee and poorly pH-balanced diet Object stuck in the nose (usually happens in kids); often a white, yellow, or bloody discharge from one nostril Gum disease (gingivitis, gingivostomatitis, ANUG) Impacted tooth Poor dental hygiene Tonsils with deep crypts and sulfur granules Sinus infection Throat infection Tobacco smoking Vitamin supplements (especially in large doses) Some medicines, including insulin shots, triamterene, and paraldehyde Some diseases that may cause breath odor are: Acute necrotizing ulcerative gingivitis (ANUG) Acute necrotizing ulcerative mucositis Gastroesophageal reflux disease (GERD) Acute renal failure Bowel obstruction Bronchiectasis Chronic kidney failure Esophageal cancer Gastric carcinoma Gastrojejunocolic fistula Hepatic encephalopathy Diabetic ketoacidosis Lung infection or abscess Ozena, or atrophic rhinitis Periodontal disease Pharyngitis Zenker diverticulum Home Care Use proper dental hygiene, especially flossing. Remember that mouthwashes are not effective in treating the underlying problem. Fresh parsley or a strong mint is often an effective way to fight temporary bad breath. Avoid smoking. Otherwise, follow your health care provider's instructions to treat any underlying cause of bad breath. When to Contact a Medical Professional Contact your provider if: Breath odor does not go away and there is not an obvious cause (such as smoking or eating foods that cause the odor). You have breath odor and signs of a respiratory infection, such as fever, cough, or face pain with discharge from your nose. What to Expect at Your Office Visit Your provider will take a medical history and perform a physical exam. You may be asked the following medical history questions: Is there a specific odor (such as fish, ammonia, fruit, feces, or alcohol)? Have you recently eaten a spicy meal, garlic, cabbage, or other \"odorous\" food? Do you take vitamin supplements? Do you smoke? What home care and oral hygiene measures have you tried? How effective are they? Have you had a recent sore throat, sinus infection, tooth abscess, or other illness? What other symptoms do you have? The physical exam will include a thorough inspection of your mouth and nose. A throat culture may be taken if you have a sore throat or mouth sores. In rare cases, tests that may be performed include: Blood tests to screen for diabetes or kidney failure Endoscopy (EGD) X-ray of the abdomen X-ray of the chest Antibiotics may be prescribed for some conditions. For an object in the nose, your provider will use an instrument to remove it. Review Date 2/5/2018 Updated by: Ilona Fotek, DMD, MS, Dental Healing Arts, Jupiter, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Bad breath could be caused by poor oral hygiene, dental and gastroesophageal diseases, infections, smoking, alcoholism, and certain foods.", "role": "assistant" } ]

[ { "content": "how do you get pulmonary hypertension\n\n Pulmonary Hypertension What Is... Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity. Overview To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum. Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen. The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich blood from your lungs. The blood is then pumped into the lower left chamber of your heart, the left ventricle. From the left ventricle, the blood is pumped to the rest of your body through an artery called the aorta. For more information about the heart and lungs, go to the Diseases and Conditions Index How the Heart Works and How the Lungs Work articles. PH begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. As a result, the pressure in your arteries rises. Also, because your heart is working harder than normal, your right ventricle becomes strained and weak. Your heart may become so weak that it can't pump enough blood to your lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH. PH is divided into five groups based on its causes. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Other diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition (that is, their parents pass the genes for PH on to them). In some cases, the cause isn't known. Outlook PH has no cure. However, research for new treatments is ongoing. The earlier PH is treated, the easier it is to control. Treatments include medicines, procedures, and other therapies. These treatments can relieve PH symptoms and slow the progress of the disease. Lifestyle changes also can help control symptoms. Types The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease. Other Names Group 1 pulmonary arterial hypertension (PAH) that occurs without a known cause often is called primary PAH or idiopathic (id-ee-o-PATH-ick) PAH. Group 1 PAH that occurs with a known cause often is called associated PAH. For example, PAH that occurs in a person who has scleroderma might be called \"PAH occurring in association with scleroderma,\" or simply \"scleroderma-associated PAH.\" Groups 2–5 pulmonary hypertension (PH) sometimes are called secondary PH. Causes Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\" Who Is at Risk The exact number of people who have pulmonary hypertension (PH) isn't known. Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight. PH that occurs with another disease or condition is more common. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include: Those who have a family history of the condition. Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to \"Types of Pulmonary Hypertension.\") Those who use street drugs (such as cocaine) or certain diet medicines. Those who live at high altitudes. Signs & Symptoms Signs and symptoms of pulmonary hypertension (PH) may include: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin Diagnosis Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the condition has no early signs or symptoms. When symptoms do occur, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose. Medical and Family Histories Your doctor may ask about your signs and symptoms and how and when they began. He or she also may ask whether you have other medical conditions that can cause PH. Your doctor will want to know whether you have any family members who have or have had PH. People who have a family history of PH are at higher risk for the condition. Physical Exam During the physical exam, your doctor will listen to your heart and lungs with a stethoscope. He or she also will check your ankles and legs for swelling and your lips and skin for a bluish color. These are signs of PH. Diagnostic Tests and Procedures Your doctor may recommend tests and procedures to confirm a diagnosis of PH and to look for its underlying cause. Your doctor also will use test results to find out the severity of your PH. Tests and Procedures To Confirm a Diagnosis Echocardiography. Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, uses sound waves to create a moving picture of your heart. This test can estimate the pressure in your pulmonary arteries. Echo also can show the size and thickness of your right ventricle and how well it's working. Chest x ray. A chest x ray takes pictures of the structures in your chest, such as your heart, lungs, and blood vessels. This test can show whether your pulmonary arteries and right ventricle are enlarged. The pulmonary arteries and right ventricle may get larger if the right ventricle has to work hard to pump blood through the pulmonary arteries. A chest x ray also may show signs of an underlying lung disease that's causing or contributing to PH. EKG (electrocardiogram). An EKG is a simple, painless test that records the heart's electrical activity. This test also shows whether your heart's rhythm is steady or irregular. An EKG may show whether your right ventricle is enlarged or strained. Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization (KATH-e-ter-ih-ZA-shun) can find any leaks between the left and right side of the heart. During this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your groin (upper thigh) or neck. The tube is threaded into the right side of your heart and into the pulmonary arteries. Through the tube, your doctor can do tests and treatments on your heart. Tests To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause. Chest CT scan. A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. These pictures can show signs of PH or a condition that may be causing PH. Chest MRI. Chest magnetic resonance imaging, or chest MRI, shows how your right ventricle is working. The test also shows blood flow in your lungs. Chest MRI also can help detect signs of PH or an underlying condition causing PH. Lung function tests. Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can help detect a lung disease that may be causing PH. Polysomnogram (PSG). This test records brain activity, eye movements, heart rate, and blood pressure while you sleep. A PSG also measures the level of oxygen in your blood. A low oxygen level during sleep is common in PH, and it can make the condition worse. A PSG usually is done while you stay overnight at a sleep center. For more information about this test, go to the Diseases and Conditions Index Sleep Studies article. Lung ventilation/perfusion (VQ) scan. A lung VQ scan measures air and blood flow in your lungs. This test can help detect blood clots in your lung's blood vessels. Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases (such as rheumatoid arthritis). Finding Out the Severity of Pulmonary Hypertension Exercise testing is used to find out the severity of PH. This testing consists of either a 6-minute walk test or a cardiopulmonary exercise test. A 6-minute walk test measures the distance you can quickly walk in 6 minutes. A cardiopulmonary exercise test measures how well your lungs and heart work while you exercise on a treadmill or bicycle. During exercise testing, your doctor will rate your activity level. Your level is linked to the severity of your PH. The rating system ranges from class 1 to class 4. Class 1 has no limits. You can do regular physical activities, such as walking or climbing stairs. These activities don't cause PH symptoms, such as tiredness, shortness of breath, or chest pain. Class 2 has slight or mild limits. You're comfortable while resting, but regular physical activity causes PH symptoms. Class 3 has marked or noticeable limits. You're comfortable while resting. However, walking even one or two blocks or climbing one flight of stairs can cause PH symptoms. Class 4 has severe limits. You're not able to do any physical activity without discomfort. You also may have PH symptoms while at rest. Over time, you may need more exercise tests to find out how well your treatments are working. Each time testing is done, your doctor will compare your activity level with the previous one. Treatment Pulmonary hypertension (PH) has no cure. However, treatment may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and its severity. (For more information, go to \"Types of Pulmonary Hypertension.\") Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH that's inherited, that has no known cause, or that's caused by certain drugs or conditions. Treatments for group 1 PAH include medicines and medical procedures. Medicines Your doctor may prescribe medicines to relax the blood vessels in your lungs and reduce excess cell growth in the blood vessels. As the blood vessels relax, more blood can flow through them. Your doctor may prescribe medicines that are taken by mouth, inhaled, or injected. Examples of medicines for group 1 PAH include: Phosphodiesterase-5 inhibitors, such as sildenafil Prostanoids, such as epoprostenol Endothelin receptor antagonists, such as bosentan and ambrisentan Calcium channel blockers, such as diltiazem Your doctor may prescribe one or more of these medicines. To find out which of these medicines works best, you'll likely have an acute vasoreactivity test. This test shows how the pressure in your pulmonary arteries reacts to certain medicines. The test is done during right heart catheterization. Medical and Surgical Procedures If you have group 1 PAH, your doctor may recommend one or more of the following procedures. Atrial septostomy (sep-TOS-toe-me). For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your leg and threaded to your heart. The tube is then put through the wall that separates your right and left atria (the upper chambers of your heart). This wall is called the septum. A tiny balloon on the tip of the tube is inflated. This creates an opening between the atria. This procedure relieves the pressure in the right atria and increases blood flow. Atrial septostomy is rarely done in the United States. Lung transplant. A lung transplant is surgery to replace a person's diseased lung with a healthy lung from a deceased donor. This procedure may be used for people who have severe lung disease that's causing PAH. Heart–lung transplant. A heart–lung transplant is surgery in which both the heart and lung are replaced with healthy organs from a deceased donor. Group 2 Pulmonary Hypertension Conditions that affect the left side of the heart, such as mitral valve disease, can cause group 2 PH. Treating the underlying condition will help treat PH. Treatments may include lifestyle changes, medicines, and surgery. Group 3 Pulmonary Hypertension Lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial lung disease, can cause group 3 PH. Certain sleep disorders, such as sleep apnea, also can cause group 3 PH. If you have this type of PH, you may need oxygen therapy. This treatment raises the level of oxygen in your blood. You'll likely get the oxygen through soft, plastic prongs that fit into your nose. Oxygen therapy can be done at home or in a hospital. Your doctor also may recommend other treatments if you have an underlying lung disease. Group 4 Pulmonary Hypertension Blood clots in the lungs or blood clotting disorders can cause group 4 PH. If you have this type of PH, your doctor will likely prescribe blood-thinning medicines. These medicines prevent clots from forming or getting larger. Sometimes doctors use surgery to remove scarring in the pulmonary arteries due to old blood clots. Group 5 Pulmonary Hypertension Various diseases and conditions, such as thyroid disease and sarcoidosis, can cause group 5 PH. An object, such as a tumor, pressing on the pulmonary arteries also can cause group 5 PH. Group 5 PH is treated by treating its cause. All Types of Pulmonary Hypertension Several treatments may be used for all types of PH. These treatments include: Diuretics, also called water pills. These medicines help reduce fluid buildup in your body, including swelling in your ankles and feet. Blood-thinning medicines. These medicines help prevent blood clots from forming or getting larger. Digoxin. This medicine helps the heart beat stronger and pump more blood. Digoxin sometimes is used to control the heart rate if abnormal heart rhythms, such as atrial fibrillation or atrial flutter, occur. Oxygen therapy. This treatment raises the level of oxygen in your blood. Physical activity. Regular activity may help improve your ability to be active. Talk with your doctor about a physical activity plan that's safe for you. Research is ongoing for better PH treatments. These treatments offer hope for the future. Living With Pulmonary hypertension (PH) has no cure. However, you can work with your doctor to manage your symptoms and slow the progress of the disease. Ongoing Care Follow your treatment plan as your doctor advises. Call your doctor if your PH symptoms worsen or change. The earlier symptoms are addressed, the easier it is to treat them. Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care. Also, talk with your doctor before taking any over-the-counter medicines. Some medicines can make your PH worse or interfere with the medicines you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot. You may have a complex schedule for taking medicines. Call your doctor or nurse if you're having problems with this schedule. Knowing the names of your medicines and how they work is helpful. Keep a list of your medicines with you. Don't stop or change medicines unless you talk with your doctor first. Pay careful attention to your weight. You may want to keep a daily record of your weight. You should weigh yourself at the same time each day. If you notice a rapid weight gain (2 or more pounds in 1 day or 5 or more pounds in 1 week), call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky for women who have PH. Consider using birth control if there is a chance you may become pregnant. Ask your doctor which birth control methods are safe for you. Lifestyle Changes Making lifestyle changes can help you manage your symptoms. These changes will depend on the type of PH you have. Talk with your doctor about which lifestyle changes can help you. Quit Smoking If you smoke, quit. Smoking makes PH symptoms worse. Ask your doctor about programs and products that can help you quit. Also, avoid exposure to secondhand smoke. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) \"Your Guide to a Healthy Heart.\" Although these resources focus on heart health, they both include general information about how to quit smoking. Follow a Healthy Diet Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, \"Your Guide to a Healthy Heart,\" and \"Your Guide to Lowering Your Blood Pressure With DASH.\" All of these resources include general advice about healthy eating. The DASH eating plan focuses on reduced-sodium foods, which may be helpful if your doctor advises you to limit the salt in your diet. Be Physically Active Physical activity is an important part of a healthy lifestyle. Try to do physical activity, such as walking, regularly. This will keep your muscles strong and help you stay active. Ask your doctor how much activity is safe for you. Your doctor may tell you to limit or avoid certain activities, such as: Those that cause straining, such as lifting heavy objects or weights. Sitting in a hot tub or sauna or taking long baths. These activities can lower your blood pressure too much. Flying in an airplane or traveling to high-altitude areas. Your doctor may ask you to use extra oxygen during air travel. Avoid activities that cause breathing problems, dizziness, or chest pain. If you have any of these symptoms, seek care right away. Emotional Issues and Support Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. ", "role": "user" }, { "content": "Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH.", "role": "assistant" } ]

[ { "content": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?\n\nLeukemia (Treatment): Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system. Common treatments used to fight leukemia include: - Chemotherapy. Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein. - Biological therapy. Biological therapy works by using treatments that help your immune system recognize and attack leukemia cells. - Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease. - Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body. You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a stem cell transplant. - Stem cell transplant. A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow. Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow. You may receive stem cells from a donor, or in some cases you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant.", "role": "user" }, { "content": "Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system. Common treatments used to fight leukemia include: - Chemotherapy. ... Biological therapy. Biological therapy works by using treatments that help your immune system recognize and attack leukemia cells. - Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. Radiation therapy.", "role": "assistant" } ]

[ { "content": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...\n\nWhat are the treatments for limb-girdle muscular dystrophy?: These resources address the diagnosis or management of limb-girdle muscular dystrophy: - Cleveland Clinic - Gene Review: Gene Review: Limb-Girdle Muscular Dystrophy Overview - Genetic Testing Registry: Limb-girdle muscular dystrophy - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1A - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1B - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1C - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1E - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1F - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1G - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1H - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2A - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2B - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2D - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2E - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2F - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2G - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2J - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2L - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C1 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C2 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C3 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C4 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C5 - Johns Hopkins Medicine - LGMD-Diagnosis.org These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care", "role": "user" }, { "content": "resources address the diagnosis or management of limb-girdle muscular dystrophy", "role": "assistant" } ]

[ { "content": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...\n\n Limb-girdle muscular dystrophy LGMD limb-girdle syndrome myopathic limb-girdle syndrome Description Limb-girdle muscular dystrophy is a term for a group of diseases that cause weakness and wasting of the muscles in the arms and legs. The muscles most affected are those closest to the body (proximal muscles), specifically the muscles of the shoulders, upper arms, pelvic area, and thighs. The severity, age of onset, and features of limb-girdle muscle dystrophy vary among the many subtypes of this condition and may be inconsistent even within the same family. Signs and symptoms may first appear at any age and generally worsen with time, although in some cases they remain mild. In the early stages of limb-girdle muscular dystrophy, affected individuals may have an unusual walking gait, such as waddling or walking on the balls of their feet, and may also have difficulty running. They may need to use their arms to press themselves up from a squatting position because of their weak thigh muscles. As the condition progresses, people with limb-girdle muscular dystrophy may eventually require wheelchair assistance. Muscle wasting may cause changes in posture or in the appearance of the shoulder, back, and arm. In particular, weak shoulder muscles tend to make the shoulder blades (scapulae) \"stick out\" from the back, a sign known as scapular winging. Affected individuals may also have an abnormally curved lower back (lordosis) or a spine that curves to the side (scoliosis). Some develop joint stiffness (contractures) that can restrict movement in their hips, knees, ankles, or elbows. Overgrowth (hypertrophy) of the calf muscles occurs in some people with limb-girdle muscular dystrophy. Weakening of the heart muscle (cardiomyopathy) occurs in some forms of limb-girdle muscular dystrophy. Some affected individuals experience mild to severe breathing problems related to the weakness of muscles needed for breathing. In some cases, the breathing problems are severe enough that affected individuals need to use a machine to help them breathe (mechanical ventilation). Intelligence is generally unaffected in limb-girdle muscular dystrophy; however, developmental delay and intellectual disability have been reported in rare forms of the disorder. Frequency It is difficult to determine the prevalence of limb-girdle muscular dystrophy because its features vary and overlap with those of other muscle disorders. Prevalence estimates range from 1 in 14,500 to 1 in 123,000 individuals. Causes The various forms of limb-girdle muscular dystrophy are caused by mutations in many different genes. These genes provide instructions for making proteins that are involved in muscle maintenance and repair. Some of the proteins produced from these genes assemble with other proteins into larger protein complexes. These complexes maintain the physical integrity of muscle tissue and allow the muscles to contract. Other proteins participate in cell signaling, cell membrane repair, or the removal of potentially toxic wastes from muscle cells. Limb-girdle muscular dystrophy is classified based on its inheritance pattern and genetic cause. Limb-girdle muscular dystrophy type 1 includes forms of the disorder that have an inheritance pattern called autosomal dominant. Mutations in the LMNA gene cause limb-girdle muscular dystrophy type 1B. Limb-girdle muscular dystrophy type 1C is one of a group of muscle disorders called caveolinopathies caused by mutations in the CAV3 gene. Limb-girdle muscular dystrophy type 2 includes forms of the disorder that have an inheritance pattern called autosomal recessive. Calpainopathy, or limb-girdle muscular dystrophy type 2A, is caused by mutations in the CAPN3 gene. Type 2A is the most common form of limb-girdle muscular dystrophy, accounting for about 30 percent of cases. Dysferlinopathy, also called limb-girdle muscular dystrophy type 2B, is caused by mutations in the DYSF gene. Sarcoglycanopathies are forms of limb-girdle muscular dystrophy caused by mutations in the SGCA, SGCB, SGCG, and SGCD genes. These sarcoglycanopathies are known as limb-girdle muscular dystrophy types 2D, 2E, 2C, and 2F respectively. A TTN gene mutation causes limb-girdle muscular dystrophy type 2J, which has been identified only in the Finnish population. Mutations in the ANO5 gene cause limb-girdle muscular dystrophy type 2L. Mutations in several other genes cause forms of limb-girdle muscular dystrophy called dystroglycanopathies, including limb-girdle muscular dystrophy types 2I, 2K, 2M, and 2N. Other rare forms of limb-girdle muscular dystrophy are caused by mutations in several other genes, some of which have not been identified. Inheritance Pattern Limb-girdle muscular dystrophy can have different inheritance patterns. Most forms of this condition are inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Several rare forms of limb-girdle muscular dystrophy are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. Sources for This Page Broglio L, Tentorio M, Cotelli MS, Mancuso M, Vielmi V, Gregorelli V, Padovani A, Filosto M. Limb-girdle muscular dystrophy-associated protein diseases. Neurologist. 2010 Nov;16(6):340-52. doi: 10.1097/NRL.0b013e3181d35b39. Review. ", "role": "user" }, { "content": "resources address the diagnosis or management of limb-girdle muscular dystrophy", "role": "assistant" } ]

[ { "content": "what is the cause of congenital heart defects\n\n Congenital Heart Defects What Are... Congenital (kon-JEN-ih-tal) heart defects are problems with the heart's structure that are present at birth. These defects can involve: The interior walls of the heart The valves inside the heart The arteries and veins that carry blood to the heart or the body Congenital heart defects change the normal flow of blood through the heart. There are many types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms. Congenital heart defects are the most common type of birth defect. They affect 8 out of every 1,000 newborns. Each year, more than 35,000 babies in the United States are born with congenital heart defects. Many of these defects are simple conditions. They need no treatment or are easily fixed. Some babies are born with complex congenital heart defects. These defects require special medical care soon after birth. The diagnosis and treatment of complex heart defects has greatly improved over the past few decades. As a result, almost all children who have complex heart defects survive to adulthood and can live active, productive lives. Most people who have complex heart defects continue to need special heart care throughout their lives. They may need to pay special attention to how their condition affects issues such as health insurance, employment, birth control and pregnancy, and other health issues. In the United States, more than 1 million adults are living with congenital heart defects. HOW THE HEART WORKS To understand congenital heart defects, it's helpful to know how a healthy heart works. Your child's heart is a muscle about the size of his or her fist. The heart works like a pump and beats 100,000 times a day. The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. The left side of the heart receives the oxygen-rich blood from the lungs and pumps it to the body. The heart has four chambers and four valves and is connected to various blood vessels. Veins are blood vessels that carry blood from the body to the heart. Arteries are blood vessels that carry blood away from the heart to the body. A Healthy Heart Cross-Section Heart Chambers The heart has four chambers or \"rooms.\" The atria (AY-tree-uh) are the two upper chambers that collect blood as it flows into the heart. The ventricles (VEN-trih-kuhls) are the two lower chambers that pump blood out of the heart to the lungs or other parts of the body. Heart Valves Four valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart. The tricuspid (tri-CUSS-pid) valve is in the right side of the heart, between the right atrium and the right ventricle. The pulmonary (PULL-mun-ary) valve is in the right side of the heart, between the right ventricle and the entrance to the pulmonary artery. This artery carries blood from the heart to the lungs. The mitral (MI-trul) valve is in the left side of the heart, between the left atrium and the left ventricle. The aortic (ay-OR-tik) valve is in the left side of the heart, between the left ventricle and the entrance to the aorta. This artery carries blood from the heart to the body. Valves are like doors that open and close. They open to allow blood to flow through to the next chamber or to one of the arteries. Then they shut to keep blood from flowing backward. When the heart's valves open and close, they make a \"lub-DUB\" sound that a doctor can hear using a stethoscope. The first sound—the \"lub\"—is made by the mitral and tricuspid valves closing at the beginning of systole (SIS-toe-lee). Systole is when the ventricles contract, or squeeze, and pump blood out of the heart. The second sound—the \"DUB\"—is made by the aortic and pulmonary valves closing at the beginning of diastole (di-AS-toe-lee). Diastole is when the ventricles relax and fill with blood pumped into them by the atria. Arteries The arteries are major blood vessels connected to your heart. The pulmonary artery carries blood from the right side of the heart to the lungs to pick up a fresh supply of oxygen. The aorta is the main artery that carries oxygen-rich blood from the left side of the heart to the body. The coronary arteries are the other important arteries attached to the heart. They carry oxygen-rich blood from the aorta to the heart muscle, which must have its own blood supply to function. Veins The veins also are major blood vessels connected to your heart. The pulmonary veins carry oxygen-rich blood from the lungs to the left side of the heart so it can be pumped to the body. The superior and inferior vena cavae are large veins that carry oxygen-poor blood from the body back to the heart. For more information about how a healthy heart works, go to the Health Topics How the Heart Works article. This article contains animations that show how your heart pumps blood and how your heart's electrical system works. TYPES With congenital heart defects, some part of the heart doesn’t form properly before birth. This changes the normal flow of blood through the heart. There are many types of congenital heart defects. Some are simple, such as a hole in the septum. The hole allows blood from the left and right sides of the heart to mix. Another example of a simple defect is a narrowed valve that blocks blood flow to the lungs or other parts of the body. Other heart defects are more complex. They include combinations of simple defects, problems with the location of blood vessels leading to and from the heart, and more serious problems with how the heart develops. Examples of Simple Congenital Heart Defects Holes in the Heart (Septal Defects) The septum is the wall that separates the chambers on left and right sides of the heart. The wall prevents blood from mixing between the two sides of the heart. Some babies are born with holes in the septum. These holes allow blood to mix between the two sides of the heart. Atrial septal defect (ASD). An ASD is a hole in the part of the septum that separates the atria—the upper chambers of the heart. The hole allows oxygen-rich blood from the left atrium to flow into the right atrium, instead of flowing into the left ventricle as it should. Many children who have ASDs have few, if any, symptoms. Cross-Section of a Normal Heart and a Heart With an Atrial Septal Defect ASDs can be small, medium, or large. Small ASDs allow only a little blood to leak from one atrium to the other. They don't affect how the heart works and don't need any special treatment. Many small ASDs close on their own as the heart grows during childhood. Medium and large ASDs allow more blood to leak from one atrium to the other. They’re less likely to close on their own. About half of all ASDs close on their own over time. Medium and large ASDs that need treatment can be repaired using a catheter procedure or open-heart surgery. Ventricular septal defect (VSD). A VSD is a hole in the part of the septum that separates the ventricles—the lower chambers of the heart. The hole allows oxygen-rich blood to flow from the left ventricle into the right ventricle, instead of flowing into the aorta and out to the body as it should. Cross-Section of a Normal Heart and a Heart With a Ventricular Septal Defect VSDs can be small, medium, or large. Small VSDs don't cause problems and may close on their own. Medium VSDs are less likely to close on their own and may require treatment. Large VSDs allow a lot of blood to flow from the left ventricle to the right ventricle. As a result, the left side of the heart must work harder than normal. Extra blood flow increases blood pressure in the right side of the heart and the lungs. The heart’s extra workload can cause heart failure and poor growth. If the hole isn't closed, high blood pressure can scar the arteries in the lungs. Doctors use open-heart surgery to repair VSDs. Patent Ductus Arteriosus Patent ductus arteriosus (PDA) is a fairly common heart defect that can occur soon after birth. In PDA, abnormal blood flow occurs between the aorta and the pulmonary artery. Before birth, these arteries are connected by a blood vessel called the ductus arteriosus. This blood vessel is an essential part of fetal blood circulation. Within minutes or up to a few days after birth, the ductus arteriosus closes. In some babies, however, the ductus arteriosus remains open (patent). The opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery. This can strain the heart and increase blood pressure in the lung arteries. A heart murmur might be the only sign of PDA. (A heart murmur is an extra or unusual sound heard during a heartbeat.) Other signs and symptoms can include shortness of breath, poor feeding and growth, tiring easily, and sweating with exertion. PDA is treated with medicines, catheter-based procedures, and surgery. Small PDAs often close without treatment. Narrowed Valves Simple congenital heart defects also can involve the heart's valves. These valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart (the aorta and the pulmonary artery). Valves can have the following types of defects: Stenosis (steh-NO-sis). This defect occurs if the flaps of a valve thicken, stiffen, or fuse together. As a result, the valve cannot fully open. Thus, the heart has to work harder to pump blood through the valve. Atresia (ah-TRE-ze-AH). This defect occurs if a valve doesn't form correctly and lacks a hole for blood to pass through. Atresia of a valve generally results in more complex congenital heart disease. Regurgitation (re-GUR-jih-TA-shun). This defect occurs if a valve doesn't close tightly. As a result, blood leaks back through the valve. The most common valve defect is pulmonary valve stenosis, which is a narrowing of the pulmonary valve. This valve allows blood to flow from the right ventricle into the pulmonary artery. The blood then travels to the lungs to pick up oxygen. Pulmonary valve stenosis can range from mild to severe. Most children who have this defect have no signs or symptoms other than a heart murmur. Treatment isn't needed if the stenosis is mild. In babies who have severe pulmonary valve stenosis, the right ventricle can get very overworked trying to pump blood to the pulmonary artery. These infants may have signs and symptoms such as rapid or heavy breathing, fatigue (tiredness), and poor feeding. Older children who have severe pulmonary valve stenosis may have symptoms such as fatigue while exercising. Some babies may have pulmonary valve stenosis and PDA or ASDs. If this happens, oxygen-poor blood can flow from the right side of the heart to the left side. This can cause cyanosis (si-ah-NO-sis). Cyanosis is a bluish tint to the skin, lips, and fingernails. It occurs because the oxygen level in the blood leaving the heart is below normal. Severe pulmonary valve stenosis is treated with a catheter procedure. Example of a Complex Congenital Heart Defect Complex congenital heart defects need to be repaired with surgery. Advances in treatment now allow doctors to successfully repair even very complex congenital heart defects. The most common complex heart defect is tetralogy of Fallot (teh-TRAL-o-je of fah-LO), which is a combination of four defects: Pulmonary valve stenosis. A large VSD. An overriding aorta. In this defect, the aorta is located between the left and right ventricles, directly over the VSD. As a result, oxygen-poor blood from the right ventricle can flow directly into the aorta instead of into the pulmonary artery. Right ventricular hypertrophy (hi-PER-tro-fe). In this defect, the muscle of the right ventricle is thicker than usual because it has to work harder than normal. In tetralogy of Fallot, not enough blood is able to reach the lungs to get oxygen, and oxygen-poor blood flows to the body. Cross-Section of a Normal Heart and a Heart With Tetralogy of Fallot Babies and children who have tetralogy of Fallot have episodes of cyanosis, which can be severe. In the past, when this condition wasn't treated in infancy, older children would get very tired during exercise and might faint. Tetralogy of Fallot is repaired in infancy now to prevent these problems. Babies and children who have tetralogy of Fallot have episodes of cyanosis, which can be severe. In the past, when this condition wasn't treated in infancy, older children would get very tired during exercise and might faint. Tetralogy of Fallot is repaired in infancy now to prevent these problems. Tetralogy of Fallot must be repaired with open-heart surgery, either soon after birth or later in infancy. The timing of the surgery will depend on how narrow the pulmonary artery is. Children who have had this heart defect repaired need lifelong medical care from a specialist to make sure they stay as healthy as possible. OTHER NAMES Congenital heart disease Heart defects Congenital cardiovascular malformations CAUSES If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don't know why congenital heart defects occur. Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect. Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects. Researchers continue to search for the causes of congenital heart defects. SIGNS & SYMPTOMS Many congenital heart defects cause few or no signs and symptoms. A doctor may not even detect signs of a heart defect during a physical exam. Some heart defects do cause signs and symptoms. They depend on the number, type, and severity of the defects. Severe defects can cause signs and symptoms, usually in newborns. These signs and symptoms may include: Rapid breathing Cyanosis (a bluish tint to the skin, lips, and fingernails) Fatigue (tiredness) Poor blood circulation Congenital heart defects don't cause chest pain or other painful symptoms. Heart defects can cause heart murmurs (extra or unusual sounds heard during a heartbeat). Doctors can hear heart murmurs using a stethoscope. However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs. Normal growth and development depend on a normal workload for the heart and normal flow of oxygen-rich blood to all parts of the body. Babies who have congenital heart defects may have cyanosis and tire easily while feeding. As a result, they may not gain weight or grow as they should. Older children who have congenital heart defects may get tired easily or short of breath during physical activity. Many types of congenital heart defects cause the heart to work harder than it should. With severe defects, this can lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Symptoms of heart failure include: Shortness of breath or trouble breathing Fatigue with physical activity A buildup of blood and fluid in the lungs Swelling in the ankles, feet, legs, abdomen, and veins in the neck DIAGNOSIS Severe congenital heart defects generally are diagnosed during pregnancy or soon after birth. Less severe defects often aren't diagnosed until children are older. Minor defects often have no signs or symptoms. Doctors may diagnose them based on results from a physical exam and tests done for another reason. Specialists Involved Pediatric cardiologists are doctors who specialize in the care of babies and children who have heart problems. Cardiac surgeons are specialists who repair heart defects using surgery. Physical Exam During a physical exam, the doctor will: Listen to your child's heart and lungs with a stethoscope Look for signs of a heart defect, such as cyanosis (a bluish tint to the skin, lips, or fingernails), shortness of breath, rapid breathing, delayed growth, or signs of heart failure Diagnostic Tests Echocardiography Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen. Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working. Echo is an important test for both diagnosing a heart problem and following the problem over time. The test can show problems with the heart's structure and how the heart is reacting to those problems. Echo will help your child's cardiologist decide if and when treatment is needed. During pregnancy, if your doctor suspects that your baby has a congenital heart defect, fetal echo can be done. This test uses sound waves to create a picture of the baby's heart while the baby is still in the womb. Fetal echo usually is done at about 18 to 22 weeks of pregnancy. If your child is diagnosed with a congenital heart defect before birth, your doctor can plan treatment before the baby is born. EKG (Electrocardiogram) An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can detect if one of the heart's chambers is enlarged, which can help diagnose a heart problem. Chest X Ray A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart and lungs. This test can show whether the heart is enlarged. It also can show whether the lungs have extra blood flow or extra fluid, a sign of heart failure. Pulse Oximetry For this test, a small sensor is attached to a finger or toe (like an adhesive bandage). The sensor gives an estimate of how much oxygen is in the blood. Cardiac Catheterization During cardiac catheterization (KATH-e-ter-ih-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck. The tube is threaded to the heart. Special dye is injected through the catheter into a blood vessel or one of the heart’s chambers. The dye allows the doctor to see blood flowing through the heart and blood vessels on an x-ray image. The doctor also can use cardiac catheterization to measure the pressure and oxygen level inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is mixing between the two sides of the heart. Cardiac catheterization also is used to repair some heart defects. TREATMENTS Although many children who have congenital heart defects don't need treatment, some do. Doctors repair congenital heart defects with catheter procedures or surgery. Sometimes doctors combine catheter and surgical procedures to repair complex heart defects, which may involve several kinds of defects. The treatment your child receives depends on the type and severity of his or her heart defect. Other factors include your child's age, size, and general health. Some children who have complex congenital heart defects may need several catheter or surgical procedures over a period of years, or they may need to take medicines for years. Catheter Procedures Catheter procedures are much easier on patients than surgery. They involve only a needle puncture in the skin where the catheter (thin, flexible tube) is inserted into a vein or an artery. Doctors don't have to surgically open the chest or operate directly on the heart to repair the defect(s). This means that recovery may be easier and quicker. The use of catheter procedures has increased a lot in the past 20 years. They have become the preferred way to repair many simple heart defects, such as atrial septal defect (ASD) and pulmonary valve stenosis. For ASD repair, the doctor inserts a catheter into a vein in the groin (upper thigh). He or she threads the tube to the heart's septum. A device made up of two small disks or an umbrella-like device is attached to the catheter. When the catheter reaches the septum, the device is pushed out of the catheter. The device is placed so that it plugs the hole between the atria. It’s secured in place and the catheter is withdrawn from the body. Within 6 months, normal tissue grows in and over the device. The closure device does not need to be replaced as the child grows. For pulmonary valve stenosis, the doctor inserts a catheter into a vein and threads it to the heart’s pulmonary valve. A tiny balloon at the end of the catheter is quickly inflated to push apart the leaflets, or \"doors,\" of the valve. Then, the balloon is deflated and the catheter and ballon are withdrawn. This procedure can be used to repair any narrowed valve in the heart. To help guide the catheter, doctors often use echocardiography (echo), transesophageal (tranz-ih-sof-uh-JEE-ul) echo (TEE), and coronary angiography (an-jee-OG-rah-fee). TEE is a special type of echo that takes pictures of the heart through the esophagus. The esophagus is the passage leading from the mouth to the stomach. Doctors also use TEE to examine complex heart defects. Surgery A child may need open-heart surgery if his or her heart defect can't be fixed using a catheter procedure. Sometimes one surgery can repair the defect completely. If that's not possible, the child may need more surgeries over months or years to fix the problem. Cardiac surgeons may use open-heart surgery to: Close holes in the heart with stitches or a patch Repair or replace heart valves Widen arteries or openings to heart valves Repair complex defects, such as problems with the location of blood vessels near the heart or how they are formed Rarely, babies are born with multiple defects that are too complex to repair. These babies may need heart transplants. In this procedure, the child's heart is replaced with a healthy heart from a deceased child. The heart has been donated by the deceased child’s family. LIVING WITH The outlook for children who have congenital heart defects is much better today than in the past. Advances in testing and treatment allow most of these children to survive to adulthood. They’re able to live active, productive lives. Many of these children need only occasional checkups with a cardiologist (heart specialist) as they grow up and go through adult life. Children who have complex heart defects need long-term care from trained specialists. This will help them stay as healthy as possible and maintain a good quality of life. Children and Teens Ongoing Medical Care Ongoing medical care is important for your child's health. This includes: Having checkups with your child's heart specialist as directed Seeing your child’s pediatrician or family doctor for routine exams Taking medicines as prescribed Children who have severe heart defects may be at slightly increased risk for infective endocarditis (IE). IE is a serious infection of the inner lining of the heart chambers and valves. Your child's doctor or dentist may give your child antibiotics before some medical or dental procedures (such as surgery or dental cleanings) that can allow bacteria into the bloodstream. Your child's doctor will tell you whether your child needs antibiotics before such procedures. To reduce the risk of IE, gently brush your young child's teeth every day as soon as they begin to come in. As your child gets older, make sure he or she brushes every day and sees a dentist regularly. Talk with your child's doctor and dentist about how to keep your child's mouth and teeth healthy. As children who have heart defects grow up and become teens, they should learn how their hearts differ from normal hearts. They also should know what kind of defect they have, how it was treated, and what kind of care is still needed. They should be able to recognize signs and symptoms and know how to respond. Work with your child’s health care providers to compile a packet of medical records and information that covers all aspects of your child's heart defect, including: Diagnosis Procedures or surgeries Prescribed medicines Recommendations about medical followup and how to prevent complications Health insurance Review your current health insurance plan so you understand your coverage. Keeping your health insurance current is important. If you plan to change jobs, find out whether your new health insurance will cover care for your child's congenital heart defect. Feeding and Nutrition Some babies and children who have congenital heart defects don't grow and develop as fast as other children. If your child's heart has to pump harder than normal because of a heart defect, he or she may tire quickly while feeding. As a result, your child may not be able to eat enough. Poor feeding may cause your child to be smaller and thinner than other children. Your child also may start certain activities—such as rolling over, sitting, and walking—later than other children. After treatments and surgery, growth and development often improve. To help your baby get enough calories, ask his or her doctor about the best feeding schedule. Also, ask whether your baby needs any nutritional supplements. Make sure your child has nutritious meals and snacks as he or she grows. This will help with growth and development. Physical Activity Physical activity helps children strengthen their muscles and stay healthy. Ask your child's doctor how much and what kinds of physical activity are best for your child. Some children and teens who have congenital heart defects may need to limit the amount or type of activity they do. Remember to ask the doctor for a note that describes any limits on your child's physical activities. Schools and other groups may need this information. Emotional Issues Children and teens who have serious conditions or illnesses may have emotional issues. For example, they may feel isolated if they have to be in the hospital a lot. Some may feel sad or frustrated with their body image and their inability to be a \"normal\" kid. Sometimes brothers or sisters are jealous of a child who needs a lot of attention for medical problems. If you have concerns about your child's emotional health, talk with his or her doctor. Transition of Care The move from pediatric care to adult care is an important step in treatment. Talk with your teen’s health care team about creating a plan to help your teen transition to adult care. Start planning as soon as your teen is able and willing to fully take part in this process. Following a transition plan has many benefits. It will help your teen: Get used to talking with health care providers Learn about the adult health care system Understand the importance of having health insurance and learn what his or her insurance covers Take responsibility for his or her medical care A transition plan also can help your teen think about other important issues, such as future education and employment, birth control and pregnancy planning, and making healthy choices about nutrition, physical activity, and other lifestyle habits. Adults Adults who needed regular medical checkups for congenital heart defects in their youth may need to keep seeing specialists into adulthood. These adults should pay attention to the following issues. Medical History Some people think that the surgery they had in childhood for their congenital heart defects was a cure. They don't realize they may need regular medical followup in adulthood to maintain good health. Some adults may not know what kind of heart defect they had (or still have) or how it was repaired. They should learn about their medical history and know as much as possible about any medicines they're taking. Preventing Infective Endocarditis People who have congenital heart defects may need antibiotics before some medical or dental procedures that can allow bacteria to enter the bloodstream. These bacteria can cause infective endocarditis (IE). IE is a serious infection of the inner lining of the heart chambers and valves. Your doctor will tell you whether you need to take antibiotics before medical or dental procedures. Regular brushing, flossing, and visits to the dentist also can help prevent IE. Birth Control and Pregnancy Women who have heart defects should talk with their doctors about the safest type of birth control for them. Many of these women can safely use most methods. However, some women should avoid certain types of birth control, such as birth control pills or intrauterine devices (IUDs). Many women who have simple heart defects can have normal pregnancies and deliveries. Women with congenital heart defects who want to become pregnant (or who are pregnant) should talk with their doctors about the health risks. They also should consult with doctors who specialize in treating pregnant women who have congenital heart defects. Women who have congenital heart defects may be at higher risk than other women of having babies who have congenital heart defects. Pregnant women who have congenital heart defects should talk with their doctors about whether to have fetal echocardiography (echo). This test uses sound waves to create images of the baby's heart. Fetal echo gives the doctor information about the size and shape of the baby's heart. This test also shows how well the heart’s chambers and valves are working. Health Insurance and Employment Adults who have congenital heart defects should carefully consider how changing jobs will affect their health insurance coverage. Some health plans have waiting periods or clauses to exclude some kinds of coverage. Before making any job changes, find out whether the change will affect your insurance coverage. Several laws protect the employment rights of people who have health conditions, such as congenital heart defects. The Americans with Disabilities Act and the Work Incentives Improvement Act try to ensure fairness in hiring for all people, including those who have health conditions. ", "role": "user" }, { "content": "Causes of congenital heart defects are unknown. Heredity may play a role in some heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.", "role": "assistant" } ]

