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How to diagnose Short Bowel Syndrome ? | A health care provider diagnoses short bowel syndrome based on a medical and family history a physical exam blood tests fecal fat tests an xray of the small and large intestines upper gastrointestinal (GI) series computerized tomography (CT) scan Medical and Family History Taking a medical and family history may help a health care provider diagnose short bowel syndrome. He or she will ask the patient about symptoms and may request a history of past operations. Physical Exam A physical exam may help diagnose short bowel syndrome. During a physical exam, a health care provider usually examines a patient's body, looking for muscle wasting or weight loss and signs of vitamin and mineral deficiencies uses a stethoscope to listen to sounds in the abdomen taps on specific areas of the patient's body Blood Tests A blood test involves drawing a patient's blood at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. Blood tests can show mineral and vitamin levels and measure complete blood count. Fecal Fat Tests A fecal fat test measures the body's ability to break down and absorb fat. For this test, a patient provides a stool sample at a health care provider's office. The patient may also use a takehome test kit. The patient collects stool in plastic wrap that he or she lays over the toilet seat and places a sample into a container. A patient can also use a special tissue provided by the health care provider's office to collect the sample and place the tissue into the container. For children wearing diapers, the parent or caretaker can line the diaper with plastic to collect the stool. The health care provider will send the sample to a lab for analysis. A fecal fat test can show how well the small intestine is working. Xray An xray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. An xray technician performs the xray at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. An xray of the small intestine can show that the last segment of the large intestine is narrower than normal. Blocked stool causes the part of the intestine just before this narrow segment to stretch and bulge. Upper Gastrointestinal Series Upper GI series, also called a barium swallow, uses x rays and fluoroscopy to help diagnose problems of the upper GI tract. Fluoroscopy is a form of x ray that makes it possible to see the internal organs and their motion on a video monitor. An xray technician performs this test at a hospital or an outpatient center, and a radiologist interprets the images. During the procedure, the patient will stand or sit in front of an xray machine and drink barium, a chalky liquid. Barium coats the esophagus, stomach, and small intestine so the radiologist and a health care provider can see the shape of these organs more clearly on xrays. A patient may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes white or lightcolored stools. A health care provider will give the patient specific instructions about eating and drinking after the test. Upper GI series can show narrowing and widening of the small and large intestines. More information is provided in the NIDDK health topic, Upper GI Series. Computerized Tomography Scan Computerized tomography scans use a combination of xrays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called a contrast medium. CT scans require the patient to lie on a table that slides into a tunnelshaped device that takes xrays. An xray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. CT scans can show bowel obstruction and changes in the intestines. |
What are the treatments for Short Bowel Syndrome ? | A health care provider will recommend treatment for short bowel syndrome based on a patient's nutritional needs. Treatment may include nutritional support medications surgery intestinal transplant Nutritional Support The main treatment for short bowel syndrome is nutritional support, which may include the following: Oral rehydration. Adults should drink water, sports drinks, sodas without caffeine, and salty broths. Children should drink oral rehydration solutionsspecial drinks that contain salts and minerals to prevent dehydrationsuch as Pedialyte, Naturalyte, Infalyte, and CeraLyte, which are sold in most grocery stores and drugstores. Parenteral nutrition. This treatment delivers fluids, electrolytes, and liquid vitamins and minerals into the bloodstream through an intravenous (IV) tubea tube placed into a vein. Health care providers give parenteral nutrition to people who cannot or should not get their nutrition or enough fluids through eating. Enteral nutrition. This treatment delivers liquid food to the stomach or small intestine through a feeding tubea small, soft, plastic tube placed through the nose or mouth into the stomach. Gallstonessmall, pebblelike substances that develop in the gallbladderare a complication of enteral nutrition. More information is provided in the NIDDK health topic, Gallstones. Vitamin and mineral supplements. A person may need to take vitamin and mineral supplements during or after parenteral or enteral nutrition. Special diet. A health care provider can recommend a specific diet plan for the patient that may include small, frequent feedings avoiding foods that can cause diarrhea, such as foods high in sugar, protein, and fiber avoiding highfat foods Medications A health care provider may prescribe medications to treat short bowel syndrome, including antibiotics to prevent bacterial overgrowth H2 blockers to treat too much gastric acid secretion proton pump inhibitors to treat too much gastric acid secretion choleretic agents to improve bile flow and prevent liver disease bilesalt binders to decrease diarrhea antisecretin agents to reduce gastric acid in the intestine hypomotility agents to increase the time it takes food to travel through the intestines, leading to increased nutrient absorption growth hormones to improve intestinal absorption teduglutide to improve intestinal absorption Surgery The goal of surgery is to increase the small intestine's ability to absorb nutrients. Approximately half of the patients with short bowel syndrome need surgery.2 Surgery used to treat short bowel syndrome includes procedures that prevent blockage and preserve the length of the small intestine narrow any dilated segment of the small intestine slow the time it takes for food to travel through the small intestine lengthen the small intestine Longterm treatment and recovery, which for some may take years, depend in part on what sections of the small intestine were removed how much of the intestine is damaged how well the muscles of the intestine work how well the remaining small intestine adapts over time Intestinal Transplant An intestinal transplant is surgery to remove a diseased or an injured small intestine and replace it with a healthy small intestine from a person who has just died, called a donor. Sometimes a living donor can provide a segment of his or her small intestine. Transplant surgeonsdoctors who specialize in performing transplant surgeryperform the surgery on patients for whom other treatments have failed and who have lifethreatening complications from longterm parenteral nutrition. An intestinaltransplant team performs the surgery in a hospital. The patient will need anesthesia. Complications of intestinal transplantation include infections and rejection of the transplanted organ. A successful intestinal transplant can be a lifesaving treatment for people with intestinal failure caused by short bowel syndrome. By 2008, transplant surgeons had performed almost 2,000 intestinal transplantations in the United Statesapproximately 75 percent of which were in patients younger than 18 years of age.3 A health care provider will tailor treatment to the severity of the patient's disease: Treatment for mild short bowel syndrome involves eating small, frequent meals; drinking fluid; taking nutritional supplements; and using medications to treat diarrhea. Treatment for moderate short bowel syndrome is similar to that for mild short bowel syndrome, with the addition of parenteral nutrition as needed. Treatment for severe short bowel syndrome involves use of parenteral nutrition and oral rehydration solutions. Patients may receive enteral nutrition or continue normal eating, even though most of the nutrients are not absorbed. Both enteral nutrition and normal eating stimulate the remaining intestine to work better and may allow patients to discontinue parenteral nutrition. Some patients with severe short bowel syndrome require parenteral nutrition indefinitely or surgery. |
How to prevent Short Bowel Syndrome ? | People can ask their health care providers about surgical techniques that minimize scar tissue. Scientists have not yet found a way to prevent short bowel syndrome that is present at birth, as its cause is unknown. |
What is (are) Short Bowel Syndrome ? | Intestinal adaptation is a process that usually occurs in children after removal of a large portion of their small intestine. The remaining small intestine goes through a period of adaptation and grows to increase its ability to absorb nutrients. Intestinal adaptation can take up to 2 years to occur, and during this time a person may be heavily dependent on parenteral or enteral nutrition.1 |
What to do for Short Bowel Syndrome ? | Researchers have not found that eating, diet, and nutrition play a role in causing or preventing short bowel syndrome. |
What to do for Short Bowel Syndrome ? | Short bowel syndrome is a group of problems related to poor absorption of nutrients. People with short bowel syndrome cannot absorb enough water, vitamins, minerals, protein, fat, calories, and other nutrients from food. The main symptom of short bowel syndrome is diarrhealoose, watery stools. Diarrhea can lead to dehydration, malnutrition, and weight loss. A health care provider will recommend treatment for short bowel syndrome based on a patient's nutritional needs. Treatment may include nutritional support medications surgery intestinal transplant |
What is (are) Zollinger-Ellison Syndrome ? | ZollingerEllison syndrome is a rare disorder that occurs when one or more tumors form in the pancreas and duodenum. The tumors, called gastrinomas, release large amounts of gastrin that cause the stomach to produce large amounts of acid. Normally, the body releases small amounts of gastrin after eating, which triggers the stomach to make gastric acid that helps break down food and liquid in the stomach. The extra acid causes peptic ulcers to form in the duodenum and elsewhere in the upper intestine. The tumors seen with ZollingerEllison syndrome are sometimes cancerous and may spread to other areas of the body. |
What is (are) Zollinger-Ellison Syndrome ? | The stomach, duodenum, and pancreas are digestive organs that break down food and liquid. The stomach stores swallowed food and liquid. The muscle action of the lower part of the stomach mixes the food and liquid with digestive juice. Partially digested food and liquid slowly move into the duodenum and are further broken down. The duodenum is the first part of the small intestinethe tubeshaped organ between the stomach and the large intestinewhere digestion of the food and liquid continues. The pancreas is an organ that makes the hormone insulin and enzymes for digestion. A hormone is a natural chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body. Insulin helps cells throughout the body remove glucose, also called sugar, from blood and use it for energy. The pancreas is located behind the stomach and close to the duodenum. |
What causes Zollinger-Ellison Syndrome ? | Experts do not know the exact cause of ZollingerEllison syndrome. About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1).1 MEN1 causes hormonereleasing tumors in the endocrine glands and the duodenum. Symptoms of MEN1 include increased hormone levels in the blood, kidney stones, diabetes, muscle weakness, weakened bones, and fractures. More information about MEN1 is provided in the NIDDK health topic, Multiple Endocrine Neoplasia Type 1. |
How many people are affected by Zollinger-Ellison Syndrome ? | ZollingerEllison syndrome is rare and only occurs in about one in every 1 million people.1 Although anyone can get ZollingerEllison syndrome, the disease is more common among men 30 to 50 years old. A child who has a parent with MEN1 is also at increased risk for ZollingerEllison syndrome.2 |
What are the symptoms of Zollinger-Ellison Syndrome ? | ZollingerEllison syndrome signs and symptoms are similar to those of peptic ulcers. A dull or burning pain felt anywhere between the navel and midchest is the most common symptom of a peptic ulcer. This discomfort usually occurs when the stomach is emptybetween meals or during the nightand may be briefly relieved by eating food lasts for minutes to hours comes and goes for several days, weeks, or months Other symptoms include diarrhea bloating burping nausea vomiting weight loss poor appetite Some people with ZollingerEllison syndrome have only diarrhea, with no other symptoms. Others develop gastroesophageal reflux (GER), which occurs when stomach contents flow back up into the esophagusa muscular tube that carries food and liquids to the stomach. In addition to nausea and vomiting, reflux symptoms include a painful, burning feeling in the midchest. More information about GER is provided in the NIDDK health topic, Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults. |
What are the symptoms of Zollinger-Ellison Syndrome ? | A person who has any of the following emergency symptoms should call or see a health care provider right away: chest pain sharp, sudden, persistent, and severe stomach pain red blood in stool or black stools red blood in vomit or vomit that looks like coffee grounds These symptoms could be signs of a serious problem, such as internal bleedingwhen gastric acid or a peptic ulcer breaks a blood vessel perforationwhen a peptic ulcer forms a hole in the duodenal wall obstructionwhen a peptic ulcer blocks the path of food trying to leave the stomach |
How to diagnose Zollinger-Ellison Syndrome ? | A health care provider diagnoses ZollingerEllison syndrome based on the following: medical history physical exam signs and symptoms blood tests upper gastrointestinal (GI) endoscopy imaging tests to look for gastrinomas measurement of stomach acid Medical History Taking a medical and family history is one of the first things a health care provider may do to help diagnose ZollingerEllison syndrome. The health care provider may ask about family cases of MEN1 in particular. Physical Exam A physical exam may help diagnose ZollingerEllison syndrome. During a physical exam, a health care provider usually examines a persons body uses a stethoscope to listen to bodily sounds taps on specific areas of the persons body Signs and Symptoms A health care provider may suspect ZollingerEllison syndrome if diarrhea accompanies peptic ulcer symptoms or if peptic ulcer treatment fails. a person has peptic ulcers without the use of nonsteroidal antiinflammatory drugs (NSAIDs) such as aspirin and ibuprofen or a bacterial Helicobacter pylori (H. pylori) infection. NSAID use and H. pylori infection may cause peptic ulcers. a person has severe ulcers that bleed or cause holes in the duodenum or stomach. a health care provider diagnoses a person or the persons family member with MEN1 or a person has symptoms of MEN1. Blood Tests The health care provider may use blood tests to check for an elevated gastrin level. A technician or nurse draws a blood sample during an office visit or at a commercial facility and sends the sample to a lab for analysis. A health care provider will ask the person to fast for several hours prior to the test and may ask the person to stop acidreducing medications for a period of time before the test. A gastrin level that is 10 times higher than normal suggests ZollingerEllison syndrome.2 A health care provider may also check for an elevated gastrin level after an infusion of secretin. Secretin is a hormone that causes gastrinomas to release more gastrin. A technician or nurse places an intravenous (IV) needle in a vein in the arm to give an infusion of secretin. A health care provider may suspect ZollingerEllison syndrome if blood drawn after the infusion shows an elevated gastrin level. Upper Gastrointestinal Endoscopy The health care provider uses an upper GI endoscopy to check the esophagus, stomach, and duodenum for ulcers and esophagitisa general term used to describe irritation and swelling of the esophagus. This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract, which includes the esophagus, stomach, and duodenum. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. The gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. A technician or nurse inserts an IV needle in a vein in the arm if anesthesia is given. Imaging Tests To help find gastrinomas, a health care provider may order one or more of the following imaging tests: Computerized tomography (CT) scan. A CT scan is an x ray that produces pictures of the body. A CT scan may include the injection of a special dye, called contrast medium. CT scans use a combination of x rays and computer technology to create images. CT scans require the person to lie on a table that slides into a tunnelshaped device where an xray technician takes x rays. A computer puts the different views together to create a model of the pancreas, stomach, and duodenum. The xray technician performs the procedure in an outpatient center or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images. The person does not need anesthesia. CT scans can show tumors and ulcers. Magnetic resonance imaging (MRI). MRI is a test that takes pictures of the bodys internal organs and soft tissues without using x rays. A specially trained technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The person does not need anesthesia, though people with a fear of confined spaces may receive light sedation, taken by mouth. An MRI may include the injection of contrast medium. With most MRI machines, the person will lie on a table that slides into a tunnelshaped device that may be open ended or closed at one end. Some machines allow the person to lie in a more open space. During an MRI, the person, although usually awake, remains perfectly still while the technician takes the images, which usually takes only a few minutes. The technician will take a sequence of images from different angles to create a detailed picture of the upper GI tract. During sequencing, the person will hear loud mechanical knocking and humming noises. Endoscopic ultrasound. This procedure involves using a special endoscope called an endoechoscope to perform ultrasound of the pancreas. The endoechoscope has a builtin miniature ultrasound probe that bounces safe, painless sound waves off organs to create an image of their structure. A gastroenterologist performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The gastroenterologist carefully feeds the endoechoscope down the esophagus, through the stomach and duodenum, until it is near the pancreas. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. A sedative helps the person stay relaxed and comfortable. The images can show gastrinomas in the pancreas. Angiogram. An angiogram is a special kind of x ray in which an interventional radiologista specially trained radiologistthreads a thin, flexible tube called a catheter through the large arteries, often from the groin, to the artery of interest. The radiologist injects contrast medium through the catheter so the images show up more clearly on the x ray. The interventional radiologist performs the procedure and interprets the images in a hospital or an outpatient center. A person does not need anesthesia, though a light sedative may help reduce a persons anxiety during the procedure. This test can show gastrinomas in the pancreas. Somatostatin receptor scintigraphy. An xray technician performs this test, also called OctreoScan, at a hospital or an outpatient center, and a radiologist interprets the images. A person does not need anesthesia. A radioactive compound called a radiotracer, when injected into the bloodstream, selectively labels tumor cells. The labeled cells light up when scanned with a device called a gamma camera. The test can show gastrinomas in the duodenum, pancreas, and other parts of the body. Small gastrinomas may be hard to see; therefore, health care providers may order several types of imaging tests to find gastrinomas. Stomachacid Measurement Using a sample of stomach juices for analysis, a health care provider may measure the amount of stomach acid a person produces. During the exam, a health care provider puts in a nasogastric tubea tiny tube inserted through the nose and throat that reaches into the stomach. A person may receive a liquid anesthetic that is gargled or sprayed on the back of the throat. Once the tube is placed, a health care provider takes samples of the stomach acid. High acid levels in the stomach indicate ZollingerEllison syndrome. |
What are the treatments for Zollinger-Ellison Syndrome ? | A health care provider treats ZollingerEllison syndrome with medications to reduce gastric acid secretion and with surgery to remove gastrinomas. A health care provider sometimes uses chemotherapymedications to shrink tumorswhen tumors are too widespread to remove with surgery. Medications A class of medications called proton pump inhibitors (PPIs) includes esomeprazole (Nexium) lansoprazole (Prevacid) pantoprazole (Protonix) omeprazole (Prilosec or Zegerid) dexlansoprazole (Dexilant) PPIs stop the mechanism that pumps acid into the stomach, helping to relieve peptic ulcer pain and promote healing. A health care provider may prescribe people who have ZollingerEllison syndrome higherthannormal doses of PPIs to control the acid production. Studies show that PPIs may increase the risk of hip, wrist, and spine fractures when a person takes them long term or in high doses, so its important for people to discuss risks versus benefits with their health care provider. Surgery Surgical removal of gastrinomas is the only cure for ZollingerEllison syndrome. Some gastrinomas spread to other parts of the body, especially the liver and bones. Finding and removing all gastrinomas before they spread is often challenging because many of the tumors are small. Chemotherapy Health care providers sometimes use chemotherapy drugs to treat gastrinomas that cannot be surgically removed, including streptozotocin (Zanosar) 5fluorouracil (Adrucil) doxorubicin (Doxil) |
What to do for Zollinger-Ellison Syndrome ? | Researchers have not found that eating, diet, and nutrition play a role in causing or preventing ZollingerEllison syndrome. |
What to do for Zollinger-Ellison Syndrome ? | ZollingerEllison syndrome is a rare disorder that occurs when one or more tumors form in the pancreas and duodenum. Experts do not know the exact cause of ZollingerEllison syndrome. About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1). Although anyone can get ZollingerEllison syndrome, the disease is more common among men 30 to 50 years old. ZollingerEllison syndrome signs and symptoms are similar to those of peptic ulcers. Some people with ZollingerEllison syndrome have only diarrhea, with no other symptoms. Others develop gastroesophageal reflux (GER). A health care provider diagnoses ZollingerEllison syndrome based on the following: medical history physical exam signs and symptoms blood tests upper gastrointestinal (GI) endoscopy imaging tests to look for gastrinomas measurement of stomach acid A health care provider treats ZollingerEllison syndrome with medications to reduce gastric acid secretion and with surgery to remove gastrinomas. A health care provider sometimes uses chemotherapymedications to shrink tumorswhen tumors are too widespread to remove with surgery. |
What is (are) Acquired Cystic Kidney Disease ? | Acquired cystic kidney disease happens when a person's kidneys develop fluidfilled sacs, called cysts, over time. Acquired cystic kidney disease is not the same as polycystic kidney disease (PKD), another disease that causes the kidneys to develop multiple cysts. Acquired cystic kidney disease occurs in children and adults who have chronic kidney disease (CKD)a condition that develops over many years and may lead to endstage kidney disease, or ESRD. The kidneys of people with CKD gradually lose their ability to filter wastes, extra salt, and fluid from the blood properly. endstage kidney diseasetotal and permanent kidney failure that requires a kidney transplant or bloodfiltering treatments called dialysis. The cysts are more likely to develop in people who are on kidney dialysis. The chance of developing acquired cystic kidney disease increases with the number of years a person is on dialysis. However, the cysts are caused by CKD or kidney failure, not dialysis treatments. More information is provided in the NIDDK health topics, kidney failureand dialysis. |
What is (are) Acquired Cystic Kidney Disease ? | Acquired cystic kidney disease differs from PKD in several ways. Unlike acquired cystic kidney disease, PKD is a genetic, or inherited, disorder that can cause complications such as high blood pressure and problems with blood vessels in the brain and heart. The following chart lists the differences: People with Polycystic Kidney Disease are born with a gene that causes the disease have enlarged kidneys develop cysts in the liver and other parts of the body People with Acquired Cystic Kidney Disease do not have a diseasecausing gene have kidneys that are normalsized or smaller do not form cysts in other parts of the body In addition, for people with PKD, the presence of cysts marks the onset of their disease, while people with acquired cystic kidney disease already have CKD when they develop cysts. More information is provided in the NIDDK health topic, Polycystic Kidney Disease. |
How many people are affected by Acquired Cystic Kidney Disease ? | Acquired cystic kidney disease becomes more common the longer a person has CKD. About 7 to 22 percent of people with CKD already have acquired cystic kidney disease before starting dialysis treatments. Almost 60 percent of people on dialysis for 2 to 4 years develop acquired cystic kidney disease.1 About 90 percent of people on dialysis for 8 years develop acquired cystic kidney disease.1 |
What causes Acquired Cystic Kidney Disease ? | Researchers do not fully understand what causes cysts to grow in the kidneys of people with CKD. The fact that these cysts occur only in the kidneys and not in other parts of the body, as in PKD, indicates that the processes that lead to cyst formation take place primarily inside the kidneys.2 |
What are the symptoms of Acquired Cystic Kidney Disease ? | A person with acquired cystic kidney disease often has no symptoms. However, the complications of acquired cystic kidney disease can have signs and symptoms. |
What are the complications of Acquired Cystic Kidney Disease ? | People with acquired cystic kidney disease may develop the following complications: an infected cyst, which can cause fever and back pain. blood in the urine, which can signal that a cyst in the kidney is bleeding. tumors in the kidneys. People with acquired cystic kidney disease are more likely than people in the general population to have cancerous kidney tumors. However, the chance of cancer spreading is lower in people with acquired cystic kidney disease than that of other kidney cancers not associated with acquired cystic kidney disease, and the longterm outlook is better.1 |
How to diagnose Acquired Cystic Kidney Disease ? | A health care provider may diagnose a person with acquired cystic kidney disease based on medical history imaging tests Medical History Taking a medical history may help a health care provider diagnose acquired cystic kidney disease. A health care provider may suspect acquired cystic kidney disease if a person who has been on dialysis for several years develops symptoms such as fever, back pain, or blood in the urine. Imaging Tests To confirm the diagnosis, the health care provider may order one or more imaging tests. A radiologista doctor who specializes in medical imaginginterprets the images from these tests, and the patient does not need anesthesia. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care provider's office, an outpatient center, or a hospital. The images can show cysts in the kidneys as well as the kidneys' size and shape. Computerized tomography (CT) scans use a combination of x rays and computer technology to create images. For a CT scan, a nurse or technician may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnelshaped device where an xray technician takes the xrays. An xray technician performs the procedure in an outpatient center or a hospital. CT scans can show cysts and tumors in the kidneys. Magnetic resonance imaging (MRI) is a test that takes pictures of the body's internal organs and soft tissues without using xrays. A specially trained technician performs the procedure in an outpatient center or a hospital. Although the patient does not need anesthesia, a health care provider may give people with a fear of confined spaces light sedation, taken by mouth. An MRI may include the injection of contrast medium. With most MRI machines, the patient will lie on a table that slides into a tunnelshaped device that may be openended or closed at one end. Some machines allow the patient to lie in a more open space. During an MRI, the patient, although usually awake, must remain perfectly still while the technician takes the images, which usually takes only a few minutes. The technician will take a sequence of images from different angles to create a detailed picture of the kidneys. During the test, the patient will hear loud mechanical knocking and humming noises from the machine. Sometimes a health care provider may discover acquired cystic kidney disease during an imaging exam for another condition. Images of the kidneys may help the health care provider distinguish acquired cystic kidney disease from PKD. |