[ { "content": "how is hemophilia treated\n\nHemophilia A (Treatment): Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: - Severity of bleeding - Site of bleeding - Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products. Some people with hemophilia A develop antibodies to factor VIII. These antibodies are called inhibitors. The inhibitors attack factor VIII so that it no longer works. In such cases, a man-made clotting factor called VIIa can be given.", "role": "user" }, { "content": "Hemophilia A (Treatment): Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: - Severity of bleeding - Site of bleeding - Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products.", "role": "assistant" } ]

[ { "content": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.\n\nAnal fissure: An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter). Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery. Signs and symptoms of an anal fissure include: - Pain, sometimes severe, during bowel movements - Pain after bowel movements that can last up to several hours - Bright red blood on the stool or toilet paper after a bowel movement - Itching or irritation around the anus - A visible crack in the skin around the anus - A small lump or skin tag on the skin near the anal fissure When to see a doctor See your doctor if you have pain during bowel movements or notice blood on stools or toilet paper after a bowel movement. Common causes of anal fissure include: - Passing large or hard stools - Constipation and straining during bowel movements - Chronic diarrhea - Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease - Childbirth Less common causes of anal fissures include: - Anal cancer - HIV - Tuberculosis - Syphilis - Herpes Factors that may increase your risk of developing an anal fissure include: - Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why. - Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area. - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing. - Childbirth. Anal fissures are more common in women after they give birth. - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing. - Anal intercourse. Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. If possible, your doctor will perform a digital rectal exam, which involves inserting a gloved finger into your anal canal, or use a short, lighted tube (anoscope) to inspect your anal canal. However, if this is too painful for you, your doctor may be able to diagnose an anal fissure only by observation. An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has the tear, as well as two separate lumps or tags of skin, one internal (sentinel pile) and one external (hypertrophied papilla). The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition: - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer. - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea. Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences: - Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually. - Drink adequate fluids. Fluids help prevent constipation. - Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. - Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your child's doctor.", "role": "user" }, { "content": "Anal fissures, small tears in the tissues that line the anus, could be caused by hard stools, chronic diarrhea and inflammation of the anorectal area, and some less common problems. Factors that increase the risk of developing an anal feature include: decreased blood flow to the rectal area due to aging; straining during bowel movements, e.g., due to constipation; chronic inflammation of the intestinal tract; and anal intercourse. Anal fissures are likely to heal within weeks if you keep your stool soft, e.g., by increasing fiber and fluids in your diet, and relax the sphincter by soaking in warm water for 10-20 minutes after bowel movements. If the fissures persist, your doctor may recommend medications to relax the sphincter, such as nitroglycerin applied externally (Rectiv), Botulinum toxin type A (Botox) injection, or oral blood pressure medications, such as nifedipine (Procardia) or diltiazem (Cardizem) . Topical anesthetics, e.g., lidocaine hydrochloride (Xylocaine) may relieve pain. For chronic fissures, surgery might be more effective. The procedure called lateral internal sphincterotomy (LIS) involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\n Pulmonary hypertension Overview Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail. Some forms of pulmonary hypertension are serious conditions that become progressively worse and are sometimes fatal. Although some forms of pulmonary hypertension aren't curable, treatment can help lessen symptoms and improve your quality of life. Symptoms The signs and symptoms of pulmonary hypertension in its early stages might not be noticeable for months or even years. As the disease progresses, symptoms become worse. Pulmonary hypertension symptoms include: - Shortness of breath (dyspnea), initially while exercising and eventually while at rest - Fatigue - Dizziness or fainting spells (syncope) - Chest pressure or pain - Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites) - Bluish color to your lips and skin (cyanosis) - Racing pulse or heart palpitations Causes Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. Pulmonary hypertension is classified into five groups, depending on the cause. Group 1: Pulmonary arterial hypertension - Cause unknown, known as idiopathic pulmonary arterial hypertension - A specific gene mutation that can cause pulmonary hypertension to develop in families, also called heritable pulmonary arterial hypertension - Certain drugs - such as certain prescription diet drugs or illegal drugs such as methamphetamines - or certain toxins - Heart abnormalities present at birth (congenital heart disease) - Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) Group 2: Pulmonary hypertension caused by left-sided heart disease - Left-sided valvular heart disease, such as mitral valve or aortic valve disease - Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease - Chronic obstructive pulmonary disease, such as emphysema - Lung disease such as pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air sacs (interstitium) - Sleep apnea and other sleep disorders - Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots - Chronic blood clots in the lungs (pulmonary emboli) Group 5: Pulmonary hypertension associated with other conditions that have unclear reasons why the pulmonary hypertension occurs - Blood disorders - Disorders that affect several organs in the body, such as sarcoidosis - Metabolic disorders, such as glycogen storage disease - Tumors pressing against pulmonary arteries Eisenmenger syndrome and pulmonary hypertension Eisenmenger syndrome, a type of congenital heart disease, causes pulmonary hypertension. It's most commonly caused by a large hole in your heart between the two lower heart chambers (ventricles), called a ventricular septal defect. This hole in your heart causes blood to circulate abnormally in your heart. Oxygen-carrying blood (red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs instead of going to the rest of your body, increasing the pressure in the pulmonary arteries and causing pulmonary hypertension. Risk factors Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude Diagnosis Pulmonary hypertension is hard to diagnose early because it's not often detected in a routine physical exam. Even when the condition is more advanced, its signs and symptoms are similar to those of other heart and lung conditions. To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, and conduct a physical examination. Doctors may order several tests to diagnose pulmonary hypertension, determine the severity of your condition and find out the cause of your condition. Tests may include: - Echocardiogram. Sound waves can create moving images of the beating heart. An echocardiogram can help your doctor to check the size and functioning of the right ventricle, and the thickness of the right ventricle's wall. An echocardiogram can also show how well your heart chambers and valves are working. Doctors may also use this to measure the pressure in your pulmonary arteries. In some cases, your doctor will recommend an exercise echocardiogram to help determine how well your heart and lungs work under stress. In this test, you'll have an echocardiogram before exercising on a stationary bike or treadmill and another test immediately afterward. This could be done as an oxygen consumption test, in which you may have to wear a mask that assesses the ability of your heart and lungs to deal with oxygen and carbon dioxide. Other exercise tests may also be done. These tests can help determine the severity and cause of your condition. They may also be done at follow-up appointments to check that your treatments are working. - Chest X-ray. A chest X-ray can show images of your heart, lungs and chest. This test can show enlargement of the right ventricle of the heart or the pulmonary arteries, which can occur in pulmonary hypertension. This test can also be used to identify other conditions that may be causing pulmonary hypertension. - Electrocardiogram (ECG). This noninvasive test shows your heart's electrical patterns and can detect abnormal rhythms. Doctors may also be able to see signs of right ventricle enlargement or strain. - Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization. This test can often help confirm that you have pulmonary hypertension and determine the severity of your condition. During the procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in your neck or groin. The catheter is then threaded into your right ventricle and pulmonary artery. Right heart catheterization allows your doctor to directly measure the pressure in the main pulmonary arteries and right ventricle. It's also used to see what effect different medications may have on your pulmonary hypertension. - Blood tests. Your doctor might order blood tests to check for certain substances in your blood that might show you have pulmonary hypertension or its complications. Blood tests can also test for certain conditions that may be causing your condition. Your doctor might order additional tests to check the condition of your lungs and pulmonary arteries and to determine the cause of your condition, including: - Computerized tomography (CT) scan. During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of your body. Doctors may inject a dye into your blood vessels that helps your arteries to be more visible on the CT pictures (CT angiography). Doctors may use this test to look at the heart's size and function and to check for blood clots in the lungs' arteries. - Magnetic resonance imaging (MRI). This test may be used to check the right ventricle's function and the blood flow in the lung's arteries. In this test, you lie on a movable table that slides into the tunnel. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of the body. - Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer. - Polysomnogram. This test detects your brain activity, heart rate, blood pressure, oxygen levels and other factors while you sleep. It can help diagnose a sleep disorder such as obstructive sleep apnea. - Ventilation/perfusion (V/Q) scan. In this test, a tracer is injected into a vein in your arm. The tracer maps blood flow and air to your lungs. This test can be used to determine whether blood clots are causing symptoms of pulmonary hypertension. - Open-lung biopsy. Rarely, a doctor might recommend an open-lung biopsy. An open-lung biopsy is a type of surgery in which a small sample of tissue is removed from your lungs under general anesthesia to check for a possible secondary cause of pulmonary hypertension. Genetic tests If a family member has had pulmonary hypertension, your doctor might screen you for genes that are linked with pulmonary hypertension. If you test positive, your doctor might recommend that other family members be screened for the same genetic mutation. Pulmonary hypertension classifications Once you've been diagnosed with pulmonary hypertension, your doctor might classify the severity of your disease into one of several classes, including: - Class I. Although you've been diagnosed with pulmonary hypertension, you have no symptoms with normal activity. - Class II. You don't have symptoms at rest, but you experience symptoms such as fatigue, shortness of breath or chest pain with normal activity. - Class III. You're comfortable at rest, but have symptoms when you're physically active. - Class IV. You have symptoms with physical activity and while at rest. Treatment Pulmonary hypertension can't be cured, but doctors can help you manage your condition. Treatment may help improve your symptoms and slow the progress of pulmonary hypertension. It often takes some time to find the most appropriate treatment for pulmonary hypertension. The treatments are often complex and require extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. When pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible. Medications - Blood vessel dilators (vasodilators). Vasodilators open narrowed blood vessels. One of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (Flolan, Veletri). The drawback to epoprostenol is that its effects last only a few minutes. This drug is continuously injected through an intravenous (IV) catheter via a small pump that you wear in a pack on your belt or shoulder. Potential side effects of epoprostenol include jaw pain, nausea, diarrhea and leg cramps, as well as pain and infection at the IV site. Another form of the drug, iloprost (Ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs. Side effects associated with iloprost include chest pain - often accompanied by a headache and nausea - and breathlessness. Treprostinil (Tyvaso, Remodulin, Orenitram), another form of the drug, can be given four times a day. It can be inhaled, taken as oral medication or administered by injection. It can cause side effects such as a headache, nausea and diarrhea. - Endothelin receptor antagonists. These medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring. These medications include bosentan (Tracleer), macitentan (Opsumit), and ambrisentan (Letairis). - Sildenafil and tadalafil. Sildenafil (Revatio, Viagra) and tadalafil (Cialis, Adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily. Side effects can include an upset stomach, headache and vision problems. - High-dose calcium channel blockers. These drugs help relax the muscles in the walls of your blood vessels. They include medications such as amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them. - Soluble guanylate cyclase (SGC) stimulator. Soluble guanylate cyclase (SGC) stimulators (Adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea. - Anticoagulants. Your doctor is likely to prescribe the anticoagulant warfarin (Coumadin, Jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking. - Digoxin. Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias. - Diuretics. Commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs. - Oxygen. Your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy. Surgeries - Atrial septostomy. If medications don't control your pulmonary hypertension, this open-heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart. Atrial septostomy can have serious complications, including heart rhythm abnormalities (arrhythmias). - Transplantation. In some cases, a lung or heart-lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension. Major risks of any type of transplantation include rejection of the transplanted organ and serious infection, and you must take immunosuppressant drugs for life to help reduce the chance of rejection. Lifestyle and home remedies Although medical treatment can't cure pulmonary hypertension, it can lessen symptoms. Lifestyle changes also can help improve your condition. Consider these tips: - Get plenty of rest. Resting can reduce the fatigue that might come from having pulmonary hypertension. - Stay as active as possible. Even the mildest forms of activity might be too exhausting for some people who have pulmonary hypertension. For others, moderate exercise such as walking might be beneficial - especially when done with oxygen. But first, talk to your doctor about specific exercise restrictions. In most cases, it's recommended that you not lift heavy weights. Your doctor can help you plan an appropriate exercise program. - Don't smoke. If you smoke, the most important thing you can do for your heart and lungs is to stop. If you can't stop smoking by yourself, ask your doctor to prescribe a treatment plan to help you quit. Also, avoid secondhand smoke if possible. - Avoid pregnancy and birth control pills. If you're a woman of childbearing age, avoid pregnancy. Pregnancy can be life-threatening for both you and your baby. Also avoid using birth control pills, which can increase your risk of blood clots. Talk to your doctor about alternative forms of birth control. If you do become pregnant, it's important to consult with your doctor as pulmonary hypertension can cause serious complications to both you and the fetus. - Avoid traveling to or living at high altitudes. High altitudes can worsen the symptoms of pulmonary hypertension. If you live at an altitude of 8,000 feet (2,438 meters) or higher, your doctor might recommend that you move to a lower altitude. - Avoid situations that can excessively lower blood pressure. These include sitting in a hot tub or sauna or taking long hot baths or showers. These activities lower your blood pressure and can cause fainting or even death. Also avoid activities that cause prolonged straining, such as lifting heavy objects or weights. - Follow a nutritious diet and stay at a healthy weight. Aim to eat a healthy diet of whole grains, a variety of fruits and vegetables, lean meats and low-fat dairy products. Avoid saturated fat, trans fat and cholesterol. It's likely your doctor will recommend limiting the amount of salt in your diet. Aim to maintain a healthy weight. - Ask your doctor about medications. Take all your medications as prescribed. Ask your doctor about any other medications before taking them, as some can interfere with your medication or worsen your condition. - See your doctor at follow-up appointments. Your doctor may recommend regular follow-up appointments. Let your doctor know if you have any questions about your condition or medications you're taking, or if you have any symptoms or side effects from your medications. If pulmonary hypertension is affecting your quality of life, ask your doctor about options that could improve your quality of life. - Get vaccines. Your doctor may recommend getting an influenza and pneumonia vaccine, as these conditions can cause serious issues for people with pulmonary hypertension. - Get support. If you're feeling stressed or worried due to your condition, get support from family or friends. Or, consider joining a support group with others who have pulmonary hypertension. ", "role": "user" }, { "content": "Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form.This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries.", "role": "assistant" } ]

[ { "content": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.\n\nEsophageal cancer: Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy , and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow. [1] [2] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Squamous cell carcinoma - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal", "role": "user" }, { "content": "Esophageal cancer affects the esophagus, the tube that carries food and liquids from the throat to the stomach. Symptoms of esophageal cancer may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is not known, but environmental and genetic factors play a role in the development of this condition. The risk factors include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy , and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow.", "role": "assistant" } ]

[ { "content": "why can you not take grapefruit with felodipine\n\n Felodipine Why is this medication prescribed? Felodipine is used to treat high blood pressure. Felodipine is in a class of medications called calcium channel blockers. It works by relaxing the blood vessels so your heart does not have to pump as hard. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation. How should this medicine be used? Felodipine comes as an extended release tablet to take by mouth. It is usually taken once a day. To help you remember to take felodipine, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take felodipine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the tablets whole; do not split, chew, or crush them. Felodipine controls high blood pressure but does not cure it. Continue to take felodipine even if you feel well. Do not stop taking felodipine without talking to your doctor. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking felodipine,</h3> /h3> tell your doctor and pharmacist if you are allergic to felodipine, any other medications, or any ingredients in felodipine tablets. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antiseizure medicines such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin, Phenytek), and phenobarbital; cimetidine (Tagamet); erythromycin (E.E.S., Eryc, Ery-tab); itraconazole (Sporanox); ketoconazole (Nizoral); ranitidine (Zantac); and tacrolimus (Astagraf SL, Prograf). tell your doctor if you have or have ever had heart, liver, or kidney disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking felodipine, call your doctor. if you are having surgery, including dental surgery, tell your doctor or dentist that you take felodipine. What special dietary instructions should I follow? Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine. Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Felodipine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> headache flushing dizziness or lightheadedness weakness fast heartbeat heartburn constipation enlargement of gum tissue around teeth <h3>Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: </h3> /h3> swelling of the face, eyes, lips, tongue, arms, or legs difficulty breathing or swallowing fainting rash If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to felodipine. Good dental hygiene decreases the chance and severity of gum swelling. Brush your teeth regularly and schedule dental cleanings every 6 months. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Plendil Brand names of combination products Lexxel (containing Enalapril, Felodipine) ", "role": "user" }, { "content": "Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine.", "role": "assistant" } ]

[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\n Menkes syndrome Copper transport disease Hypocupremia, Congenital Kinky Hair Syndrome Menkea syndrome Menkes Disease MK MNK Steely Hair Syndrome X-linked copper deficiency Description Menkes syndrome is a disorder that affects copper levels in the body. It is characterized by sparse, kinky hair; failure to gain weight and grow at the expected rate (failure to thrive); and deterioration of the nervous system. Additional signs and symptoms include weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood. Occipital horn syndrome (sometimes called X-linked cutis laxa) is a less severe form of Menkes syndrome that begins in early to middle childhood. It is characterized by wedge-shaped calcium deposits in a bone at the base of the skull (the occipital bone), coarse hair, and loose skin and joints. Frequency The incidence of Menkes syndrome and occipital horn syndrome is estimated to be 1 in 100,000 newborns. Causes Mutations in the ATP7A gene cause Menkes syndrome. The ATP7A gene provides instructions for making a protein that is important for regulating copper levels in the body. Copper is necessary for many cellular functions, but it is toxic when present in excessive amounts. Mutations in the ATP7A gene result in poor distribution of copper to the body's cells. Copper accumulates in some tissues, such as the small intestine and kidneys, while the brain and other tissues have unusually low levels of copper. The decreased supply of copper can reduce the activity of numerous copper-containing enzymes that are necessary for the structure and function of bone, skin, hair, blood vessels, and the nervous system. The signs and symptoms of Menkes syndrome and occipital horn syndrome are caused by the reduced activity of these copper-containing enzymes. Inheritance Pattern Menkes syndrome is inherited in an X-linked recessive pattern. The gene associated with this condition is located on the X chromosome, which is one of the two sex chromosomes. In males (who have only one X chromosome), one altered copy of the gene in each cell is sufficient to cause the condition. In females (who have two X chromosomes), a mutation would have to occur in both copies of the gene to cause the disorder. Because it is unlikely that females will have two altered copies of this gene, males are affected by X-linked recessive disorders much more frequently than females. A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. In about one-third of cases, Menkes syndrome is caused by new mutations in the ATP7A gene. People with a new mutation do not have a history of the disorder in their family. Sources for This Page Barnes N, Tsivkovskii R, Tsivkovskaia N, Lutsenko S. The copper-transporting ATPases, menkes and wilson disease proteins, have distinct roles in adult and developing cerebellum. J Biol Chem. 2005 Mar 11;280(10):9640-5. Epub 2005 Jan 5. ", "role": "user" }, { "content": "Menkes syndrome is a disorder that affects copper levels in the body. The symptoms include kinky hair, failure to thrive, deterioration of the nervous system, weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood.", "role": "assistant" } ]

[ { "content": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also\n\n Scoliosis Overview Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis. Symptoms Signs and symptoms of scoliosis may include: - Uneven shoulders - One shoulder blade that appears more prominent than the other - Uneven waist - One hip higher than the other If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. When to see a doctor Go to your doctor if you notice signs or symptoms of scoliosis in your child. Mild curves, however, can develop without the parent or child knowing it because they appear gradually and usually don't cause pain. Occasionally, teachers, friends and sports teammates are the first to notice a child's scoliosis. Causes Doctors don't know what causes the most common type of scoliosis - although it appears to involve hereditary factors, because the disorder tends to run in families. Less common types of scoliosis may be caused by: - Neuromuscular conditions, such as cerebral palsy or muscular dystrophy - Birth defects affecting the development of the bones of the spine - Injuries to or infections of the spine Risk factors Risk factors for developing the most common type of scoliosis include: - Age. Signs and symptoms typically begin during the growth spurt that occurs just prior to puberty. - Sex. Although both boys and girls develop mild scoliosis at about the same rate, girls have a much higher risk of the curve worsening and requiring treatment. - Family history. Scoliosis can run in families, but most children with scoliosis don't have a family history of the disease. Diagnosis The doctor will initially take a detailed medical history and may ask questions about recent growth. During the physical exam, your doctor may have your child stand and then bend forward from the waist, with arms hanging loosely, to see if one side of the rib cage is more prominent than the other. Your doctor may also perform a neurological exam to check for: - Muscle weakness - Numbness - Abnormal reflexes Imaging tests Plain X-rays can confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. If a doctor suspects that an underlying condition - such as a tumor - is causing the scoliosis, he or she may recommend additional imaging tests, such as an MRI. Treatment Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines. While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include: - Sex. Girls have a much higher risk of progression than do boys. - Severity of curve. Larger curves are more likely to worsen with time. - Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves. - Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine. - Maturity. If a child's bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing. Braces If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents further progression of the curve. The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips. Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities. Braces are discontinued after the bones stop growing. This typically occurs: - About two years after girls begin to menstruate - When boys need to shave daily - When there are no further changes in height Surgery Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months. Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed. Lifestyle and home remedies Although physical therapy exercises can't stop scoliosis, general exercise or participating in sports may have the benefit of improving overall health and well-being. Alternative medicine Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements ", "role": "user" }, { "content": "Studies indicate that the following treatments for scoliosis are ineffective: - Chiropractic manipulation - Electrical stimulation of muscles - Dietary supplements", "role": "assistant" } ]

[ { "content": "How bad can endometriosis get?\n\n Endometriosis Overview Endometriosis happens when the lining of the uterus (womb) grows outside of the uterus. It may affect more than 11% of American women between 15 and 44.1 It is especially common among women in their 30s and 40s and may make it harder to get pregnant. Several different treatment options can help manage the symptoms and improve your chances of getting pregnant. What is endometriosis? Endometriosis, sometimes called \"endo,\" is a common health problem in women. It gets its name from the word endometrium(en-doh-MEE-tree-um), the tissue that normally lines the uterus or womb. Endometriosis happens when this tissue grows outside of your uterus and on other areas in your body where it doesn't belong. Most often, endometriosis is found on the: Other sites for growths can include the vagina, cervix, vulva, bowel, bladder, or rectum. Rarely, endometriosis appears in other parts of the body, such as the lungs, brain, and skin. What are the symptoms of endometriosis? Symptoms of endometriosis can include: Why does endometriosis cause pain and health problems? Endometriosis growths are benign (not cancerous). But they can still cause problems. Endometriosis happens when tissue that is normally on the inside of your uterus or womb grows outside of your uterus or womb where it doesn't belong. Endometriosis growths bleed in the same way the lining inside of your uterus does every month - during your menstrual period. This can cause swelling and pain because the tissue grows and bleeds in an area where it cannot easily get out of your body. The growths may also continue to expand and cause problems, such as: How common is endometriosis? Endometriosis is a common health problem for women. Researchers think that at least 11% of women, or more than 6 1/2 million women in the United States, have endometriosis.1 Who gets endometriosis? Endometriosis can happen in any girl or woman who has menstrual periods, but it is more common in women in their 30s and 40s. You might be more likely to get endometriosis if you have: What causes endometriosis? No one knows for sure what causes this disease. Researchers are studying possible causes: How can I prevent endometriosis? You can't prevent endometriosis. But you can reduce your chances of developing it by lowering the levels of the hormone estrogen in your body. Estrogen helps to thicken the lining of your uterus during your menstrual cycle. To keep lower estrogen levels in your body, you can: How is endometriosis diagnosed? If you have symptoms of endometriosis, talk with your doctor. The doctor will talk to you about your symptoms and do or prescribe one or more of the following to find out if you have endometriosis: How is endometriosis treated? There is no cure for endometriosis, but treatments are available for the symptoms and problems it causes. Talk to your doctor about your treatment options. If you are not trying to get pregnant, hormonal birth control is generally the first step in treatment. This may include: Hormonal treatment works only as long as it is taken and is best for women who do not have severe pain or symptoms. If you are trying to get pregnant, your doctor may prescribe a gonadotropin-releasing hormone (GnRH) agonist. This medicine stops the body from making the hormones responsible for ovulation, the menstrual cycle, and the growth of endometriosis. This treatment causes a temporary menopause, but it also helps control the growth of endometriosis. Once you stop taking the medicine, your menstrual cycle returns, but you may have a better chance of getting pregnant. Surgery is usually chosen for severe symptoms, when hormones are not providing relief or if you are having fertility problems. During the operation, the surgeon can locate any areas of endometriosis and may remove the endometriosis patches. After surgery, hormone treatment is often restarted unless you are trying to get pregnant. Other treatments you can try, alone or with any of the treatments listed above, include: Learn more about endometriosis treatments. Does endometriosis go away after menopause? For some women, the painful symptoms of endometriosis improve after menopause. As the body stops making the hormone estrogen, the growths shrink slowly. However, some women who take menopausal hormone therapy may still have symptoms of endometriosis. If you are having symptoms of endometriosis after menopause, talk to your doctor about treatment options. Can I get pregnant if I have endometriosis? Yes. Many women with endometriosis get pregnant. But, you may find it harder to get pregnant. Endometriosis affects about one-half (50%) of women with infertility.6 No one knows exactly how endometriosis might cause infertility. Some possible reasons include:7 If you have endometriosis and are having trouble getting pregnant, talk to your doctor. He or she can recommend treatments, such as surgery to remove the endometrial growths.7 What other health conditions are linked to endometriosis? Research shows a link between endometriosis and other health problems in women and their families. Some of these include: Did we answer your question about endometriosis? For more information about endometriosis, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Endometriosis happens when the lining of the uterus (womb) grows outside of the uterus. It is especially common among women in their 30s and 40s and may make it harder to get pregnant. Endometriosis growths bleed in the same way the lining inside of your uterus does every month - during your menstrual period. This can cause swelling and pain because the tissue grows and bleeds in an area where it cannot easily get out of your body.", "role": "assistant" } ]

[ { "content": "what is binge eating disorder\n\n Binge eating disorder Overview Binge eating disorder is the most common type of eating disorder in the United States. People with binge eating disorder often feel out of control and eat a large amount of food at one time (called a binge). Unlike other eating disorders, people who have binge eating disorder do not throw up the food or exercise too much. Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment. What is binge eating disorder? Binge eating disorder is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise. According to the American Psychiatric Association, women with binge eating disorder feel out of control and eat too much (binge), at least once a week for at least three months. During binges women with binge eating disorder usually eat faster than normal, eat until they are uncomfortable, eat when they are not physically hungry, and feel embarrassed, disgusted, or depressed because of the binges. Women with this type of eating disorder may be overweight or obese. What is the difference between binge eating disorder and other eating disorders? Women with eating disorders, such as binge eating disorder, bulimia, and anorexia, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health. Unlike people with anorexia or bulimia, people with binge eating disorder do not throw up their food, exercise a lot, or starve themselves. People with binge eating disorder are often overweight or obese. But not all people with binge eating disorder are overweight, and being overweight does not always mean you have binge eating disorder. It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment. Who is at risk for binge eating disorder? Binge eating disorder affects more than 3% of women in the United States. More than half of people with binge eating disorder are women.1 Binge eating disorder affects women of all races and ethnicities. It is the most common eating disorder among Hispanic, Asian-American, and African-American women.2,3,4 Some women may be more at risk for binge eating disorder. What are the symptoms of binge eating disorder? It can be difficult to tell whether someone has binge eating disorder. Many women with binge eating disorder hide their behavior because they are embarrassed. You may have binge eating disorder if, for at least once a week over the past three months, you have binged. Binge eating disorder means you have at least three of these symptoms while binging:8 People with binge eating disorder may also have other mental health problems, such as depression, anxiety, or substance abuse. What causes binge eating disorder? Researchers are not sure exactly what causes binge eating disorder and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses. Studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.9,10 Researchers are studying how changing levels of brain chemicals may affect eating habits. Neuroimaging, or pictures of the brain, may lead to a better understanding of binge eating disorder.11 Learn more about current research on binge eating disorder. How does binge eating disorder affect a woman's health? Many, but not all, women with binge eating disorder are overweight or obese. Obesity raises your risk for many serious health problems:12 People with binge eating disorder often have other serious mental health illnesses such as depression, anxiety, or substance abuse. These problems can seriously affect a woman's everyday life and can be treated. How is binge eating disorder diagnosed? Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help. Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder. How is binge eating disorder treated? Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better. Treatment plans may include one or more of the following: Most girls and women do get better with treatment and are able to eat in healthy ways again.14 Some may get better after the first treatment. Others get well but may relapse and need treatment again. How does binge eating disorder affect pregnancy? Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control. Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for: Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16 After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17 If I had an eating disorder in the past, can I still get pregnant? Yes. Women who have recovered from binge eating disorder, are at a healthy weight, and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy. Tell your doctor if you had an eating disorder in the past and are trying to become pregnant. If I take medicine to treat binge eating disorder, can I breastfeed my baby? Maybe. Some medicines used to treat binge eating disorder can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding. Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding. You can also enter a medicine into the LactMed database to find out if the medicine passes through breastmilk and about any possible side effects for your nursing baby. Did we answer your question about binge eating disorder? For more information about binge eating disorder, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Binge eating disorder is the most common eating disorder in the United States. People with binge eating disorder often feel out of control and eat a large amount of food at one time (called a binge). Unlike other eating disorders, people who have binge eating disorder do not throw up the food or exercise too much. Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment.", "role": "assistant" } ]