What are the treatments for Acquired Cystic Kidney Disease ? | If acquired cystic kidney disease is not causing complications, a person does not need treatment. A health care provider will treat infections with antibioticsmedications that kill bacteria. If large cysts are causing pain, a health care provider may drain the cyst using a long needle inserted into the cyst through the skin. When a surgeon transplants a new kidney into a patient's body to treat kidney failure, acquired cystic kidney disease in the damaged kidneys, which usually remain in place after a transplant, often disappears. A surgeon may perform an operation to remove tumors or suspected tumors. In rare cases, a surgeon performs an operation to stop cysts from bleeding. Have Regular Screenings to Look for Cyst or Tumor Growth Some health care providers recommend all people with endstage kidney disease get screened for kidney cancer using CT scans or MRIs after 3 years of dialysis. People with acquired cystic kidney disease should talk with their health care provider about when to begin screening. |
What to do for Acquired Cystic Kidney Disease ? | No specific diet will prevent or delay acquired cystic kidney disease. In general, a diet designed for people on hemodialysis or peritoneal dialysis reduces the amount of wastes that accumulate in the body between dialysis sessions. More information is provided in the NIDDK health topics, Eat Right to Feel Right on Hemodialysis and Nutrition for Advanced Chronic Kidney Disease in Adults. |
What to do for Acquired Cystic Kidney Disease ? | Acquired cystic kidney disease happens when a person's kidneys develop fluidfilled sacs, called cysts, over time. Acquired cystic kidney disease occurs in children and adults who have chronic kidney disease (CKD) endstage kidney disease (ESRD) People with acquired cystic kidney disease may develop the following complications: an infected cyst, which can cause fever and back pain blood in the urine, which can signal that a cyst in the kidney is bleeding tumors in the kidneys To confirm the diagnosis, the health care provider may order one or more imaging tests: Ultrasound Computerized tomography (CT) scan Magnetic resonance imaging (MRI) If acquired cystic kidney disease is not causing complications, a person does not need treatment. A health care provider will treat infections with antibioticsmedications that kill bacteria. If large cysts are causing pain, a health care provider may drain the cyst using a long needle inserted into the cyst through the skin. A surgeon may perform an operation to remove tumors or suspected tumors. In rare cases, a surgeon performs an operation to stop cysts from bleeding. |
What is (are) Smoking and the Digestive System ? | The digestive system is made up of the gastrointestinal (GI) tractalso called the digestive tractand the liver, pancreas, and gallbladder. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestinewhich includes the colon and rectumand anus. Food enters the mouth and passes to the anus through the hollow organs of the GI tract. The liver, pancreas, and gallbladder are the solid organs of the digestive system. The digestive system helps the body digest food, which includes breaking food down into nutrients the body needs. Nutrients are substances the body uses for energy, growth, and cell repair. |
Who is at risk for Smoking and the Digestive System? ? | Smoking has been found to increase the risk of cancers of the3 mouth esophagus stomach pancreas 3 , 4 , 5 liver colon rectum More information about the link between smoking and cancers of the digestive system can be found on the National Cancer Institute website at www.cancer.gov/cancertopics/tobacco/smoking. |
What is (are) Smoking and the Digestive System ? | Smoking contributes to many common disorders of the digestive system, such as heartburn and gastroesophageal reflux disease (GERD), peptic ulcers, and some liver diseases. Smoking increases the risk of Crohns disease, colon polyps, and pancreatitis, and it may increase the risk of gallstones. |
What to do for Smoking and the Digestive System ? | Eating, diet, and nutrition can play a role in causing, preventing, and treating some of the diseases and disorders of the digestive system that are affected by smoking, including heartburn and GERD, liver diseases, Crohns disease, colon polyps, pancreatitis, and gallstones. More information about eating, diet, and nutrition and these conditions can be found on the Digestive Diseases AZ list. |
What to do for Smoking and the Digestive System ? | Smoking has been found to increase the risk of cancers of the mouth, esophagus, stomach, and pancreas. Research suggests that smoking may also increase the risk of cancers of the liver, colon, and rectum. Smoking increases the risk of heartburn and gastroesophageal reflux disease (GERD). Smoking increases the risk of peptic ulcers. Smoking may worsen some liver diseases, including primary biliary cirrhosis and nonalcoholic fatty liver disease (NAFLD). Current and former smokers have a higher risk of developing Crohns disease than people who have never smoked. People who smoke are more likely to develop colon polyps. Smoking increases the risk of developing pancreatitis. Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed. Quitting smoking can reverse some of the effects of smoking on the digestive system. |
What is (are) Indigestion ? | Indigestion, also known as dyspepsia, is a term used to describe one or more symptoms including a feeling of fullness during a meal, uncomfortable fullness after a meal, and burning or pain in the upper abdomen. Indigestion is common in adults and can occur once in a while or as often as every day. |
What causes Indigestion ? | Indigestion can be caused by a condition in the digestive tract such as gastroesophageal reflux disease (GERD), peptic ulcer disease, cancer, or abnormality of the pancreas or bile ducts. If the condition improves or resolves, the symptoms of indigestion usually improve. Sometimes a person has indigestion for which a cause cannot be found. This type of indigestion, called functional dyspepsia, is thought to occur in the area where the stomach meets the small intestine. The indigestion may be related to abnormal motilitythe squeezing or relaxing actionof the stomach muscle as it receives, digests, and moves food into the small intestine. |
What are the symptoms of Indigestion ? | Most people with indigestion experience more than one of the following symptoms: Fullness during a meal. The person feels overly full soon after the meal starts and cannot finish the meal. Bothersome fullness after a meal. The person feels overly full after a mealit may feel like the food is staying in the stomach too long. Epigastric pain. The epigastric area is between the lower end of the chest bone and the navel. The person may experience epigastric pain ranging from mild to severe. Epigastric burning. The person feels an unpleasant sensation of heat in the epigastric area. Other, less frequent symptoms that may occur with indigestion are nausea and bloatingan unpleasant tightness in the stomach. Nausea and bloating could be due to causes other than indigestion. Sometimes the term indigestion is used to describe the symptom of heartburn, but these are two different conditions. Heartburn is a painful, burning feeling in the chest that radiates toward the neck or back. Heartburn is caused by stomach acid rising into the esophagus and may be a symptom of GERD. A person can have symptoms of both indigestion and heartburn. |
How to diagnose Indigestion ? | To diagnose indigestion, the doctor asks about the person's current symptoms and medical history and performs a physical examination. The doctor may order x rays of the stomach and small intestine. The doctor may perform blood, breath, or stool tests if the type of bacteria that causes peptic ulcer disease is suspected as the cause of indigestion. The doctor may perform an upper endoscopy. After giving a sedative to help the person become drowsy, the doctor passes an endoscopea long, thin tube that has a light and small camera on the endthrough the mouth and gently guides it down the esophagus into the stomach. The doctor can look at the esophagus and stomach with the endoscope to check for any abnormalities. The doctor may perform biopsiesremoving small pieces of tissue for examination with a microscopeto look for possible damage from GERD or an infection. Because indigestion can be a sign of a more serious condition, people should see a doctor right away if they experience frequent vomiting blood in vomit weight loss or loss of appetite black tarry stools difficult or painful swallowing abdominal pain in a nonepigastric area indigestion accompanied by shortness of breath, sweating, or pain that radiates to the jaw, neck, or arm symptoms that persist for more than 2 weeks |
What are the treatments for Indigestion ? | Some people may experience relief from symptoms of indigestion by eating several small, lowfat meals throughout the day at a slow pace refraining from smoking abstaining from consuming coffee, carbonated beverages, and alcohol stopping use of medications that may irritate the stomach liningsuch as aspirin or antiinflammatory drugs getting enough rest finding ways to decrease emotional and physical stress, such as relaxation therapy or yoga The doctor may recommend overthecounter antacids or medications that reduce acid production or help the stomach move food more quickly into the small intestine. Many of these medications can be purchased without a prescription. Nonprescription medications should only be used at the dose and for the length of time recommended on the label unless advised differently by a doctor. Informing the doctor when starting a new medication is important. Antacids, such as AlkaSeltzer, Maalox, Mylanta, Rolaids, and Riopan, are usually the first drugs recommended to relieve symptoms of indigestion. Many brands on the market use different combinations of three basic saltsmagnesium, calcium, and aluminumwith hydroxide or bicarbonate ions to neutralize the acid in the stomach. Antacids, however, can have side effects. Magnesium salt can lead to diarrhea, and aluminum salt may cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as Tums, Titralac, and Alka2, can also be a supplemental source of calcium, though they may cause constipation. H2 receptor antagonists (H2RAs) include ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid) and are available both by prescription and overthecounter. H2RAs treat symptoms of indigestion by reducing stomach acid. They work longer than but not as quickly as antacids. Side effects of H2RAs may include headache, nausea, vomiting, constipation, diarrhea, and unusual bleeding or bruising. Proton pump inhibitors (PPIs) include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium) and are available by prescription. Prilosec is also available in overthecounter strength. PPIs, which are stronger than H2RAs, also treat indigestion symptoms by reducing stomach acid. PPIs are most effective in treating symptoms of indigestion in people who also have GERD. Side effects of PPIs may include back pain, aching, cough, headache, dizziness, abdominal pain, gas, nausea, vomiting, constipation, and diarrhea. Prokinetics such as metoclopramide (Reglan) may be helpful for people who have a problem with the stomach emptying too slowly. Metoclopramide also improves muscle action in the digestive tract. Prokinetics have frequent side effects that limit their usefulness, including fatigue, sleepiness, depression, anxiety, and involuntary muscle spasms or movements. If testing shows the type of bacteria that causes peptic ulcer disease, the doctor may prescribe antibiotics to treat the condition. |
What to do for Indigestion ? | Indigestion, also known as dyspepsia, is a term used to describe one or more symptoms including a feeling of fullness during a meal, uncomfortable fullness after a meal, and burning or pain in the upper abdomen. Indigestion can be caused by a condition in the digestive tract such as gastroesophageal reflux disease (GERD), peptic ulcer disease, cancer, or abnormality of the pancreas or bile ducts. Sometimes a person has indigestion for which a cause cannot be found. This type of indigestion is called functional dyspepsia. Indigestion and heartburn are different conditions, but a person can have symptoms of both. The doctor may order x rays; blood, breath, and stool tests; and an upper endoscopy with biopsies to diagnose indigestion. Some people may experience relief from indigestion by making some lifestyle changes and decreasing stress. The doctor may prescribe antacids, H2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), prokinetics, or antibiotics to treat the symptoms of indigestion. |
What are the symptoms of Prevent diabetes problems: Keep your eyes healthy ? | Often, no symptoms appear during the early stages of diabetes retina problems. As retina problems worsen, your symptoms might include blurry or double vision rings, flashing lights, or blank spots in your vision dark or floating spots in your vision pain or pressure in one or both of your eyes trouble seeing things out of the corners of your eyes |
What are the treatments for Prevent diabetes problems: Keep your eyes healthy ? | You can help your diabetes retina problems by controlling your blood glucose blood pressure cholesterol and triglycerides, or types of blood fat If your retinopathy still does not improve, then you may need other treatments. You will need to see an ophthalmologist who can decide whether you need one of these treatments: Medicines. Your doctor treats macular edema with injections of medicines into the eye. These medicines block a protein in the body that causes abnormal blood vessel growth and fluid leakage. Reducing the fluid leakage often allows the retina to return to normal thickness. The ophthalmologist will numb your eye and then insert a tiny needle to deliver the medicine. Laser treatment. Your doctor can also treat macular edema with focal laser treatment. In one visit, the ophthalmologist will numb your eye and place many small laser burns in the areas leaking fluid near the macula. These burns slow the leakage of fluid and reduce the amount of fluid in your retina. Sometimes your doctor also treats diabetic retinopathy with scatter laser treatment. In two or more visits, the ophthalmologist will numb your eye and place thousands of laser burns around the new, weak blood vessels away from the macula, causing them to shrink. Laser treatment can greatly reduce your chances of blindness from retina damage. However, laser treatment often cannot restore vision that has already been lost. Treatment with medicines or lasers can be performed in your ophthalmologists office. Vitrectomy. If the bleeding in your eye is severe, you may need to go to the hospital for a surgery called a vitrectomy. Your ophthalmologist will numb your eye or give you general anesthesia to help you fall asleep. The ophthalmologist will make a tiny cut in your eye and remove the vitreous gel that is clouded with blood. The ophthalmologist replaces the vitreous gel with a salt solution. |
What is (are) Your Guide to Diabetes: Type 1 and Type 2 ? | Diabetes is when your blood glucose, also called blood sugar, is too high. Blood glucose is the main type of sugar found in your blood and your main source of energy. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries glucose to all of your bodys cells to use for energy. Your pancreasan organ, located between your stomach and spine, that helps with digestionreleases a hormone it makes, called insulin, into your blood. Insulin helps your blood carry glucose to all your bodys cells. Sometimes your body doesnt make enough insulin or the insulin doesnt work the way it should. Glucose then stays in your blood and doesnt reach your cells. Your blood glucose levels get too high and can cause diabetes or prediabetes. Over time, having too much glucose in your blood can cause health problems. *See the Pronunciation Guide for tips on how to say the the words in bold type. |
What is (are) Your Guide to Diabetes: Type 1 and Type 2 ? | Prediabetes is when the amount of glucose in your blood is above normal yet not high enough to be called diabetes. With prediabetes, your chances of getting type 2 diabetes, heart disease, and stroke are higher. With some weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. You can even return to normal glucose levels, possibly without taking any medicines. |
What are the symptoms of Your Guide to Diabetes: Type 1 and Type 2 ? | The signs and symptoms of diabetes are being very thirsty urinating often feeling very hungry feeling very tired losing weight without trying sores that heal slowly dry, itchy skin feelings of pins and needles in your feet losing feeling in your feet blurry eyesight Some people with diabetes dont have any of these signs or symptoms. The only way to know if you have diabetes is to have your doctor do a blood test. |
What is (are) Diarrhea ? | Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own. Diarrhea lasting more than 2 days may be a sign of a more serious problem. Chronic diarrheadiarrhea that lasts at least 4 weeksmay be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual or they may come and go. Diarrhea of any duration may cause dehydration, which means the body lacks enough fluid and electrolyteschemicals in salts, including sodium, potassium, and chlorideto function properly. Loose stools contain more fluid and electrolytes and weigh more than solid stools. People of all ages can get diarrhea. In the United States, adults average one bout of acute diarrhea each year,1 and young children have an average of two episodes of acute diarrhea each year.2 |
What causes Diarrhea ? | Acute diarrhea is usually caused by a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to a functional disorder such as irritable bowel syndrome or an intestinal disease such as Crohns disease. The most common causes of diarrhea include the following: Bacterial infections. Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli (E. coli). Viral infections. Many viruses cause diarrhea, including rotavirus, norovirus, cytomegalovirus, herpes simplex virus, and viral hepatitis. Infection with the rotavirus is the most common cause of acute diarrhea in children. Rotavirus diarrhea usually resolves in 3 to 7 days but can cause problems digesting lactose for up to a month or longer. Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium. Functional bowel disorders. Diarrhea can be a symptom of irritable bowel syndrome. Intestinal diseases. Inflammatory bowel disease, ulcerative colitis, Crohns disease, and celiac disease often lead to diarrhea. Food intolerances and sensitivities. Some people have difficulty digesting certain ingredients, such as lactose, the sugar found in milk and milk products. Some people may have diarrhea if they eat certain types of sugar substitutes in excessive quantities. Reaction to medicines. Antibiotics, cancer drugs, and antacids containing magnesium can all cause diarrhea. Some people develop diarrhea after stomach surgery, which may cause food to move through the digestive system more quickly. People who visit certain foreign countries are at risk for travelers diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Travelers diarrhea can be a problem for people traveling to developing countries in Africa, Asia, Latin America, and the Caribbean. Visitors to Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for travelers diarrhea. In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own within 1 to 2 days, finding the cause is not usually necessary. |
What are the symptoms of Diarrhea ? | Diarrhea may be accompanied by cramping, abdominal pain, nausea, an urgent need to use the bathroom, or loss of bowel control. Some infections that cause diarrhea can also cause a fever and chills or bloody stools. Dehydration Diarrhea can cause dehydration. Loss of electrolytes through dehydration affects the amount of water in the body, muscle activity, and other important functions. Dehydration is particularly dangerous in children, older adults, and people with weakened immune systems. Dehydration must be treated promptly to avoid serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious. Signs of dehydration in adults include thirst less frequent urination than usual darkcolored urine dry skin fatigue dizziness lightheadedness Signs of dehydration in infants and young children include dry mouth and tongue no tears when crying no wet diapers for 3 hours or more sunken eyes, cheeks, or soft spot in the skull high fever listlessness or irritability Also, when people are dehydrated, their skin does not flatten back to normal right away after being gently pinched and released. Anyone with signs of dehydration should see a health care provider immediately. Severe dehydration may require hospitalization. Although drinking plenty of water is important in preventing dehydration, water does not contain electrolytes. Adults can prevent dehydration by also drinking liquids that contain electrolytes, such as fruit juices, sports drinks, caffeinefree soft drinks, and broths. Children with diarrhea should be given oral rehydration solutions such as Pedialyte, Naturalyte, Infalyte, and CeraLyte to prevent dehydration. |
How to diagnose Diarrhea ? | If acute diarrhea lasts 2 days or less, diagnostic tests are usually not necessary. If diarrhea lasts longer or is accompanied by symptoms such as fever or bloody stools, a doctor may perform tests to determine the cause. Diagnostic tests to find the cause of diarrhea may include the following: Medical history and physical examination. The doctor will ask about eating habits and medication use and will perform a physical examination to look for signs of illness. Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection. Blood tests. Blood tests can be helpful in ruling out certain diseases. Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask a person to avoid foods with lactose, carbohydrates, wheat, or other ingredients to see whether the diarrhea responds to a change in diet. Sigmoidoscopy or colonoscopy. These tests may be used to look for signs of intestinal diseases that cause chronic diarrhea. For sigmoidoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end to look at the inside of the rectum and lower part of the colon. Colonoscopy is similar to sigmoidoscopy, but it allows the doctor to view the entire colon. |
What are the treatments for Diarrhea ? | In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration. Overthecounter medicines such as loperamide (Imodium) and bismuth subsalicylate (PeptoBismol and Kaopectate) may help stop diarrhea in adults. However, people with bloody diarrheaa sign of bacterial or parasitic infectionshould not use these medicines. If diarrhea is caused by bacteria or parasites, overthecounter medicines may prolong the problem, so doctors usually prescribe antibiotics instead. Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctors guidance. |
What to do for Diarrhea ? | Until diarrhea subsides, avoiding caffeine and foods that are greasy, high in fiber, or sweet may lessen symptoms. These foods can aggravate diarrhea. Some people also have problems digesting lactose during or after a bout of diarrhea. Yogurt, which has less lactose than milk, is often better tolerated. Yogurt with active, live bacterial cultures may even help people recover from diarrhea more quickly. As symptoms improve, soft, bland foods can be added to the diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the health care provider may also recommend a bland diet. Once the diarrhea stops, the health care provider will likely encourage children to return to a normal and healthy diet if it can be tolerated. Infants with diarrhea should be given breast milk or fullstrength formula as usual, along with oral rehydration solutions. Some children recovering from viral diarrheas have problems digesting lactose for up to a month or more. |
How to prevent Diarrhea ? | Two types of diarrhea can be preventedrotavirus diarrhea and travelers diarrhea. Rotavirus Diarrhea Two oral vaccines have been approved by the U.S. Food and Drug Administration to protect children from rotavirus infections: rotavirus vaccine, live, oral, pentavalent (RotaTeq); and rotavirus vaccine, live, oral (Rotarix). RotaTeq is given to infants in three doses at 2, 4, and 6 months of age. Rotarix is given in two doses. The first dose is given when infants are 6 weeks old, and the second is given at least 4 weeks later but before infants are 24 weeks old. Parents of infants should discuss rotavirus vaccination with a health care provider. For more information, parents can visit the Centers for Disease Control and Prevention rotavirus vaccination webpage at www.cdc.gov/vaccines/vpdvac/rotavirus. Travelers Diarrhea To prevent travelers diarrhea, people traveling from the United States to developing countries should avoid drinking tap water, using tap water to brush their teeth, or using ice made from tap water drinking unpasteurized milk or milk products eating raw fruits and vegetables, including lettuce and fruit salads, unless they peel the fruits or vegetables themselves eating raw or rare meat and fish eating meat or shellfish that is not hot when served eating food from street vendors Travelers can drink bottled water, soft drinks, and hot drinks such as coffee or tea. People concerned about travelers diarrhea should talk with a health care provider before traveling. The health care provider may recommend that travelers bring medicine with them in case they develop diarrhea during their trip. Health care providers may advise some peopleespecially people with weakened immune systemsto take antibiotics before and during a trip to help prevent travelers diarrhea. Early treatment with antibiotics can shorten a bout of travelers diarrhea. |
What to do for Diarrhea ? | Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day. Diarrhea is a common problem that usually goes away on its own. The most common causes of diarrhea include bacterial, viral, and parasitic infections; functional bowel disorders; intestinal diseases; food intolerances and sensitivities; and reactions to medicines. Diarrhea can cause dehydration, which is particularly dangerous in children, older adults, and people with weakened immune systems. Treatment involves replacing lost fluids and electrolytes. Depending on the cause of the problem, medication may also be needed to stop the diarrhea or treat an infection. Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes. Adults with any of the following symptoms should see a health care provider: signs of dehydration, diarrhea for more than 2 days, severe pain in the abdomen or rectum, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry. Children with any of the following symptoms should see a health care provider: signs of dehydration, diarrhea for more than 24 hours, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry. People can take steps to prevent two types of diarrhearotavirus diarrhea and travelers diarrhea. |
What to do for What I need to know about Physical Activity and Diabetes ? | Starting a physical activity program can help you lose weight or keep a healthy weight and keep your blood glucose levels on target. Always talk with your health care team before you start a new physical activity program. Ask your health care team if you need to change the amount of medicine you take or the food you eat before any physical activity. Talk with your health care team about what types of physical activity are safe for you, such as walking, weightlifting, or housework. To make sure you stay active, find activities you like to do. Ask a friend or family member to be your exercise buddy. Write down your blood glucose levels and when and how long you are physically active in a record book. Doctors suggest that you aim for 30 to 60 minutes of moderate to vigorous physical activity most days of the week. Children and adolescents with type 2 diabetes who are 10 to 17 years old should aim for 60 minutes of moderate to vigorous activity every day. Not all physical activity has to take place at the same time. For example, you might take a walk for 20 minutes, lift hand weights for 10 minutes, and walk up and down the stairs for 5 minutes. Doing moderate to vigorous aerobic exercise for 30 to 60 minutes a day most days of the week provides many benefits. You can even split up these minutes into several parts. Start exercising slowly, with 5 to 10 minutes a day, and add a little more time each week. Try walking briskly, hiking, or climbing stairs. Whether youre a man or a woman, you can do strength training with hand weights, elastic bands, or weight machines two to three times a week. Stretching exercises are a light to moderate physical activity that both men and women can do. When you stretch, you increase your flexibility, lower your stress, and help prevent sore muscles. Increase daily activity by spending less time watching TV or at the computer. Try these simple ways to add light, moderate, or vigorous physical activities in your life every day: Walk around while you talk on the phone. Take a walk through your neighborhood. Do chores, such as work in the garden or rake leaves, clean the house, or wash the car. If you have type 1 diabetes, try not to do vigorous physical activity when you have ketones in your blood or urine. |
What is (are) What I need to know about Lactose Intolerance ? | Lactose * intestine lactase , enzyme *See the Pronunciation Guide for tips on how to say the words in bold type. |