[ { "content": "what is the cause of ocd\n\n Obsessive-compulsive disorder (OCD) Overview Obsessive-compulsive disorder (OCD) features a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress. You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior - the vicious cycle of OCD. OCD often centers around certain themes - for example, a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they're sore and chapped. If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective. Symptoms Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social or work functioning. OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you're trying to think of or do other things. Obsessions often have themes to them, such as: - Fear of contamination or dirt - Needing things orderly and symmetrical - Aggressive or horrific thoughts about harming yourself or others - Unwanted thoughts, including aggression, or sexual or religious subjects Examples of obsession signs and symptoms include: - Fear of being contaminated by touching objects others have touched - Doubts that you've locked the door or turned off the stove - Intense stress when objects aren't orderly or facing a certain way - Images of hurting yourself or someone else that are unwanted and make you uncomfortable - Thoughts about shouting obscenities or acting inappropriately that are unwanted and make you uncomfortable - Avoidance of situations that can trigger obsessions, such as shaking hands - Distress about unpleasant sexual images repeating in your mind OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to prevent or reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety. You may make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they're intended to fix. As with obsessions, compulsions typically have themes, such as: - Washing and cleaning - Checking - Counting - Orderliness - Following a strict routine - Demanding reassurances Examples of compulsion signs and symptoms include: - Hand-washing until your skin becomes raw - Checking doors repeatedly to make sure they're locked - Checking the stove repeatedly to make sure it's off - Counting in certain patterns - Silently repeating a prayer, word or phrase - Arranging your canned goods to face the same way OCD usually begins in the teen or young adult years. Symptoms usually begin gradually and tend to vary in severity throughout life. Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling. There's a difference between being a perfectionist - someone who requires flawless results or performance, for example - and having OCD. OCD thoughts aren't simply excessive worries about real problems in your life or liking to have things clean or arranged in a specific way. If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health professional. Causes The cause of obsessive-compulsive disorder isn't fully understood. Main theories include: - Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. - Genetics. OCD may have a genetic component, but specific genes have yet to be identified. - Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed. Risk factors Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include: - Family history. Having parents or other family members with the disorder can increase your risk of developing OCD. - Stressful life events. If you've experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD. - Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders. Complications Problems resulting from OCD may include, among others: - Health issues, such as contact dermatitis from frequent hand-washing - Inability to attend work, school or social activities - Troubled relationships - Overall poor quality of life - Suicidal thoughts and behavior Diagnosis Steps to help diagnose OCD may include: - Physical exam. This may be done to help rule out other problems that could be causing your symptoms and to check for any related complications. - Lab tests. These may include, for example, a complete blood count (CBC), a check of your thyroid function, and screening for alcohol and drugs. - Psychological evaluation. This includes discussing your thoughts, feelings, symptoms and behavior patterns. With your permission, this may include talking to your family or friends. - Diagnostic criteria for OCD. Your doctor may use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Diagnostic challenges It's sometimes difficult to diagnose OCD because symptoms can be similar to those of obsessive-compulsive personality disorder, anxiety disorders, depression, schizophrenia or other mental health disorders. And it's possible to have both OCD and another mental disorder. Work with your doctor so that you can get the appropriate diagnosis and treatment. Treatment Obsessive-compulsive disorder treatment may not result in a cure, but it can help bring symptoms under control so that they don't rule your daily life. Some people need treatment for the rest of their lives. The two main treatments for OCD are psychotherapy and medications. Often, treatment is most effective with a combination of these. Psychotherapy Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD. Exposure and response prevention (ERP), a type of CBT therapy, involves gradually exposing you to a feared object or obsession, such as dirt, and having you learn healthy ways to cope with your anxiety. ERP takes effort and practice, but you may enjoy a better quality of life once you learn to manage your obsessions and compulsions. Therapy may take place in individual, family or group sessions. Medications Certain psychiatric medications can help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried first. Antidepressants approved by the Food and Drug Administration (FDA) to treat OCD include: - Clomipramine (Anafranil) for adults and children 10 years and older - Fluoxetine (Prozac) for adults and children 7 years and older - Fluvoxamine for adults and children 8 years and older - Paroxetine (Paxil, Pexeva) for adults only - Sertraline (Zoloft) for adults and children 6 years and older However, your doctor may prescribe other antidepressants and psychiatric medications. Medications: What to consider Here are some issues to discuss with your doctor about medications for OCD: - Choosing a medication. In general, the goal is to effectively control symptoms at the lowest possible dosage. It's not unusual to try several drugs before finding one that works well. Your doctor might recommend more than one medication to effectively manage your symptoms. It can take weeks to months after starting a medication to notice an improvement in symptoms. - Side effects. All psychiatric medications have potential side effects. Talk to your doctor about possible side effects and about any health monitoring needed while taking psychiatric drugs. And let your doctor know if you experience troubling side effects. - Suicide risk. Most antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. If suicidal thoughts occur, immediately contact your doctor or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood. - Interactions with other substances. When taking an antidepressant, tell your doctor about any other prescription or over-the-counter medications, herbs or other supplements you take. Some antidepressants can cause dangerous reactions when combined with certain medications or herbal supplements. - Stopping antidepressants. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur. So stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, sometimes called discontinuation syndrome. Don't stop taking your medication without talking to your doctor, even if you're feeling better - you may have a relapse of OCD symptoms. Work with your doctor to gradually and safely decrease your dose. Talk to your doctor about the risks and benefits of using specific medications. Other treatment Sometimes, medications and psychotherapy aren't effective enough to control OCD symptoms. Research continues on the potential effectiveness of deep brain stimulation (DBS) for treating OCD that doesn't respond to traditional treatment approaches. Because DBS hasn't been thoroughly tested for use in treating OCD, make sure you understand all the pros and cons and possible health risks. Lifestyle and home remedies Obsessive-compulsive disorder is a chronic condition, which means it may always be part of your life. While OCD warrants treatment by a professional, you can do some things for yourself to build on your treatment plan: - Take your medications as directed. Even if you're feeling well, resist any temptation to skip your medications. If you stop, OCD symptoms are likely to return. - Pay attention to warning signs. You and your doctor may have identified issues that can trigger your OCD symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. - Check first before taking other medications. Contact the doctor who's treating you for OCD before you take medications prescribed by another doctor or before taking any over-the-counter medications, vitamins, herbal remedies or other supplements to avoid possible interactions. - Practice what you learn. Work with your mental health professional to identify techniques and skills that help manage symptoms, and practice these regularly. ", "role": "user" }, { "content": "The known risk factors of developing obsessive-compulsive disorder are having parents or other family members with the disorder, traumatic or stressful life events, and having other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.", "role": "assistant" } ]

[ { "content": "what is epilepsy\n\nProgressive myoclonic epilepsy: Progressive myoclonus epilepsy (PME) refers to a group of inherited conditions involving the central nervous system and representing more than a dozen different diseases. These diseases share certain features, including a worsening of symptoms over time and the presence of both muscle contractions ( myoclonus) and seizures ( epilepsy). PME is different from myoclonic epilepsy. [1] Other features include  dementia , dystonia , and trouble walking or speaking. These rare disorders often get worse over time and sometimes are fatal. Many of these PME diseases begin in childhood or adolescence. [2] The following diseases are related to Progressive myoclonic epilepsy. If you have a question about any of these diseases, you can contact GARD. Familial encephalopathy with neuroserpin inclusion bodies Lafora disease Unverricht-Lundborg disease", "role": "user" }, { "content": "Epilepsy seizures and muscle contractions are present in a group of rare hereditary disorders called Progressive myoclonus epilepsy (PME.) Many PME diseases begin in childhood or adolescence, get worse over time and sometimes are fatal.", "role": "assistant" } ]

[ { "content": "how is congenital heart disease passed down\n\n Congenital heart disease Summary Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. Causes CHD can describe a number of different problems affecting the heart. It is the most common type of birth defect. CHD causes more deaths in the first year of life than any other birth defects. CHD is often divided into two types: cyanotic (blue skin color caused by a lack of oxygen) and non-cyanotic. The following lists cover the most common CHDs: Cyanotic: Ebstein's anomaly Hypoplastic left heart Pulmonary atresia Tetralogy of Fallot Total anomalous pulmonary venous return Transposition of the great vessels Tricuspid atresia Truncus arteriosus Non-cyanotic: Aortic stenosis Bicuspid aortic valve Atrial septal defect (ASD) Atrioventricular canal (endocardial cushion defect) Coarctation of the aorta Patent ductus arteriosus (PDA) Pulmonic stenosis Ventricular septal defect (VSD) These problems may occur alone or together. Most children with CHD do not have other types of birth defects. However, heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families. Examples include: DiGeorge syndrome Down syndrome Marfan syndrome Noonan syndrome Edwards syndrome Trisomy 13 Turner syndrome Often, no cause for the heart disease can be found. CHDs continue to be investigated and researched. Drugs such as retinoic acid for acne, chemicals, alcohol, and infections (such as rubella) during pregnancy can contribute to some congenital heart problems. Poorly controlled blood sugar in women who have diabetes during pregnancy has also been linked to a high rate of congenital heart defects. Symptoms Symptoms depend on the condition. Although CHD is present at birth, the symptoms may not appear right away. Defects such as coarctation of the aorta may not cause problems for years. Other problems, such as a small VSD, ASD, or PDA may never cause any problems. Exams and Tests Most congenital heart defects are found during a pregnancy ultrasound. When a defect is found, a pediatric heart doctor, surgeon, and other specialists can be there when the baby is delivered. Having medical care ready at the delivery can mean the difference between life and death for some babies. Which tests are done on the baby depend on the defect and the symptoms. Treatment Which treatment is used, and how well the baby responds to it, depends on the condition. Many defects need to be followed carefully. Some will heal over time, while others will need to be treated. Some CHDs can be treated with medicine alone. Others need to be treated with one or more heart procedures or surgeries. Prevention Women who are pregnant should get good prenatal care: Avoid alcohol and illegal drugs during pregnancy. Tell your health care provider that you are pregnant before taking any new medicines. Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery. Pregnant women who have diabetes should try to get good control over their blood sugar level. Certain genes may play a role in CHD. Many family members may be affected. Talk to your provider about genetic counseling and screening if you have a family history of CHD. Review Date 12/8/2017 Updated by: Steven Kang, MD, Director, Cardiac Electrophysiology, Alta Bates Summit Medical Center, Stanford Healthcare, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Congenital heart disease can describe a number of different problems affecting the heart. heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families. Examples include: - DiGeorge syndrome - Down syndrome - Marfan syndrome - Noonan syndrome - Trisomy 13 - Turner syndrome Often, no cause for the heart disease can be found.", "role": "assistant" } ]

[ { "content": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.\n\n Thalassemia Overview Thalassemia (thal-uh-SEE-me-uh) is an inherited blood disorder characterized by less hemoglobin and fewer red blood cells in your body than normal. Hemoglobin is the substance in your red blood cells that allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause anemia, leaving you fatigued. If you have mild thalassemia, you may not need treatment. But if you have a more severe form of the disorder, you may need regular blood transfusions. You can also take steps on your own to cope with fatigue, such as choosing a healthy diet and exercising regularly. Symptoms Thalassemia signs and symptoms may include: - Fatigue - Weakness - Pale or yellowish skin - Facial bone deformities - Slow growth - Abdominal swelling - Dark urine Several types of thalassemia exist, including alpha-thalassemia, thalassemia intermedia and Cooley anemia. The signs and symptoms you experience depend on the type and severity of your condition. Some babies show signs and symptoms of thalassemia at birth, while others may develop them during the first two years of life. Some people who have only one affected hemoglobin gene don't experience any thalassemia symptoms. Make an appointment with your child's doctor for an evaluation if he or she has any signs or symptoms that worry you. Causes Thalassemia is caused by mutations in the DNA of cells that make hemoglobin - the substance in your red blood cells that carries oxygen throughout your body. The mutations associated with thalassemia are passed from parents to children. Thalassemia disrupts the normal production of hemoglobin and healthy red blood cells. This causes anemia. With anemia, your blood doesn't have enough red blood cells to carry oxygen to your tissues - leaving you fatigued. The type of thalassemia you have depends on the number of gene mutations you inherit from your parents and which part of the hemoglobin molecule is affected by the mutations. The more mutated genes, the more severe your thalassemia. Hemoglobin molecules are made of alpha and beta parts that can be affected by mutations. Four genes are involved in making the alpha hemoglobin chain. You get two from each of your parents. If you inherit: - 1 mutated gene, you'll have no signs or symptoms of thalassemia. But you are a carrier of the disease and can pass it on to your children. - 2 mutated genes, your thalassemia signs and symptoms will be mild. This condition may be called alpha-thalassemia trait. - 3 mutated genes, your signs and symptoms will be moderate to severe. - 4 mutated genes. This type is rare. Affected fetuses have severe anemia and usually are stillborn. Babies born with this condition often die shortly after birth or require lifelong transfusion therapy. In rare cases, a child born with this condition may be treated with transfusions and a stem cell transplant, which is also called a bone marrow transplant. Two genes are involved in making the beta hemoglobin chain. You get one from each of your parents. If you inherit: - 1 mutated gene, you'll have mild signs and symptoms. This condition is called thalassemia minor or beta-thalassemia. - 2 mutated genes, your signs and symptoms will be moderate to severe. This condition is called thalassemia major, or Cooley anemia. Babies born with two defective beta hemoglobin genes usually are healthy at birth but develop signs and symptoms within the first two years of life. A milder form, called thalassemia intermedia, also may occur with two mutated genes. Risk factors Factors that increase your risk of thalassemia include: - Family history of thalassemia. Thalassemia is passed from parents to children through mutated hemoglobin genes. If you have a family history of thalassemia, you may have an increased risk of the condition. - Certain ancestry. Thalassemia occurs most often in African-Americans and in people of Mediterranean and Southeast Asian ancestry. Complications Possible complications of thalassemia include: - Iron overload. People with thalassemia can get too much iron in their bodies, either from the disease or from frequent blood transfusions. Too much iron can result in damage to your heart, liver and endocrine system. This system includes hormone-producing glands that regulate processes throughout your body. - Infection. People with thalassemia have an increased risk of infection. This is especially true if you've had your spleen removed. In cases of severe thalassemia, the following complications can occur: - Bone deformities. Thalassemia can make your bone marrow expand, which causes your bones to widen. This can result in abnormal bone structure, especially in your face and skull. Bone marrow expansion also makes bones thin and brittle, increasing the chance of broken bones. - Enlarged spleen (splenomegaly). The spleen helps your body fight infection and filter unwanted material, such as old or damaged blood cells. Thalassemia is often accompanied by the destruction of a large number of red blood cells. This causes your spleen to enlarge and work harder than normal. Splenomegaly can make anemia worse, and it can reduce the life of transfused red blood cells. If your spleen grows too big, your doctor may suggest surgery to remove it (splenectomy). - Slowed growth rates. Anemia can cause a child's growth to slow. And thalassemia may cause a delay in puberty. - Heart problems. Heart problems - such as congestive heart failure and abnormal heart rhythms (arrhythmias) - may be associated with severe thalassemia. Diagnosis Most children with moderate to severe thalassemia show signs and symptoms within their first two years of life. If your doctor suspects your child has thalassemia, he or she may confirm a diagnosis using blood tests. If your child has thalassemia, blood tests may reveal: - A low level of red blood cells - Smaller than expected red blood cells - Pale red blood cells - Red blood cells that are varied in size and shape - Red blood cells with uneven hemoglobin distribution, which gives the cells a bull's-eye appearance under the microscope Blood tests may also be used to: - Measure the amount of iron in your child's blood - Evaluate his or her hemoglobin - Perform DNA analysis to diagnose thalassemia or to determine if a person is carrying mutated hemoglobin genes Prenatal testing Testing can be done before a baby is born to find out if he or she has thalassemia and determine how severe it may be. Tests used to diagnose thalassemia in fetuses include: - Chorionic villus sampling. This test is usually done around the 11th week of pregnancy and involves removing a tiny piece of the placenta for evaluation. - Amniocentesis. This test is usually done around the 16th week of pregnancy and involves taking a sample of the fluid that surrounds the fetus. Assisted reproductive technology A form of assisted reproductive technology that combines preimplantation genetic diagnosis with in vitro fertilization may help parents who have thalassemia or who are carriers of a defective hemoglobin gene give birth to healthy babies. The procedure involves retrieving mature eggs and fertilizing them with sperm in a dish in a laboratory. The embryos are tested for the defective genes, and only those without genetic defects are implanted into the uterus. Treatment Treatment for thalassemia depends on which type you have and how severe it is. Treatments for mild thalassemia Signs and symptoms are usually mild with thalassemia minor and little, if any, treatment is needed. Occasionally, you may need a blood transfusion, particularly after surgery, after having a baby or to help manage thalassemia complications. People with severe beta-thalassemia will need blood transfusions. And because this treatment can cause iron overload, they will also need treatment to remove excess iron. An oral medication called deferasirox (Exjade, Jadenu) can help remove the excess iron. Treatments for moderate to severe thalassemia Treatments for moderate to severe thalassemia may include: - Frequent blood transfusions. More-severe forms of thalassemia often require frequent blood transfusions, possibly every few weeks. Over time, blood transfusions cause a buildup of iron in your blood, which can damage your heart, liver and other organs. To help your body get rid of the extra iron, you may need to take medications that rid your body of extra iron. - Stem cell transplant. Also called a bone marrow transplant, a stem cell transplant may be an option in select cases, including children born with severe thalassemia. It can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, you receive infusions of stem cells from a compatible donor, usually a sibling. Lifestyle and home remedies You can help manage your thalassemia by following your treatment plan and adopting healthy-living habits. The following tips will help: - Avoid excess iron. Unless your doctor recommends it, don't take vitamins or other supplements that contain iron. - Eat a healthy diet. Eating a balanced diet that contains plenty of nutritious foods can help you feel better and boost your energy. Your doctor also may recommend you take a folic acid supplement to help your body make new red blood cells. Also, to keep your bones healthy, make sure your diet contains adequate calcium and vitamin D. Ask your doctor what the right amounts are for you and whether you need to take a supplement. - Avoid infections. Protect yourself from infections with frequent hand-washing and by avoiding sick people. This is especially important if you've had to have your spleen removed. You'll also need an annual flu shot, as well as the meningitis, pneumococcal and hepatitis B vaccines to prevent infections. If you develop a fever or other signs and symptoms of an infection, see your doctor for treatment. ", "role": "user" }, { "content": "People with severe beta-thalassemia need frequent blood transfusions, which can cause iron overload, Excess iron could be removed using oral medication called deferasirox (Exjade, Jadenu.) In some cases, stem cell transplant (bone marrow transplant) can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, patients receive infusions of stem cells from a compatible donor, usually a sibling.", "role": "assistant" } ]

[ { "content": "how to prevent diabetes\n\nType 2 diabetes (Prevention): You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.", "role": "user" }, { "content": "You can help prevent type 2 diabetes by staying at a healthy body weight. You can get to a healthy weight by eating healthy foods, controlling your portion sizes, and leading an active lifestyle. Some medicines can also delay or prevent type 2 diabetes in people at risk of developing the disease.", "role": "assistant" } ]

[ { "content": "what is the treatment for lymphoma\n\nLymphoma (Treatment): Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. Lymphoma treatments include: - Active surveillance. Some forms of lymphoma are very slow growing. You and your doctor may decide to wait to treat your lymphoma when it causes signs and symptoms that interfere with your daily activities. Until then, you may undergo periodic tests to monitor your condition. - Chemotherapy. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs you receive. - Other drug therapy. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. - Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. - Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they travel to your bones and rebuild your bone marrow.", "role": "user" }, { "content": "Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. Lymphoma treatments include: - Active surveillance. Some forms of lymphoma are very slow growing. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. - Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. - Bone marrow transplant.", "role": "assistant" } ]

[ { "content": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?\n\nRubella (Lifestyle and home remedies): In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella.", "role": "user" }, { "content": "In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - - Tell your child's school or child care provider that your child has rubella.", "role": "assistant" } ]

[ { "content": "what are the causes of pulmonary hypertension\n\nPulmonary Hypertension (Causes): Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\"", "role": "user" }, { "content": "Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors can also cause PH. For example, if the walls of the arteries tighten, blood clots may become stiff from an overgrowth of cells.", "role": "assistant" } ]

[ { "content": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.\n\nGastritis (Treatment): Treatment depends on what is causing the problem. Some of the causes will go away over time. You may need to stop taking aspirin, ibuprofen, naproxen, or other medicines that may be causing gastritis. Always talk to your health care provider before stopping any medicine. You may use other over-the-counter and prescription drugs that decrease the amount of acid in the stomach, such as: - Antacids - H2 antagonists: famotidine (Pepsid), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid) - Proton pump inhibitors (PPIs): omeprazole (Prilosec), esomeprazole (Nexium), iansoprazole (Prevacid), rabeprazole (AcipHex), and pantoprazole (Protonix) Antibiotics may be used to treat chronic gastritis caused by infection with Helicobacter pylori bacteria.", "role": "user" }, { "content": "To treat gastritis caused by medications, such as aspirin, ibuprofen, or naproxen. your doctor might recommend stopping medications. Antibiotics may be used to treat chronic gastritis caused by infection with Helicobacter pylori bacteria. Your doctor might also recommend drugs that decrease the amount of acid in the stomach, such as antacids and proton pump inhibitors.", "role": "assistant" } ]

[ { "content": "what is epilepsy\n\n Epilepsy Definition The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Treatment Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. Prognosis While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy. ", "role": "user" }, { "content": "The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.", "role": "assistant" } ]

[ { "content": "what are the symptoms for cystic fibrosis\n\nCystic fibrosis - resources (Summary): The following organizations are good resources for information on cystic fibrosis: - Cystic Fibrosis Foundation -- www.cff.org - March of Dimes -- www.marchofdimes.org/baby/cystic-fibrosis-and-your-baby.aspx - National Heart, Lung, and Blood Institute -- www.nhlbi.nih.gov/health/health-topics/topics/cf - US National Library of Medicine, Genetics Home Reference -- ghr.nlm.nih.gov/condition/cystic-fibrosis", "role": "user" }, { "content": "The following organizations are good resources for information on cystic fibrosis: Cystic Fibrosis Foundation, -- www.cff.org, March of Dimes -- www.marchofdimes.org/baby/cystic-fibrosis-and-your-baby.aspx, National Heart, Lung, and Blood Institute -- www.nhlbi.nih.gov/health/health-topics/topics/cf, US National Library of Medicine, Genetics Home Reference -- ghr.nlm.nih.gov/condition/cystic-fibrosis.", "role": "assistant" } ]

[ { "content": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks\n\n Hiatal hernia Overview A hiatal hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm). Your diaphragm has a small opening (hiatus) through which your food tube (esophagus) passes before connecting to your stomach. In a hiatal hernia, the stomach pushes up through that opening and into your chest. A small hiatal hernia usually doesn't cause problems. You may never know you have one unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms. A very large hiatal hernia might require surgery. Symptoms Most small hiatal hernias cause no signs or symptoms. But larger hiatal hernias can cause: - Heartburn - Regurgitation of food or liquids into the mouth - Backflow of stomach acid into the esophagus (acid reflux) - Difficulty swallowing - Chest or abdominal pain - Shortness of breath - Vomiting of blood or passing of black stools, which may indicate gastrointestinal bleeding When to see a doctor See your doctor if you have any persistent signs or symptoms that worry you. Causes A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It's not always clear why this happens. But a hiatal hernia might be caused by: - Age-related changes in your diaphragm - Injury to the area, for example, after trauma or certain types of surgery - Being born with an unusually large hiatus - Persistent and intense pressure on the surrounding muscles, such as while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects Diagnosis A hiatal hernia is often discovered during a test or procedure to determine the cause of heartburn or chest or upper abdominal pain. These tests or procedures include: - X-ray of your upper digestive system. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. - Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach and check for inflammation. - Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus. Treatment Most people with a hiatal hernia don't experience any signs or symptoms and won't need treatment. If you experience signs and symptoms, such as recurrent heartburn and acid reflux, you may need medication or surgery. Medications If you experience heartburn and acid reflux, your doctor may recommend: - Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids and Tums, may provide quick relief. Overuse of some antacids can cause side effects, such as diarrhea or sometimes kidney problems. - Medications to reduce acid production. These medications - known as H-2-receptor blockers - include cimetidine (Tagamet famotidine (Pepcid), nizatidine (Axid ) and ranitidine (Zantac). Stronger versions are available by prescription. - Medications that block acid production and heal the esophagus. These medications - known as proton pump inhibitors - are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec, Zegerid). Stronger versions are available in prescription form. Surgery Sometimes a hiatal hernia requires surgery. Surgery is generally used for people who aren't helped by medications to relieve heartburn and acid reflux, or have complications such as severe inflammation or narrowing of the esophagus. Surgery to repair a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller, reconstructing an esophageal sphincter or removing the hernia sac. Or your surgeon may insert a tiny camera and special surgical tools through several small incisions in your abdomen. The operation is then performed while your surgeon views images from inside your body that are displayed on a video monitor (laparoscopic surgery). Sometimes surgery is done using a single incision in your chest wall (thoracotomy). Lifestyle and home remedies Making a few lifestyle changes may help control the symptoms and signs caused by a hiatal hernia. Try to: - Eat several smaller meals throughout the day rather than a few large meals - Avoid foods that trigger heartburn, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine - Avoid lying down after a meal or eating late in the day - Eat at least two to three hours before bedtime. - Maintain a healthy weight - Stop smoking - Elevate the head of your bed 6 inches (about 15 centimeters) ", "role": "user" }, { "content": "If a hiatal hernia does not have any symptoms, it won't need treatment. If the hernia causes heartburn and acid reflux, your doctor may recommend antacids. If the medications do not help or hiatal hernia causes inflammation or narrowing of the esophagus, you doctor might recommend surgery.", "role": "assistant" } ]

[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\n Menkes disease Steely hair disease Menkes kinky hair syndrome Kinky hair disease Copper transport disease Trichopoliodystrophy X-linked copper deficiency Summary Menkes disease is an inherited disorder in which the body has a problem absorbing copper. The disease affects development, both mental and physical. Causes Menkes disease is caused by a defect in the <em>ATP7A</em> gene. The defect makes it hard for the body to properly distribute (transport) copper throughout the body. As a result, the brain and other parts of the body do not get enough copper, while it builds up in the small intestine and kidneys. A low copper level can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is usually inherited, which means it runs in families. The gene is on the X-chromosome, so if a mother carries the defective gene, each of her sons has a 50% (1 in 2) chance of developing the disease, and 50% of her daughters will be a carrier of the disease. This kind of gene inheritance is called X-linked recessive. In some people, the disease is not inherited. Instead, the gene defect occurs after birth. Symptoms Common symptoms of Menkes disease in infants are: Brittle, kinky, steely, sparse, or tangled hair Pudgy, rosy cheeks, sagging facial skin Feeding difficulties Irritability Lack of muscle tone, floppiness Low body temperature Intellectual disability and developmental delay Seizures Skeletal changes Exams and Tests Once Menkes disease is suspected, tests that may be done include: Ceruloplasmin blood test (substance that transports copper in the blood) Copper blood test Skin cell culture X-ray of the skeleton or x-ray of the skull Gene testing to check for defect of the <em>ATP7A</em> gene Treatment Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results and depends on whether the <em>ATP7A</em> gene still has some activity. Support Groups These resources can provide more information on Menkes syndrome: National Organization for Rare Disorders -- rarediseases.org/rare-diseases/menkes-disease NIH/NLM Genetics Home Reference -- ghr.nlm.nih.gov/condition/menkes-syndrome Outlook (Prognosis) Most children with this disease die within the first few years of life. When to Contact a Medical Professional Talk to your health care provider if you have a family history of Menkes syndrome and you plan to have children. A baby with this condition will often show symptoms early in infancy. Prevention See a genetic counselor if you want to have children and you have a family history of Menkes syndrome. Maternal relatives (relatives on the mother's side of the family) of a boy with this syndrome should be seen by a geneticist to find out if they are carriers. Review Date 5/1/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it. Menkes syndrome is caused by a defect in the ATP7A gene. The defect makes it hard for the body to distribute copper in food from the intestines into the bloodstream for use in other areas. As a result, the brain and other parts of the body do not get enough copper. Copper can build up in the small intestine and kidneys, but low copper levels in other areas can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is inherited, which means it runs in families. Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes There is often a history of Menkes syndrome in a male relative. Signs include: - Abnormal appearance of the hair under a microscope - Abnormally low body temperature - Bleeding in the brain - Slow growth in the womb In males, all of the hairs will be abnormal. In females who carry this trait, half of them may have areas of abnormal hair. Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results. Most people with this condition die within the first few years of life.", "role": "assistant" } ]

[ { "content": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP\n\nDiarrhea (Treatment): Most cases of diarrhea clear on their own within a couple of days without treatment. If you've tried lifestyle changes and home remedies for diarrhea without success, your doctor might recommend medications or other treatments. Antibiotics Antibiotics might help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. Treatment to replace fluids Your doctor likely will advise you to replace the fluids and salts. For most adults, that means drinking water, juice or broth. If drinking liquids upsets your stomach or causes diarrhea, your doctor might recommend getting fluids through a vein in your arm (intravenously). Water is a good way to replace fluids, but it doesn't contain the salts and electrolytes - minerals such as sodium and potassium - you need to maintain the electric currents that keep your heart beating. You can help maintain your electrolyte levels by drinking fruit juices for potassium or eating soups for sodium. Certain fruit juices, such as apple juice, might make diarrhea worse. For children, ask your doctor about using an oral rehydration solution, such as Pedialyte, to prevent dehydration or replace lost fluids. Adjusting medications you're taking If your doctor determines that an antibiotic caused your diarrhea, your doctor might lower your dose or switch to another medication. Treating underlying conditions If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition. You might be referred to a specialist, such as a gastroenterologist, who can help devise a treatment plan for you.", "role": "user" }, { "content": "Most cases of diarrhea clear on their own within a couple of days without treatment. If you've tried lifestyle changes and home remedies for diarrhea without success, your doctor might recommend medications or other treatments. ... Antibiotics might help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. ... Your doctor likely will advise you to replace the fluids and salts. For most adults, that means drinking water, juice or broth. ... Certain fruit juices, such as apple juice, might make diarrhea worse.", "role": "assistant" } ]

[ { "content": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.\n\nLewy body dementia (Symptoms): Lewy body dementia signs and symptoms may include: - Visual hallucinations. Hallucinations may be one of the first symptoms, and they often recur. They may include seeing shapes, animals or people that aren't there. Sound (auditory), smell (olfactory) or touch (tactile) hallucinations are possible. - Movement disorders. Signs of Parkinson's disease (parkinsonian symptoms), such as slowed movement, rigid muscles, tremor or a shuffling walk may occur. - Poor regulation of body functions (autonomic nervous system). Blood pressure, pulse, sweating and the digestive process are regulated by a part of the nervous system that is often affected by Lewy body dementia. This can result in dizziness, falls and bowel issues such as constipation. - Cognitive problems. You may experience thinking (cognitive) problems similar to those of Alzheimer's disease, such as confusion, poor attention, visual-spatial problems and memory loss. - Sleep difficulties. You may have rapid eye movement (REM) sleep behavior disorder, which can cause you to physically act out your dreams while you're asleep. - Fluctuating attention. Episodes of drowsiness, long periods of staring into space, long naps during the day or disorganized speech are possible. - Depression. You may experience depression sometime during the course of your illness. - Apathy. You may have loss of motivation.", "role": "user" }, { "content": "Lewy body dementia signs and symptoms may include: - Visual hallucinations. Hallucinations may be one of the first symptoms, and they often recur. Sound (auditory), smell (olfactory) or touch (tactile) hallucinations are possible. - Movement disorders. Signs of Parkinson's disease (parkinsonian symptoms), such as slowed movement, rigid muscles, tremor or a shuffling walk may occur. - Poor regulation of body functions (autonomic nervous system). Blood pressure, pulse, sweating and the digestive process are regulated by a part of the nervous system that is often affected by Lewy body dementia. This can result in dizziness, falls and bowel issues such as constipation. - Cognitive problems. You may experience thinking (cognitive) problems similar to those of Alzheimer's disease, such as confusion, poor attention, visual-spatial problems and memory loss. - Sleep difficulties. You may have rapid eye movement (REM) sleep behavior disorder, which can cause you to physically act out your dreams while you're asleep. - Fluctuating attention. Episodes of drowsiness, long periods of staring into space, long naps during the day or disorganized speech are possible. - Depression. You may experience depression sometime during the course of your illness. - Apathy. You may have loss of motivation.", "role": "assistant" } ]

[ { "content": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...\n\nLimb-girdle muscular dystrophies (Treatment): There are no known treatments that reverse the muscle weakness. Gene therapy may become available in the future. Supportive treatment can decrease the complications of the disease. The condition is managed based on the person’s symptoms. It includes: - Heart monitoring - Mobility aids - Physical therapy - Respiratory care - Weight control Surgery is sometimes needed for any bone or joint problems.", "role": "user" }, { "content": "There are no known treatments that reverse the muscle weakness. Gene therapy may become available in the future. Supportive treatment can decrease the complications of the disease. The condition is managed based on the symptoms and may include heart monitoring, mobility aids, physical therapy, respiratory care, weight control and surgery.", "role": "assistant" } ]

[ { "content": "how do you diagnose anxiety\n\nAnxiety: Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood. Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety you have, treatment can help. Anxiety care at Mayo Clinic Common anxiety signs and symptoms include: - Feeling nervous, restless or tense - Having a sense of impending danger, panic or doom - Having an increased heart rate - Breathing rapidly (hyperventilation) - Sweating - Trembling - Feeling weak or tired - Trouble concentrating or thinking about anything other than the present worry - Having trouble sleeping - Experiencing gastrointestinal (GI) problems - Having difficulty controlling worry - Having the urge to avoid things that trigger anxiety Several types of anxiety disorders exist: - Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. - Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem. - Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events - even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression. - Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred. - Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning. - Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles. - Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others. - Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people. - Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of abusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs. - Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive. When to see a doctor See your doctor if: - You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life - Your fear, worry or anxiety is upsetting to you and difficult to control - You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety - You think your anxiety could be linked to a physical health problem - You have suicidal thoughts or behaviors - if this is the case, seek emergency treatment immediately Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early. The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor. Medical causes For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem. Examples of medical problems that can be linked to anxiety include: - Heart disease - Diabetes - Thyroid problems, such as hyperthyroidism - Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma - Drug abuse or withdrawal - Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications - Chronic pain or irritable bowel syndrome - Rare tumors that produce certain \"fight-or-flight\" hormones Sometimes anxiety can be a side effect of certain medications. It's possible that your anxiety may be due to an underlying medical condition if: - You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder - You didn't have an anxiety disorder as a child - You don't avoid certain things or situations because of anxiety - You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety These factors may increase your risk of developing an anxiety disorder: - Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders. - Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future. - Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety - for example, a death in the family, work stress or ongoing worry about finances. - Personality. People with certain personality types are more prone to anxiety disorders than others are. - Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder. - Having blood relatives with an anxiety disorder. Anxiety disorders can run in families. - Drugs or alcohol. Drug or alcohol use or abuse or withdrawal can cause or worsen anxiety. Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as: - Depression (which often occurs with an anxiety disorder) or other mental health disorders - Substance abuse - Trouble sleeping (insomnia) - Digestive or bowel problems - Headaches and chronic pain - Social isolation - Problems functioning at school or work - Poor quality of life - Suicide You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety. Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety. CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms. Medications Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example: - Certain antidepressants are also used to treat anxiety disorders. - An anti-anxiety medication called buspirone may be prescribed. - In limited circumstances, your doctor may prescribe a certain type of sedative called a benzodiazepine for short-term relief of anxiety symptoms. Talk with your doctor about benefits, risks and possible side effects of medications. While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you. - Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety. - Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions. Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.", "role": "user" }, { "content": "Talk to your primary care doctor to find out if your anxiety could be related to your physical health. However, if you have severe anxiety, you may need to see a mental health specialist such as a psychiatrist, psychologist, or other mental health professional. To help diagnose an anxiety disorder, your provider may give you a psychological evaluation. This includes describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.", "role": "assistant" } ]

[ { "content": "I am 23yr boy,i have knock knees i want treatment. Please help me.\n\n Knock knees Genu valgum Summary Knock knees are condition in which the knees touch, but the ankles do not touch. The legs turn inward. Causes Infants start out with bowlegs because of their folded position while in their mother's womb. The legs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child becomes knock-kneed. When the child stands, the knees touch but the ankles are apart. By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position). Knock knees can also develop as a result of a medical problem or disease, such as: Injury of the shinbone (only one leg will be knock-kneed) Osteomyelitis (bone infection) Overweight or obesity Rickets (a disease caused by a lack of vitamin D) Exams and Tests A health care provider will examine your child. Tests will be done if there are signs that knock knees are not a part of normal development. Treatment Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. Outlook (Prognosis) Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. Possible Complications Complications may include: Difficulty walking (very rare) Self-esteem changes related to cosmetic appearance of knock knees If left untreated, knock knees can lead to early arthritis of the knee When to Contact a Medical Professional Call your provider if you think your child has knock knees. Prevention There is no known prevention for normal knock knees. Review Date 12/9/2016 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Rare complications of knock knees include difficulty walking and self-esteem changes related to appearance of the knees. Untreated knock knees can lead to early arthritis of the knee.", "role": "assistant" } ]

[ { "content": "what are pancreatic enzymes?\n\nPancreatic cancer: Pancreatic cancer begins in the tissues of your pancreas - an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar. Pancreatic cancer typically spreads rapidly to nearby organs. It is seldom detected in its early stages. But for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early. One sign of pancreatic cancer is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back. Treatment may include surgery, chemotherapy, radiation therapy or a combination of these. Pancreatic cancer care at Mayo Clinic Signs and symptoms of pancreatic cancer often don't occur until the disease is advanced. They may include: - Pain in the upper abdomen that radiates to your back - Loss of appetite or unintended weight loss - Depression - New-onset diabetes - Blood clots - Fatigue - Yellowing of your skin and the whites of your eyes (jaundice) When to see a doctor See your doctor if you experience unexplained weight loss or if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you. Many conditions can cause these symptoms, so your doctor may check for these conditions as well as for pancreatic cancer. It's not clear what causes pancreatic cancer in most cases. Doctors have identified factors, such as smoking, that increase your risk of developing the disease. Understanding your pancreas Your pancreas is about 6 inches (15 centimeters) long and looks something like a pear lying on its side. It releases (secretes) hormones, including insulin, to help your body process sugar in the foods you eat. And it produces digestive juices to help your body digest food. How pancreatic cancer forms Pancreatic cancer occurs when cells in your pancreas develop mutations in their DNA. These mutations cause cells to grow uncontrollably and to continue living after normal cells would die. These accumulating cells can form a tumor. Untreated pancreatic cancer spreads to nearby organs and blood vessels. Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic adenocarcinoma or pancreatic exocrine cancer. Rarely, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas. These types of cancer are called islet cell tumors, pancreatic endocrine cancer and pancreatic neuroendocrine tumors. Factors that may increase your risk of pancreatic cancer include: - Chronic inflammation of the pancreas (pancreatitis) - Diabetes - Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome and familial atypical mole-malignant melanoma (FAMMM) syndrome - Family history of pancreatic cancer - Smoking - Obesity - Older age, as most people are diagnosed after age 65 A large study demonstrated that the combination of smoking, long-standing diabetes and a poor diet increases the risk of pancreatic cancer beyond the risk of any one of these factors alone. As pancreatic cancer progresses, it can cause complications such as: - Weight loss. A number of factors may cause weight loss in people with pancreatic cancer. The cancer itself may cause weight loss. Nausea and vomiting caused by cancer treatments or a tumor pressing on your stomach may make it difficult to eat. Or your body may have difficulty processing nutrients from food because your pancreas isn't making enough digestive juices. Your doctor may recommend pancreatic enzyme supplements to aid in digestion. Try to maintain your weight by adding extra calories where you can and making mealtime as pleasant and relaxed as possible. - Jaundice. Pancreatic cancer that blocks the liver's bile duct can cause jaundice. Signs include yellow skin and eyes, dark-colored urine, and pale-colored stools. Jaundice usually occurs without abdominal pain. Your doctor may recommend that a plastic or metal tube (stent) be placed inside the bile duct to hold it open. This is done with the help of a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During ERCP an endoscope is passed down your throat, through your stomach and into the upper part of your small intestine. A dye is then injected into the pancreatic and bile ducts through a small hollow tube (catheter) that's passed through the endoscope. Finally, images are taken of the ducts. - Pain. A growing tumor may press on nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Radiation therapy might help stop tumor growth temporarily to give you some relief. In severe cases, your doctor might recommend a procedure to inject alcohol into the nerves that control pain in your abdomen (celiac plexus block). This procedure stops the nerves from sending pain signals to your brain. - Bowel obstruction. Pancreatic cancer that grows into or presses on the first part of the small intestine (duodenum) can block the flow of digested food from your stomach into your intestines. Your doctor may recommend a tube (stent) be placed in your small intestine to hold it open. Or surgery may be necessary to attach your stomach to a lower point in your intestines that isn't blocked by cancer. If your doctor suspects pancreatic cancer, he or she may have you undergo one or more of the following tests: - Imaging tests that create pictures of your internal organs. These tests help your doctors visualize your internal organs, including the pancreas. Techniques used to diagnose pancreatic cancer include ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and, sometimes, positron emission tomography (PET) scans. - Using a scope to create ultrasound pictures of your pancreas. An endoscopic ultrasound (EUS) uses an ultrasound device to make images of your pancreas from inside your abdomen. The device is passed through a thin, flexible tube (endoscope) down your esophagus and into your stomach in order to obtain the images. - Removing a tissue sample for testing (biopsy). A biopsy is a procedure to remove a small sample of tissue for examination under a microscope. Your doctor may obtain a sample of tissue from the pancreas by inserting a needle through your skin and into your pancreas (fine-needle aspiration). Or he or she may remove a sample during EUS, guiding special tools into the pancreas. - Blood test. Your doctor may test your blood for specific proteins (tumor markers) shed by pancreatic cancer cells. One tumor marker test used in pancreatic cancer is called CA19-9. But the test isn't always reliable, and it isn't clear how best to use the CA19-9 test results. Some doctors measure your levels before, during and after treatment. If your doctor confirms a diagnosis of pancreatic cancer, he or she tries to determine the extent (stage) of the cancer. Using information from staging tests, your doctor assigns your pancreatic cancer a stage, which helps determine what treatments are most likely to benefit to you. The stages of pancreatic cancer are indicated by Roman numerals ranging from 0 to IV. The lowest stages indicate that the cancer is confined to the pancreas. By stage IV, the cancer has spread to other parts of the body. The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you. Don't hesitate to ask your doctor about his or her experience with diagnosing pancreatic cancer. If you have any doubts, get a second opinion. Treatment for pancreatic cancer depends on the stage and location of the cancer as well as on your overall health and personal preferences. For most people, the first goal of pancreatic cancer treatment is to eliminate the cancer, when possible. When that isn't an option, the focus may be on improving your quality of life and preventing the cancer from growing or causing more harm. Treatment may include surgery, radiation, chemotherapy or a combination of these. When pancreatic cancer is advanced and these treatments aren't likely to offer a benefit, your doctor will offer symptom relief (palliative care) that makes you as comfortable as possible. Surgery Operations used in people with pancreatic cancer include: - Surgery for tumors in the pancreatic head. If your cancer is located in the head of the pancreas, you may consider an operation called a Whipple procedure (pancreaticoduodenectomy). The Whipple procedure is technically difficult operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and part of the bile duct. In some situations, part of the stomach and nearby lymph nodes may be removed as well. Your surgeon reconnects the remaining parts of your pancreas, stomach and intestines to allow you to digest food. - Surgery for tumors in the pancreatic body and tail. Surgery to remove the left side (body and tail) of the pancreas is called distal pancreatectomy. Your surgeon may also remove your spleen. - Surgery to remove the entire pancreas. In some people, the entire pancreas may need to be removed. This is called total pancreatectomy. You can live relatively normally without a pancreas but do need lifelong insulin and enzyme replacement. - Surgery for tumors affecting nearby blood vessels. Many people with advanced pancreatic cancer are not considered eligible for the Whipple procedure or other pancreatic surgeries if their tumors involve nearby blood vessels. At a very few medical centers in the United States, highly specialized and experienced surgeons will safely perform these operations with removal and reconstruction of parts of blood vessels in select patients. Each of these surgeries carries the risk of bleeding and infection. After surgery some people experience nausea and vomiting if the stomach has difficulty emptying (delayed gastric emptying). Expect a long recovery after any of these procedures. You'll spend several days in the hospital and then recover for several weeks at home. Extensive research shows pancreatic cancer surgery tends to cause fewer complications when done by highly experienced surgeons at centers that do many of these operations. Don't hesitate to ask about your surgeon's and hospital's experience with pancreatic cancer surgery. If you have any doubts, get a second opinion. Chemotherapy Chemotherapy uses drugs to help kill cancer cells. These drugs can be injected into a vein or taken orally. You may receive one chemotherapy drug or a combination of them. Chemotherapy can also be combined with radiation therapy (chemoradiation). Chemoradiation is typically used to treat cancer that has spread beyond the pancreas, but only to nearby organs and not to distant regions of the body. At specialized medical centers, this combination may be used before surgery to help shrink the tumor. Sometimes it is used after surgery to reduce the risk that pancreatic cancer may recur. In people with advanced pancreatic cancer, chemotherapy is often used to control cancer growth and prolong survival. Radiation therapy Radiation therapy uses high-energy beams, such as those made from X-rays and protons, to destroy cancer cells. You may receive radiation treatments before or after cancer surgery, often in combination with chemotherapy. Or your doctor may recommend a combination of radiation and chemotherapy treatments when your cancer can't be treated surgically. Radiation therapy usually comes from a machine that moves around you, directing radiation to specific points on your body (external beam radiation). In specialized medical centers, radiation therapy may be delivered during surgery (intraoperative radiation). Radiation therapy traditionally uses X-rays to treat cancer. Some medical centers offer proton beam radiation therapy, which may be a treatment option for some people with advanced pancreatic cancer. Clinical trials Clinical trials are studies to test new treatments, such as systemic therapy, and new approaches to surgery or radiation therapy. If the treatment being studied proves to be safer and more effective than are current treatments, it can become the new standard of care. Clinical trials for pancreatic cancer might give you a chance to try new targeted therapy, chemotherapy drugs, immunotherapy treatments or vaccines. Clinical trials can't guarantee a cure, and they might have serious or unexpected side effects. On the other hand, cancer clinical trials are closely monitored to ensure they're conducted as safely as possible. And they offer access to treatments that wouldn't otherwise be available to you. Talk to your doctor about what clinical trials might be appropriate for you. Supportive (palliative) care Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy and radiation therapy. When palliative care is used along with other appropriate treatments - even soon after the diagnosis - people with cancer may feel better and live longer. Palliative care is provided by teams of doctors, nurses and other specially trained professionals. These teams aim to improve the quality of life for people with cancer and their families. Palliative care is not the same as hospice care or end-of-life care. Some integrative and alternative medicine approaches may help with signs and symptoms you experience due to your cancer or cancer treatments. Treatments to help you cope with distress People with cancer frequently experience distress. Some research suggests distress is more common in people with pancreatic cancer than it is in people with other types of cancer. If you're distressed, you may have difficulty sleeping and find yourself constantly thinking about your cancer. You may feel angry or sad. Discuss your feelings with your doctor. Specialists can help you sort through your feelings and help you devise strategies for coping. In some cases, medications may help. Integrative medicine and alternative therapies may also help you cope with distress. Examples include: - Art therapy - Exercise - Meditation - Music therapy - Relaxation exercises - Spirituality Talk with your doctor if you're interested in these treatment options.", "role": "user" }, { "content": "Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar.", "role": "assistant" } ]

[ { "content": "what blood tests confirm celiac disease\n\n Celiac Disease Definition and Facts Celiac disease is a digestive disorder that damages the small intestine. People with celiac disease cannot eat gluten, a protein found in wheat, barley, and rye. The disease can cause long-term digestive problems and keep you from getting nutrients you need. What is celiac disease? Celiac disease is a digestive disorder that damages the small intestine. The disease is triggered by eating foods containing gluten. Gluten is a protein found naturally in wheat, barley, and rye, and is common in foods such as bread, pasta, cookies, and cakes. Many pre-packaged foods, lip balms and lipsticks, hair and skin products, toothpastes, vitamin and nutrient supplements, and, rarely, medicines, contain gluten.Celiac disease can be very serious. The disease can cause long-lasting digestive problems and keep your body from getting all the nutrients it needs. Celiac disease can also affect the body outside the intestine.Celiac disease is different from gluten sensitivity or wheat intolerance. If you have gluten sensitivity, you may have symptoms similar to those of celiac disease, such as abdominal pain and tiredness. Unlike celiac disease, gluten sensitivity does not damage the small intestine.Celiac disease is also different from a wheat allergy. In both cases, your body's immune system reacts to wheat. However, some symptoms in wheat allergies, such as having itchy eyes or a hard time breathing, are different from celiac disease. Wheat allergies also do not cause long-term damage to the small intestine.1 How common is celiac disease? As many as one in 141 Americans has celiac disease, although most don't know it.2 Who is more likely to develop celiac disease? Although celiac disease affects children and adults in all parts of the world, the disease is more common in Caucasians and more often diagnosed in females. You are more likely to develop celiac disease if someone in your family has the disease. Celiac disease also is more common among people with certain other diseases, such as Down syndrome, Turner syndrome, and type 1 diabetes. What other health problems do people with celiac disease have? If you have celiac disease, you also may be at risk forAddison's disease Hashimoto's disease primary biliary cirrhosis type 1 diabetes What are the complications of celiac disease? Long-term complications of celiac disease includemalnutrition, a condition in which you don't get enough vitamins, minerals, and other nutrients you need to be healthy accelerated osteoporosis or bone softening, known as osteomalacia nervous system problems problems related to reproductionRare complications can includeintestinal cancer liver diseases lymphoma, a cancer of part of the immune system called the lymph system that includes the gutIn rare cases, you may continue to have trouble absorbing nutrients even though you have been following a strict gluten-free diet. If you have this condition, called refractory celiac disease, your intestines are severely damaged and can't heal. You may need to receive nutrients through an IV. Definition & Facts Symptoms and Causes If you have celiac disease, you may experience digestive symptoms or symptoms in other parts of your body. Digestive symptoms are more common in children than adults. Some people with celiac disease have no symptoms. What are the symptoms of celiac disease? Most people with celiac disease have one or more symptoms. However, some people with the disease may not have symptoms or feel sick. Sometimes health issues such as surgery, a pregnancy, childbirth, bacterial gastroenteritis, a viral infection, or severe mental stress can trigger celiac disease symptoms.If you have celiac disease, you may have digestive problems or other symptoms. Digestive symptoms are more common in children and can includebloating, or a feeling of fullness or swelling in the abdomen chronic diarrhea constipation gas nausea pale, foul-smelling, or fatty stools that float stomach pain vomitingFor children with celiac disease, being unable to absorb nutrients when they are so important to normal growth and development can lead todamage to the permanent teeth's enamel delayed puberty failure to thrive in infants mood changes or feeling annoyed or impatient slowed growth and short height weight lossAdults are less likely to have digestive symptoms and, instead, may have one or more of the following:anemia a red, smooth, shiny tongue bone or joint pain depression or anxiety dermatitis herpetiformis headaches infertility or repeated miscarriage missed menstrual periods mouth problems such a canker sores or dry mouth seizures tingling numbness in the hands and feet tiredness weak and brittle bonesAdults who have digestive symptoms with celiac disease may haveabdominal pain and bloating intestinal blockages tiredness that lasts for long periods of time ulcers, or sores on the stomach or lining of the intestineCeliac disease also can produce a reaction in which your immune system, or your body's natural defense system, attacks healthy cells in your body. This reaction can spread outside your digestive tract to other areas of your body, including yourbones joints nervous system skin spleenDepending on how old you are when a doctor diagnoses your celiac disease, some symptoms, such as short height and tooth defects, will not improve.Dermatitis herpetiformis is an itchy, blistering skin rash that usually appears on the elbows, knees, buttocks, back, or scalp. The rash affects about 10 percent of people with celiac disease. The rash can affect people of all ages but is most likely to appear for the first time between the ages of 30 and 40. Men who have the rash also may have oral or, rarely, genital sores. Some people with celiac disease may have the rash and no other symptoms. Why are celiac disease symptoms so varied? Symptoms of celiac disease vary from person to person. Your symptoms may depend onhow long you were breastfed as an infant; some studies have shown that the longer you were breastfed, the later celiac disease symptoms appear how much gluten you eat how old you were when you started eating gluten the amount of damage to your small intestine your age-symptoms can vary between young children and adultsPeople with celiac disease who have no symptoms can still develop complications from the disease over time if they do not get treatment. What causes celiac disease? Research suggests that celiac disease only happens to individuals who have particular genes. These genes are common and are carried by about one-third of the population. Individuals also have to be eating food that contains gluten to get celiac disease. Researchers do not know exactly what triggers celiac disease in people at risk who eat gluten over a long period of time. Sometimes the disease runs in families. About 10 to 20 percent of close relatives of people with celiac disease also are affected.3Your chances of developing celiac disease increase when you have changes in your genes, or variants. Certain gene variants and other factors, such as things in your environment, can lead to celiac disease. Symptoms & Causes Diagnosis Your doctor may diagnose celiac disease with a medical and family history, a physical exam, blood tests, an intestinal biopsy, a skin biopsy, and genetic tests. Doctors in the United Stated do not routinely screen people for celiac disease. How do doctors diagnose celiac disease? Celiac disease can be hard to diagnose because some of the symptoms are like symptoms of other diseases, such as irritable bowel syndrome (IBS) and lactose intolerance. Your doctor may diagnose celiac disease with a medical and family history, physical exam, and tests. Tests may include blood tests, genetic tests, and biopsy.Your doctor will ask you for information about your family's health-specifically, if anyone in your family has a history of celiac disease.During a physical exam, a doctor most oftenchecks your body for a rash or malnutrition, a condition that arises when you don't get enough vitamins, minerals, and other nutrients you need to be healthy listens to sounds in your abdomen using a stethoscope taps on your abdomen to check for pain and fullness or swellingFor some people, a dental visit can be the first step toward discovering celiac disease. Dental enamel defects, such as white, yellow, or brown spots on the teeth, are a pretty common problem in people with celiac disease, especially children. These defects can help dentists and other health care professionals identify celiac disease. What tests do doctors use to diagnose celiac disease? A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.4 You are very unlikely to have celiac disease if these gene variants are not present. Having these variants alone is not enough to diagnose celiac disease because they also are common in people without the disease. In fact, most people with these genes will never get celiac disease.If blood tests suggest you have celiac disease, your doctor will perform a biopsy to be sure. During a biopsy, the doctor takes a small piece of tissue from your small intestine during a procedure called an upper GI endoscopy.If a doctor suspects you have dermatitis herpetiformis, he or she will perform a skin biopsy. For a skin biopsy, the doctor removes tiny pieces of skin tissue to examine with a microscope.A doctor examines the skin tissue and checks the tissue for antibodies common in celiac disease. If the skin tissue has the antibodies, a doctor will perform blood tests to confirm celiac disease. If the skin biopsy and blood tests both suggest celiac disease, you may not need an intestinal biopsy. Do doctors screen for celiac disease? Screening is testing for diseases when you have no symptoms. Doctors in the United States do not routinely screen people for celiac disease. However, blood relatives of people with celiac disease and those with type 1 diabetes should talk with their doctor about their chances of getting the disease.Many researchers recommend routine screening of all family members, such as parents and siblings, for celiac disease.5 However, routine genetic screening for celiac disease is not usually helpful when diagnosing the disease. Diagnosis Treatment Doctors treat celiac disease by prescribing a gluten-free diet. Symptoms significantly improve for most people with celiac disease who follow a gluten-free diet. A dietitian can teach you how to avoid gluten while following a healthy and nutritious diet. How do doctors treat celiac disease? Doctors treat celiac disease with a gluten-free diet. Gluten is a protein found naturally in wheat, barley, and rye that triggers a reaction if you have celiac disease. Symptoms greatly improve for most people with celiac disease who stick to a gluten-free diet. In recent years, grocery stores and restaurants have added many more gluten-free foods and products, making it easier to stay gluten free.Your doctor may refer you to a dietitian who specializes in treating people with celiac disease. The dietitian will teach you how to avoid gluten while following a healthy diet. He or she will help youcheck food and product labels for gluten design everyday meal plans make healthy choices about the types of foods to eatFor most people, following a gluten-free diet will heal damage in the small intestine and prevent more damage. You may see symptoms improve within days to weeks of starting the diet. The small intestine usually heals in 3 to 6 months in children. Complete healing can take several years in adults. Once the intestine heals, the villi, which were damaged by the disease, regrow and will absorb nutrients from food into the bloodstream normally.If you have dermatitis herpetiformis-an itchy, blistering skin rash-skin symptoms generally respond to a gluten-free diet. However, skin symptoms may return if you add gluten back into your diet. Medicines such as dapsone, taken by mouth, can control the skin symptoms. People who take dapsone need to have regular blood tests to check for side effects from the medicine.Dapsone does not treat intestinal symptoms or damage, which is why you should stay on a gluten-free diet if you have the rash. Even when you follow a gluten-free diet, the rash may take months or even years to fully heal-and often comes back over the years. Avoiding medicines and nonfood products that may contain gluten In addition to prescribing a gluten-free diet, your doctor will want you to avoid all hidden sources of gluten. If you have celiac disease, ask a pharmacist about ingredients inherbal and nutritional supplements prescription and over-the-counter medicines vitamin and mineral supplementsYou also could take in or transfer from your hands to your mouth other products that contain gluten without knowing it. Products that may contain gluten includechildren's modeling dough, such as Play-Doh cosmetics lipstick, lip gloss, and lip balm skin and hair products toothpaste and mouthwash communion wafersMedications are rare sources of gluten. Even if gluten is present in a medicine, it is likely to be in such small quantities that it would not cause any symptoms.Reading product labels can sometimes help you avoid gluten. Some product makers label their products as being gluten-free. If a product label doesn't list the product's ingredients, ask the maker of the product for an ingredients list. Treatment If you don't improve after starting a gluten-free diet, you may still be eating or using small amounts of gluten. You probably will start responding to the gluten-free diet once you find and cut out all hidden sources of gluten. Hidden sources of gluten include additives made with wheat, such asmodified food starch malt flavoring preservatives stabilizersIf you still have symptoms even after changing your diet, you may have other conditions or disorders that are more common with celiac disease, such as irritable bowel syndrome (IBS), lactose intolerance, microscopic colitis, dysfunction of the pancreas, and small intestinal bacterial overgrowth. Eating, Diet, and Nutrition Eating, diet, and nutrition play a major role in treating celiac disease. You should maintain a gluten-free diet by avoiding all products that contain gluten. You can maintain a well-balanced diet with a variety of foods that do not include gluten. What should I avoid eating if I have celiac disease? Avoiding foods with gluten, a protein found naturally in wheat, rye, and barley, is critical in treating celiac disease. Removing gluten from your diet will improve symptoms, heal damage to your small intestine, and prevent further damage over time. While you may need to avoid certain foods, the good news is that many healthy, gluten-free foods and products are available.You should avoid all products that contain gluten, such as most cereal, grains, and pasta, and many processed foods. Be sure to always read food ingredient lists carefully to make sure the food you want to eat doesn't have gluten. In addition, discuss gluten-free food choices with a dietitian or health care professional who specializes in celiac disease. What should I eat if I have celiac disease? Foods such as meat, fish, fruits, vegetables, rice, and potatoes without additives or seasonings do not contain gluten and are part of a well-balanced diet. You can eat gluten-free types of bread, pasta, and other foods that are now easier to find in stores, restaurants, and at special food companies. You also can eat potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour.In the past, doctors and dietitians advised against eating oats if you have celiac disease. Evidence suggests that most people with the disease can safely eat moderate amounts of oats, as long as they did not come in contact with wheat gluten during processing. You should talk with your health care team about whether to include oats in your diet.When shopping and eating out, remember toread food labels-especially on canned, frozen, and processed foods-for ingredients that contain gluten identify foods labelled \"gluten-free;\" by law, these foods must contain less than 20 parts per million, well below the threshold to cause problems in the great majority of patients with celiac disease ask restaurant servers and chefs about how they prepare the food and what is in it find out whether a gluten-free menu is available ask a dinner or party host about gluten-free options before attending a social gatheringFoods labeled gluten-free tend to cost more than the same foods that have gluten. You may find that naturally gluten-free foods are less expensive. With practice, looking for gluten can become second nature.If you have just been diagnosed with celiac disease, you and your family members may find support groups helpful as you adjust to a new approach to eating. Is a gluten-free diet safe if I don't have celiac disease? In recent years, more people without celiac disease have adopted a gluten-free diet, believing that avoiding gluten is healthier or could help them lose weight. No current data suggests that the general public should maintain a gluten-free diet for weight loss or better health. 6, 7A gluten-free diet isn't always a healthy diet. For instance, a gluten-free diet may not provide enough of the nutrients, vitamins, and minerals the body needs, such as fiber, iron, and calcium. Some gluten-free products can be high in calories and sugar.If you think you might have celiac disease, don't start avoiding gluten without first speaking with your doctor. If your doctor diagnoses you with celiac disease, he or she will put you on a gluten-free diet. Gluten-free food labeling requirements The U.S. Food and Drug Administration (FDA) published a rule defining what \"gluten-free\" means on food labels. The \"gluten-free\" for food labeling rule requires that any food with the terms \"gluten-free,\" \"no gluten,\" \"free of gluten,\" and \"without gluten\" on the label must meet all of the definition's requirements.While the FDA rule does not apply to foods regulated by the U.S. Department of Agriculture, including meat and egg products, it is often still observed. Eating, Diet, & Nutrition ", "role": "user" }, { "content": "A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.", "role": "assistant" } ]

[ { "content": "what are the causes of headaches\n\nWhat causes Headaches - danger signs?: Problems with blood vessels and bleeding in the brain cancause as a headache. These include: - Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. - Blood flow to part of the brain stops. This is called a stroke. - Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. - Bleeding in the area between the brain and the thin tissue that covers the brain. This iscalled a subarachnoid hemorrhage Other causes of headaches that should be checked by a doctor right awayinclude: - Blood pressure that is very high - Brain tumor - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) - Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudomotor cerebri) - Carbon monoxide poisoning - Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess - Swollen, inflamed arterythat supplies blood to part of the head, temple, and neck area (temporal arteritis)", "role": "user" }, { "content": "What causes Headaches - danger signs? Problems with blood vessels and bleeding in the brain can cause as a headache. These include: - Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. - Blood flow to part of the brain stops. This is called a stroke. - Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. - Bleeding in the area between the brain and the thin tissue that covers the brain.", "role": "assistant" } ]

[ { "content": "I am suffering from Kartagener's syndrome and wanted information from you or from Dr. . for this syndrome. (About fertility) and if possible other symptoms. Thank you.\n\n Kartagener syndrome Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Dextrocardia bronchiectasis and sinusitis Siewert syndrome Immotile cilia syndrome, Kartagener type Primary ciliary dyskinesia, Kartagener type Dextrocardia-bronchiectasis-sinusitis syndrome Primary ciliary dyskinesia and situs inversus See More Summary Kartagener syndrome is a type of p that is also characterized by situs inversus totalis (mirror-image reversal of internal organs ). The signs and symptoms vary but may include neonatal respiratory distress; frequent lung, sinus and middle ear infections beginning in early childhood; and infertility. [1] [2] [3] It can be cause by changes ( mutations ) in many different genes that are inherited in an autosomal recessive manner. Although scientists have identified many of the genes associated with Kartagener syndrome, the genetic cause of some cases is unknown. [4] [2] There is no cure for Kartagener syndrome. Treatment varies based on the signs and symptoms present in each person but may include airway clearance therapy and antibiotics . [1] [2] [3] Symptoms Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. [1] [2] The signs and symptoms of primary ciliary dyskinesia vary, but may include: [1] [2] [3] Neonatal respiratory distress Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility Cause Kartagener syndrome can be caused by changes ( mutations ) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . The coordinated movement of cilia in wave-like motions is important to the normal functioning of certain organs and tissues throughout the body and ensures the proper placement of organs in the developing embryo. Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. [1] [4] [3] Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. [1] [4] [3] Inheritance Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. Diagnosis Kartagener syndrome is typically suspected based on the presence of characteristic signs and symptoms. A diagnosis can be confirmed by examining a small sample of tissue ( biopsy ) from an area of the body known to have cilia such as the sinus cavities or the airway. Abnormalities in the structure of cilia, as seen in people affected by Kartagener syndrome, can be observed under a special microscope (called an electron microscope). If the disease-causing change ( mutation ) is known, genetic testing can also be used to confirm the diagnosis. [1] [2] [3] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Treatment There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. Surgery to insert ear tubes may be recommended in children with chronic ear infections that are resistant to antibiotics. In people with severe lung disease, lung transplantation may be an option. [1] [2] [3] For more information on the treatment and management of Kartagener syndrome, please click here. Prognosis The long-term outlook for people with Kartagener syndrome varies widely and largely depends on timely diagnosis and treatment. Chronic childhood infections can be very debilitating. However, with appropriate treatment, the progression of lung disease can be slowed and other complications such as hearing loss can be avoided. [3] [2] [5] ", "role": "user" }, { "content": "Kartagener syndrome is inherited in an autosomal recessive manner. [4] This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier.", "role": "assistant" } ]

[ { "content": "would you help me to fine article or jurnal about Cri du chat syndrome\n\n Cri du chat syndrome Chromosome 5p deletion syndrome 5p minus syndrome Cat cry syndrome Summary Cri du chat syndrome is a group of symptoms that result from missing a piece of chromosome number 5. The syndrome's name is based on the infant's cry, which is high-pitched and sounds like a cat. Causes Cri du chat syndrome is rare. It is caused by a missing piece of chromosome 5. Most cases are believed to occur during the development of the egg or sperm. A small number of cases occur when a parent passes a different, rearranged form of the chromosome to their child. Symptoms Symptoms include: Cry that is high-pitched and may sound like a cat Downward slant to the eyes Low birth weight and slow growth Low-set or abnormally shaped ears Intellectual disability Partial webbing or fusing of fingers or toes Single line in the palm of the hand Skin tags just in front of the ear Slow or incomplete development of motor skills Small head (microcephaly) Small jaw (micrognathia) Wide-set eyes Exams and Tests The health care provider will perform a physical exam. This may show: Inguinal hernia Diastasis recti (separation of the muscles in the belly area) Low muscle tone Epicanthal folds, an extra fold of skin over the inner corner of the eye Problems with the folding of the outer ears Genetic tests can show a missing part of chromosome 5. Skull x-ray may reveal any problems with the shape of the base of the skull. Treatment There is no specific treatment. Your provider will suggest ways to treat or manage the symptoms. Parents of a child with this syndrome should have genetic counseling and testing to determine if one parent has a change in chromosome 5. Support Groups 5P- Society -- www.fivepminus.org Outlook (Prognosis) Intellectual disability is common. One half of children with this syndrome learn enough verbal skills to communicate. The cat-like cry becomes less noticeable over time. Possible Complications Complications depend on the amount of intellectual disability and physical problems. Symptoms may affect the person's ability to care for themselves. When to Contact a Medical Professional This syndrome is most often diagnosed at birth. Your provider will discuss your baby's symptoms with you. It is important to continue regular visits with the child's providers after leaving the hospital. Genetic counseling and testing is recommended for all people with a family history of this syndrome. Prevention There is no known prevention. Couples with a family history of this syndrome who wish to become pregnant may consider genetic counseling. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Cri du chat syndrome refers to a group of symptoms that result in the deletion of a piece of chromosome 5. It's name is french for the sound of the afflicted infant's cry.", "role": "assistant" } ]