What is (are) What I need to know about Lactose Intolerance ? | Lactose intolerance means you have symptoms such as bloating, diarrhea, and gas after you have milk or milk products. If your small intestine does not produce much lactase, you cannot break down much lactose. Lactose that does not break down goes to your colon. The colon is an organ that absorbs water from stool and changes it from a liquid to a solid form. In your colon, bacteria that normally live in the colon break down the lactose and create fluid and gas, causing you to have symptoms. The causes of low lactase in your small intestine can include the following: In some people, the small intestine makes less lactase starting at about age 2, which may lead to symptoms of lactose intolerance. Other people start to have symptoms later, when they are teenagers or adults. Infection, disease, or other problems that harm the small intestine can cause low lactase levels. Low lactase levels can cause you to become lactose intolerant until your small intestine heals. Being born early may cause babies to be lactose intolerant for a short time after they are born. In a rare form of lactose intolerance, the small intestine produces little or no lactase enzyme from birth. Not all people with low lactase levels have symptoms. If you have symptoms, you are lactose intolerant. Most people who are lactose intolerant can have some milk or milk products and not have symptoms. The amount of lactose that causes symptoms is different from person to person. People sometimes confuse lactose intolerance with a milk allergy. While lactose intolerance is a digestive problem, a milk allergy is a reaction by the bodys immune system to one or more milk proteins. If you have a milk allergy, having even a small amount of milk or milk product can be life threatening. A milk allergy most commonly occurs in the first year of life. Lactose intolerance occurs more often during the teen years or adulthood. |
What are the symptoms of What I need to know about Lactose Intolerance ? | Common symptoms of lactose intolerance include bloating, a feeling of fullness or swelling, in your belly pain in your belly diarrhea gas nausea You may feel symptoms 30 minutes to 2 hours after you have milk or milk products. You may have mild or severe symptoms. |
What to do for What I need to know about Lactose Intolerance ? | Talk with your doctor about your dietary plan. A dietary plan can help you manage the symptoms of lactose intolerance and get enough nutrients. If you have a child with lactose intolerance, follow the diet plan that your childs doctor recommends. Milk and milk products. You may be able to have milk and milk products without symptoms if you drink small amounts of milkhalf a cup or lessat a time drink small amounts of milk with meals, such as having milk with cereal or having cheese with crackers add small amounts of milk and milk products to your diet a little at a time and see how you feel eat milk products that are easier for people with lactose intolerance to break down: yogurt hard cheeses such as cheddar and Swiss Lactosefree and lactosereduced milk and milk products. You can find lactosefree and lactosereduced milk and milk products at the grocery store. These products are just as healthy for you as regular milk and milk products. Lactase products. You can use lactase tablets and drops when you have milk and milk products. The lactase enzyme breaks down the lactose in food. Using lactase tablets or drops can help you prevent symptoms of lactose intolerance. Check with your doctor before using these products. Some people, such as young children and pregnant and breastfeeding women, may not be able to use these products. Calcium and Vitamin D If you are lactose intolerant, make sure you get enough calcium each day. Milk and milk products are the most common sources of calcium. Other foods that contain calcium include fish with soft bones, such as canned salmon or sardines broccoli and other leafy green vegetables oranges almonds, Brazil nuts, and dried beans tofu products with the label showing added calcium, such as cereals, fruit juices, and soy milk Vitamin D helps the body absorb and use calcium. Be sure to eat foods that contain vitamin D, such as eggs, liver, and certain kinds of fish, such as salmon. Also, being outside in the sunlight helps your body make vitamin D. Some companies add vitamin D to milk and milk products. If you are able to drink small amounts of milk or eat yogurt, choose those that have vitamin D added. Talk with your doctor about how to get enough nutrientsincluding calcium and vitamin Din your diet or your childs diet. Ask if you should also take a supplement to get enough calcium and vitamin D. For safety reasons, talk with your doctor before using dietary supplements or any other nonmainstream medicine together with or in place of the treatment your doctor prescribes. Read more at www.ods.od.nih.gov and www.nccam.nih.gov. |
What to do for What I need to know about Lactose Intolerance ? | Lactose is a sugar found in milk and milk products. Lactose intolerance means you have symptoms such as bloating, diarrhea, and gas after you have milk or milk products. Your doctor will try to find out if you have lactose intolerance with a medical, family, and diet history; a physical exam; and medical tests. Most people with lactose intolerance can eat or drink some lactose without symptoms. If you have lactose intolerance, you can make changes to what you eat and drink. Some people may only need to have less lactose. Others may need to avoid lactose altogether. Talk with your doctor about how to get enough nutrientsincluding calcium and vitamin Din your diet or your childs diet. Ask if you should also take a supplement to get enough calcium and vitamin D. For safety reasons, talk with your doctor before using dietary supplements or any other nonmainstream medicine together with or in place of the treatment your doctor prescribes. Lactose is in many food products and in some medicines. |
What is (are) Proctitis ? | Proctitis is inflammation of the lining of the rectum, the lower end of the large intestine leading to the anus. The large intestine and anus are part of 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. With proctitis, inflammation of the rectal liningcalled the rectal mucosais uncomfortable and sometimes painful. The condition may lead to bleeding or mucous discharge from the rectum, among other symptoms. |
What is (are) Proctitis ? | Proctitis is inflammation of the lining of the rectum, the lower end of the large intestine leading to the anus. The large intestine and anus are part of 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. With proctitis, inflammation of the rectal liningcalled the rectal mucosais uncomfortable and sometimes painful. The condition may lead to bleeding or mucous discharge from the rectum, among other symptoms. |
What causes Proctitis ? | Proctitis has many causes, including acute, or sudden and shortterm, and chronic, or longlasting, conditions. Among the causes are the following: Sexually transmitted diseases (STDs). STDs that can be passed when a person is receiving anal sex are a common cause of proctitis. Common STD infections that can cause proctitis include gonorrhea, chlamydia, syphilis, and herpes. Herpesinduced proctitis may be particularly severe in people who are also infected with the HIV virus. NonSTD infections. Infections that are not sexually transmitted also can cause proctitis. Salmonella and Shigella are examples of foodborne bacteria that can cause proctitis. Streptococcal proctitis sometimes occurs in children who have strep throat. Anorectal trauma. Proctitis can be caused by trauma to the anorectal areawhich includes the rectum and anusfrom anal sex or the insertion of objects or harmful substances into the rectum, including the chemicals in some enemas. Ulcerative colitis and Crohns disease. Two forms of inflammatory bowel disease (IBD)ulcerative colitis and Crohns diseasecan cause proctitis. Ulcerative colitis causes irritation and ulcers, also called sores, in the inner lining of the colonpart of the large intestineand rectum. Crohns disease usually causes irritation in the lower small intestinealso called the ileumor the colon, but it can affect any part of the GI tract. Radiation therapy. People who have had radiation therapy that targets the pelvic area also may develop proctitis. Examples of those at risk are people with rectal, ovarian, or prostate cancer who have received radiation treatment directed to those areas. Symptoms of radiation proctitis, most commonly rectal bleeding, will typically occur within 6 weeks after beginning radiation therapy or more than 9 months after its completion. Antibiotics. Use of antibiotics may be associated with proctitis in some people. While meant to kill infectioncausing bacteria, antibiotics can also kill nonharmful, or commensal, bacteria in the GI tract. The loss of commensal bacteria can then allow other harmful bacteria known as Clostridium difficile to cause an infection in the colon and rectum. |
What causes Proctitis ? | Proctitis has many causes, including acute, or sudden and shortterm, and chronic, or longlasting, conditions. Among the causes are the following: Sexually transmitted diseases (STDs). STDs that can be passed when a person is receiving anal sex are a common cause of proctitis. Common STD infections that can cause proctitis include gonorrhea, chlamydia, syphilis, and herpes. Herpesinduced proctitis may be particularly severe in people who are also infected with the HIV virus. NonSTD infections. Infections that are not sexually transmitted also can cause proctitis. Salmonella and Shigella are examples of foodborne bacteria that can cause proctitis. Streptococcal proctitis sometimes occurs in children who have strep throat. Anorectal trauma. Proctitis can be caused by trauma to the anorectal areawhich includes the rectum and anusfrom anal sex or the insertion of objects or harmful substances into the rectum, including the chemicals in some enemas. Ulcerative colitis and Crohns disease. Two forms of inflammatory bowel disease (IBD)ulcerative colitis and Crohns diseasecan cause proctitis. Ulcerative colitis causes irritation and ulcers, also called sores, in the inner lining of the colonpart of the large intestineand rectum. Crohns disease usually causes irritation in the lower small intestinealso called the ileumor the colon, but it can affect any part of the GI tract. Radiation therapy. People who have had radiation therapy that targets the pelvic area also may develop proctitis. Examples of those at risk are people with rectal, ovarian, or prostate cancer who have received radiation treatment directed to those areas. Symptoms of radiation proctitis, most commonly rectal bleeding, will typically occur within 6 weeks after beginning radiation therapy or more than 9 months after its completion. Antibiotics. Use of antibiotics may be associated with proctitis in some people. While meant to kill infectioncausing bacteria, antibiotics can also kill nonharmful, or commensal, bacteria in the GI tract. The loss of commensal bacteria can then allow other harmful bacteria known as Clostridium difficile to cause an infection in the colon and rectum. |
What are the symptoms of Proctitis ? | Tenesmusan uncomfortable and frequent urge to have a bowel movementis one of the most common symptoms of proctitis. Other symptoms may include bloody bowel movements rectal bleeding a feeling of rectal fullness anal or rectal pain crampy abdominal pain rectal discharge of mucus or pus diarrhea or frequent passage of loose or liquid stools |
How to diagnose Proctitis ? | To diagnose proctitis, a health care provider will take a complete medical history and do a physical exam. The health care provider will ask the patient about symptoms, current and past medical conditions, family history, and sexual behavior that increases the risk of STDinduced proctitis. The physical exam will include an assessment of the patients vital signs, an abdominal exam, and a rectal exam. Based on the patients physical exam, symptoms, and other medical information, the doctor will decide which lab tests and diagnostic tests are needed. Lab tests may include blood tests such as a complete blood count to evaluate for blood loss or infection, stool tests to isolate and identify bacteria that may cause disease, and an STD screening. The doctor also may use one of the following diagnostic tests: Rectal culture. A cotton swab is inserted into the rectum to obtain a sample that can be used in tests that isolate and identify organisms that may cause disease. Anoscopy. This test allows examination of the anal canal and lower rectum by opening the anus using a special instrument called an anoscope. Flexible sigmoidoscopy and colonoscopy. These tests are used to help diagnose Crohns disease. The tests are similar, but colonoscopy is used to view the entire colon and rectum, while flexible sigmoidoscopy is used to view just the lower colon and rectum. For both tests, a health care provider will provide written bowel prep instructions to follow at home before the test. The person may be asked to follow a clear liquid diet for 1 to 3 days before the test. A laxative may be required the night before the test. One or more enemas may be required the night before and about 2 hours before the test. |