[ { "content": "what are the risk factors of type ii diabetes\n\n Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. Type 1 Diabetes Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. Gestational Diabetes Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. Prediabetes Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Signs of Diabetes Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. How Many Have Diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) If Diabetes is Not Managed Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, heart, gums and teeth. If you have diabetes, you are more likely than people without diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure and cholesterol and to avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Risk Factors Diabetes is a serious, life-long disease. It can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage. More than 8 million people in the United States have type 2 diabetes and don’t know it. Many people don’t find out they have diabetes until they are faced with problems such as blurry vision or heart trouble. Certain factors can increase your risk for diabetes, and it’s important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body’s own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a person’s risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Learn more about the causes of type 2 diabetes. Prediabetes and Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. People with prediabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Prediabetes is increasingly common in the U.S. adult population. In 2012, about 86 million people in the U.S. had pre-diabetes, and 51% of those 65 or older had prediabetes. Learn more about prediabetes. Gestational Diabetes Some women develop diabetes during the late stages of pregnancy. This is called gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it has a lifelong risk for developing diabetes, mostly type 2. Prevention The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that type 2 diabetes can be prevented or delayed in people at risk for the disease. Preventing type 2 diabetes can mean a healthier and longer life without serious complications from the disease such as heart disease, stroke, blindness, kidney failure, and amputations. Preventing Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. The good news is that if you have prediabetes, there are ways to reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes Benefits of Weight Loss and Exercise The Diabetes Prevention Program (DPP) is a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases. DPP researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The drug metformin reduced the risk of type 2 diabetes by 34 percent but was more effective in younger and heavier adults. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) The benefits of weight loss and regular exercise have long-lasting value. In a DPP follow-up trial known as the Diabetes Prevention Program Outcome Study (DPPOS), people at risk of type 2 diabetes who kept off the weight they had lost and who continued to exercise regularly delayed the onset of type 2 diabetes by about 4 years. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. How to Lower Your Risk Making modest lifestyle changes can help prevent or delay type 2 diabetes in people who are at risk. Here are some tips. Reach and Maintain a Reasonable Body Weight Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The Body Mass Index chart (seen here) can be used to find out whether someone is normal weight, overweight, or obese. Body mass index is a measurement of body weight relative to height for adults age 20 or older. To use the chart - find the person's height in the left-hand column - move across the row to find the number closest to the person's weight - find the number at the top of that column - The number at the top of the column is the person’s BMI. find the person's height in the left-hand column move across the row to find the number closest to the person's weight find the number at the top of that column The number at the top of the column is the person’s BMI. The words above the BMI number indicate whether the person is normal weight, overweight, or obese. People who are overweight or obese should consider talking with a health care provider about ways to lose weight and reduce the risk of diabetes. The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle. Waist Measurement. In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. This is true even if a person’s body mass index (BMI) falls within the normal range. To measure the waist, a person should - place a tape measure around the bare abdomen just above the hip bone - make sure the tape is snug but isn’t digging into the skin and is parallel to the floor - relax, exhale, and measure. place a tape measure around the bare abdomen just above the hip bone make sure the tape is snug but isn’t digging into the skin and is parallel to the floor relax, exhale, and measure. Make Healthy Food Choices What you eat has a big impact on your weight and overall health. By developing healthy eating habits, you can help manage your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Here are more tips for eating well with diabetes. - Make a diabetes meal plan with help from your health care team. - Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. - Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. - Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. - Drink water instead of juice and regular soda. - When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. Make a diabetes meal plan with help from your health care team. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. Drink water instead of juice and regular soda. When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta. For more about healthy eating and older adults see \"Eating Well as You Get Older.\" Be Physically Active Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways. It - helps you lose weight - controls your cholesterol and blood pressure - improves your body's use of insulin. helps you lose weight controls your cholesterol and blood pressure improves your body's use of insulin. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. For more information on exercise and older adults, see Exercises to Try or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Signs and Diagnosis Diabetes is often called a \"silent\" disease because it can cause serious complications even before you have symptoms. Symptoms can also be so mild that you don’t notice them. An estimated 8 million people in the United States have type 2 diabetes and don’t know it, according to 2012 estimates by the Centers for Disease Control and Prevention (CDC). Common Signs Some common symptoms of diabetes are: - being very thirsty - frequent urination - feeling very hungry or tired - losing weight without trying - having sores that heal slowly - having dry, itchy skin - loss of feeling or tingling in the feet - having blurry eyesight. being very thirsty frequent urination feeling very hungry or tired losing weight without trying having sores that heal slowly having dry, itchy skin loss of feeling or tingling in the feet having blurry eyesight. Signs of type 1 diabetes usually develop over a short period of time. The signs for type 2 diabetes develop more gradually. Tests for Diabetes The following tests are used to diagnose diabetes or prediabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and prediabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not prediabetes. - An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. Get more details about tests for diabetes. Who Should Get Tested? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. See risk factors for type 2 diabetes. Why Early Detection is Important Diabetes is a serious disease that can lead to a number of health problems such as heart disease, stroke, vision problems, kidney disease and even death. Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as a heart attack or stroke. Finding out early if you have diabetes is important because treatment can prevent or delay the complications of the disease. Diet and Exercise Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. People with type 1 diabetes manage their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can manage blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both. Diabetes is a progressive disease and, over time, people with diabetes may need both lifestyle modification and medications. Follow a Meal Plan Making healthy food choices is very important to help keep your blood glucose level under control. A registered dietitian can work with you to develop a healthy eating plan. He or she can help you design a meal plan that takes into consideration various factors including your weight and daily physical activity, blood glucose levels, other health conditions and medications. If you are overweight, a plan to help you achieve a weight that is right for you will help manage your blood glucose. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you. (Watch the video to learn about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What to Eat People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in your target range, and prevent or delay heart and blood vessel disease. For more information on nutrition and older adults, see Eating Well As You Get Older. Get Regular Physical Activity Regular physical activity is important for people with diabetes. Being physically active has been shown to improve blood glucose levels in older people whose levels are high. Exercise is especially good for people with diabetes because it - helps manage weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps manage weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Safety First Before you begin physical activity, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some activities like weightlifting may not be safe. Your health care team can help you find safe ways to be active. For tips on safety issues older adults should consider before starting a new exercise program, see Exercise: Safety First Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to be physically active. You can even get exercise when you clean house or work in your garden. How Much? How Often? Try to be active almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) To see examples of exercises for older adults, see Exercises to Try. Or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Medications Manage Your Diabetes Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Diabetes pills and insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. People with type 1 diabetes control their blood sugar with insulin -- either delivered by injection or a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Taking Diabetes Pills If your body is still making some insulin, but not enough to keep your blood glucose levels under control, you may need diabetes pills. Some medications are taken once a day; others must be taken more often. Ask your health care team when you should take your pills. Remember to take your medicines every day, even when you feel well. Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don't lower blood glucose all by themselves. You will still want to follow a meal plan and exercise to help lower your blood glucose. Taking Insulin You need insulin if your body has stopped making insulin or if your body doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. Insulin can't be taken as a pill. It is usually taken by shots or with an insulin pump or insulin pen. Insulin pumps are small machines, usually worn on the hip, that contain insulin and deliver small steady doses of insulin throughout the day, Some pumps are attached directly to the skin. Other people use an insulin pen, which holds a cartridge of insulin that is dialed to the prescribed dose of insulin and then injected. Sometimes, people who take diabetes pills may need insulin shots for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose. Get more information about taking diabetes medicines. Know Your Diabetes ABCs Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol A is for the A1C test B is for Blood pressure C is for Cholesterol The A1C Test The A1C test (A-one-C), also called the hemoglobin A1C test, shows overall blood glucose for the past 3 months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. If your A1C is above your target goal, take action. You may need a change in your meal plan, your level of physical activity, or the medications you take to lower your chance of getting diabetes problems like heart disease or kidney damage. Talk with your health care provider about your A1C goal and how to reach it. Learn more about the A1C test. Check Your Blood Pressure High blood pressure makes your heart work too hard. This can lead to a stroke and other problems such as kidney disease. Your blood pressure should be checked at every doctor visit. The target blood pressure for most people with diabetes is less than 140/90 but may be different for you. Talk with your health care provider about your blood pressure goal. Learn about ways to check your blood pressure. Have Your LDL Cholesterol Checked Low density lipoprotein, or LDL cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Learn more about lowering LDL cholesterol. Stop Smoking Smoking and diabetes are a dangerous mix. Smoking raises your risk for many diabetes problems. If you quit smoking, - you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation - your cholesterol and blood pressure levels might improve - your blood circulation will improve. you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputation your cholesterol and blood pressure levels might improve your blood circulation will improve. If you smoke, stop smoking. Ask for help so that you don’t have to do it alone. You can start by calling 1–800–QUITNOW or 1–800–784–8669. For more on how to quit smoking, see Quitting Smoking for Older Adults. Manage Your Diabetes Every Day Diabetes cannot be cured, but it can be managed. Managing blood glucose (blood sugar) as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. Know What To Do Every Day To manage your diabetes, here are things to do every day. - Take your medicines. - Keep track of your blood glucose (blood sugar). - Check your blood pressure if your doctor advises. - Check your feet. - Brush your teeth and floss. - Stop smoking. - Eat well. - Be active. Take your medicines. Keep track of your blood glucose (blood sugar). Check your blood pressure if your doctor advises. Check your feet. Brush your teeth and floss. Stop smoking. Eat well. Be active. (Watch the video to learn more about what one woman does to manage her diabetes every day. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Take Your Diabetes Medicines People with type 1 diabetes control their blood sugar with insulin -- delivered either by injection or with a pump. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some may need both, as well as lifestyle modification. Ask your doctor if you need to take aspirin every day to prevent a heart attack or stroke. Keep Track of Your Blood Glucose One of the best ways to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medication. Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three a day or even more. You may be told to check before eating, before bed, and sometimes in the middle of the night. Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for some of the supplies and equipment you need to check your glucose levels. See what diabetes supplies and services Medicare covers. Check Your Blood Pressure Check your blood pressure if your doctor advises and keep a record of it. You can check your pressure at home with a home blood pressure measurement device or monitor. Blood pressure monitors can be bought at discount chain stores and drug stores. When you are taking your blood pressure at home, sit with your back supported and your feet flat on the floor. Rest your arm on a table at the level of your heart. Check with your health care provider to make sure you are using the monitor correctly. Check Your Feet Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. Brush Your Teeth and Floss People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose also can make tooth and gum problems worse. You can even lose your teeth. Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. Learn more about how diabetes can affect your mouth and teeth. Stop Smoking If you smoke, stop. Smoking raises your risk for many diabetes problems, including heart attack and stroke. Ask for help to quit. Call 1-800 QUITNOW (1-800-784-8669). For more information on smoking and older adults, see Quitting Smoking for Older Adults. Eat Well People with diabetes don't need to buy or prepare special foods. The foods that are best for someone with diabetes are excellent choices for everyone: foods that are low in fat, salt, and sugar, and high in fiber, such as beans, fruits, vegetables, and whole grains. These foods help you reach and stay at a weight that's good for your body, keep your blood pressure, glucose and cholesterol in a desirable range, and prevent or delay heart and blood vessel disease. For more on healthy eating, see Small Steps for Eating Healthy Foods. Be Active Try to exercise almost every day for a total of about 30 to 60 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercise: How to Get Started or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be sure to check with your doctor before starting an exercise program. Other Areas To Manage Here are other areas to manage if you have diabetes. - Take care of your eyes. - Protect your kidneys. - Protect your skin. - Learn how to cope with stress. Take care of your eyes. Protect your kidneys. Protect your skin. Learn how to cope with stress. Take Care of Your Eyes High blood glucose and high blood pressure from diabetes can hurt your eyes. It can even cause blindness, or other painful eye problems. Here are ways to prevent diabetes eye problems. - Keep your blood glucose and blood pressure as close to normal as you can. - Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Keep your blood glucose and blood pressure as close to normal as you can. Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. Learn more about eye disease and diabetes. Protect Your Kidneys High blood glucose and high blood pressure may damage the kidneys. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Here are ways to prevent diabetes kidney problems. - Keep your blood glucose and blood pressure as close to your target goal as you can. - Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. - Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Keep your blood glucose and blood pressure as close to your target goal as you can. Get tested at least once a year for kidney disease. Ask your doctor if you should be tested. Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein. Learn more about keeping your kidneys healthy. Protect Your Skin Skin care is very important, too. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean and taking care of minor cuts and bruises. Learn How To Cope With Stress Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music. Frequently Asked Questions What is diabetes? Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. What is the difference between type 1 and type 2 diabetes? Type 1 diabetes, which used to be called called juvenile diabetes or insulin-dependent diabetes, develops most often in young people. However, type 1 diabetes can also develop in adults. With this form of diabetes, your body no longer makes insulin or doesn’t make enough insulin because your immune system has attacked and destroyed the insulin-producing cells. About 5 to 10 percent of people with diabetes have type 1 diabetes. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Learn more about type 1 diabetes here. Learn more about type 1 diabetes here. Type 2 diabetes, which used to be called adult-onset diabetes or non insulin-dependent diabetes, is the most common form of diabetes. Although people can develop type 2 diabetes at any age -- even during childhood -- type 2 diabetes develops most often in middle-aged and older people. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. If your pancreas can no longer make enough insulin, you will need to treat your type 2 diabetes. Learn more about type 2 diabetes here. How many people have diabetes? Nearly 29 million Americans age 20 or older (12.3 percent of all people in this age group) have diabetes, according to 2014 estimates from the Centers for Disease Control and Prevention (CDC). About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 alone. People can get diabetes at any age, but the risk increases as we get older. In 2014, over 11 million older adults living in the U.S -- nearly 26 percent of people 65 or older -- had diabetes. See more statistics about diabetes from the National Diabetes Statistics Report 2014. (Centers for Disease Control and Prevention.) What is prediabetes? Prediabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. In 2012, about 86 million people in the U.S. had prediabetes, and 51% of those 65 or older had prediabetes. People with prediabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have prediabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. Learn more about prediabetes here. Why can I do about prediabetes? Studies have shown that most people with prediabetes develop type 2 diabetes within a few years, unless they change their lifestyle. Most people with prediabetes don’t have any symptoms. Your doctor can test your blood to find out if your blood glucose levels are higher than normal. Losing weight—at least 5 to 10 percent of your starting weight—can prevent or delay diabetes or even reverse prediabetes. That’s 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting the amount of calories and fat you consume and by being physically active at least 30 to 60 minutes every day. Physical activity also helps your body use the hormone insulin properly. Your body needs insulin to use glucose for energy. Medicine can help control the amount of glucose in your blood. Ask your doctor if medicine to control glucose is right for you. Learn more about prediabetes here. What are the signs of diabetes? Many people with diabetes experience one or more symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. What causes diabetes? Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the body's own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the insulin-producing cells in the pancreas in people with type 1 diabetes. However, many believe that both genetic factors and environmental factors are involved. Studies now are underway to identify these factors and prevent type 1 diabetes in people at risk. Type 2 diabetes—the most common form of diabetes—is caused by a combination of factors, including insulin resistance, a condition in which the body’s muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Get more details about who should be tested for diabetes. If diabetes is not managed, what problems might occur? Diabetes is a very serious disease. Over time, diabetes that is not well managed causes serious damage to the eyes, kidneys, nerves, and heart, gums and teeth. If you have diabetes, you are more likely than someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. The best way to protect yourself from the serious complications of diabetes is to manage your blood glucose, blood pressure, and cholesterol and avoid smoking. It is not always easy, but people who make an ongoing effort to manage their diabetes can greatly improve their overall health. Who is at risk for developing type 2 diabetes? Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Can diabetes be prevented? The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that making modest lifestyle changes can prevent or delay type 2 diabetes in people at risk for the disease. In the Diabetes Prevention Program (DPP), a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases, researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent. (Watch the video to learn more about preventing type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) What kind of meal plan should a person with diabetes follow? Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. This plan, often called medical nutrition therapy, will include regular monitoring by your dietitian and education about how to adjust your eating habits as the need occurs. Medical nutrition therapy is usually covered by insurance or Medicare as long as your doctor refers you. Your dietitian can help you plan meals that include foods that you and your family like and that are good for you. Your healthy eating plan will include - breads, cereals, rice, and whole grains - fruits and vegetables - meat and meat substitutes - dairy products - healthy fats. breads, cereals, rice, and whole grains fruits and vegetables meat and meat substitutes dairy products healthy fats. Your plan will also help you learn how to eat the right amount, or portions, of food. Making good food choices will - help you reach and stay at a healthy weight - keep your blood glucose, blood pressure, and cholesterol levels under control - prevent heart and blood vessel disease. help you reach and stay at a healthy weight keep your blood glucose, blood pressure, and cholesterol levels under control prevent heart and blood vessel disease. (Watch the video to learn more about eating healthy with diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) If I have diabetes, should I avoid all sweets and sugars? If you have diabetes you should limit the amount of fats and sweets you eat. These foods have calories, but not much nutrition. Some contain saturated fats and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control. It is okay to have sweets once in a while. Try having sugar-free popsicles, diet soda, fat-free ice cream or frozen yogurt, or sugar-free hot cocoa mix to satisfy a \"sweet tooth.\" Remember, fat-free and low sugar foods still have calories. Talk with your diabetes educator about how to fit sweets into your meal plan. Who should be tested for diabetes? Because type 2 diabetes is more common in older people, anyone who is 45 or older should consider getting tested. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more risk factors, you also should talk with your doctor about being tested. Get more information about tests for diabetes. How do doctors diagnose diabetes and pre-diabetes? Doctors use the following tests to diagnose diabetes. - An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. An A1C test measures your average blood glucose levels over the past 3 months. It can be used to diagnose type 2 diabetes and pre-diabetes. It does not require fasting and blood can be drawn for the test any time of the day. - A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. A fasting plasma glucose, or FPG test measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or prediabetes. - In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. In a random plasma glucose test, the doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. - An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. An oral glucose tolerance test, or OGTT measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women. If any of these tests show that you might have diabetes, your doctor will need to repeat the test with a second measurement unless there are clear symptoms of diabetes. How do I manage my diabetes every day? People with type 1 diabetes control their blood sugar with insulin -- either with shots or an insulin pen. Many people with type 2 diabetes can control blood glucose levels with diet and exercise alone. Others require oral medications or insulin, and some people may need to take both, along with lifestyle modification. (Watch the video to learn how one woman manages her type 2 diabetes. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) To manage your diabetes, here are things to do every day. - Take your medicines for diabetes and for any other health problems, even when you feel good. Take your medicines for diabetes and for any other health problems, even when you feel good. - Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. Keep track of your blood glucose (blood sugar). You may want to check it one or more times a day. Be sure to talk about it with your health care team. - Check your blood pressure if your doctor advises and keep a record of it. Check your blood pressure if your doctor advises and keep a record of it. - Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. Check your feet every day for cuts, blisters, red spots and swelling. Call your health care team right away about any sores that do not go away. - Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy. - Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) Stop smoking. Ask for help to quit. Call 1-800 QUIT NOW ( 1-800-784-8669) - Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. Eat well. Ask your doctor to give you the name of someone trained to help you create a healthy eating plan, such as a dietitian. See small steps for eating healthy foods. - Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. Be active. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. To learn more, see Exercise: How To Get Started, or visit Go4Life®, the exercise and physical activity campaign for older adults from the National Institute on Aging. How should I take care of my feet? Foot care is very important for people with diabetes. High blood glucose levels and a reduced blood supply to the limbs cause nerve damage that reduces feeling in the feet. Someone with nerve damage may not feel a pebble inside his or her sock that is causing a sore. Or a blister caused by poorly fitting shoes may go unnoticed. Foot injuries such as these can cause ulcers, which may, if not cared for, ultimately lead to the need for amputation. If you have diabetes, - check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. - report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. - never walk barefoot. - have your feet checked at every doctor visit. - take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. check your feet every day and watch for any cuts, sores, red spots, swelling, and infected toenails. report sores, blisters, breaks in the skin, infections, or buildup of calluses to a podiatrist or a family doctor. never walk barefoot. have your feet checked at every doctor visit. take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet. Learn more about taking care of your feet. How can diabetes affect my teeth and gums? People with diabetes can have tooth and gum problems more often if their blood glucose stays high. Glucose is present in your saliva—the fluid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow. These bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath. The most common mouth problems from diabetes are - gingivitis (unhealthy or inflamed gums) - periodontitis (an infection of the gums) - thrush or candidiasis - dry mouth - oral burning (a burning sensation inside the mouth). gingivitis (unhealthy or inflamed gums) periodontitis (an infection of the gums) thrush or candidiasis dry mouth oral burning (a burning sensation inside the mouth). How can I protect my teeth and gums? Here are ways to protect your teeth and gums. - Keep your blood glucose as close to normal as possible. - Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. - Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. - If you wear false teeth, keep them clean. - Call your dentist right away if you have problems with your teeth and gums. Keep your blood glucose as close to normal as possible. Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times. Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth. If you wear false teeth, keep them clean. Call your dentist right away if you have problems with your teeth and gums. What kinds of medication do people take for diabetes? Controlling blood glucose (blood sugar) is the best defense against the serious complications of diabetes. Insulin and diabetes pills are the two kinds of medicines used to lower blood glucose. You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too. If your body makes insulin but the insulin doesn't lower your blood glucose, you may need diabetes pills. What are the ABCs of diabetes? Heart disease and stroke are the leading causes of death for people with diabetes. Controlling the ABCs of diabetes -- your blood glucose, your blood pressure, and your cholesterol, as well as stopping smoking -- can help prevent these and other complications from diabetes. - A is for the A1C test - B is for Blood pressure - C is for Cholesterol. A is for the A1C test B is for Blood pressure C is for Cholesterol. - The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. The A1C test (A-one-C) shows you what your blood glucose has been over the last three months. Your health care provider does this test to see what your blood glucose level is most of the time. This test should be done at least twice a year for all people with diabetes and for some people more often as needed. For many people with diabetes, an A1C test result of under 7 percent usually means that their diabetes treatment is working well and their blood glucose is under control. - B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. B is for Blood pressure. The goal for most people is 140/90 but may be different for you. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your blood pressure should be checked at every doctor visit. Talk with your health care provider about your blood pressure goal. - C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. C is for Cholesterol (ko-LES-ter-ol). The LDL goal for most people is less than 100. Low density lipoprotein, or LDL-cholesterol, is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. Talk with your health care provider about your cholesterol goal. Ask your health care team - what your A1C, blood pressure, and cholesterol numbers are. - what your ABCs should be. - what you can do to reach your target. what your A1C, blood pressure, and cholesterol numbers are. what your ABCs should be. what you can do to reach your target. How should I work with my health care team to manage my diabetes? See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. If you have diabetes, take these steps. At each visit, be sure you have a - blood pressure check - foot check - weight check - review of your self-care plan. blood pressure check foot check weight check review of your self-care plan. Two times each year, get - an A1C test. It may be checked more often if it is over 7. an A1C test. It may be checked more often if it is over 7. Once each year, be sure you have a - cholesterol test - triglyceride (try-GLISS-er-ide) test - a type of blood fat - complete foot exam - dental exam to check teeth and gums. Tell your dentist you have diabetes. - dilated eye exam to check for eye problems - flu shot - urine and a blood test to check for kidney problems. cholesterol test triglyceride (try-GLISS-er-ide) test - a type of blood fat complete foot exam dental exam to check teeth and gums. Tell your dentist you have diabetes. dilated eye exam to check for eye problems flu shot urine and a blood test to check for kidney problems. At least once, get a - pneumonia (nu-MOH-nya) shot. pneumonia (nu-MOH-nya) shot. If you have Medicare, ask your health care team if Medicare will cover some of the costs for - learning about healthy eating and diabetes self-care - special shoes, if you need them - medical supplies - diabetes medicines. learning about healthy eating and diabetes self-care special shoes, if you need them medical supplies diabetes medicines. (Watch the video for important things to remember when visiting your health care team. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Why is exercise important in controlling diabetes? Exercise is especially good for people with diabetes because it - helps control weight - helps insulin work better to lower blood glucose - is good for your heart and lungs - gives you more energy. helps control weight helps insulin work better to lower blood glucose is good for your heart and lungs gives you more energy. Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises may not be safe. Your health care team can help you find safe exercises. What types of exercise should I do, and how often? People with diabetes should - do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. - do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. - stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. do aerobic activities, such as brisk walking, which use the body’s large muscles to make the heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements. do activities to strengthen muscles and bone, such as sit-ups or lifting weights. Aim for two times a week. stretch to increase flexibility, lower stress, and help prevent muscle soreness after physical activity. Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day. (Tip: you don’t need to get your exercise in all at one time.) For more information on exercise and older adults, see Exercises To Try or visit Go4Life®, the exercise and physical activity campaign from the National Institute on Aging. Always talk with a doctor before starting a new physical activity program. What steps can I take to lose weight to prevent or delay type 2 diabetes? Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. If you are overweight or obese, choose sensible ways to reach and maintain a reasonable body weight. - Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. Make healthy food choices. What you eat has a big impact on your weight and overall health. By developing healthy eating habits you can help control your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet. - Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways: it helps you lose weight, controls your cholesterol and blood pressure, and improves your body's use of insulin. Many people make walking part of their daily routine because it's easy, fun and convenient. But you can choose any activity that gets you moving. It's fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program. Does Medicare help pay for services and supplies for people with diabetes? Medicare helps pay for certain services and supplies for people with diabetes who have Medicare Part B. All require a doctor's prescription. The diabetes-related services and supplies that are covered include - blood sugar monitor and supplies - an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. - dilated eye examinations to check for diabetic eye diseases - glaucoma screening - flu and pneumonia shots - diabetes self-management training - medical nutrition therapy services. blood sugar monitor and supplies an A1C test, which is a lab test that measures how well your blood glucose has been controlled over the past 3 months. dilated eye examinations to check for diabetic eye diseases glaucoma screening flu and pneumonia shots diabetes self-management training medical nutrition therapy services. Get more information about the diabetes supplies and services covered by Medicare. You can also contact the Centers for Medicare and Medicaid Services at 1-800-MEDICARE, or 1-800-633-4227. TTY users dial 1-877-486-2048. ", "role": "user" }, { "content": "Certain factors can increase your risk for diabetes. For type 1 diabetes, scientists do not currently know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors are involved. There are many risk factors for type 2 diabetes. Here a few of them: Being over 45 years of age, being overweight, having a first-degree relative with diabetes, or being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. Additionally, other risk factors include giving birth to at least one baby weighing more than 9 pounds, having high blood pressure, having abnormal cholesterol levels, or exercising fewer than three times a week.", "role": "assistant" } ]

[ { "content": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem\n\nSpina Bifida (Is there a cure?): There is no cure for spina bifida, but there are treatments for a wide array of related conditions. Visit the section on treatments for more information. « How is it diagnosed? Are there associated conditions? »", "role": "user" }, { "content": "There is no cure for spina bifida, but there are treatments for a wide array of related conditions.", "role": "assistant" } ]

[ { "content": "help with obesity I would like help on my obesity problem and if I can get help\n\nObesity (Treatment): The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals - including a dietitian, behavior counselor or an obesity specialist - to help you understand and make changes in your eating and activity habits. The initial treatment goal is usually a modest weight loss - 3 to 5 percent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to lose only about 6 to 10 pounds (2.7 to 4.5 kg) for your health to begin to improve. However, the more weight you lose, the greater the benefits. All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Other treatment tools include: - Dietary changes - Exercise and activity - Behavior change - Prescription weight-loss medications - Weight-loss surgery Dietary changes Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term. Plan to participate in a comprehensive weight-loss program for at least six months and in the maintenance phase of a program for at least a year to boost your odds of weight-loss success. There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you. Dietary changes to treat obesity include: - Cutting calories. The key to weight loss is reducing how many calories you take in. You and your health care providers can review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. You and your doctor can decide how many calories you need to take in each day to lose weight, but a typical amount is 1,200 to 1,500 calories for women and 1,500 to 1,800 for men. - Feeling full on less. The concept of energy density can help you satisfy your hunger with fewer calories. All foods have a certain number of calories within a given amount (volume). Some foods - such as desserts, candies, fats and processed foods - are high in energy density. This means that a small volume of that food has a large number of calories. In contrast, other foods, such as fruits and vegetables, have lower energy density. These foods provide a larger portion size with a fewer number of calories. By eating larger portions of foods that have fewer calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall. - Making healthier choices. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Also emphasize lean sources of protein - such as beans, lentils and soy - and lean meats. If you like fish, try to include fish twice a week. Limit salt and added sugar. Stick with low-fat dairy products. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as olive, canola and nut oils. - Restricting certain foods. Certain diets limit the amount of a particular food group, such as high-carbohydrate or full-fat foods. Ask your doctor which diet plans have been found effective and which might be helpful for you. Drinking sugar-sweetened beverages is a sure way to consume more calories than you intended, and limiting these drinks or eliminating them altogether is a good place to start cutting calories. - Meal replacements. These plans suggest that you replace one or two meals with their products - such as low-calorie shakes or meal bars - and eat healthy snacks and a healthy, balanced third meal that's low in fat and calories. In the short term, this type of diet can help you lose weight. Keep in mind that these diets likely won't teach you how to change your overall lifestyle, though, so you may have to keep this up if you want to keep your weight off. Be wary of quick fixes. You may be tempted by fad diets that promise fast and easy weight loss. The reality, however, is that there are no magic foods or quick fixes. Fad diets may help in the short term, but the long-term results don't appear to be any better than other diets. Similarly, you may lose weight on a crash diet, but you're likely to regain it when you stop the diet. To lose weight - and keep it off - you have to adopt healthy-eating habits that you can maintain over time. Exercise and activity Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking. To boost your activity level: - Exercise. People who are overweight or obese need to get at least 150 minutes a week of moderate-intensity physical activity to prevent further weight gain or to maintain the loss of a modest amount of weight. To achieve more-significant weight loss, you may need to exercise 300 minutes or more a week. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve. - Keep moving. Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burn calories. Making simple changes throughout your day can add up to big benefits. Park farther from store entrances, rev up your household chores, garden, get up and move around periodically, and wear a pedometer to track how many steps you actually take over the course of a day. Behavior changes A behavior modification program can help you make lifestyle changes and lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesity. Everyone is different and has different obstacles to managing weight, such as a lack of time to exercise or late-night eating. Tailor your behavior changes to address your individual concerns. Behavior modification, sometimes called behavior therapy, can include: - Counseling. Therapy or interventions with trained mental health or other professionals can help you address emotional and behavioral issues related to eating. Therapy can help you understand why you overeat and learn healthy ways to cope with anxiety. You can also learn how to monitor your diet and activity, understand eating triggers, and cope with food cravings. Therapy can take place on both an individual and group basis. More-intensive programs - those that include 12 to 26 sessions a year - may be more helpful in achieving your weight-loss goals. - Support groups. You can find camaraderie and understanding in support groups where others share similar challenges with obesity. Check with your doctor, local hospitals or commercial weight-loss programs for support groups in your area, such as Weight Watchers. Prescription weight-loss medication Losing weight requires a healthy diet and regular exercise. But in certain situations, prescription weight-loss medication may help. Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. If you don't make these other changes in your life, medication is unlikely to work. Your doctor may recommend weight-loss medication if other methods of weight loss haven't worked for you and you meet one of the following criteria: - Your body mass index (BMI) is 30 or greater - Your BMI is greater than 27, and you also have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea Before selecting a medication for you, your doctor will consider your health history, as well as possible side effects. Some weight-loss medications can't be used by women who are pregnant, or people who take certain medications or have chronic health conditions. Commonly prescribed weight-loss medications include orlistat (Xenical), lorcaserin (Belviq), phentermine and topiramate (Qsymia), buproprion and naltrexone (Contrave), and liraglutide (Saxenda). You will need close medical monitoring while taking a prescription weight-loss medication. Also, keep in mind that a weight-loss medication may not work for everyone, and the effects may wane over time. When you stop taking a weight-loss medication, you may regain much or all of the weight you lost. Weight-loss surgery In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery limits the amount of food you're able to comfortably eat or decreases the absorption of food and calories or both. While weight-loss surgery offers the best chance of losing the most weight, it can pose serious risks. Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight that haven't worked and: - You have extreme obesity (BMI of 40 or higher) - Your BMI is 35 to 39.9, and you also have a serious weight-related health problem, such as diabetes or high blood pressure - You're committed to making the lifestyle changes that are necessary for surgery to work It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits. It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits. Common weight-loss surgeries include: - Gastric bypass surgery. In gastric bypass (Roux-en-Y gastric bypass), the surgeon creates a small pouch at the top of your stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of your stomach. - Laparoscopic adjustable gastric banding (LAGB). In this procedure, your stomach is separated into two pouches with an inflatable band. Pulling the band tight, like a belt, the surgeon creates a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently. - Biliopancreatic diversion with duodenal switch. This procedure begins with the surgeon removing a large part of the stomach. The surgeon leaves the valve that releases food to the small intestine and the first part of the small intestine (duodenum). Then the surgeon closes off the middle section of the intestine and attaches the last part directly to the duodenum. The separated section of the intestine is reattached to the end of the intestine to allow bile and digestive juices to flow into this part of the intestine. - Gastric sleeve. In this procedure, part of the stomach is removed, creating a smaller reservoir for food. It's a less complicated surgery than gastric bypass or biliopancreatic diversion with duodenal switch. Other treatments Vagal nerve blockade is another treatment for obesity. It involves implanting a device under the skin of the abdomen that sends intermittent electrical pulses to the abdominal vagus nerve, which tells the brain when the stomach feels empty or full. This new technology received FDA approval in 2014 for use by adults who have not been able to lose weight with a weight-loss program and who have a BMI of 35 to 45 with at least one obesity-related condition, such as type 2 diabetes. Preventing weight regain after obesity treatment Unfortunately, it's common to regain weight no matter what obesity treatment methods you try. If you take weight-loss medications, you'll probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or overindulge in high-calorie foods. But that doesn't mean your weight-loss efforts are futile. One of the best ways to prevent regaining the weight you've lost is to get regular physical activity. Aim for 60 minutes a day. Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost. You may always have to remain vigilant about your weight. Combining a healthier diet and more activity in a practical and sustainable manner are the best ways to keep the weight you lost off for the long term. Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.", "role": "user" }, { "content": "The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals - including a dietitian, behavior counselor or an obesity specialist - to help you understand and make changes in your eating and activity habits. All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Other treatment tools include: - Dietary changes - Exercise and activity - Behavior change - Prescription weight-loss medications - Weight-loss surgery", "role": "assistant" } ]

[ { "content": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?\n\nPeripheral Neuropathy (Definition): Peripheral neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body. More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis. Impaired function and symptoms depend on the type of nerves -- motor, sensory, or autonomic -- that are damaged.  Some people may experience temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness. Others may suffer more extreme symptoms, including burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Peripheral neuropathy may be either inherited or acquired. Causes of acquired peripheral neuropathy include physical injury (trauma) to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, medical procedures, and vascular and metabolic disorders. Acquired peripheral neuropathies are caused by systemic disease, trauma from external agents, or infections or autoimmune disorders affecting nerve tissue. Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations.", "role": "user" }, { "content": "Peripheral neuropathy pertains to more than 100 types of damage to the nerves that transmit information from the brain and spinal cord to every other part of the body. Peripheral neuropathy may be inherited or caused by physical injury (trauma) to a nerve, systemic disease, tumors, toxins, infections, autoimmune disorders, nutritional deficiencies, alcoholism, medical procedures, and vascular and metabolic disorders.", "role": "assistant" } ]

[ { "content": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks\n\nGastroparesis (Eating, Diet, and Nutrition): Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying.A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars.When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met.When the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given.MedicationsSeveral prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment.Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesia—a disorder that affects movement.Metoclopramide (Reglan).Erythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps.Erythromycin.Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting.Other medications.Botulinum ToxinBotulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.11Gastric Electrical StimulationThis treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms.JejunostomyIf medications and dietary changes don’t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe.Parenteral NutritionWhen gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition—an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis.", "role": "user" }, { "content": "Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal?instead of lying down?may assist with gastric emptying.A health care provider may also recommend avoiding high-fat and fibrous foods. A combination of medications may be used to find the most effective treatment.Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Botulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Gastric Electrical StimulationThis treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. If medications and dietary changes don?t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. When gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition?an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis.", "role": "assistant" } ]

[ { "content": "how do we treat the burns caused by radiation?\n\nWhat to do for Radiation sickness?: - DO NOT remain in area where exposure occurred. - DO NOT apply ointments to burned areas. - DO NOT remain in contaminated clothing. - DO NOT hesitate to seek emergency medical treatment.", "role": "user" }, { "content": "DO NOT apply ointments to burned areas. DO NOT hesitate to seek emergency medical treatment.", "role": "assistant" } ]

[ { "content": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you\n\nWhat are the treatments for Dementia With Lewy Bodies?: There is no cure for DLB. Treatments are aimed at controlling the cognitive, psychiatric, and motor symptoms of the disorder. Acetylcholinesterase inhibitors, such as donepezil and rivastigmine, are primarily used to treat the cognitive symptoms of DLB, but they may also be of some benefit in reducing the psychiatric and motor symptoms. Doctors tend to avoid prescribing antipsychotics for hallucinatory symptoms of DLB because of the risk that neuroleptic sensitivity could worsen the motor symptoms. Some individuals with DLB may benefit from the use of levodopa for their rigidity and loss of spontaneous movement.", "role": "user" }, { "content": "There is currently no cure for Dementia with Lewy Bodies. However, there are treatments for controlling the cognitive, psychiatric, and motor symptoms of the disorder, such as acetylcholinesterase inhibitors. While antipsychotics may have some benefit, doctors tend to avoid prescribing these as they can worsen the motor symptoms. Levadopa may reduce rigidity and loss of spontaneous movement.", "role": "assistant" } ]

[ { "content": "how is epilepsy diagnosed\n\nEpilepsy - overview (Exams and Tests): The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, you may need to: - Wear an EEG recorder for days or weeks as you go about your everyday life. - Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain.", "role": "user" }, { "content": "To diagnose epilepsy, your medical provider will order an electroencephalogram (EEG) to check the electrical activity in the brain. This may show the area in the brain where the seizures start. You may need to wear an EEG recorder over the course of a few days, or stay in a hospital where brain activity can be monitored on video EEG. Other tests your provider might order include include blood tests, kidney or liver function tests, or potentially CT or MRI scans.", "role": "assistant" } ]

[ { "content": "can i take keflex to cure staph?\n\nWhat are the treatments for Staph infections - self-care at home?: If test results show you have a staph infection, treatment may include: - Taking antibiotics - Cleaning and draining the wound - Surgery to remove an infected device", "role": "user" }, { "content": "Treatments for staph infection may include antibiotics.", "role": "assistant" } ]