What are the treatments for Proctitis ? | Treatment of proctitis depends on its cause. The goal of treatment is to reduce inflammation, control symptoms, and eliminate infection, if it is present. Only a doctor can determine the cause of proctitis and the best course of treatment. With proper medical attention, proctitis can be successfully treated. Proctitis from Infection If lab tests confirm that an STD or nonSTD infection is present, medication is prescribed based on the type of infection found. Antibiotics are prescribed to kill bacteria; antiviral medications are prescribed to treat viruses. Although some STD viruses cannot be eliminated, antivirals can control their symptoms. Proctitis from Other Causes If antibiotic use triggered proctitis, the doctor may prescribe a different antibiotic designed to destroy the harmful bacteria that have developed in the intestines. If proctitis is caused by anorectal trauma, the activity causing the inflammation should be stopped. Healing usually occurs in 4 to 6 weeks. The doctor may recommend overthecounter medications such as antidiarrheals and those used for pain relief, such as aspirin and ibuprofen. Treatment of radiation proctitis is based on symptoms. Radiation proctitis causing only mild symptoms such as occasional bleeding or tenesmus may heal without treatment. For people with persistent or severe bleeding, thermal therapy may be used to stop bleeding and inflammation. Thermal therapy is done during flexible sigmoidoscopy or colonoscopy and targets the rectal lining with a heat probe, electric current, or laser. Argon plasma coagulation is the most common thermal therapy used to control bleeding in radiation proctitis. In many cases, several treatments are required. Obstruction that results from a stricturea narrowing of the rectumcaused by radiation proctitis may be treated with stool softeners in mild cases. In people with narrower strictures, dilation to enlarge the narrow area may be required. Sucralfate, 5aminosalicylic acidknown as 5ASAor corticosteroid enemas can also be used to ease pain and reduce inflammation from radiation proctitis, although their effectiveness is limited. When a chronic IBD such as ulcerative colitis or Crohns disease causes proctitis, treatment aims to reduce inflammation, control symptoms, and induce and maintain remissiona period when the person is symptomfree. Treatment depends on the extent and severity of the disease. Antiinflammation medications. Mild proctitis can often be effectively treated with topical mesalamine, either suppositories or enemas. Some people with IBD and proctitis cannot tolerateor may have an incomplete response torectal therapy with 5ASA suppositories or enemas. For these people, the doctor may prescribe oral medications alone or in combination with rectal therapy. Oral medications commonly used for proctitis contain salicylate. These include sulfasalazine or mesalaminecontaining medications, such as Asacol, Dipentum, or Pentasa. Possible side effects of oral administration of sulfasalazine or mesalaminecontaining medications include nausea, vomiting, heartburn, diarrhea, and headache. Improvement in symptoms, including a decrease in bleeding, can occur within a few days, although complete healing requires 4 to 6 weeks of therapy. Cortisone or steroids. These medications, also called corticosteroids, are effective at reducing inflammation. Prednisone and budesonide are generic names of two medications in this group. Corticosteroids for proctitis may be taken in pill, suppository, or enema form. When symptoms are at their worst, corticosteroids are usually prescribed in a large dose. The dosage is then gradually lowered once symptoms are controlled. Corticosteroids can cause serious side effects, including greater susceptibility to infection and osteoporosis, or weakening of the bones. Immune system suppressors. Medications that suppress the immune systemcalled immunosuppressive medicationsare also used to treat proctitis. The most commonly prescribed medication is 6mercaptopurine or a related medication, azathioprine. Immunosuppressive medications work by blocking the immune reaction that contributes to inflammation. These medications may cause side effects such as nausea, vomiting, and diarrhea and may lower a persons resistance to infection. Some patients are treated with a combination of corticosteroids and immunosuppressive medications. Some studies suggest that immunosuppressive medications may enhance the effectiveness of corticosteroids. Infliximab (Remicade). Researchers have found that high levels of a protein produced by the immune system, called tumor necrosis factor (TNF), are present in people with Crohns disease. Infliximab is the first of a group of medications that bind to TNF substances to block the bodys inflammation response. The U.S. Food and Drug Administration approved the medication for the treatment of moderate to severe Crohns disease that does not respond to standard therapiesmesalamine substances, corticosteroids, immunosuppressive medicationsand for the treatment of open, draining fistulas. The medication is also given to people who have Crohns disease with proctitis. Some studies suggest that infliximab may enhance the effectiveness of immunosuppressive medications. Bacterial infection can occur with flareups of ulcerative colitis or Crohns disease. Antibiotics may also be used to treat flareups in people with IBD and proctitis. More information about the treatment of IBD is provided in the NIDDK health topics, Ulcerative Colitis and Crohns Disease. |
What to do for Proctitis ? | Drinking plenty of fluids is important when diarrhea or frequent passage of loose or liquid stools occurs. Avoiding caffeine and foods that are greasy, high in fiber, or sweet may lessen diarrhea symptoms. Some people also have problems digesting lactosethe sugar found in milk and milk productsduring or after a bout of diarrhea. Yogurt, which has less lactose than milk, is often better tolerated. Yogurt with active, live bacterial cultures may even help people recover from diarrhea more quickly. If diarrhea symptoms improve, soft, bland foods can be added to the diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. If the diarrhea stops, a normal diet may be resumed if tolerated. |
What are the treatments for Proctitis ? | Proctitis that is not treated or does not respond to treatment may lead to complications, including severe bleeding and anemiaa condition in which red blood cells are fewer or smaller than normal, which means less oxygen is carried to the bodys cells abscessespainful, swollen, pusfilled areas caused by infection ulcers on the intestinal lining fistulasabnormal connections between two parts inside the body |
How to prevent Proctitis ? | People who receive anal sex can avoid getting STDrelated proctitis by having their partner use a condom. If anorectal trauma caused proctitis, stopping the activity that triggered inflammation often will stop the inflammation and prevent recurrence. Other causes of proctitis cannot always be prevented. However, their symptoms can be treated by a doctor. |
What to do for Proctitis ? | Proctitis is inflammation of the lining of the rectum, the lower end of the large intestine leading to the anus. Common causes of proctitis are sexually transmitted diseases (STDs), nonSTD infections, anorectal trauma, ulcerative colitis and Crohns disease, radiation therapy, and antibiotic use. Treatment of proctitis depends on its cause; the goal of treatment is to reduce inflammation, control symptoms, and eliminate infection, if present. With proper medical attention, proctitis can be successfully treated. If infection is present with proctitis, antibiotics can be used to kill bacteria and antiviral medications can treat viral infections. People who receive anal sex can avoid getting STDrelated proctitis by having their partner use a condom. If anorectal trauma caused proctitis, stopping the activity that triggered inflammation often will stop the inflammation and prevent recurrence. Some causes of proctitis cannot always be prevented, but their symptoms can be treated by a doctor. |
What is (are) What I need to know about Hirschsprung Disease ? | Hirschsprung* disease (HD) is a disease of the large intestine that causes severe constipation or intestinal obstruction. Constipation means stool moves through the intestines slower than usual. Bowel movements occur less often than normal and stools are difficult to pass. Some children with HD cant pass stool at all, which can result in the complete blockage of the intestines, a condition called intestinal obstruction. People with HD are born with it and are usually diagnosed when they are infants. Less severe cases are sometimes diagnosed when a child is older. An HD diagnosis in an adult is rare. *See Pronunciation Guide for tips on how to say the words in bold type. |
What is (are) What I need to know about Hirschsprung Disease ? | The large intestine, which includes the colon and rectum, is the last part of the digestive tract. The large intestines main job is to absorb water and hold stool. The rectum connects the colon to the anus. Stool passes out of the body through the anus. At birth, the large intestine is about 2 feet long. An adults large intestine is about 5 feet long. |
What causes What I need to know about Hirschsprung Disease ? | People with HD have constipation because they lack nerve cells in a part or all of the large intestine. The nerve cells signal muscles in the large intestine to push stool toward the anus. Without a signal to push stool along, stool will remain in the large intestine. How severe HD is depends on how much of the large intestine is affected. Shortsegment HD means only the last part of the large intestine lacks nerve cells. Longsegment HD means most or all of the large intestine, and sometimes the last part of the small intestine, lacks nerve cells. In a person with HD, stool moves through the large intestine until it reaches the part lacking nerve cells. At that point, the stool moves slowly or stops, causing an intestinal obstruction. |
What causes What I need to know about Hirschsprung Disease ? | Before birth, a childs nerve cells normally grow along the intestines in the direction of the anus. With HD, the nerve cells stop growing too soon. Why the nerve cells stop growing is unclear. Some HD is inherited, meaning it is passed from parent to child through genes. HD is not caused by anything a mother did while pregnant. |
What are the symptoms of What I need to know about Hirschsprung Disease ? | The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. Constipation in infants and children is common and usually comes and goes, but if your child has had ongoing constipation since birth, HD may be the problem. Symptoms in Newborns Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. Other symptoms include green or brown vomit explosive stools after a doctor inserts a finger into the rectum swelling of the belly, also known as the abdomen lots of gas bloody diarrhea Symptoms in Toddlers and Older Children Symptoms of HD in toddlers and older children include not being able to pass stools without laxatives or enemas. A laxative is medicine that loosens stool and increases bowel movements. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle. swelling of the abdomen. lots of gas. bloody diarrhea. slow growth or development. lack of energy because of a shortage of red blood cells, called anemia. |
How to diagnose What I need to know about Hirschsprung Disease ? | HD is diagnosed based on symptoms and test results. A doctor will perform a physical exam and ask questions about your childs bowel movements. HD is much less likely if parents can identify a time when their childs bowel habits were normal. If HD is suspected, the doctor will do one or more tests. X rays An x ray is a blackandwhite picture of the inside of the body. To make the large intestine show up better, the doctor may fill it with barium liquid. Barium liquid is inserted into the large intestine through the anus. If HD is the problem, the last segment of the large intestine will look narrower than normal. Just before this narrow segment, the intestine will look bulged. The bulging is caused by blocked stool stretching the intestine. Manometry During manometry, the doctor inflates a small balloon inside the rectum. Normally, the rectal muscles will relax. If the muscles dont relax, HD may be the problem. This test is most often done in older children and adults. Biopsy Biopsy is the most accurate test for HD. The doctor removes a tiny piece of the large intestine and looks at it with a microscope. If nerve cells are missing, HD is the problem. |
What are the treatments for What I need to know about Hirschsprung Disease ? | Pullthrough Procedure HD is treated with surgery called a pullthrough procedure. A surgeon removes the segment of the large intestine lacking nerve cells and connects the healthy segment to the anus. The pullthrough procedure is usually done soon after diagnosis. Ostomy surgery An ostomy allows stool to leave the body through an opening in the abdomen. Although most children with HD do not need an ostomy, a child who has been very sick from HD may need an ostomy to get better before the pullthrough procedure. For ostomy surgery, the surgeon first takes out the diseased segment of the large intestine. The end of the healthy intestine is moved to an opening in the abdomen where a stoma is created. A stoma is created by rolling the intestines end back on itself, like a shirt cuff, and stitching it to the abdominal wall. An ostomy pouch is attached to the stoma and worn outside the body to collect stool. The pouch will need to be emptied several times each day. If the surgeon removes the entire large intestine and connects the small intestine to the stoma, the surgery is called an ileostomy. If the surgeon leaves part of the large intestine and connects it to the stoma, the surgery is called a colostomy. Later, during the pullthrough procedure, the surgeon removes the stoma and closes the abdomen with stitches. |
What to do for What I need to know about Hirschsprung Disease ? | Hirschsprung disease (HD) is a disease of the large intestine that causes severe constipation or intestinal obstruction. People with HD are born with it. The large intestine, which includes the colon and rectum, is the last part of the digestive tract. The cause of HD is unclear. HD is not caused by anything a mother did while pregnant. The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. HD is diagnosed based on symptoms and test results. HD is treated with surgery called a pullthrough procedure. A child who has been very sick from HD may need an ostomy to get better before the pullthrough procedure. Most children pass stool normally after the pullthrough procedure. People with HD can suffer from an infection of the intestines, called enterocolitis, before or after surgery. If you have a child with HD, your chance of having more children with HD is greater. |
What is (are) What I need to know about Gestational Diabetes ? | Gestational* diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. Your body uses glucose for energy. Too much glucose in your blood is not good for you or your baby. Gestational diabetes is usually diagnosed during late pregnancy. If you are diagnosed with diabetes earlier in your pregnancy, you may have had diabetes before you became pregnant. Treating gestational diabetes can help both you and your baby stay healthy. You can protect your baby and yourself by taking action right away to control your blood glucose levels. If you have gestational diabetes, a health care team will likely be part of your care. In addition to your obstetriciangynecologist, or OB/GYNthe doctor who will deliver your babyyour team might include a doctor who treats diabetes, a diabetes educator, and a dietitian to help you plan meals. For Women with Type 1 or Type 2 Diabetes If you already have type 1 or type 2 diabetes and are thinking about having a baby, talk with your doctor before you get pregnant. Untreated or poorly controlled diabetes can cause serious problems for your baby. More information is provided in the NIDDK health topic, What I need to know about Preparing for Pregnancy if I Have Diabetes or call 18008608747 and request a copy. *See the Pronunciation Guide for tips on how to say the words in bold type. |
What causes What I need to know about Gestational Diabetes ? | Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels. During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body's cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body's need for insulin. If your pancreas can't make enough insulin, you will have gestational diabetes. All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnancy with an increased need for insulin and are more likely to have gestational diabetes. What are my chances of getting gestational diabetes? Your chances of getting gestational diabetes are higher if you are overweight have had gestational diabetes before have given birth to a baby weighing more than 9 pounds have a parent, brother, or sister with type 2 diabetes have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American have a hormonal disorder called polycystic ovary syndrome, also known as PCOS |
What is (are) What I need to know about Gestational Diabetes ? | Your chances of getting gestational diabetes are higher if you are overweight have had gestational diabetes before have given birth to a baby weighing more than 9 pounds have a parent, brother, or sister with type 2 diabetes have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American have a hormonal disorder called polycystic ovary syndrome, also known as PCOS |
How to diagnose What I need to know about Gestational Diabetes ? | Doctors use blood tests to diagnose gestational diabetes. All diabetes blood tests involve drawing blood at a doctor's office or a commercial facility. Blood samples are sent to a lab for analysis. Screening Glucose Challenge Test For this test, you will drink a sugary beverage and have your blood glucose level checked an hour later. This test can be done at any time of the day. If the results are above normal, you may need to have an oral glucose tolerance test. Oral Glucose Tolerance Test You will need to fast for at least 8 hours before the test. Fasting means having nothing to eat or drink except water. Your doctor will give you other instructions to follow before the test. Your fasting blood glucose level will be checked before the test begins. Then you will drink a sugary beverage. Your blood glucose levels will be checked 1 hour, 2 hours, and possibly 3 hours later. Your doctor will use your test results to find out whether you have gestational diabetes. |
How to diagnose What I need to know about Gestational Diabetes ? | If you have gestational diabetes, your doctor may recommend that you have some extra tests to check your baby's health, such as ultrasound exams, which use sound waves to make images that show your baby's growth and whether your baby is larger than normal a nonstress test, which uses a monitor placed on your abdomen to check whether your baby's heart rate increases as it should when your baby is active kick counts to check the time between your baby's movements |
What are the treatments for What I need to know about Gestational Diabetes ? | Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. Targets are numbers you aim for. Your doctor will help you set your targets. You will learn how to control your blood glucose using healthy eating physical activity insulin shots, if needed |
What to do for What I need to know about Gestational Diabetes ? | Your health care team will help you make a healthy eating plan with food choices that are good for both you and your baby. These choices are good for you to follow throughout pregnancy and after, as you raise your family. Using a healthy eating plan will help your blood glucose stay in your target range. The plan will help you know which foods to eat, how much to eat, and when to eat. Food choices, amounts, and timing are all important in keeping your blood glucose levels in your target range. More information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes. Physical Activity Physical activity can help you reach your blood glucose targets. Talk with your doctor about the type of activity that is best for you. If you are already active, tell your doctor what you do. Being physically active will also help lower your chances of having type 2 diabetesand its problemsin the future. Now is the time to develop good habits for you and your baby. For more information about physical activity and pregnancy, visit www.womenshealth.gov/pregnancy. Insulin Shots If you have trouble meeting your blood glucose targets, you may need to take a medicine called insulin, along with following a healthy meal plan and being physically active. Your health care team will show you how to give yourself insulin shots. Insulin will not harm your baby. |
How to diagnose What I need to know about Gestational Diabetes ? | Your health care team may teach you how to test for chemicals called ketones in your morning urine or in your blood. High levels of ketones are a sign that your body is using your body fat for energy instead of the food you eat. Using fat for energy is not recommended during pregnancy. Ketones may be harmful for your baby. If your ketone levels are high, your doctor may suggest that you change the type or amount of food you eat. Or you may need to change your meal or snack times. |
How to prevent What I need to know about Gestational Diabetes ? | You can do a lot to prevent or delay type 2 diabetes by making these lifestyle changes: Reach and stay at a healthy weight. Try to reach your prepregnancy weight 6 to 12 months after your baby is born. Then, if you still weigh too much, work to lose at least 5 to 7 percent of your body weight and keep it off. For example, if you weigh 200 pounds, losing 10 to 14 pounds can greatly reduce your chance of getting diabetes. Be physically active for at least 30 minutes most days of the week. Follow a healthy eating plan. Eat more grains, fruits, and vegetables. Cut down on fat and calories. Your health care team can help you design a meal plan. Ask your doctor if you should take the diabetes medicine metformin. Metformin can lower your chances of having type 2 diabetes, especially if you are younger and heavier and have prediabetes or if you have had gestational diabetes. These changes can help you enjoy a longer, healthier life. Your health care team can give you information and support to help you make these changes. By delaying or preventing type 2 diabetes, you will also lower your chances of having heart and blood vessel disease and other problems as you get older. Talk with your doctor if you are thinking about having another baby. For the safety of your baby, your blood glucose needs to be at healthy levels before you get pregnant again. Your doctor can help ensure you are ready for your next child. |
What to do for What I need to know about Gestational Diabetes ? | Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels. You will probably be tested for gestational diabetes between weeks 24 and 28 of your pregnancy. If you have a higher chance of getting gestational diabetes, your doctor may test you for diabetes during your first visit after you become pregnant. If you have high blood glucose levels because your gestational diabetes is not under control, your baby will also have high blood glucose. Untreated or uncontrolled gestational diabetes can cause problems for your baby. Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. Even if your blood glucose levels return to normal after your pregnancy, your chances of getting diabetesusually type 2 diabeteslater in life are high. Therefore, you should be tested at least every 3 years for diabetes or prediabetes. You can give your baby a healthy start by breastfeeding. You can help your child be healthy by showing your child how to make healthy lifestyle choices, including being physically active, limiting screen time in front of the TV or video games, eating a healthy diet, and staying at a healthy weight. |
What is (are) Insulin Resistance and Prediabetes ? | Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood. Insulin plays a major role in metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy. Insulin's Role in Blood Glucose Control When blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body. Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels. Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen. Insulin also lowers blood glucose levels by reducing glucose production in the liver. In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range. |
What is (are) Insulin Resistance and Prediabetes ? | Insulin resistance is a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes. Most people with insulin resistance don't know they have it for many yearsuntil they develop type 2 diabetes, a serious, lifelong disease. The good news is that if people learn they have insulin resistance early on, they can often prevent or delay diabetes by making changes to their lifestyle. Insulin resistance can lead to a variety of serious health disorders. The section "What is metabolic syndrome?" provides more information about other health disorders linked to insulin resistance. |
What causes Insulin Resistance and Prediabetes ? | Although the exact causes of insulin resistance are not completely understood, scientists think the major contributors to insulin resistance are excess weight and physical inactivity. Excess Weight Some experts believe obesity, especially excess fat around the waist, is a primary cause of insulin resistance. Scientists used to think that fat tissue functioned solely as energy storage. However, studies have shown that belly fat produces hormones and other substances that can cause serious health problems such as insulin resistance, high blood pressure, imbalanced cholesterol, and cardiovascular disease (CVD). Belly fat plays a part in developing chronic, or longlasting, inflammation in the body. Chronic inflammation can damage the body over time, without any signs or symptoms. Scientists have found that complex interactions in fat tissue draw immune cells to the area and trigger lowlevel chronic inflammation. This inflammation can contribute to the development of insulin resistance, type 2 diabetes, and CVD. Studies show that losing the weight can reduce insulin resistance and prevent or delay type 2 diabetes. Physical Inactivity Many studies have shown that physical inactivity is associated with insulin resistance, often leading to type 2 diabetes. In the body, more glucose is used by muscle than other tissues. Normally, active muscles burn their stored glucose for energy and refill their reserves with glucose taken from the bloodstream, keeping blood glucose levels in balance. Studies show that after exercising, muscles become more sensitive to insulin, reversing insulin resistance and lowering blood glucose levels. Exercise also helps muscles absorb more glucose without the need for insulin. The more muscle a body has, the more glucose it can burn to control blood glucose levels. Other Causes Other causes of insulin resistance may include ethnicity; certain diseases; hormones; steroid use; some medications; older age; sleep problems, especially sleep apnea; and cigarette smoking. Does sleep matter? Yes. Studies show that untreated sleep problems, especially sleep apnea, can increase the risk of obesity, insulin resistance, and type 2 diabetes. Night shift workers may also be at increased risk for these problems. Sleep apnea is a common disorder in which a person's breathing is interrupted during sleep. People may often move out of deep sleep and into light sleep when their breathing pauses or becomes shallow. This results in poor sleep quality that causes problem sleepiness, or excessive tiredness, during the day. Many people aren't aware of their symptoms and aren't diagnosed. People who think they might have sleep problems should talk with their health care provider. More information about sleep problems is available from the National Heart, Lung, and Blood Institute at http://www.nhlbi.nih.gov/health/resources/sleep. |
What is (are) Insulin Resistance and Prediabetes ? | Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes. Prediabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that at least 86 million U.S. adults ages 20 or older had prediabetes in 2012.1 People with prediabetes are at increased risk of developing type 2 diabetes and CVD, which can lead to heart attack or stroke. |
What are the symptoms of Insulin Resistance and Prediabetes ? | Insulin resistance and prediabetes usually have no symptoms. People may have one or both conditions for several years without knowing they have them. Even without symptoms, health care providers can identify people at high risk by their physical characteristics, also known as risk factors. The section "Who should be tested for prediabetes?" lists these risk factors. People with a severe form of insulin resistance may have dark patches of skin, usually on the back of the neck. Sometimes people have a dark ring around their neck. Dark patches may also appear on elbows, knees, knuckles, and armpits. This condition is called acanthosis nigricans. |
What is (are) Insulin Resistance and Prediabetes ? | Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both CVD and type 2 diabetes. Metabolic syndrome is defined* as the presence of any three of the following2: large waist sizewaist measurement of 40 inches or more for men and 35 inches or more for women high triglycerides in the bloodtriglyceride level of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride level abnormal levels of cholesterol in the bloodHDL, or good, cholesterol level below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL high blood pressureblood pressure level of 130/85 or above, or taking medication for elevated blood pressure higher than normal blood glucose levelsfasting blood glucose level of 100 mg/dL or above, or taking medication for elevated blood glucose In addition to type 2 diabetes, metabolic syndrome has been linked to the following health disorders: obesity CVD PCOS nonalcoholic fatty liver disease chronic kidney disease However, not everyone with these disorders has insulin resistance, and some people may have insulin resistance without getting these disorders. People who are obese or who have metabolic syndrome, insulin resistance, type 2 diabetes, or prediabetes often also have lowlevel inflammation throughout the body and blood clotting defects that increase the risk of developing blood clots in the arteries. These conditions contribute to increased risk for CVD. *Similar definitions have been developed by the World Health Organization and the American Association of Clinical Endocrinologists. |