[ { "content": "how do you get a prolapse bladder\n\nPelvic organ prolapse: Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Many women are embarrassed to talk to their doctor about their symptoms or think that their symptoms are normal. But pelvic organ prolapse is treatable. The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina. Pelvic organ prolapse is a type of pelvic floor disorder. The most common pelvic floor disorders are: The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include: Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina. Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect one in five women in the United States.1 Pelvic organ prolapse is less common than urinary or fecal incontinence but affects almost 3% of U.S. women.1 Pelvic organ prolapse happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups.2,3 Some women develop more than one pelvic floor disorder, such as pelvic organ prolapse with urinary incontinence. The pressure from prolapse can cause a bulge in the vagina that can sometimes be felt or seen. Women with pelvic organ prolapse may feel uncomfortable pressure during physical activity or sex. Other symptoms of pelvic organ prolapse include: Some women say that their symptoms are worse at certain times of the day, during physical activity, or after standing for a long time. Talk to your doctor or nurse about your symptoms. Pelvic organ prolapse happens when the muscles or connective tissues of the pelvis do not work as they should. The most common risk factors are: Your doctor will talk to you about your symptoms and do a pelvic exam. You may be asked to strain or cough during the exam so your doctor can see whether these actions cause prolapse or urine leakage. Your doctor may also do other tests to see whether you can completely empty your bladder when you go to the bathroom. Treatment for pelvic organ prolapse depends on the type of prolapse you have, your symptoms, your age, other health problems, and whether you are sexually active. Your treatment may include one or more of the following: Researchers are studying ways to prevent pelvic organ prolapse. The following steps may reduce your risk of getting a pelvic floor problem: For more information about pelvic organ prolapse, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:", "role": "user" }, { "content": "Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs become weak or loose, and do not work as they should. This allows one or more of the pelvic organs to drop or press into/out of the vagina.", "role": "assistant" } ]

[ { "content": "what medications are prescribed for brucellosis\n\n Brucellosis Overview Brucellosis is a bacterial infection that spreads from animals to people - most often via unpasteurized milk, cheese and other dairy products. More rarely, the bacteria that cause brucellosis can spread through the air or through direct contact with infected animals. Brucellosis symptoms may include fever, joint pain and fatigue. The infection can usually be treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common. While brucellosis is uncommon in the United States, the disease affects hundreds of thousands of people and animals worldwide. Avoiding unpasteurized dairy products and taking precautions when working with animals or in a laboratory can help prevent brucellosis. Symptoms Symptoms of brucellosis may show up anytime from a few days to a few months after you're infected. Signs and symptoms are similar to those of the flu and include: - Fever - Chills - Loss of appetite - Sweats - Weakness - Fatigue - Joint, muscle and back pain - Headache Brucellosis symptoms may disappear for weeks or months and then return. In some people, brucellosis becomes chronic, with symptoms persisting for years, even after treatment. Long-term signs and symptoms may include fatigue, recurrent fevers, arthritis, swelling of the heart (endocarditis) and spondylitis - an inflammatory arthritis that affects the spine and adjacent joints. When to see a doctor Brucellosis can be hard to identify, especially in the early stages, when it often resembles many other conditions, such as the flu. See your doctor if you develop a rapidly rising fever, muscle aches or unusual weakness and have any risk factors for the disease, or if you have a persistent fever. Causes Brucellosis affects many wild and domestic animals. Cattle, goats, sheep, pigs, dogs, camels, wild boar and reindeer are especially prone to the disease. A form of brucellosis also affects harbor seals, porpoises and certain whales. The bacteria may be spread from animals to people in three main ways: - Raw dairy products. Brucella bacteria in the milk of infected animals can spread to humans in unpasteurized milk, ice cream, butter and cheeses. The bacteria can also be transmitted in raw or undercooked meat from infected animals. - Inhalation. Brucella bacteria spread easily in the air. Farmers, laboratory technicians and slaughterhouse workers can inhale the bacteria. - Direct contact. Bacteria in the blood, semen or placenta of an infected animal can enter your bloodstream through a cut or other wound. Because normal contact with animals - touching, brushing or playing - doesn't cause infection, people rarely get brucellosis from their pets. Even so, people with weakened immune systems should avoid handling dogs known to have the disease. Brucellosis normally doesn't spread from person to person, but in a few cases, women have passed the disease to their infants during birth or through their breast milk. Rarely, brucellosis may spread through sexual activity or through contaminated blood or bone marrow transfusions. Risk factors Brucellosis is very rare in the United States. Other parts of the world have much higher rates of brucellosis infection, especially: - Around the Mediterranean Sea - Eastern Europe - Latin America - Asia - Africa - The Caribbean - The Middle East People who live or travel in these areas are more likely to consume unpasteurized goat cheese, sometimes called village cheese. Unpasteurized goat cheese imported from Mexico has been linked to many cases of brucellosis in the United States. Occupations at higher risk People who work with animals or come into contact with infected blood are at higher risk of brucellosis. Examples include: - Veterinarians - Dairy farmers - Ranchers - Slaughterhouse workers - Hunters - Microbiologists Complications Brucellosis can affect almost any part of your body, including your reproductive system, liver, heart and central nervous system. Chronic brucellosis may cause complications in just one organ or throughout your body. Possible complications include: - Infection of the heart's inner lining (endocarditis). This is one of the most serious complications of brucellosis. Untreated endocarditis can damage or destroy the heart valves and is the leading cause of brucellosis-related deaths. - Arthritis. Joint infection is marked by pain, stiffness and swelling in your joints, especially the knees, hips, ankles, wrists and spine. Spondylitis - inflammation of the joints between the bones (vertebrae) of your spine or between your spine and pelvis - can be particularly hard to treat and may cause lasting damage. - Inflammation and infection of the testicles (epididymo-orchitis). The bacteria that cause brucellosis can infect the epididymis, the coiled tube that connects the vas deferens and the testicle. From there, the infection may spread to the testicle itself, causing swelling and pain, which may be severe. - Inflammation and infection of the spleen and liver. Brucellosis can also affect the spleen and liver, causing them to enlarge beyond their normal size. - Central nervous system infections. These include potentially life-threatening illnesses such as meningitis, an inflammation of the membranes surrounding the brain and spinal cord, and encephalitis, inflammation of the brain itself. Diagnosis Doctors usually confirm a diagnosis of brucellosis by testing a sample of blood or bone marrow for the brucella bacteria or by testing blood for antibodies to the bacteria. To help detect complications of brucellosis, you may have additional tests, including: - X-rays. X-rays can reveal changes in your bones and joints. - Computerized tomography (CT) scan or magnetic resonance imaging (MRI). These imaging tests help identify inflammation or abscesses in the brain or other tissues. - Cerebrospinal fluid culture. This checks a small sample of the fluid that surrounds your brain and spinal cord for infections such as meningitis and encephalitis. - Echocardiography. This test uses sound waves to create images of your heart to check for signs of infection or damage to your heart. Treatment Treatment for brucellosis aims to relieve symptoms, prevent a relapse of the disease and avoid complications. You'll need to take antibiotics for at least six weeks, and your symptoms may not go away completely for several months. The disease can also return and may become chronic. ", "role": "user" }, { "content": "Brucellosis is a bacterial infection that spreads from animals to people - most often via unpasteurized milk, cheese and other dairy products. The infection can usually be treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common.", "role": "assistant" } ]

[ { "content": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??\n\nWhat is Adrenoleukodystrophy?: Adrenoleukodystrophy describes several closely related disorders that disrupt the breakdown of certain fats. These disorders are passed down (inherited) in families.", "role": "user" }, { "content": "Adrenoleukodystrophy is a family of hereditary disorders that disrupt the breakdown of certain fats.", "role": "assistant" } ]

[ { "content": "how is generalized anxiety disorder diagnosed\n\n Generalized anxiety disorder Overview It's normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder. It's possible to develop generalized anxiety disorder as a child or an adult. Generalized anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they're all different conditions. Living with generalized anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders. In most cases, generalized anxiety disorder improves with psychotherapy or medications. Making lifestyle changes, learning coping skills and using relaxation techniques also can help. Generalized anxiety disorder care at Mayo Clinic Symptoms Generalized anxiety disorder symptoms can vary. They may include: - Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events - Overthinking plans and solutions to all possible worst-case outcomes - Perceiving situations and events as threatening, even when they aren't - Difficulty handling uncertainty - Indecisiveness and fear of making the wrong decision - Inability to set aside or let go of a worry - Inability to relax, feeling restless, and feeling keyed up or on edge - Difficulty concentrating, or the feeling that your mind \"goes blank\" Physical signs and symptoms may include: - Fatigue - Trouble sleeping - Muscle tension or muscle aches - Trembling, feeling twitchy - Nervousness or being easily startled - Sweating - Nausea, diarrhea or irritable bowel syndrome - Irritability There may be times when your worries don't completely consume you, but you still feel anxious even when there's no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen. Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age. Children and teenagers may have similar worries to adults, but also may have excessive worries about: - Performance at school or sporting events - Family members' safety - Being on time (punctuality) - Earthquakes, nuclear war or other catastrophic events A child or teen with excessive worry may: - Feel overly anxious to fit in - Be a perfectionist - Redo tasks because they aren't perfect the first time - Spend excessive time doing homework - Lack confidence - Strive for approval - Require a lot of reassurance about performance - Have frequent stomachaches or other physical complaints - Avoid going to school or avoid social situations Some anxiety is normal, but see your doctor if: - You feel like you're worrying too much, and it's interfering with your work, relationships or other parts of your life - You feel depressed or irritable, have trouble with drinking or drugs, or you have other mental health concerns along with anxiety - You have suicidal thoughts or behaviors - seek emergency treatment immediately Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe - it may be easier to treat early on. Causes As with many mental health conditions, the cause of generalized anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include: - Differences in brain chemistry and function - Genetics - Differences in the way threats are perceived - Development and personality Risk factors Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder: - Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are. - Genetics. Generalized anxiety disorder may run in families. - Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk. Complications Having generalized anxiety disorder can be disabling. It can: - Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating - Take your time and focus from other activities - Sap your energy - Increase your risk of depression Generalized anxiety disorder can also lead to or worsen other physical health conditions, such as: - Digestive or bowel problems, such as irritable bowel syndrome or ulcers - Headaches and migraines - Chronic pain and illness - Sleep problems and insomnia - Heart-health issues Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some mental health disorders that commonly occur with generalized anxiety disorder include: - Phobias - Panic disorder - Post-traumatic stress disorder (PTSD) - Obsessive-compulsive disorder (OCD) - Depression - Suicidal thoughts or suicide - Substance abuse Diagnosis To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association Treatment Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success. Medications Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects. - Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants. - Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. - Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse. Lifestyle and home remedies While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Use relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. - Avoid alcohol and recreational drugs. These substances can worsen anxiety. - Quit smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety. Alternative medicine Several herbal remedies have been studied as treatments for anxiety. Results tend to be mixed, and in several studies people report no benefits from their use. More research is needed to fully understand the risks and benefits. Some herbal supplements, such as kava and valerian, increase the risk of serious liver damage. Other supplements, such as passionflower or theanine, may have a calming effect, but they're often combined with other products so it's hard to tell whether they help with symptoms of anxiety. Before taking any herbal remedies or supplements, talk with your doctor to make sure they're safe and won't interact with any medications you take. ", "role": "user" }, { "content": "To help diagnose generalized anxiety disorder, your doctor or mental health professional will be able to take a few approaches: They will look for signs that link your anxiety to medications or other medical conditions. They can order blood, urine, or other tests, and they will ask questions about your symptoms and medical history. There are also psychological questionnaires that can help to determine a diagnosis, as can the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Association.", "role": "assistant" } ]

[ { "content": "how do you check for lupus?\n\nLupus nephritis: Lupus nephritis is a kidney disorder which is a complication of systemic lupus erythematosus. Systemic lupus erythematosus (SLE or lupus) is an autoimmune disease. This means there is a problem with the body's immune system. Normally, the immune system helps protect the body from infection or harmful substances. But in people with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissues. SLE may damage different parts of the kidney. This can lead lead to disorders such as interstitial nephritis, nephrotic syndrome, and membranous glomerulonephritis. Over time, kidney failure can result. Symptoms of lupus nephritis include: - Blood in the urine - Foamy appearance to urine - High blood pressure - Swelling of any area of the body A physical exam shows signs of decreased kidney functioning with body swelling (edema). Blood pressure may be high. Abnormal sounds may be heard when the doctor listens to your heart and lungs. Tests that may be done include: - ANA titer - BUN and creatinine - Complement levels - Urinalysis - Urine protein - Kidney biopsy, to determine appropriate treatment The goal of treatment is to improve kidney function and to delay kidney failure. Medicines may include drugs that suppress the immune system, such as corticosteroids, cyclophosphamide, mycophenolate mofetil, or azathioprine. You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney. How well you do, depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms. Some people with this condition develop chronic kidney failure. Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease. Complications that may result from lupus nephritis include: - Acute renal failure - Chronic renal failure Call your health care provider if you have blood in the urine or swelling of your body. If you have lupus nephritis, call your provider if you notice decreased urine output. Treating lupus may help prevent or delay onset of lupus nephritis. Updated by: Charles Silberberg, DO, private practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "Tests to determine the appropriate treatment for lupus include ANA titer, urinalysis, and kidney biopsy.", "role": "assistant" } ]

[ { "content": "My daughter has menkes syndrome and would like to know how to go about. Thx\n\nMenkes syndrome (Symptoms): Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes", "role": "user" }, { "content": "Symptoms of Menkes syndrome include bone spurs, brittle kinky hair, feeding difficulties, irritability, lack of muscle tone, floppiness, low body temperature, mental deterioration, pudgy rosy cheeks, seizures, and skeletal changes.", "role": "assistant" } ]

[ { "content": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.\n\nLewy body dementia (Inheritance): Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. [4] Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ). [6] [5]", "role": "user" }, { "content": "Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ).", "role": "assistant" } ]

[ { "content": "How bad can endometriosis get?\n\n Endometriosis Overview Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside the uterus. It is one of the most common gynecological diseases, and its primary symptoms include pain and infertility. About Endometriosis ​ What causes endometriosis? ​ The exact cause of endometriosis is not known, but researchers have some theories.The female reproductive organs are shown with red patches representing endometriosis. The arrows indicate that the menstrual flow is going backwards into the fallopian tubes instead of out of the body as it should.One theory suggests that endometriosis may result from something called \"retrograde menstrual flow,\" in which some of the tissue that a woman sheds during her period flows through her fallopian tubes into her pelvis. While most women have some retrograde menstrual flow during their periods, not all of these women have endometriosis. Researchers are trying to uncover what other factors might cause the tissue to attach and grow in some women, but not in others.1,2​Researchers believe that endometriosis likely results from a combination of factors, including (but not limited to) some of the following:- Because endometriosis runs in families, genes are probably involved with endometriosis to some degree. - Estrogen (a hormone involved in the female reproductive cycle) also likely contributes to endometriosis, because endometriosis is an estrogen-dependent, inflammatory disease. - In endometriosis, the endometrium may not respond as it should to progesterone, another hormone involved in the female reproductive cycle. This means that the endometrium has \"progesterone resistance.\" - In some cases of endometriosis, the immune system fails to destroy endometrial tissue, which enables it to grow outside the uterus. This means immune system dysfunction plays a role in these cases. - Environmental exposures in the womb, such as to chemicals like dioxin and organochlorine pesticides, have also been linked to developing endometriosis.1,2NICHD’s Endometriosis: Natural History, Diagnosis, and Outcomes (ENDO) Study conducted by the Division of Intramural Population Health Research examines risk factors associated with endometriosis. The study has found evidence of increased risk of endometriosis associated with environmental exposures:- Exposure to certain phthalates (chemicals used in plastics and other everyday products)3 - Exposure to certain industrial chemicals called “persistent organochlorine pollutants”4 - Exposure to some perfluoroalkyl and polyfluoroalkyl substances (PFAAs)5 - A specific ultraviolet filter (sunscreen) used in cosmetics6 - High urine concentrations of chromium and copper7 How many people are affected by or at risk for endometriosis?​​​ ​​- Factors that May Increase the Risk of Endometriosis Studies show that women are at higher risk for endometriosis if their: - Mother, sister, or daughter had endometriosis (raises the risk about sixfold)2 - Periods started at an early age (before age 11)3 - Monthly cycles are short (less than 27 days)3 - Menstrual cycles are heavy and last more than 7 days3 - Mother, sister, or daughter had endometriosis (raises the risk about sixfold)2 - Periods started at an early age (before age 11)3 - Monthly cycles are short (less than 27 days)3 - Menstrual cycles are heavy and last more than 7 days3 - Factors that May Lower the Risk of Endometriosis Studies also show that some factors may lower the risk for endometriosis, including: - Pregnancy - Starting menstruation late in adolescence4 - Regular exercise of more than 4 hours a week3 - Low amount of body fat - Pregnancy - Starting menstruation late in adolescence4 - Regular exercise of more than 4 hours a week3 - Low amount of body fat What are the symptoms of endometriosis? The primary symptoms of endometriosis are pain and infertility.- Among women with pelvic pain, endometriosis may occur in about 75%.1,2 - Among women with fertility problems, endometriosis may occur in as many as 50%.1Other common symptoms of endometriosis include:- Painful, even debilitating, menstrual cramps, which may get worse over time - Pain during or after sex - Pain in the intestine or lower abdomen - Painful bowel movements or painful urination during menstrual periods - Heavy menstrual periods - Premenstrual spotting or bleeding between periodsIn addition, women who are diagnosed with endometriosis may have painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy.2For some women, the pain symptoms associated with endometriosis get milder after menopause, but this is not always the case. Hormone therapy such as estrogen or birth control pills, given to reduce menopausal symptoms, may cause these endometriosis symptoms to continue.Researchers know that pain is a primary symptom of endometriosis, but it is not known how pain arises in women with endometriosis.The severity of pain does not correspond with the number, location, or extent of endometriosis lesions. Some women with only a few small lesions experience severe pain; other women may have very large patches of endometriosis, but only experience little pain.3,4Current evidence suggests several possible explanations for pain associated with endometriosis, including (but not limited to):3,4- Patches of endometriosis respond to hormones in a similar way as the lining of the uterus. These tissues may bleed or have evidence of inflammation every month, similar to a regular menstrual period. However, the blood and tissue shed from endometriosis patches stay in the body and are irritants, which can cause pain. - In some cases, inflammation and chemicals produced by the endometriosis areas can cause the pelvic organs to adhere, or stick together, causing scar tissue. This makes the uterus, ovaries, and fallopian tubes, as well as the bladder and rectum, appear as one large organ. - Hormones and chemicals released by endometriosis tissue also may irritate nearby tissue and cause the release of other chemicals known to cause pain. - Over time, some endometriosis areas may form nodules or bumps as they create lesions on the surface of pelvic organs or can become cysts (fluid-filled sacs) on the ovaries. - Some endometriosis lesions have nerves in them, tying the patches directly into the central nervous system. These nerves may be more sensitive to pain-causing chemicals released in the lesions and surrounding areas. Over time, they may be more easily activated by the chemicals than normal nerve cells are. - Patches of endometriosis might also press against nearby nerve cells to cause pain. - Some women report less endometriosis pain after pregnancy, but the reason for this is unclear. Researchers are trying to determine if the reduction results from the hormones released by the body during pregnancy, or from changes in the cervix, uterus, or endometrium that occur during pregnancy and delivery.Pain from endometriosis can be severe, interfering with day-to-day activities. Understanding how endometriosis is related to pain is a very active area of research because it could allow for more effective treatments for this specific type of pain. How do health care providers diagnose endometriosis?​ Surgery is currently the only way to confirm a diagnosis of endometriosis.The most common surgery is called laparoscopy (pronounced lap-uh-ROS-kuh-pee). In this procedure:- The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas. - After making a small cut in the abdomen, the surgeon uses a small viewing instrument with a light, called a laparoscope (pronounced LAP-er-uh-skohp), to look at the reproductive organs, intestines, and other surfaces to see if there is any endometriosis. - He or she can make a diagnosis based on how the patches of endometriosis look. - In some cases, the surgeon will also do a biopsy, which involves taking a small tissue sample and studying it under a microscope, to confirm the diagnosis.1 - While the most common surgery is a laparoscopy, sometimes a laparotomy—a surgical procedure involving a larger incision—is used to make a diagnosis.Health care providers may also use imaging methods to produce a \"picture\" of the inside of the body to help detect endometriosis. Imaging allows them to locate larger endometriosis areas, such as nodules or cysts. The two most common imaging tests are ultrasound, which uses sound waves to make the picture, and magnetic resonance imaging (MRI), which uses magnets and radio waves to make the picture. These types of imaging will not aid in the diagnosis of small lesions or adhesions.1Your health care provider will perform a laparoscopy only after learning your full medical history and giving you a complete physical and pelvic exam. This information, in addition to the results of an ultrasound or MRI, will help you and your health care provider make more informed decisions about treatment.Researchers are also seeking less invasive ways to diagnose endometriosis and to determine how severe the disease is. NICHD-funded researchers in the National Centers for Translational Research in Reproduction and Infertility created a “diagnostic classifier” for endometriosis based on the presence of particular genes. The classifier was 90% to 100% accurate. Once the classifier is validated, a simple biopsy in the doctor’s office may be a non-surgical way to diagnose endometriosis in most women.2 What are the treatments for endometriosis?​ ​​- Treatments for Pain from Endometriosis Treatments for endometriosis pain fall into three general categories: - Pain medications - Hormone therapy - Surgical treatment Pain Medications Pain medications may work well if your pain or other symptoms are mild. These medications range from over-the-counter pain relievers to strong prescription pain relievers. The most common types of pain relievers are nonsteroidal anti-inflammatory drugs, also called NSAIDS (pronounced ENN-sedds), and opioids (pronounced OH-pee-oyds), strong pain drugs that interact directly with the nervous system. Evidence on the effectiveness of these medications for relieving endometriosis-associated pain is limited. Understanding which drugs relieve pain associated with endometriosis could also shed light on how endometriosis causes pain.1,2 Hormone Treatments Because hormones cause endometriosis patches to go through a cycle similar to the menstrual cycle, hormones also can be effective in treating the symptoms of endometriosis. Additionally, our perception of pain may be altered by different hormones. Hormone therapy is used to treat endometriosis-associated pain. Hormones come in the form of a pill, a shot or injection, or a nasal spray. Hormone treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation. This may help slow the growth and local activity of both the endometrium and the endometrial lesions. Treatment also prevents the growth of new areas and scars (adhesions), but it will not make existing adhesions go away. Health care providers may suggest one of the hormone treatments described below to treat pain from endometriosis:3,2,4 - Oral contraceptives, or birth control pills. These help make your period lighter, more regular, and shorter. Women prescribed contraceptives also report relief from pain.5 - In general, the therapy contains two hormones-estrogen and progestin, a progesterone-like hormone. Women who can't take estrogen because of cardiovascular disease or a high risk of blood clots can use progestin-only pills to reduce menstrual flow. - Typically, a woman takes the pill for 21 days and then takes sugar pills for 7 days to mimic the natural menstrual cycle. Some women take birth control pills continuously, without using the sugar pills that signal the body to go through menstruation. Taken without the sugar pills, birth control pills may stop the menstrual period altogether, which can reduce or eliminate the pain. There are also birth control pills available that provide only a couple days of sugar pills every 3 months; these also help reduce or eliminate pain. - Pain relief usually lasts only while taking the pills, while the endometriosis is suppressed. When treatment stops, the symptoms of endometriosis may return (along with the ability to get pregnant). Many women continue treatment indefinitely. Occasionally, some women have no pain for several years after stopping treatment. - There are some mild side effects from these hormones, such as weight gain, bloating, and bleeding between periods (especially when women first start to take the pills continuously). - Progesterone and progestin, taken as a pill, by injection, or through an intrauterine device (IUD), improve symptoms by reducing a woman's period or stopping it completely. This also prevents pregnancy. - As a pill taken daily, these hormones reduce menstrual flow without causing the uterus lining to grow. As soon as a woman stops taking the progestin pill, symptoms may return and pregnancy is possible. - An IUD containing progestin, such as Mirena®, may be effective in reducing endometriosis-associated pain. It reduces the size of lesions and reduces menstrual flow (one third of women no longer get their period after a year of use).6 - As an injection taken every 3 months, these hormones usually stop menstrual flow. However, one-third of women bleed several times in the first year of injection use. During these times of bleeding, pain may occur. Additionally, it may take a few months for a period to return after stopping the injections. When menstruation starts again, the ability to get pregnant returns. - Women taking these hormones may gain weight, feel depressed, or have irregular vaginal bleeding. - Gonadotropin-releasing hormone (GnRH) agonists (pronounced AG-uh-nists) stop the production of certain hormones to prevent ovulation, menstruation, and the growth of endometriosis. This treatment sends the body into a \"menopausal\" state. - GnRH agonists come in a nose spray taken daily, as an injection given once a month, or as an injection given every 3 months. - Most health care providers recommend staying on GnRH agonists for only about 6 months at a time, with several months between treatments if they are repeated. The risk for heart complications and bone loss can rise when taking them longer.2 After stopping the GnRH agonist, the body comes out of the menopausal state, menstruation begins, and pregnancy is possible.7 - As with all hormonal treatments, endometriosis symptoms return after women stop taking GnRH agonists. - These medications also have side effects, including hot flashes, tiredness, problems sleeping, headache, depression, joint and muscle stiffness, bone loss, and vaginal dryness. - Danazol (pronounced DAY-nuh-zawl, also called Danocrine®) treatment stops the release of hormones that are involved in the menstrual cycle. While taking this drug, women will have a period only now and then or sometimes not at all. - Common side effects include oily skin, pimples or acne, weight gain, muscle cramps, tiredness, smaller breasts, and sore breasts. Headaches, dizziness, weakness, hot flashes, or a deepening of the voice may also occur while on this treatment. Danazol's side effects are more severe than those from other hormone treatment options.2 - Danazol can harm a developing fetus. Therefore, it is important to prevent pregnancy while on this medication. Hormonal birth control methods are not recommended while on danazol. Instead, health care providers recommend using barrier methods of birth control, such as condoms or a diaphragm. Researchers are exploring the use of other hormones for treating endometriosis and the pain related to it. One example is gestrinone (pronounced GES-trih-nohn), which has been used in Europe but is not available in the United States. Drugs that lower the amount of estrogen in the body, called aromatase (pronounced uh-ROH-muh-tase) inhibitors, are also being studied. Some research shows that they can be effective in reducing endometriosis pain, but they are still considered experimental in the United States. They are not approved by the Food and Drug Administration for treatment of endometriosis.8 Surgical Treatments Research shows that some surgical treatments can provide significant, although short-term, pain relief from endometriosis,2 so health care providers may recommend surgery to treat severe pain from endometriosis. During the operation, the surgeon can locate any areas of endometriosis and examine the size and degree of growth; he or she also may remove the endometriosis patches at that time. It is important to understand what is planned during surgery as some procedures cannot be reversed and others can affect a woman's fertility. Therefore, a woman should have a detailed discussion with a health care provider about all available options before making final decisions about treatment. Health care providers may suggest one of the following surgical treatments for pain from endometriosis.1,2,3 - Laparoscopy. The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas and then inserts a small viewing instrument with a light, called a laparoscope, into the abdomen through a small cut to see the growths. - To remove the endometriosis, the surgeon makes at least two more small cuts in the abdomen and inserts lasers or other surgical instruments to: - Remove the lesions, which is a process called excising (pronounced eks-SIZE-ing). - Destroy the lesions with intense heat and seal the blood vessels without stitches, a process called cauterizing (pronounced KAW-tur-ize-ing) or vaporizing. - Some surgeons also will remove scar tissue at this time because it may be contributing to endometriosis-associated pain. - The goal is to treat the endometriosis without harming the healthy tissue around it. - Although most women have relief from pain with surgery in the short term, pain often returns.2 The excision of deep lesions seems to be associated with long-term pain relief. - Some evidence shows that surgical treatment for endometriosis-related pain is actually more effective in women who have moderate endometriosis rather than minimal endometriosis. The reason is that women with minimal endometriosis may have changes in their pain perception that persist after the lesions are removed.1,6 - Laparotomy. In this major abdominal surgery procedure, the surgeon may remove the endometriosis patches. Sometimes, the endometriosis lesions are too small to see in a laparotomy. - During this procedure, the surgeon may also remove the uterus. Removing the uterus is called hysterectomy (pronounced his-tuh-REK-tuh-mee). - If the ovaries have endometriosis on them or if damage is severe, the surgeon may remove the ovaries and fallopian tubes along with the uterus. This process is called total hysterectomy and bilateral (meaning \"on both sides\") salpingo-oophorectomy (pronounced sal-PING-go ooh-for-EK-toh-mee). - When possible, health care providers will try to leave the ovaries in place because of the important role ovaries play in overall health. - Health care providers recommend major surgery as a last resort for endometriosis treatment. - Having a hysterectomy or salpingo-oophorectomy does not guarantee that the lesions will not return or that the pain will go away. Endometriosis symptoms and lesions may come back in as many as 15% of women who have a total hysterectomy with bilateral salpingo-oophorectomy.2 - Surgery to sever pelvic nerves. If the pain is located in the center of the abdomen, health care providers may recommend cutting nerves in the pelvis to lessen the pain. This can be done during either laparoscopy or laparotomy.2 - Two procedures are used to sever different nerves in the pelvis. - Presacral neurectomy (pronounced pree-SEY-kruhl [or pree-SAK-ruhl]) nyoo-REK-tuh-mee). This procedure severs the nerves connected to the uterus. Research shows that this procedure can be useful in relieving pain along the center of the abdomen.6,8 - Laparoscopic uterine nerve ablation (pronounced a-BLEY-shuhn) (LUNA) This procedure involves severing nerves in the ligaments that secure the uterus. However, studies have shown that LUNA did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain.2,6,8 - The American College of Obstetricians and Gynecologists (ACOG) reports several clinical trials that showed these procedures to be ineffective at relieving pain from endometriosis. These procedures are not currently included in the ACOG recommendations for management of endometriosis.2 In some cases, hormone therapy is used before or after surgery to reduce pain and/or continue treatment. Current evidence supports the use of an intrauterine device (IUD) containing progestin after surgery to reduce pain.6 Currently, the only such device approved by the FDA is Mirena®. [top] - Pain medications - Hormone therapy - Surgical treatment - Oral contraceptives, or birth control pills. These help make your period lighter, more regular, and shorter. Women prescribed contraceptives also report relief from pain.5 - In general, the therapy contains two hormones-estrogen and progestin, a progesterone-like hormone. Women who can't take estrogen because of cardiovascular disease or a high risk of blood clots can use progestin-only pills to reduce menstrual flow. - Typically, a woman takes the pill for 21 days and then takes sugar pills for 7 days to mimic the natural menstrual cycle. Some women take birth control pills continuously, without using the sugar pills that signal the body to go through menstruation. Taken without the sugar pills, birth control pills may stop the menstrual period altogether, which can reduce or eliminate the pain. There are also birth control pills available that provide only a couple days of sugar pills every 3 months; these also help reduce or eliminate pain. - Pain relief usually lasts only while taking the pills, while the endometriosis is suppressed. When treatment stops, the symptoms of endometriosis may return (along with the ability to get pregnant). Many women continue treatment indefinitely. Occasionally, some women have no pain for several years after stopping treatment. - There are some mild side effects from these hormones, such as weight gain, bloating, and bleeding between periods (especially when women first start to take the pills continuously). - Progesterone and progestin, taken as a pill, by injection, or through an intrauterine device (IUD), improve symptoms by reducing a woman's period or stopping it completely. This also prevents pregnancy. - As a pill taken daily, these hormones reduce menstrual flow without causing the uterus lining to grow. As soon as a woman stops taking the progestin pill, symptoms may return and pregnancy is possible. - An IUD containing progestin, such as Mirena®, may be effective in reducing endometriosis-associated pain. It reduces the size of lesions and reduces menstrual flow (one third of women no longer get their period after a year of use).6 - As an injection taken every 3 months, these hormones usually stop menstrual flow. However, one-third of women bleed several times in the first year of injection use. During these times of bleeding, pain may occur. Additionally, it may take a few months for a period to return after stopping the injections. When menstruation starts again, the ability to get pregnant returns. - Women taking these hormones may gain weight, feel depressed, or have irregular vaginal bleeding. - Gonadotropin-releasing hormone (GnRH) agonists (pronounced AG-uh-nists) stop the production of certain hormones to prevent ovulation, menstruation, and the growth of endometriosis. This treatment sends the body into a \"menopausal\" state. - GnRH agonists come in a nose spray taken daily, as an injection given once a month, or as an injection given every 3 months. - Most health care providers recommend staying on GnRH agonists for only about 6 months at a time, with several months between treatments if they are repeated. The risk for heart complications and bone loss can rise when taking them longer.2 After stopping the GnRH agonist, the body comes out of the menopausal state, menstruation begins, and pregnancy is possible.7 - As with all hormonal treatments, endometriosis symptoms return after women stop taking GnRH agonists. - These medications also have side effects, including hot flashes, tiredness, problems sleeping, headache, depression, joint and muscle stiffness, bone loss, and vaginal dryness. - Danazol (pronounced DAY-nuh-zawl, also called Danocrine®) treatment stops the release of hormones that are involved in the menstrual cycle. While taking this drug, women will have a period only now and then or sometimes not at all. - Common side effects include oily skin, pimples or acne, weight gain, muscle cramps, tiredness, smaller breasts, and sore breasts. Headaches, dizziness, weakness, hot flashes, or a deepening of the voice may also occur while on this treatment. Danazol's side effects are more severe than those from other hormone treatment options.2 - Danazol can harm a developing fetus. Therefore, it is important to prevent pregnancy while on this medication. Hormonal birth control methods are not recommended while on danazol. Instead, health care providers recommend using barrier methods of birth control, such as condoms or a diaphragm. - Laparoscopy. The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas and then inserts a small viewing instrument with a light, called a laparoscope, into the abdomen through a small cut to see the growths. - To remove the endometriosis, the surgeon makes at least two more small cuts in the abdomen and inserts lasers or other surgical instruments to: - Remove the lesions, which is a process called excising (pronounced eks-SIZE-ing). - Destroy the lesions with intense heat and seal the blood vessels without stitches, a process called cauterizing (pronounced KAW-tur-ize-ing) or vaporizing. - Remove the lesions, which is a process called excising (pronounced eks-SIZE-ing). - Destroy the lesions with intense heat and seal the blood vessels without stitches, a process called cauterizing (pronounced KAW-tur-ize-ing) or vaporizing. - Some surgeons also will remove scar tissue at this time because it may be contributing to endometriosis-associated pain. - The goal is to treat the endometriosis without harming the healthy tissue around it. - Although most women have relief from pain with surgery in the short term, pain often returns.2 The excision of deep lesions seems to be associated with long-term pain relief. - Some evidence shows that surgical treatment for endometriosis-related pain is actually more effective in women who have moderate endometriosis rather than minimal endometriosis. The reason is that women with minimal endometriosis may have changes in their pain perception that persist after the lesions are removed.1,6 - Laparotomy. In this major abdominal surgery procedure, the surgeon may remove the endometriosis patches. Sometimes, the endometriosis lesions are too small to see in a laparotomy. - During this procedure, the surgeon may also remove the uterus. Removing the uterus is called hysterectomy (pronounced his-tuh-REK-tuh-mee). - If the ovaries have endometriosis on them or if damage is severe, the surgeon may remove the ovaries and fallopian tubes along with the uterus. This process is called total hysterectomy and bilateral (meaning \"on both sides\") salpingo-oophorectomy (pronounced sal-PING-go ooh-for-EK-toh-mee). - When possible, health care providers will try to leave the ovaries in place because of the important role ovaries play in overall health. - Health care providers recommend major surgery as a last resort for endometriosis treatment. - Having a hysterectomy or salpingo-oophorectomy does not guarantee that the lesions will not return or that the pain will go away. Endometriosis symptoms and lesions may come back in as many as 15% of women who have a total hysterectomy with bilateral salpingo-oophorectomy.2 - Surgery to sever pelvic nerves. If the pain is located in the center of the abdomen, health care providers may recommend cutting nerves in the pelvis to lessen the pain. This can be done during either laparoscopy or laparotomy.2 - Two procedures are used to sever different nerves in the pelvis. - Presacral neurectomy (pronounced pree-SEY-kruhl [or pree-SAK-ruhl]) nyoo-REK-tuh-mee). This procedure severs the nerves connected to the uterus. Research shows that this procedure can be useful in relieving pain along the center of the abdomen.6,8 - Laparoscopic uterine nerve ablation (pronounced a-BLEY-shuhn) (LUNA) This procedure involves severing nerves in the ligaments that secure the uterus. However, studies have shown that LUNA did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain.2,6,8 - Presacral neurectomy (pronounced pree-SEY-kruhl [or pree-SAK-ruhl]) nyoo-REK-tuh-mee). This procedure severs the nerves connected to the uterus. Research shows that this procedure can be useful in relieving pain along the center of the abdomen.6,8 - Laparoscopic uterine nerve ablation (pronounced a-BLEY-shuhn) (LUNA) This procedure involves severing nerves in the ligaments that secure the uterus. However, studies have shown that LUNA did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain.2,6,8 - The American College of Obstetricians and Gynecologists (ACOG) reports several clinical trials that showed these procedures to be ineffective at relieving pain from endometriosis. These procedures are not currently included in the ACOG recommendations for management of endometriosis.2 - Treatments for Infertility Related to Endometriosis In most cases, health care providers will recommend laparoscopy to remove or vaporize the growths as a way to also improve fertility in women who have mild or minimal endometriosis.6 Although studies show improved pregnancy rates following this type of surgery, the success rate is not clear. If pregnancy does not occur after laparoscopic treatment, in vitro fertilization (IVF) may be the best option to improve fertility. Taking any other hormonal therapy usually used for endometriosis-associated pain will only suppress ovulation and delay pregnancy. Performing another laparoscopy is not the preferred approach to improving fertility unless symptoms of pain prevent undergoing IVF. Multiple surgeries, especially those that remove cysts from the ovaries, may reduce ovarian function and hamper the success of IVF.6 IVF makes it possible to combine sperm and eggs in a laboratory to make an embryo. Then the resulting embryos are placed into the woman's uterus. IVF is one type of assisted reproductive technology that may be an option for women and families affected by infertility related to endometriosis. In general, the process of IVF involves the following steps. First, a woman takes hormones to cause \"superovulation,\" which triggers her body to produce many eggs at one time. Once mature, the eggs are collected from the woman, using a probe inserted into the vagina and guided by ultrasound. The collected eggs are placed in a dish for fertilization with a man's sperm. The fertilized cells are then placed in an incubator, a machine that keeps them warm and allows them to develop into embryos. After 3 to 5 days, the embryos are transferred to the woman's uterus. It takes about 2 weeks to know if the process is successful. Even though the use of hormones in IVF is successful in treating infertility related to endometriosis, other forms of hormone therapy are not as successful. For instance, ACOG does not recommend using oral contraceptive pills or GnRH agonists to treat endometriosis-related infertility. The use of these hormonal agents prevents ovulation and delays pregnancy.2,9 In addition, the hormones used during IVF do not cure the endometriosis lesions, which means that pain may recur after pregnancy and that not all women with endometriosis are able to become pregnant with IVF. Researchers are still looking for hormone treatments for infertility due to endometriosis. Other Endometriosis FAQs - If I have endometriosis, will I be able to get pregnant? Among women with fertility problems, endometriosis may occur in as many as 50%.1 But exactly how endometriosis causes infertility is not clear. Some evidence suggests that infertility is related to the extent of the endometriosis patches, because the patches can distort the pelvic anatomy. This would make it difficult for sperm to travel to the ovary or a fertilized egg to travel to the uterus.2,3 Other evidence suggests that the inflammation in the abdomen may disrupt ovulation or fertilization, or that the endometrium may not develop properly, hampering the attachment of the embryo to the uterus. There are treatments for endometriosis-related infertility that may help women get pregnant even with endometriosis. - Is endometriosis the same as endometrial cancer? Endometriosis and endometrial cancer are not the same. The word \"endometrium\" describes the tissue that lines the inside of the uterus. Endometrial cancer is a type of cancer that affects the lining of the inside of the uterus. Endometriosis itself is not a form of cancer. - Can endometriosis lead to cancer? There is a slight increase in the risk of ovarian cancer among women with endometriosis, particularly among women who were diagnosed with the condition at an early age. However, it is unclear whether endometriosis causes ovarian cancer or if the two conditions share risk factors or disease mechanisms that make them more likely to occur together.3,4 In some cases, women with endometriosis also have breast cancer or non-Hodgkin's lymphoma. However, these situations are rare.5 - Does endometriosis ever go away? For about one-quarter of women diagnosed with endometriosis, endometriosis patches go away on their own.6 Also, after menopause, symptoms of endometriosis typically lessen because there is a drop in the woman's natural hormones and the growths gradually shrink. However, this is not true for all women. If a woman takes hormones for menopausal symptoms, both her pain symptoms and the growths may return. Women with endometriosis who are experiencing symptoms, especially after menopause, should talk with their health care providers about treatment options. ", "role": "user" }, { "content": "The primary symptoms of endometriosis are pain and infertility ... Other common symptoms of endometriosis include:- Painful, even debilitating, menstrual cramps, which may get worse over time - Pain during or after sex - Pain in the intestine or lower abdomen - Painful bowel movements or painful urination during menstrual periods - Heavy menstrual periods - Premenstrual spotting or bleeding between periodsIn addition, women who are diagnosed with endometriosis may have painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy. ... For some women, the pain symptoms associated with endometriosis get milder after menopause ... In some cases, inflammation and chemicals produced by the endometriosis areas can cause the pelvic organs to adhere, or stick together, causing scar tissue. This makes the uterus, ovaries, and fallopian tubes, as well as the bladder and rectum, appear as one large organ. ...Over time, some endometriosis areas may form nodules or bumps as they create lesions on the surface of pelvic organs or can become cysts (fluid-filled sacs) on the ovaries. - Some endometriosis lesions have nerves in them, tying the patches directly into the central nervous system. ... Some women report less endometriosis pain after pregnancy ... Pain from endometriosis can be severe, interfering with day-to-day activities.", "role": "assistant" } ]

[ { "content": "how to prevent schizophrenia\n\n Schizophrenia Psychosis - schizophrenia Psychotic disorders - schizophrenia Summary Schizophrenia is a mental disorder that makes it hard to tell the difference between what is real and not real. It also makes it hard to think clearly, have normal emotional responses, and act normally in social situations. Causes Schizophrenia is a complex illness. Mental health experts are not sure what causes it. Genes may play a role. Schizophrenia occurs in just as many men as women. It usually begins in the teen or young adult years, but it may begin later in life. In women, it tends to begin later and is a milder condition. Schizophrenia in children usually begins after age 5. Childhood schizophrenia is rare and can be hard to tell apart from other developmental problems, such as autism spectrum disorder. Symptoms Symptoms usually develop slowly over months or years. The person may have many symptoms, or only a few. People with schizophrenia may have trouble keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors. Early symptoms may include: Irritable or tense feelings Trouble concentrating Trouble sleeping As the illness continues, the person may have problems with thinking, emotions, and behavior, including: Hearing or seeing things that are not there (hallucinations) Isolation Reduced emotions in tone of voice or expression of face Problems with understanding and making decisions Problems paying attention and following through with activities Strongly held beliefs that are not real (delusions) Talking in a way that does not make sense Thoughts that \"jump\" between different topics (loose associations) Exams and Tests There are no medical tests to diagnose schizophrenia. A psychiatrist should examine the person and make the diagnosis. The diagnosis is made based on an interview of the person and family members. The psychiatrist will ask about the following: How long symptoms have lasted How the person's ability to function has changed What the person's developmental background was like About the person's genetic and family history How well medicines have worked Whether the person has problems with substance abuse Other medical conditions the person has Brain scans (such as CT or MRI) and blood tests may help rule out other conditions that have similar symptoms. Treatment During an episode of schizophrenia, the person may need to stay in the hospital for safety reasons. MEDICINES Antipsychotic drugs are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms. These drugs can cause side effects, but many side effects can be managed. Side effects should not prevent the person from getting treated for this serious condition. Common side effects from antipsychotics may include: Dizziness Feelings of restlessness or jitteriness Sleepiness (sedation) Slowed movements Tremor Weight gain Long-term use of antipsychotics may increase the risk of a movement disorder called tardive dyskinesia. This condition causes repeated movements that the person cannot control. Call the health care provider right away if you think you or your family member may have this condition due to the medicine. When schizophrenia does not improve with antipsychotics, other medicines may be tried. Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotics for life. SUPPORT PROGRAMS AND THERAPIES Support therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better in social and work situations. Job training and relationship-building classes are also important. Family members and caregivers are very important during treatment. Therapy can teach important skills, such as: Coping with symptoms that continue, even while taking medicines Following a healthy lifestyle, including getting enough sleep and staying away from recreational drugs Taking medicines correctly and managing side effects Watching for the return of symptoms, and knowing what to do when they return Getting the right support services Outlook (Prognosis) Outlook is hard to predict. Most of the time, symptoms improve with medicines. But many people may have trouble functioning. They are at risk of repeated episodes, especially during the early stages of the illness. People with schizophrenia may need housing, job training, and other community support programs. Those with the most severe forms of this disorder may not be able to live alone. They may need to live in group homes or other long-term, structured residences. Symptoms are very likely to return when medicine is stopped. Possible Complications Having schizophrenia increases the risk of: Developing a problem with alcohol or drugs. Using these substances increases the chances that symptoms will return. Physical illness. This is due to an inactive lifestyle and side effects of medicines. Suicide. When to Contact a Medical Professional Call your provider if you (or a family member): Hear voices telling you to hurt yourself or others Have the urge to hurt yourself or others Feel scared or overwhelmed See things that are not really there Feel that you cannot leave the house Feel that you are not able to care for yourself Prevention Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them. Review Date 8/14/2017 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Internal review and update on 11/06/2018 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them.", "role": "assistant" } ]

[ { "content": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?\n\n Asthma Bronchial asthma Wheezing - asthma - adults Summary Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughing. Causes Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway. In people who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens or triggers. Common asthma triggers include: Animals (pet hair or dander) Dust mites Certain medicines (aspirin and other NSAIDS) Changes in weather (most often cold weather) Chemicals in the air or in food Exercise Mold Pollen Respiratory infections, such as the common cold Strong emotions (stress) Tobacco smoke Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals. Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies. Symptoms Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom. Asthma attacks can last for minutes to days. Attacks can become dangerous if airflow is severely blocked. Symptoms of asthma include: Cough with or without sputum (phlegm) production Pulling in of the skin between the ribs when breathing (intercostal retractions) Shortness of breath that gets worse with exercise or activity Wheezing Emergency symptoms that need prompt medical help include: Bluish color to the lips and face Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Sweating Other symptoms that may occur: Abnormal breathing pattern -- breathing out takes more than twice as long as breathing in Breathing temporarily stops Chest pain Tightness in the chest Exams and Tests The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances Arterial blood gas (usually only done with people who are having a severe asthma attack) Chest x-ray Lung function tests, including peak flow measurements Treatment The goals of treatment are: Control airway swelling Stay away from substances that trigger your symptoms Help you to be able to do normal activities without asthma symptoms You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms. MEDICINES FOR ASTHMA There are two kinds of medicines for treating asthma: Control medicines to help prevent attacks Quick-relief (rescue) medicines for use during attacks LONG-TERM MEDICINES These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK. Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you. QUICK-RELIEF MEDICINES These are also called rescue medicines. They are taken: For coughing, wheezing, trouble breathing, or an asthma attack Just before exercising to help prevent asthma symptoms caused by exercise Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs. Quick-relief medicines include: Short-acting inhaled bronchodilators Oral corticosteroids for when you have an asthma attack that is not going away A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV). ASTHMA CARE AT HOME Know the asthma symptoms to watch for. Know how to take your peak flow reading and what it means. Know which triggers make your asthma worse and what to do when this happens. Know how to care for your asthma when you exercise. Asthma action plans are written documents for managing asthma. An asthma action plan should include: Instructions for taking asthma medicines when your condition is stable A list of asthma triggers and how to avoid them How to recognize when your asthma is getting worse, and when to call your provider A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action. Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack. Outlook (Prognosis) There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life. Possible Complications The complications of asthma can be severe, and may include: Death Decreased ability to exercise and take part in other activities Lack of sleep due to nighttime symptoms Permanent changes in the function of the lungs Persistent cough Trouble breathing that requires breathing assistance (ventilator) When to Contact a Medical Professional Call for an appointment with your provider if asthma symptoms develop. Call your provider or go to the emergency room if: An asthma attack requires more medicine than recommended Symptoms get worse or do not improve with treatment You have shortness of breath while talking Your peak flow measurement is 50% to 80% of your personal best Go to the emergency room if these symptoms occur: Drowsiness or confusion Severe shortness of breath at rest A peak flow measurement of less than 50% of your personal best Severe chest pain Bluish color to the lips and face Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Prevention You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways. Cover bedding with allergy-proof casings to reduce exposure to dust mites. Remove carpets from bedrooms and vacuum regularly. Use only unscented detergents and cleaning materials in the home. Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches. Body parts and droppings from cockroaches can trigger asthma attacks in some people. If someone is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating outlets to trap animal dander. Change the filter in furnaces and air conditioners often. Eliminate tobacco smoke from the home. This is the single most important thing a family can do to help someone with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair. This can trigger asthma symptoms. If you smoke, now is a good time to quit. Avoid air pollution, industrial dust, and irritating fumes as much as possible. Review Date 2/19/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life.", "role": "assistant" } ]

[ { "content": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.\n\n Sickle beta thalassemia Hemoglobin sickle-beta thalassemia Hb S beta-thalassemia Sickle cell - beta-thalassemia disease Hemoglobin sickle-beta thalassemia Hb S beta-thalassemia Sickle cell - beta-thalassemia disease HbS - beta-thalassemia HbS-beta-thalassemia syndrome Sickle cell-beta-thalassemia disease syndrome See More Summary Sickle beta thalassemia is an inherited condition that affects hemoglobin, the protein in red blood cells that carries oxygen to different parts of the body. It is a type of sickle cell disease. Affected people have a different change ( mutation ) in each copy of their HBB gene : one that causes red blood cells to form a \"sickle\" or crescent shape and a second that is associated with beta thalassemia, a blood disorder that reduces the production of hemoglobin. Depending on the beta thalassemia mutation, people may have no normal hemoglobin (called sickle beta zero thalassemia) or a reduced amount of normal hemoglobin (called sickle beta plus thalassemia). The presence of sickle-shaped red blood cells, which often breakdown prematurely and can get stuck in blood vessels, combined with the reduction or absence of mature red blood cells leads to the many signs and symptoms of sickle beta thalassemia. Features, which may include anemia (low levels of red blood cells), repeated infections, and frequent episodes of pain, generally develop in early childhood and vary in severity depending on the amount of normal hemoglobin made. Sickle beta thalassemia is inherited in an autosomal recessive manner. Treatment is supportive and depends on the signs and symptoms present in each person. [1] [2] [3] Symptoms Signs and symptoms of sickle beta thalassemia may include: [3] [4] Anemia (low levels of red blood cells ) Repeated infections Frequent episodes of pain Pulmonary hypertension Acute chest syndrome (pneumonia-like condition due to entrapment of infection or sickle cells in the lungs) Stroke Enlarged spleen and/or liver Heart murmurs Delayed puberty Slowed growth Jaundice The symptoms of sickle beta thalassemia vary in severity based on the amount of normal hemoglobin made. Affected people may have no normal hemoglobin (called sickle beta zero thalassemia) or a reduced amount of normal hemoglobin (called sickle beta plus thalassemia). Although these two forms share many of the same features, people with sickle beta zero thalassemia are generally more severely affected than those with sickle beta plus thalassemia. For example, people with sickle beta plus thalassemia generally experience less frequent episodes of pain and are less likely to develop stroke, pulmonary hypertension and acute chest syndrome. [4] Cause Sickle beta thalassemia is caused by changes ( mutations ) in the HBB gene . HBB encodes a component of hemoglobin called \"beta globin\". Different mutations in HBB impact the production of hemoglobin in various ways. One specific mutation leads to an abnormal form of hemoglobin (called hemoglobin S) that causes red blood cells to form a \"sickle\" or crescent shape. Other mutations reduce the production of beta globin, which leads to low levels of functional hemoglobin and a low number or mature red blood cells (beta thalassemia). [2] People affected by sickle beta thalassemia have a different mutation in each copy of the HBB gene: one that produces hemoglobin S and a second that is associated with beta thalassemia. Depending on the beta thalassemia mutation, people may have no normal hemoglobin (called sickle beta zero thalassemia) or a reduced amount of normal hemoglobin (called sickle beta plus thalassemia). The presence of sickle-shaped red blood cells, which often breakdown prematurely and can get stuck in blood vessels, combined with the reduction or absence of mature red blood cells leads to the many signs and symptoms of sickle beta thalassemia. [2] Inheritance Sickle beta thalassemia is inherited in an autosomal recessive manner. This means that to be affected, a person must have a mutation in both copies of the responsible gene in each cell . People affected by sickle beta thalassemia inherit a different mutation in the HBB gene from each parent: one that produces sickle hemoglobin (called sickle trait ) and a second that results in reduced levels of functional hemoglobin (called beta thalassemia). [1] The parents of an affected person usually each carry one mutated copy of the gene and are referred to as carriers . Carriers typically do not show signs or symptoms of the condition. When two carriers of an autosomal recessive condition have children, each child has a 25% (1 in 4) risk to have the condition, a 50% (1 in 2) risk to be a carrier like each of the parents, and a 25% chance to not have the condition and not be a carrier. Diagnosis In the United States, babies affected by sickle beta thalassemia are often diagnosed at birth through newborn screening . In the absence of newborn screening , a diagnosis is usually suspected in infants or young children with signs and symptoms associated with the condition. Specialized laboratory tests that measure the amounts of abnormal hemoglobin in the blood and/or genetic testing to identify changes ( mutations ) in the HBB gene can be used to confirm a diagnosis. [1] Carrier testing for at-risk relatives and prenatal testing are possible if both disease-causing mutations in the family are known. [1] The Genetic Testing Registry (GTR) is a centralized online resource for information about genetic tests. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Newborn Screening An ACTion (ACT) sheet is available for this condition that describes the short-term actions a health professional should follow when an infant has a positive newborn screening result. ACT sheets were developed by experts in collaboration with the American College of Medical Genetics. An Algorithm flowchart is available for this condition for determining the final diagnosis in an infant with a positive newborn screening result. Algorithms are developed by experts in collaboration with the American College of Medical Genetics. Baby's First Test is the nation's newborn screening education center for families and providers. This site provides information and resources about screening at the local, state, and national levels and serves as the Clearinghouse for newborn screening information. The Newborn Screening Coding and Terminology Guide has information on the standard codes used for newborn screening tests. Using these standards helps compare data across different laboratories. This resource was created by the National Library of Medicine. National Newborn Screening and Global Resource Center (NNSGRC) provides information and resources in the area of newborn screening and genetics to benefit health professionals, the public health community, consumers and government officials. Treatment Treatment for sickle beta thalassemia is supportive and usually depends on the signs and symptoms present in each person. It is generally recommended that all affected people drink plenty of water; avoid climate extremes, activities that lead to inflammation and extreme fatigue; and stay up-to-date on all immunizations. Because sickle beta thalassemia is associated with a variety of health problems, affected people are usually followed closely by their healthcare provider with regular physical examinations that may include specialized laboratory tests and imaging studies (i.e. chest X-ray, transcranial doppler ultrasound, ECG). Blood transfusions may be prescribed on a regular basis for affected people with a history of or risk factors for stroke and other specific health problems, such as pulmonary hypertension. Hydroxyurea, a drug approved by the U.S. Food and Drug Administration for the treatment of sickle cell disease, can decrease the frequency and severity of pain episodes; reduce the need of blood transfusions; and increase life span. [1] [3] For more information regarding the treatment of sickle beta thalassemia and other sickle cell diseases, please click here. Prognosis The long-term outlook ( prognosis ) for people with sickle beta thalassemia varies depending on the severity of the condition. Sickle beta zero thalassemia (no normal hemoglobin) is usually associated with a worse prognosis and more severe disease course than sickle beta plus thalassmia (a reduced amount of normal hemoglobin). Although sickle cell diseases, including sickle beta thalassemia, can be fatal and are often associated with a shortened life span, early detection and the introduction of new treatment options have lead to significant increases in life expectancy and survival of people with these conditions. [5] ", "role": "user" }, { "content": "Treatment for sickle beta thalassemia may include regular blood transfusions for people at risk for stroke and other specific health problems, such as pulmonary hypertension. Hydroxyurea, a drug approved by the U.S. Food and Drug Administration for the treatment of sickle cell disease, can decrease the frequency and severity of pain episodes; reduce the need of blood transfusions; and increase life span.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\nWhat to do for Skull fracture?: - Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems.", "role": "user" }, { "content": "Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems.", "role": "assistant" } ]

[ { "content": "Treatment for optic nerve atrophy. Hello Name's case : Sex : Male Date of Birth : 1964 Nationality : X Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards /\n\nOptic nerve atrophy (Treatment): Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable.", "role": "user" }, { "content": "Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable.", "role": "assistant" } ]

[ { "content": "what are the symptoms for cystic fibrosis\n\n Cystic fibrosis Overview Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s. Cystic fibrosis care at Mayo Clinic Symptoms Screening of newborns for cystic fibrosis is now performed in every state in the United States. As a result, the condition can be diagnosed within the first month of life, before symptoms develop. For people born before newborn screening was performed, it's important to be aware of the signs and symptoms of cystic fibrosis. Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis. Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. If you or your child has symptoms of cystic fibrosis - or if someone in your family has cystic fibrosis - talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. Causes In cystic fibrosis, a defect (mutation) in a gene changes a protein that regulates the movement of salt in and out of cells. The result is thick, sticky mucus in the respiratory, digestive and reproductive systems, as well as increased salt in sweat. Many different defects can occur in the gene. The type of gene mutation is associated with the severity of the condition. Children need to inherit one copy of the gene from each parent in order to have the disease. If children inherit only one copy, they won't develop cystic fibrosis. However, they will be carriers and possibly pass the gene to their own children. Risk factors - Family history. Because cystic fibrosis is an inherited disorder, it runs in families. - Race. Although cystic fibrosis occurs in all races, it is most common in white people of Northern European ancestry. Complications - Damaged airways (bronchiectasis). Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways. This makes it harder to move air in and out of the lungs and clear mucus from the airways (bronchial tubes). - Chronic infections. Thick mucus in the lungs and sinuses provides an ideal breeding ground for bacteria and fungi. People with cystic fibrosis may often have sinus infections, bronchitis or pneumonia. - Growths in the nose (nasal polyps). Because the lining inside the nose is inflamed and swollen, it can develop soft, fleshy growths (polyps). - Coughing up blood (hemoptysis). Over time, cystic fibrosis can cause thinning of the airway walls. As a result, teenagers and adults with cystic fibrosis may cough up blood. - Pneumothorax. This condition, in which air collects in the space that separates the lungs from the chest wall, also is more common in older people with cystic fibrosis. Pneumothorax can cause chest pain and breathlessness. - Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. - Acute exacerbations. People with cystic fibrosis may experience worsening of their respiratory symptoms, such as coughing and shortness of breath, for several days to weeks. This is called an acute exacerbation and requires treatment in the hospital. - Nutritional deficiencies. Thick mucus can block the tubes that carry digestive enzymes from your pancreas to your intestines. Without these enzymes, your body can't absorb protein, fats or fat-soluble vitamins. - Diabetes. The pancreas produces insulin, which your body needs to use sugar. Cystic fibrosis increases the risk of diabetes. Around 30 percent of people with cystic fibrosis develop diabetes by age 30. - Blocked bile duct. The tube that carries bile from your liver and gallbladder to your small intestine may become blocked and inflamed, leading to liver problems and sometimes gallstones. - Intestinal obstruction. Intestinal obstruction can happen to people with cystic fibrosis at all ages. Children and adults with cystic fibrosis are more likely than are infants to develop intussusception, a condition in which a section of the intestines folds in on itself like an accordion. - Distal intestinal obstruction syndrome (DIOS). DIOS is partial or complete obstruction where the small intestine meets the large intestine. Almost all men with cystic fibrosis are infertile because the tube that connects the testes and prostate gland (vas deferens) is either blocked with mucus or missing entirely. Certain fertility treatments and surgical procedures sometimes make it possible for men with cystic fibrosis to become biological fathers. Although women with cystic fibrosis may be less fertile than other women, it's possible for them to conceive and to have successful pregnancies. Still, pregnancy can worsen the signs and symptoms of cystic fibrosis, so be sure to discuss the possible risks with your doctor. - Thinning of the bones (osteoporosis). People with cystic fibrosis are at higher risk of developing a dangerous thinning of bones. - Electrolyte imbalances and dehydration. Because people with cystic fibrosis have saltier sweat, the balance of minerals in their blood may be upset. Signs and symptoms include increased heart rate, fatigue, weakness and low blood pressure. Diagnosis To diagnose cystic fibrosis, doctors may conduct several tests. Newborn screening and diagnosis Every state in the U.S. now routinely screens newborns for cystic fibrosis. Early diagnosis means treatment can begin immediately. In one screening test, a blood sample is checked for higher than normal levels of a chemical (immunoreactive trypsinogen, or IRT) released by the pancreas. A newborn's IRT levels may be high because of premature birth or a stressful delivery. For that reason other tests may be needed to confirm a diagnosis of cystic fibrosis. Genetic tests may be used in addition to checking the IRT levels to confirm the diagnosis. Doctors may also conduct genetic tests to test for specific defects on the gene responsible for cystic fibrosis. To evaluate if an infant has cystic fibrosis, doctors may also conduct a sweat test when the infant is at least 2 weeks old. In a sweat test, doctors apply a sweat-producing chemical to a small area of skin. They then collect the sweat to test it and see if it's saltier than normal. Testing may be done at a center specializing in cystic fibrosis. Testing of older children and adults Cystic fibrosis tests may be recommended for older children and adults who weren't screened at birth. Your doctor may suggest genetic and sweat tests for cystic fibrosis if you have recurring bouts of inflamed pancreas (pancreatitis), nasal polyps, chronic sinus or lung infections, bronchiectasis, or male infertility. Treatment There is no cure for cystic fibrosis, but treatment can ease symptoms and reduce complications. Close monitoring and early, aggressive intervention is recommended. Managing cystic fibrosis is complex, so consider obtaining treatment at a center staffed by doctors and other staff trained in cystic fibrosis. Doctors may work with a multidisciplinary team of doctors and medical professionals trained in cystic fibrosis to evaluate and treat your condition. The goals of treatment include: - Preventing and controlling infections that occur in the lungs - Removing and loosening mucus from the lungs - Treating and preventing intestinal blockage - Providing adequate nutrition Medications The options may include: - Antibiotics to treat and prevent lung infections - Anti-inflammatory medications to lessen swelling in the airways in your lungs - Mucus-thinning drugs to help you cough up the mucus, which can improve lung function - Inhaled medications called bronchodilators that can help keep your airways open by relaxing the muscles around your bronchial tubes - Oral pancreatic enzymes to help your digestive tract absorb nutrients For those with cystic fibrosis who have certain gene mutations, doctors may recommend a newer medication called ivacaftor (Kalydeco). This medication may improve lung function and weight, and reduce the amount of salt in sweat. It has been approved by the Food and Drug Administration for people with cystic fibrosis who are age 6 and older. The dose depends on your weight and age. Doctors may conduct liver function tests and eye examinations before prescribing ivacaftor and on a regular basis while you're taking it to check for side effects such as liver function abnormalities and cataracts. For people with a certain gene mutation who are age 12 and older, another drug (Orkambi) is available that combines ivacaftor with a medication called lumacaftor. The combination of these medications may improve lung function and reduce the risk of exacerbations. However, some people may experience side effects such as chest discomfort and shortness of breath soon after starting the medication. Some people may also have high blood pressure while taking the medication. Doctors may monitor you for any side effects. Chest physical therapy Loosening the thick mucus in the lungs makes it easier to cough up. Chest physical therapy helps loosen mucus. It is usually done from one to four times a day. A common technique is clapping with cupped hands on the front and back of the chest. Certain breathing techniques also may be used to help loosen the mucus. Your doctor will instruct you about the type of chest physical therapy he or she recommends for you. Mechanical devices also can help loosen lung mucus. These include a vibrating vest or a tube or mask you breathe into. Pulmonary rehabilitation Your doctor may recommend a long-term program that may improve your lung function and overall well-being. Pulmonary rehabilitation is usually done on an outpatient basis and may include: - Physical exercise that may improve your condition - Breathing techniques that may help loosen mucus and improve breathing - Nutritional counseling - Counseling and support - Education about your condition Surgical and other procedures - Nasal polyp removal. Your doctor may recommend surgery to remove nasal polyps that obstruct breathing. - Oxygen therapy. If your blood oxygen level declines, your doctor may recommend that you breathe pure oxygen to prevent high blood pressure in the lungs (pulmonary hypertension). - Endoscopy and lavage. Mucus may be suctioned from obstructed airways through an endoscope. - Feeding tube. Cystic fibrosis interferes with digestion, so you can't absorb nutrients from food very well. Your doctor may suggest temporarily using a feeding tube to deliver extra nutrition while you sleep. This tube may be inserted in your nose and guided to your stomach, or it may be surgically implanted into the abdomen. - Bowel surgery. If a blockage develops in your bowel, you may need surgery to remove it. Intussusception, where a section of bowel has folded in on itself, also may require surgical repair. - Lung transplant. If you have severe breathing problems, life-threatening lung complications or increasing resistance to antibiotics used to treat lung infections, lung transplantation may be an option. Because bacteria line the airways in diseases that cause permanent widening of the large airways (bronchiectasis), such as cystic fibrosis, both lungs need to be replaced. Cystic fibrosis does not recur in transplanted lungs. However, other complications associated with cystic fibrosis - such as sinus infections, diabetes, pancreas problems and osteoporosis - can still occur after a lung transplant. Lifestyle and home remedies You can manage your condition and minimize complications in several ways. Always talk to your doctor before starting home remedies. Cystic fibrosis can cause malnourishment because the enzymes needed for digestion can't reach your small intestine, preventing food from being absorbed. People with cystic fibrosis may need a significantly higher number of calories daily than do people without the condition. A healthy diet is important to maintain good lung function. It's also important to drink lots of fluids, which can help thin the mucus in your lungs. You may work with a dietitian to develop a nutrition plan. Most people with cystic fibrosis need to take pancreatic enzyme capsules with every meal and snack. In addition, your doctor may recommend: - Antacids - Supplemental high-calorie nutrition - Special fat-soluble vitamins - Extra fiber to prevent intestinal blockage - Extra salt, especially during hot weather or before exercising - Adequate water during hot weather In addition to other usual childhood vaccines, people with cystic fibrosis should have the annual flu vaccine and any other vaccines their doctor recommends. Cystic fibrosis doesn't affect the immune system, but children with cystic fibrosis are more likely to develop complications when they become sick. Regular exercise helps loosen mucus in your airways, and strengthens your heart. For many people with cystic fibrosis, participating in sports can improve confidence and self-esteem. Anything that gets you moving, including walking and biking, can help. Don't smoke in your home or car, and don't allow other people to smoke around you or your child. Secondhand smoke is harmful for everyone, but especially for people with cystic fibrosis. Teach all the members of your family to wash their hands thoroughly before eating, after using the bathroom, when coming home from work or school, and after being around a person who is sick. Hand-washing is the best way to protect against infection. You'll have ongoing care from your doctor and other medical professionals. Make sure to attend your regular follow-up appointments. Take your medications as prescribed and follow therapies as instructed. Contact your doctor if you experience any signs or symptoms such as severe constipation, more mucus than usual, blood in your mucus or reduced energy. ", "role": "user" }, { "content": "Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse).", "role": "assistant" } ]

[ { "content": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks\n\nGastroparesis: Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether.Gastroparesis slows or stops the movement of food from the stomach to the small intestine.Gastroparesis slows or stops the movement of food from the stomach to the small intestine. Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. Other identifiable causes of gastroparesis include intestinal surgery and nervous system diseases such as Parkinson’s disease or multiple sclerosis. For reasons that are still unclear, gastroparesis is more commonly found in women than in men. The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food—sometimes several hours after a meal. Other symptoms of gastroparesis includegastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomach pain in the stomach area abdominal bloating lack of appetitegastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomachpain in the stomach areaabdominal bloatinglack of appetiteSymptoms may be aggravated by eating greasy or rich foods, large quantities of foods with fiber—such as raw fruits and vegetables—or drinking beverages high in fat or carbonation. Symptoms may be mild or severe, and they can occur frequently in some people and less often in others. The symptoms of gastroparesis may also vary in intensity over time in the same individual. Sometimes gastroparesis is difficult to diagnose because people experience a range of symptoms similar to those of other diseases. Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the GI tract, and gastric emptying tests. Tests may also identify a nutritional disorder or underlying disease. To rule out any blockage or other structural problems, the health care provider may perform one or more of the following tests:Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract, which includes the esophagus, stomach, and duodenum—the first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologist—a doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoars—solid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach—that are sometimes softened, dissolved, or broken up during an upper GI endoscopy. Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test. 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 provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a person’s digestive symptoms, rather than gastroparesis. Gastric emptying scintigraphy. The test involves eating a bland meal—such as eggs or an egg substitute—that contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed. SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the person’s waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract. Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying.Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract, which includes the esophagus, stomach, and duodenum—the first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologist—a doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoars—solid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach—that are sometimes softened, dissolved, or broken up during an upper GI endoscopy.Upper gastrointestinal (GI) endoscopy.Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test.Upper GI series.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 provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a person’s digestive symptoms, rather than gastroparesis.Ultrasound.Gastric emptying scintigraphy. The test involves eating a bland meal—such as eggs or an egg substitute—that contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed.Gastric emptying scintigraphy.SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the person’s waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract.SmartPill.Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying.Gastric emptying breath test. Treatment of gastroparesis depends on the severity of the person’s symptoms. In most cases, treatment does not cure gastroparesis, which is usually a chronic, or long-lasting, condition. Gastroparesis is also a relapsing condition—the symptoms can come and go for periods of time. Treatment helps people manage the condition so they can be as comfortable and active as possible. Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying.A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars.When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met.When the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given.MedicationsSeveral prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment.Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesia—a disorder that affects movement.Metoclopramide (Reglan).Erythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps.Erythromycin.Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting.Other medications.Botulinum ToxinBotulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.11Gastric Electrical StimulationThis treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms.JejunostomyIf medications and dietary changes don’t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe.Parenteral NutritionWhen gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition—an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis. An elevated blood glucose level directly interferes with normal stomach emptying, so good blood glucose control in people with diabetes is important. However, gastroparesis can make blood glucose control difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Gastric emptying is unpredictable with gastroparesis, causing a person’s blood glucose levels to be erratic and difficult to control.The primary treatment goals for gastroparesis related to diabetes are to improve gastric emptying and regain control of blood glucose levels. In addition to the dietary changes and treatments already described, a health care provider will likely adjust the person’s insulin regimen.To better control blood glucose, people with diabetes and gastroparesis may need totake insulin more often or change the type of insulin they take take insulin after meals, instead of before check blood glucose levels frequently after eating and administer insulin when necessarytake insulin more often or change the type of insulin they taketake insulin after meals, instead of beforecheck blood glucose levels frequently after eating and administer insulin when necessaryA health care provider will give specific instructions for taking insulin based on the individual’s needs and the severity of gastroparesis.In some cases, the dietitian may suggest eating several liquid or puréed meals a day until gastroparesis symptoms improve and blood glucose levels are more stable. The problems of gastroparesis can includesevere dehydration due to persistent vomiting gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagus bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form difficulty managing blood glucose levels in people with diabetes malnutrition due to poor absorption of nutrients or a low calorie intake decreased quality of life, including work absences due to severe symptomssevere dehydration due to persistent vomitinggastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagusbezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill formdifficulty managing blood glucose levels in people with diabetesmalnutrition due to poor absorption of nutrients or a low calorie intakedecreased quality of life, including work absences due to severe symptoms Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether. Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food— sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite. Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests. Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or puréed diet may be prescribed. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition. For people with gastroparesis and diabetes, a health care provider will likely adjust the person’s insulin regimen.Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine.Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether.Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests.Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve.The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food— sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite.Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests.Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or puréed diet may be prescribed.Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition.For people with gastroparesis and diabetes, a health care provider will likely adjust the person’s insulin regimen. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.What are clinical trials, and are they right for you?Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.Find out if clinical trials are right for youWhat clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.www.ClinicalTrials.govThis information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information.This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information.www.fda.govThe U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.What is gastroparesis? Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether. Gastroparesis slows or stops the movement of food from the stomach to the small intestine. What causes gastroparesis? Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. Other identifiable causes of gastroparesis include intestinal surgery and nervous system diseases such as Parkinson’s disease or multiple sclerosis. For reasons that are still unclear, gastroparesis is more commonly found in women than in men. What are the symptoms of gastroparesis? The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food—sometimes several hours after a meal. Other symptoms of gastroparesis include gastroesophageal reflux (GER), also called acid reflux or acid regurgitation—a condition in which stomach contents flow back up into the esophagus, the organ that connects the mouth to the stomach pain in the stomach area abdominal bloating lack of appetite Symptoms may be aggravated by eating greasy or rich foods, large quantities of foods with fiber—such as raw fruits and vegetables—or drinking beverages high in fat or carbonation. Symptoms may be mild or severe, and they can occur frequently in some people and less often in others. The symptoms of gastroparesis may also vary in intensity over time in the same individual. Sometimes gastroparesis is difficult to diagnose because people experience a range of symptoms similar to those of other diseases. How is gastroparesis diagnosed? Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the GI tract, and gastric emptying tests. Tests may also identify a nutritional disorder or underlying disease. To rule out any blockage or other structural problems, the health care provider may perform one or more of the following tests: Upper gastrointestinal (GI) endoscopy. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract, which includes the esophagus, stomach, and duodenum—the first part of the small intestine. The test is performed at a hospital or outpatient center by a gastroenterologist—a doctor who specializes in digestive diseases. The endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. An intravenous (IV) needle is placed in a vein in the arm if general anesthesia is given. The test may show blockage or large bezoars—solid collections of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach—that are sometimes softened, dissolved, or broken up during an upper GI endoscopy. Upper GI series. An upper GI series may be done to look at the small intestine. The test is performed at a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. No eating or drinking is allowed for 8 hours before the procedure, if possible. If the person has diabetes, a health care provider may give different instructions about fasting before the test. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of gastroparesis show up more clearly on x rays. Gastroparesis is likely if the x ray shows food in the stomach after fasting. A person may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored. A health care provider will give the person specific instructions about eating and drinking after the test. 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 provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. The images can show whether gallbladder disease and pancreatitis could be the cause of a person’s digestive symptoms, rather than gastroparesis. Gastric emptying scintigraphy. The test involves eating a bland meal—such as eggs or an egg substitute—that contains a small amount of radioactive material. The test is performed in a radiology center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal. If more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed. SmartPill. The SmartPill is a small electronic device in capsule form. The SmartPill test is available at specialized outpatient centers. The images are interpreted by a radiologist. The device is swallowed and moves through the entire digestive tract, sending information to a cell-phone-sized receiver worn around the person’s waist or neck. The recorded information provides a detailed record of how quickly food travels through each part of the digestive tract. Gastric emptying breath test. With this test, the person eats a special test meal that includes a natural material with a special type of carbon in it. Then, breath samples are taken over a period of several hours to measure the amount of the material in the exhaled breath. The results allow the health care provider to calculate how fast the stomach is emptying. How is gastroparesis treated? Treatment of gastroparesis depends on the severity of the person’s symptoms. In most cases, treatment does not cure gastroparesis, which is usually a chronic, or long-lasting, condition. Gastroparesis is also a relapsing condition—the symptoms can come and go for periods of time. Treatment helps people manage the condition so they can be as comfortable and active as possible. Eating, Diet, and Nutrition Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying. A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars. When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met. When the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given. Medications Several prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment. Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesia—a disorder that affects movement. Erythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps. Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting. Botulinum Toxin Botulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.1 Gastric Electrical Stimulation This treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms. Jejunostomy If medications and dietary changes don’t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe. Parenteral Nutrition When gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition—an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis. How is gastroparesis treated if a person has diabetes? An elevated blood glucose level directly interferes with normal stomach emptying, so good blood glucose control in people with diabetes is important. However, gastroparesis can make blood glucose control difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Gastric emptying is unpredictable with gastroparesis, causing a person’s blood glucose levels to be erratic and difficult to control. The primary treatment goals for gastroparesis related to diabetes are to improve gastric emptying and regain control of blood glucose levels. In addition to the dietary changes and treatments already described, a health care provider will likely adjust the person’s insulin regimen. To better control blood glucose, people with diabetes and gastroparesis may need to take insulin more often or change the type of insulin they take take insulin after meals, instead of before check blood glucose levels frequently after eating and administer insulin when necessary A health care provider will give specific instructions for taking insulin based on the individual’s needs and the severity of gastroparesis. In some cases, the dietitian may suggest eating several liquid or puréed meals a day until gastroparesis symptoms improve and blood glucose levels are more stable. What are the problems of gastroparesis? The problems of gastroparesis can include severe dehydration due to persistent vomiting gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagus bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form difficulty managing blood glucose levels in people with diabetes malnutrition due to poor absorption of nutrients or a low calorie intake decreased quality of life, including work absences due to severe symptoms Points to Remember Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether. Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food— sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite. Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests. Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or puréed diet may be prescribed. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition. For people with gastroparesis and diabetes, a health care provider will likely adjust the person’s insulin regimen. References [1] Bai Y, Xu MJ, Yang X, et al. A systematic review on intrapyloric botulinum toxin injection for gastroparesis. Digestion. 2010;81(1):27–34. Clinical Trials The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. What are clinical trials, and are they right for you? Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you. What clinical trials are open? Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your health care provider for more information. The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.", "role": "user" }, { "content": "Causes of gastroparesis, or delayed gastric emptying, are unknown in most people. The most common known cause is diabetes. The symptoms of gastrparesis, a disorder that mostly affects women, are nausea, gastroesophageal reflux, a feeling of fullness after eating only a small amount of food, and vomiting undigested food, sometimes several hours after a meal. Your doctor will diagnose gastroparesis through a physical examination, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal tract, and gastric emptying tests. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy (surgery to place a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum), and parenteral nutrition.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\n Atherosclerosis What Is... Español Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. OTHER NAMES Arteriosclerosis Hardening of the arteries CAUSES The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open). When this happens, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body. Depending on which arteries are affected, blood clots can worsen angina (chest pain) or cause a heart attack or stroke. Researchers continue to look for the causes of atherosclerosis. They hope to find answers to questions such as: Why and how do the arteries become damaged? How does plaque develop and change over time? Why does plaque rupture and lead to blood clots? WHO IS AT RISK The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms \"overweight\" and \"obesity\" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported \"trigger\" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. SIGNS & SYMPTOMS Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected. Coronary Arteries The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), a common symptom is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Other symptoms of CHD are shortness of breath and arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy. Carotid Arteries The carotid arteries supply oxygen-rich blood to your brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), you may have symptoms of a stroke. These symptoms may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache Peripheral Arteries Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease). If these major arteries are narrowed or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Renal Arteries The renal arteries supply oxygen-rich blood to your kidneys. If plaque builds up in these arteries, you may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function. Early kidney disease often has no signs or symptoms. As the disease gets worse it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness, and trouble concentrating. DIAGNOSIS Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Specialists Involved If you have atherosclerosis, a primary care doctor, such as an internist or family practitioner, may handle your care. Your doctor may recommend other health care specialists if you need expert care, such as: A cardiologist. This is a doctor who specializes in diagnosing and treating heart diseases and conditions. You may go to a cardiologist if you have peripheral artery disease (P.A.D.) or coronary microvascular disease (MVD). A vascular specialist. This is a doctor who specializes in diagnosing and treating blood vessel problems. You may go to a vascular specialist if you have P.A.D. A neurologist. This is a doctor who specializes in diagnosing and treating nervous system disorders. You may see a neurologist if you've had a stroke due to carotid artery disease. A nephrologist. This is a doctor who specializes in diagnosing and treating kidney diseases and conditions. You may go to a nephrologist if you have chronic kidney disease. Physical Exam During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup. Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Diagnostic Tests Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for atherosclerosis. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure. Ankle/Brachial Index This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D. Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Computed Tomography Scan A computed tomography (CT) scan creates computer-generated pictures of the heart, brain, or other areas of the body. The test can show hardening and narrowing of large arteries. A cardiac CT scan also can show whether calcium has built up in the walls of the coronary (heart) arteries. This may be an early sign of CHD. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. When your heart is working hard, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. Angiography Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your arteries. This test can show whether plaque is blocking your arteries and how severe the blockage is. A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. Dye that can be seen on an x-ray picture is injected through the catheter into the arteries. By looking at the x-ray picture, your doctor can see the flow of blood through your arteries. Other Tests Other tests are being studied to see whether they can give a better view of plaque buildup in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET). TREATMENTS Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking. Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat—found mostly in foods that come from animals Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25.0 and 29.9 is considered overweight. A BMI of 30.0 or higher is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, visit Aim for a Healthy Weight. If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans Quitting Smoking If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. For more information about how to quit smoking, visit Smoking and Your Heart. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke. PREVENTION Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. LIVING WITH Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. ", "role": "user" }, { "content": "You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures.", "role": "assistant" } ]

[ { "content": "I have a fractured nose i need it fixed. its been broke for 3 years now\n\nRhinoplasty: Rhinoplasty is surgery to repair or reshape the nose. Rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the person's preference. It is performed in a surgeon's office, a hospital, or an outpatient surgery center. Complex procedures may require a short hospital stay. The procedure often takes 1 to 2 hours. It may take longer. With local anesthesia, the nose and the area around it are numbed. You will probably be lightly sedated, but awake during the surgery (relaxed and not feeling pain). General anesthesia allows you to sleep through the operation. The surgery is usually done through a cut (incision) made inside the nostrils. In some cases, the cut is made from outside, around the base of the nose. This type of cut is used to perform work on the tip of the nose or if you need a cartilage graft. If the nose needs to be narrowed, the incision may extend around the nostrils. Small incisions may be made on the side of the nose to break, and reshape the bone. A splint (metal or plastic) may be placed on the outside of the nose. This helps maintain the new shape of the bone when the surgery is finished. Soft plastic splints or nasal packs also may be placed in the nostrils. This helps keep the dividing wall between the air passages (septum) stable. Rhinoplasty is one of the most common plastic surgery procedures. It can be used to: - Reduce or increase the size of the nose - Change the shape of the tip or the nasal bridge - Narrow the opening of the nostrils - Change the angle between the nose and the upper lip - Correct a birth defect or injury - Help relieve some breathing problems Nose surgery is considered elective when it is done for cosmetic reasons. In these cases, the purpose is to change the shape of the nose to one that the person finds more desirable. Many surgeons prefer to perform cosmetic nose surgery after the nasal bone has finished growing. This is around age 14 or 15 for girls and a bit later for boys. Risks for anesthesia and surgery in general are: - Reactions to medicines, problems breathing - Bleeding, infection, or bruising Risks for this procedure include: - Loss of support of the nose - Contour deformities of the nose - Need for further surgery After surgery, tiny blood vessels that have burst may appear as tiny red spots on the skin surface. These are usually minor, but are permanent. There are no visible scars if the rhinoplasty is performed from inside the nose. If the procedure narrows flared nostrils, there may be small scars at the base of the nose that are not often visible. In rare cases, a second procedure is needed to fix a minor deformity. Your surgeon may give you instructions to follow before your surgery. You may need to: - Stop any medicines that thin your blood. Your surgeon will give you a list of these medicines. - See your regular health care provider to have some routine tests and make sure it is safe for you to have surgery. - To aid with healing, stop smoking 2 to 3 weeks before and after surgery. - Arrange to have someone drive you home after surgery. You will usually go home on the same day as your surgery. Right after surgery, your nose and face will be swollen and painful. Headaches are common. The nasal packing is usually removed in 3 to 5 days, after which you will feel more comfortable. The splint may be left in place for 1 to 2 weeks. Full recovery takes several weeks. Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for months. You may not be able to see the final results for up to a year. Updated by: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.", "role": "user" }, { "content": "The plastic surgery procedure to correct your nose after injury is called rhinoplasty. It can reduce or increase the size of the nose, change the shape of the tip or the nasal bridge, change the angle between the nose and the upper lip, and narrow the nostrils.", "role": "assistant" } ]

[ { "content": "how to deal with anxiety\n\nSocial anxiety disorder (Treatment): The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: - Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. - Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. - Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. - These medicines should only be taken under a doctor's direction. - Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. - They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. - If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. - Get regular exercise, enough sleep, and regularly scheduled meals. - Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants.", "role": "user" }, { "content": "For social anxiety disorder, treatment may help you learn to function effectively. The success of treatment depends on the severity of your fears. Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition. Systematic desensitization or exposure therapy may also be used to help you work through your fears. Group therapy may help you practice social skills. There are also medicines that may help make your symptoms less severe. Lifestyle changes can reduce the frequency of the attacks, such as getting regular exercise, enough sleep, and regular meals.", "role": "assistant" } ]

[ { "content": "how do you administer lanreotide\n\n Lanreotide Injection Why is this medication prescribed? Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated with surgery or radiation. Lanreotide injection is also used to treat people with neuroendocrine tumors in the gastrointestinal (GI) tract or the pancreas (GEP-NETs) that have spread or cannot be removed by surgery. Lanreotide injection is in a class of medications called somatostatin agonists. It works by decreasing the amounts of certain natural substances produced by the body. How should this medicine be used? Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before receiving lanreotide injection,</h3> /h3> tell your doctor and pharmacist if you are allergic to lanreotide injection, any other medications, or any of the ingredients in lanreotide injection. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); bromocriptine (Cycloset, Parlodel); cyclosporine (Gengraf, Neoral, Sandimmune); insulin and oral medications for diabetes; quinidine (in Nuedexta), or terfenadine (no longer available in the U.S.). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had diabetes, or gallbladder, heart, kidney, thyroid, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving lanreotide injection, call your doctor. you should know that lanreotide injection may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What side effects can this medication cause? This medication may cause changes in your blood sugar. You should know the symptoms of high and low blood sugar and what to do if you have these symptoms. <h3>Lanreotide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> diarrhea loose stools constipation gas vomiting weight loss headache redness, pain, itching, or a lump at the injection site depression <h3>Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment: </h3> /h3> pain in the upper right part of the stomach, center of the stomach, back, or shoulder muscle pain or discomfort yellowing of the skin and eyes fever with chills nausea swelling of the face, throat, tongue, lips, or eyes tightness in the throat difficulty breathing and swallowing wheezing hoarseness rash itching hives shortness of breath slowed or irregular heartbeat Lanreotide injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? If you are storing the prefilled syringes in your home until it is time for it to be injected by your doctor or nurse, you should always store it in original carton in the refrigerator and protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication. In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to lanreotide injection. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Somatuline Depot ", "role": "user" }, { "content": "Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results.", "role": "assistant" } ]

[ { "content": "how smoking tobacco affects the rest of the body\n\n Benefits of quitting tobacco Secondhand smoke Cigarette smoking - quitting Tobacco cessation Smoking and smokeless tobacco - quitting Why you should quit smoking Summary If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, without success, in the past. View any past attempts to quit as a learning experience, not a failure. There are many reasons to quit using tobacco. Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING You may enjoy the following when you quit smoking. Your breath, clothes, and hair will smell better. Your sense of smell will return. Food will taste better. Your fingers and fingernails will slowly appear less yellow. Your stained teeth may slowly become whiter. Your children will be healthier and will be less likely to start smoking. It will be easier and cheaper to find an apartment or hotel room. You may have an easier time getting a job. Friends may be more willing to be in your car or home. It may be easier to find a date. Many people do not smoke and do not like to be around people who smoke. You will save money. If you smoke a pack a day, you spend about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. Within 24 hours of quitting: Your risk of a sudden heart attack goes down. Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes. Other health benefits of quitting smoking include: Lower chance of blood clots in the legs, which may travel to the lungs Lower risk of erectile dysfunction Fewer problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip Lower risk of infertility due to damaged sperm Healthier teeth, gums, and skin Infants and children who you live with will have: Asthma that is easier to control Fewer visits to the emergency room Fewer colds, ear infections, and pneumonia Reduced risk of sudden infant death syndrome (SIDS) MAKING THE DECISION Like any addiction, quitting tobacco is difficult, especially if you do it alone. There are a lot of ways to quit smoking and many resources to help you. Talk to your health care provider about nicotine replacement therapy and smoking cessation medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Review Date 11/20/2017 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. - Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. - Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. - Within 24 hours of quitting: Your risk of a sudden heart attack goes down. - Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. - Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. - Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. - Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. - Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. - Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes.", "role": "assistant" } ]

[ { "content": "Is it necessary to go to the dr. when getting a skull fracture?\n\n Skull fracture Basilar skull fracture Depressed skull fracture Linear skull fracture Summary A skull fracture is a fracture or break in the cranial (skull) bones. Considerations Skull fractures may occur with head injuries. The skull provides good protection for the brain. However, a severe impact or blow can cause the skull to break. It may be accompanied by concussion or other injury to the brain. The brain can be affected directly by damage to the nervous system tissue and bleeding. The brain can also be affected by bleeding under the skull. This can compress the underlying brain tissue (subdural or epidural hematoma). A simple fracture is a break in the bone without damage to the skin. A linear skull fracture is a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of bone. A depressed skull fracture is a break in a cranial bone (or \"crushed\" portion of skull) with depression of the bone in toward the brain. A compound fracture involves a break in, or loss of, skin and splintering of the bone. Causes Causes of skull fracture can include: Head trauma Falls, automobile accidents, physical assault, and sports Symptoms Symptoms may include: Bleeding from wound, ears, nose, or around eyes Bruising behind the ears or under the eyes Changes in pupils (sizes unequal, not reactive to light) Confusion Convulsions Difficulties with balance Drainage of clear or bloody fluid from ears or nose Drowsiness Headache Loss of consciousness Nausea and vomiting Restlessness, irritability Slurred speech Stiff neck Swelling Visual disturbances In some cases, the only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop. First Aid Take the following steps if you think someone has a skull fracture: <li>Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR.</li> <li>Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance.</li> <li>If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn.</li> <li>Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury.</li> <li>If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss.</li> <li>If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure.</li> <li>If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit.</li> <li>If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the person does not think medical help is needed).</li> DO NOT Follow these precautions: DO NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. DO NOT remove protruding objects. DO NOT allow the person to continue with physical activities. DO NOT forget to watch the person closely until medical help arrives. DO NOT give the person any medicines before talking to a doctor. DO NOT leave the person alone, even if there are no obvious problems. When to Contact a Medical Professional Get medical help right away if: There are problems with breathing or circulation. Direct pressure does not stop bleeding from the nose, ears, or wound. There is drainage of clear fluid from the nose or ears. There is facial swelling, bleeding, or bruising. There is an object protruding from the skull. The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly. Prevention Not all head injuries can be prevented. The following simple steps can help keep you and your child safe: <li>Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats.</li> <li>Learn and follow bicycle safety recommendations.</li> <li>Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired. </li> Review Date 10/16/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. ", "role": "user" }, { "content": "Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems.", "role": "assistant" } ]

[ { "content": "what the treatment for bronchitis\n\nWhat are the treatments for Bronchitis - acute?: Most people DO NOT need antibiotics for acute bronchitis. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better: - Drink plenty of fluids. - If you have asthma or another chronic lung condition, use your inhaler. - Get plenty of rest. - Take aspirin or acetaminophen (Tylenol and other brands) if you have a fever. Do not give aspirin to children. - Use a humidifier or steam in the bathroom. Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word \"guaifenesin\" on the label. Ask the pharmacist if you need help finding it. If your symptoms do not improve or if you are wheezing, your doctor may prescribe an inhaler to open your airways. If your doctor thinks you also have bacteria in your airways, he or she may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. A bacterial infection is more common if you also have a chronic lung disease like COPD. Sometimes, bacteria may infect the airways along with the virus. If your doctor thinks this has happened, you may be prescribed antibiotics. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs. Other tips include: - Do not smoke. - Avoid secondhand smoke and air pollution. - Wash your hands (and your children's hands) often to avoid spreading viruses and other germs.", "role": "user" }, { "content": "Most cases of acute bronchitis get better without treatment, usually within a week. Cases of bronchitis that are caused by viral infections do not need antibiotics. If doctors suspect that the infection is bacterial, they may prescribe an antibiotic. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs. Doctors may also recommend cough medicine containing guaifenesin. The following steps may help: drinking plenty of fluids; getting rest; taking aspirin or acetaminophen case of a fever; using a humidifier or steam in the bathroom; quitting smoking and avoiding secondhand smoke and air pollution; wash hands often to avoid spreading viruses and other germs.", "role": "assistant" } ]

[ { "content": "how to prevent atherosclerosis\n\nHardening of the arteries (Outlook (Prognosis)): Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse. This can help reduce the chances of having a heart attack and stroke as a result of atherosclerosis.", "role": "user" }, { "content": "Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse. This can help reduce the chances of having a heart attack and stroke as a result of atherosclerosis.", "role": "assistant" } ]

[ { "content": "what is binge eating disorder\n\n Binge eating disorder Overview Binge eating disorder is the most common type of eating disorder in the United States. People with binge eating disorder often feel out of control and eat a large amount of food at one time (called a binge). Unlike other eating disorders, people who have binge eating disorder do not throw up the food or exercise too much. Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment. What is binge eating disorder? Binge eating disorder is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise. According to the American Psychiatric Association, women with binge eating disorder feel out of control and eat too much (binge), at least once a week for at least three months. During binges women with binge eating disorder usually eat faster than normal, eat until they are uncomfortable, eat when they are not physically hungry, and feel embarrassed, disgusted, or depressed because of the binges. Women with this type of eating disorder may be overweight or obese. What is the difference between binge eating disorder and other eating disorders? Women with eating disorders, such as binge eating disorder, bulimia, and anorexia, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health. Unlike people with anorexia or bulimia, people with binge eating disorder do not throw up their food, exercise a lot, or starve themselves. People with binge eating disorder are often overweight or obese. But not all people with binge eating disorder are overweight, and being overweight does not always mean you have binge eating disorder. It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment. Who is at risk for binge eating disorder? Binge eating disorder affects more than 3% of women in the United States. More than half of people with binge eating disorder are women.1 Binge eating disorder affects women of all races and ethnicities. It is the most common eating disorder among Hispanic, Asian-American, and African-American women.2,3,4 Some women may be more at risk for binge eating disorder. What are the symptoms of binge eating disorder? It can be difficult to tell whether someone has binge eating disorder. Many women with binge eating disorder hide their behavior because they are embarrassed. You may have binge eating disorder if, for at least once a week over the past three months, you have binged. Binge eating disorder means you have at least three of these symptoms while binging:8 People with binge eating disorder may also have other mental health problems, such as depression, anxiety, or substance abuse. What causes binge eating disorder? Researchers are not sure exactly what causes binge eating disorder and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses. Studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.9,10 Researchers are studying how changing levels of brain chemicals may affect eating habits. Neuroimaging, or pictures of the brain, may lead to a better understanding of binge eating disorder.11 Learn more about current research on binge eating disorder. How does binge eating disorder affect a woman's health? Many, but not all, women with binge eating disorder are overweight or obese. Obesity raises your risk for many serious health problems:12 People with binge eating disorder often have other serious mental health illnesses such as depression, anxiety, or substance abuse. These problems can seriously affect a woman's everyday life and can be treated. How is binge eating disorder diagnosed? Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help. Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder. How is binge eating disorder treated? Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better. Treatment plans may include one or more of the following: Most girls and women do get better with treatment and are able to eat in healthy ways again.14 Some may get better after the first treatment. Others get well but may relapse and need treatment again. How does binge eating disorder affect pregnancy? Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control. Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for: Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16 After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17 If I had an eating disorder in the past, can I still get pregnant? Yes. Women who have recovered from binge eating disorder, are at a healthy weight, and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy. Tell your doctor if you had an eating disorder in the past and are trying to become pregnant. If I take medicine to treat binge eating disorder, can I breastfeed my baby? Maybe. Some medicines used to treat binge eating disorder can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding. Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding. You can also enter a medicine into the LactMed database to find out if the medicine passes through breastmilk and about any possible side effects for your nursing baby. Did we answer your question about binge eating disorder? For more information about binge eating disorder, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources ", "role": "user" }, { "content": "Binge eating disorder can cause problems getting pregnant and during pregnancy. Alternatively, pregnancy can also raise the risk for binge eating disorder in women who are at higher risk for eating disorders.", "role": "assistant" } ]

[ { "content": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks\n\n Inguinal hernia Overview An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure. Symptoms Inguinal hernia signs and symptoms include: - A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain - A burning or aching sensation at the bulge - Pain or discomfort in your groin, especially when bending over, coughing or lifting - A heavy or dragging sensation in your groin - Weakness or pressure in your groin - Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum You should be able to gently push the hernia back into your abdomen when you're lying down. If not, applying an ice pack to the area may reduce the swelling enough so that the hernia slides in easily. Lying with your pelvis higher than your head also may help. Incarcerated hernia If you aren't able to push the hernia in, the contents of the hernia can be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated. Signs and symptoms of a strangulated hernia include: - Nausea, vomiting or both - Fever - Sudden pain that quickly intensifies - A hernia bulge that turns red, purple or dark - Inability to move your bowels or pass gas If any of these signs or symptoms occurs, call your doctor right away. Signs and symptoms in children Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. He or she might be irritable and have less appetite than usual. In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period. When to see a doctor See your doctor if you have a painful or noticeable bulge in your groin on either side of your pubic bone. The bulge is likely to be more noticeable when you're standing, and you usually can feel it if you put your hand directly over the affected area. Seek immediate medical care if a hernia bulge turns red, purple or dark. Causes Some inguinal hernias have no apparent cause. Others might occur as a result of: - Increased pressure within the abdomen - A pre-existing weak spot in the abdominal wall - A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall - Straining during bowel movements or urination - Strenuous activity - Pregnancy - Chronic coughing or sneezing In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth when the abdominal lining (peritoneum) doesn't close properly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing that accompanies smoking. Weaknesses can also occur in the abdominal wall later in life, especially after an injury or abdominal surgery. In men, the weak spot usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone. Risk factors Factors that contribute to developing an inguinal hernia include: - Being male. Men are eight times more likely to develop an inguinal hernia than are women. - Being older. Muscles weaken as you age. - Being white. - Family history. You have a close relative, such as a parent or sibling, who has the condition. - Chronic cough, such as from smoking. - Chronic constipation. Constipation causes straining during bowel movements. - Pregnancy. Being pregnant can weaken the abdominal muscles and cause increased pressure inside your abdomen. - Premature birth and low birth weight. - Previous inguinal hernia or hernia repair. Even if your previous hernia occurred in childhood, you're at higher risk of developing another inguinal hernia. Complications Complications of an inguinal hernia include: - Pressure on surrounding tissues. Most inguinal hernias enlarge over time if not repaired surgically. In men, large hernias can extend into the scrotum, causing pain and swelling. - Incarcerated hernia. If the contents of the hernia become trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas. - Strangulation. An incarcerated hernia can cut off blood flow to part of your intestine. Strangulation can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery. Diagnosis A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain. If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI. Treatment If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications. There are two general types of hernia operations - open hernia repair and laparoscopic repair. Open hernia repair In this procedure, which might be done with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue. After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume normal activities. Laparoscopy In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh. People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities. However, some studies indicate that hernia recurrence is more likely with laparoscopic repair than with open surgery. Laparoscopy allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after traditional hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral). Some studies indicate that a laparoscopic repair can increase the risk of complications and of recurrence. Having the procedure performed by a surgeon with extensive experience in laparoscopic hernia repairs can reduce the risks. ", "role": "user" }, { "content": "Small asymptomatic hernias do not require treatments. If the hernia increases in size or becomes painful, it will need surgery.", "role": "assistant" } ]

[ { "content": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.\n\n Congenital diaphragmatic hernia congenital diaphragmatic defect Description Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, which is composed of muscle and other fibrous tissue, separates the organs in the abdomen from those in the chest. Abnormal development of the diaphragm before birth leads to defects ranging from a thinned area in the diaphragm to its complete absence. An absent or partially formed diaphragm results in an abnormal opening (hernia) that allows the stomach and intestines to move into the chest cavity and crowd the heart and lungs. This crowding can lead to underdevelopment of the lungs (pulmonary hypoplasia), potentially resulting in life-threatening breathing difficulties that are apparent from birth. In 5 to 10 percent of affected individuals, signs and symptoms of congenital diaphragmatic hernia appear later in life and may include breathing problems or abdominal pain from protrusion of the intestine into the chest cavity. In about 1 percent of cases, congenital diaphragmatic hernia has no symptoms; it may be detected incidentally when medical imaging is done for other reasons. Congenital diaphragmatic hernias are often classified by their position. A Bochdalek hernia is a defect in the side or back of the diaphragm. Between 80 and 90 percent of congenital diaphragmatic hernias are of this type. A Morgnani hernia is a defect involving the front part of the diaphragm. This type of congenital diaphragmatic hernia, which accounts for approximately 2 percent of cases, is less likely to cause severe symptoms at birth. Other types of congenital diaphragmatic hernia, such as those affecting the central region of the diaphragm, or those in which the diaphragm muscle is absent with only a thin membrane in its place, are rare. Frequency Congenital diaphragmatic hernia affects approximately 1 in 2,500 newborns. Causes Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. Inheritance Pattern Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition. Sources for This Page Bielinska M, Jay PY, Erlich JM, Mannisto S, Urban Z, Heikinheimo M, Wilson DB. Molecular genetics of congenital diaphragmatic defects. Ann Med. 2007;39(4):261-74. Review. ", "role": "user" }, { "content": "Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. ... Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. ... More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. ... Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia", "role": "assistant" } ]

[ { "content": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks\n\nGastroparesis (Eating, Diet, and Nutrition): Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. If less food enters the stomach each time a person eats, the stomach may not become overly full, allowing it to empty more easily. Chewing food well, drinking noncarbonated liquids with a meal, and walking or sitting for 2 hours after a meal—instead of lying down—may assist with gastric emptying.A health care provider may also recommend avoiding high-fat and fibrous foods. Fat naturally slows digestion and some raw vegetables and fruits are more difficult to digest than other foods. Some foods, such as oranges and broccoli, contain fibrous parts that do not digest well. People with gastroparesis should minimize their intake of large portions of these foods because the undigested parts may remain in the stomach too long. Sometimes, the undigested parts form bezoars.When a person has severe symptoms, a liquid or puréed diet may be prescribed. As liquids tend to empty more quickly from the stomach, some people may find a puréed diet helps improve symptoms. Puréed fresh or cooked fruits and vegetables can be incorporated into shakes and soups. A health care provider may recommend a dietitian to help a person plan meals that minimize symptoms and ensure all nutritional needs are met.When the most extreme cases of gastroparesis lead to severe nausea, vomiting, and dehydration, urgent care may be required at a medical facility where IV fluids can be given.MedicationsSeveral prescription medications are available to treat gastroparesis. A combination of medications may be used to find the most effective treatment.Metoclopramide (Reglan). This medication stimulates stomach muscle contractions to help with gastric emptying. Metoclopramide also helps reduce nausea and vomiting. The medication is taken 20 to 30 minutes before meals and at bedtime. Possible side effects of metoclopramide include fatigue, sleepiness, and depression. Currently, this is the only medication approved by the FDA for treatment of gastroparesis. However, the FDA has placed a black box warning on this medication because of rare reports of it causing an irreversible neurologic side effect called tardive dyskinesia—a disorder that affects movement.Metoclopramide (Reglan).Erythromycin. This antibiotic, prescribed at low doses, may improve gastric emptying. Like metaclopramide, erythromycin works by increasing the contractions that move food through the stomach. Possible side effects of erythromycin include nausea, vomiting, and abdominal cramps.Erythromycin.Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, medications known as antiemetics are used to help control nausea and vomiting.Other medications.Botulinum ToxinBotulinum toxin is a nerve blocking agent also known as Botox. After passing an endoscope into the stomach, a health care provider injects the Botox into the pylorus, the opening from the stomach into the duodenum. Botox is supposed to help keep the pylorus open for longer periods of time and improve symptoms of gastroparesis. Although some initial research trials showed modest improvement in gastroparesis symptoms and the rate of gastric emptying following the injections, other studies have failed to show the same degree of effectiveness of the Botox injections.11Gastric Electrical StimulationThis treatment alternative may be effective for some people whose nausea and vomiting do not improve with dietary changes or medications. A gastric neurostimulator is a surgically implanted battery-operated device that sends mild electrical pulses to the stomach muscles to help control nausea and vomiting. The procedure may be performed at a hospital or outpatient center by a gastroenterologist. General anesthesia may be required. The gastroenterologist makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the stomach to a video monitor, giving the gastroenterologist a close-up view of the tissues. Once implanted, the settings on the battery-operated device can be adjusted to determine the settings that best control symptoms.JejunostomyIf medications and dietary changes don’t work, and the person is losing weight or requires frequent hospitalization for dehydration, a health care provider may recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The surgical procedure is known as a jejunostomy. The procedure is performed by a surgeon at a hospital or outpatient center. Anesthesia is needed. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum. The jejunostomy is used only when gastroparesis is extremely severe.Parenteral NutritionWhen gastroparesis is so severe that dietary measures and other treatments are not helping, a health care provider may recommend parenteral nutrition—an IV liquid food mixture supplied through a special tube in the chest. The procedure is performed by a surgeon at a hospital or outpatient center; anesthesia is needed. The surgeon inserts a thin, flexible tube called a catheter into a chest vein, with the catheter opening outside the skin. A bag containing liquid nutrients is attached to the catheter, and the nutrients are transported through the catheter into the chest vein and into the bloodstream. This approach is a less preferable alternative to a jejunostomy and is usually a temporary treatment to get through a difficult period of gastroparesis.", "role": "user" }, { "content": "Gastroparesis symptoms may sometimes be controlled by the following changes in the diet: eating six small meals a day instead of three large ones; chewing food well; drinking noncarbonated liquids with a meal; avoiding high-fat and fibrous foods; and walking or sitting for 2 hours after a meal, instead of lying down. Your doctor may recommend one of the following medications: metoclopramide (reglan), which stimulates stomach muscle contractions to help with gastric emptying and reduces nausea and vomiting; botulinum toxin (Botox) injections into pylorus that might keep it open and help gastric emptying. If nausea and vomiting do not improve with dietary changes or medications, your doctor might suggest Gastric Electrical Stimulation using an implanted device that stimulated stomach muscles. If none of the above work, your doctor might recommend surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum (jejunostomy.) A temporary treatment for the difficult periods of gastroparesis may involve parenteral nutrition which delivers intravenous liquid food mixture supplied through a special tube in the chest vein.", "role": "assistant" } ]