How to diagnose Insulin Resistance and Prediabetes ? | Health care providers use blood tests to determine whether a person has prediabetes, but they do not usually test specifically for insulin resistance. Insulin resistance can be assessed by measuring the level of insulin in the blood. However, the test that most accurately measures insulin resistance, called the euglycemic clamp, is too costly and complicated to be used in most health care providers' offices. The clamp is a research tool used by scientists to learn more about glucose metabolism. Research has shown that if blood tests indicate prediabetes, insulin resistance most likely is present. Blood Tests for Prediabetes All blood tests involve drawing blood at a health care provider's office or commercial facility and sending the sample to a lab for analysis. Lab analysis of blood is needed to ensure test results are accurate. Glucose measuring devices used in a health care provider's office, such as fingerstick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose. Prediabetes can be detected with one of the following blood tests: the A1C test the fasting plasma glucose (FPG) test the oral glucose tolerance test (OGTT) A1C test. Sometimes called hemoglobin A1c, HbA1c, or glycohemoglobin test, this test reflects average blood glucose levels over the past 3 months. This test is the most reliable test for prediabetes, but it is not as sensitive as the other tests. In some individuals, it may miss prediabetes that could be caught by glucose tests. Although some health care providers can quickly measure A1C in their office, that type of measurementcalled a pointofcare testis not considered reliable for diagnosis. For diagnosis of prediabetes, the A1C test should be analyzed in a laboratory using a method that is certified by the NGSP. The A1C test can be unreliable for diagnosing prediabetes in people with certain conditions that are known to interfere with the results. Interference should be suspected when A1C results seem very different from the results of a blood glucose test. People of African, Mediterranean, or Southeast Asian descent, or people with family members with sickle cell anemia or a thalassemia, are particularly at risk of interference. People in these groups may have a less common type of hemoglobin, known as a hemoglobin variant, that can interfere with some A1C tests. An A1C of 5.7 to 6.4 percent indicates prediabetes. More information about the A1C test is provided in the NIDDK health topic, The A1C Test and Diabetes. Fasting plasma glucose test. This test measures blood glucose in people who have not eaten anything for at least 8 hours. This test is most reliable when done in the morning. Prediabetes found with this test is called IFG. Fasting glucose levels of 100 to 125 mg/dL indicate prediabetes. OGTT. This test measures blood glucose after people have not eaten for at least 8 hours and 2 hours after they drink a sweet liquid provided by a health care provider or laboratory. Prediabetes found with this test is called IGT. A blood glucose level between 140 and 199 mg/dL indicates prediabetes. The following table lists the blood test levels for a diagnosis of prediabetes. |
What to do for Insulin Resistance and Prediabetes ? | Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weightloss solutions. People may need to get help from a dietitian or join a weightloss program for support. In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan. The DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/healthtopics/topics/dash. The U.S. Dietary Guidelines for Americans also offers healthy eating advice and tools for changing eating habits at www.choosemyplate.gov. Dietary Supplements Vitamin D studies show a link between people's ability to maintain healthy blood glucose levels and having enough vitamin D in their blood. However, studies to determine the proper vitamin D levels for preventing diabetes are ongoing; no special recommendations have been made about vitamin D levels or supplements for people with prediabetes. Currently, the Institute of Medicine (IOM), the agency that recommends supplementation levels based on current science, provides the following guidelines for daily vitamin D intake: People ages 1 to 70 years may require 600 International Units (IUs). People ages 71 and older may require as much as 800 IUs. The IOM also recommended that no more than 4,000 IUs of vitamin D be taken per day. To help ensure coordinated and safe care, people should discuss use of complementary and alternative medicine practices, including the use of dietary supplements, with their health care provider. More information about using dietary supplements to help with diabetes is provided in the NIDDK health topic, Complementary and Alternative Medical Therapies for Diabetes. Physical Activity Regular physical activity tackles several risk factors at once. Regular physical activity helps the body use insulin properly. Regular physical activity also helps a person lose weight control blood glucose levels control blood pressure control cholesterol levels People in the DPP who were physically active for 30 minutes a day, 5 days a week, reduced their risk of type 2 diabetes. Many chose brisk walking as their physical activity. Most people should aim for at least 30 minutes of exercise most days of the week. For best results, people should do both aerobic activities, which use large muscle groups and make the heart beat faster, and muscle strengthening activities. Aerobic activities include brisk walking, climbing stairs, swimming, dancing, and other activities that increase the heart rate. Muscle strengthening activities include lifting weights and doing situps or pushups. People who haven't been physically active recently should talk with their health care provider about which activities are best for them and have a checkup before starting an exercise program. Not Smoking Those who smoke should quit. A health care provider can help people find ways to quit smoking. Studies show that people who get help have a better chance of quitting. For more information about how to reverse insulin resistance and prediabetes with diet and increased physical activity, see the following National Diabetes Education Program publications at www.yourdiabetesinfo.org: Get Real! You Don't Have to Knock Yourself Out to Prevent Diabetes! More Than 50 Ways to Prevent Diabetes Small Steps. Big Rewards. Your Game Plan to Prevent Type 2 Diabetes. Medication The medication metformin is recommended for treatment of some individuals at very high risk of developing type 2 diabetes. In the DPP, metformin was shown to be most effective in preventing or delaying the development of type 2 diabetes in younger, heavier people with prediabetes. In general, metformin is recommend for those who are younger than age 60 and have combined IGT and IFG A1C above 6 percent low HDL cholesterol elevated triglycerides a parent or sibling with diabetes a BMI of at least 35 Metformin also lowers the risk of diabetes in women who have had gestational diabetes. People at high risk should ask their health care provider if they should take metformin to prevent type 2 diabetes. Several medications have been shown to reduce type 2 diabetes risk to varying degrees, but the only medication recommended by the ADA for type 2 diabetes prevention is metformin. Other medications that have delayed diabetes have side effects or haven't shown longlasting benefits. No medication, including metformin, is approved by the U.S. Food and Drug Administration to treat insulin resistance or prediabetes or to prevent type 2 diabetes. |
What to do for Insulin Resistance and Prediabetes ? | Insulin is a hormone that helps cells throughout the body absorb glucose and use it for energy. Insulin resistance is a condition in which the body produces insulin but does not use it effectively. Insulin resistance increases the risk of developing type 2 diabetes and prediabetes. The major contributors to insulin resistance are excess weight, especially around the waist, and physical inactivity. Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes. The Diabetes Prevention Program (DPP) study and its followup study, the Diabetes Prevention Program Outcomes Study (DPPOS), confirmed that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity. By losing weight and being more physically active, people can reverse insulin resistance and prediabetes, thus preventing or delaying type 2 diabetes. People with insulin resistance and prediabetes can decrease their risk for diabetes by eating a healthy diet and reaching and maintaining a healthy weight, increasing physical activity, not smoking, and taking medication. The DPP showed the diabetes medication metformin to be most effective in preventing or delaying the development of type 2 diabetes in younger and heavier people with prediabetes and women who have had gestational diabetes. |
What is (are) Crohn's Disease ? | Crohn's disease is a chronic, or long lasting, disease that causes inflammationirritation or swellingin the gastrointestinal (GI) tract. Most commonly, Crohn's affects the small intestine and the beginning of the large intestine. However, the disease can affect any part of the GI tract, from the mouth to the anus. Crohn's disease is a chronic inflammatory disease of the GI tract, called inflammatory bowel disease (IBD). Ulcerative colitis and microscopic colitis are the other common IBDs. More information is provided in the NIDDK health topics, Ulcerative Colitis and Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis. Crohn's disease most often begins gradually and can become worse over time. Most people have periods of remissiontimes when symptoms disappearthat can last for weeks or years. Some people with Crohn's disease receive care from a gastroenterologist, a doctor who specializes in digestive diseases. |
What is (are) Crohn's Disease ? | The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anusa 1inchlong opening through which stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. Organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestinewhich includes the appendix, cecum, colon, and rectumand anus. The last part of the GI tractcalled the lower GI tractconsists of the large intestine and anus. The intestines are sometimes called the bowel. |
What causes Crohn's Disease ? | The exact cause of Crohn's disease is unknown. Researchers believe the following factors may play a role in causing Crohn's disease: autoimmune reaction genes environment Autoimmune reaction. Scientists believe one cause of Crohn's disease may be an autoimmune reactionwhen a person's immune system attacks healthy cells in the body by mistake. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Researchers believe bacteria or viruses can mistakenly trigger the immune system to attack the inner lining of the intestines. This immune system response causes the inflammation, leading to symptoms. Genes. Crohn's disease sometimes runs in families. Research has shown that people who have a parent or sibling with Crohn's disease may be more likely to develop the disease. Researchers continue to study the link between genes and Crohn's disease. Environment. Some studies suggest that certain things in the environment may increase the chance of a person getting Crohn's disease, although the overall chance is low. Nonsteroidal antiinflammatory drugs,1 antibiotics,2 and oral contraceptives2 may slightly increase the chance of developing Crohn's disease. A highfat diet may also slightly increase the chance of getting Crohn's disease.3 Some people incorrectly believe that eating certain foods, stress, or emotional distress can cause Crohn's disease. Emotional distress and eating certain foods do not cause Crohn's disease. Sometimes the stress of living with Crohn's disease can make symptoms worse. Also, some people may find that certain foods can trigger or worsen their symptoms. |
What are the symptoms of Crohn's Disease ? | The most common signs and symptoms of Crohn's disease are diarrhea abdominal cramping and pain weight loss Other general signs and symptoms include feeling tired nausea or loss of appetite fever anemiaa condition in which the body has fewer red blood cells than normal Signs and symptoms of inflammation outside of the intestines include joint pain or soreness eye irritation skin changes that involve red, tender bumps under the skin The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs. |
How to diagnose Crohn's Disease ? | A health care provider diagnoses Crohn's disease with the following: medical and family history physical exam lab tests upper GI series computerized tomography (CT) scan intestinal endoscopy The health care provider may perform a series of medical tests to rule out other bowel diseases, such as irritable bowel syndrome, ulcerative colitis, or celiac disease, that cause symptoms similar to those of Crohn's disease. Medical and Family History Taking a medical and family history can help a health care provider diagnose Crohn's disease and understand a patient's symptoms. He or she will ask the patient to describe his or her family history symptoms current and past medical conditions current medications Physical Exam A physical exam may help diagnose Crohn's disease. During a physical exam, the health care provider most often checks for abdominal distension, or swelling listens to sounds within the abdomen using a stethoscope taps on the abdomen to check for tenderness and pain and establish if the liver or spleen is abnormal or enlarged Lab Tests A health care provider may order lab tests, including blood and stool tests. Blood tests. A blood test involves drawing blood at a health care provider's office or a lab. A lab technologist will analyze the blood sample. A health care provider may use blood tests to look for changes in red blood cells. When red blood cells are fewer or smaller than normal, a patient may have anemia. white blood cells. When the white blood cell count is higher than normal, a person may have inflammation or infection somewhere in his or her body. Stool tests. A stool test is the analysis of a sample of stool. A health care provider will give the patient a container for catching and storing the stool at home. The patient returns the sample to the health care provider or to a lab. A lab technologist will analyze the stool sample. Health care providers commonly order stool tests to rule out other causes of GI diseases. Upper Gastrointestinal Series An upper GI series, also called a barium swallow, uses xrays and fluoroscopy to help diagnose problems of the upper GI tract. Fluoroscopy is a form of xray that makes it possible to see the internal organs and their motion on a video monitor. An xray technician performs this test at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. This test does not require anesthesia. A patient should not eat or drink before the procedure, as directed by the health care provider. Patients should ask their health care provider about how to prepare for an upper GI series. During the procedure, the patient will stand or sit in front of an xray machine and drink barium, a chalky liquid. Barium coats the esophagus, stomach, and small intestine so the radiologist and a health care provider can see the shape of these organs more clearly on xrays. A patient may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes white or lightcolored stools. A health care provider will give the patient specific instructions about eating and drinking after the test. Computerized Tomography Scan Computerized tomography scans use a combination of xrays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnelshaped device where the xrays are taken. An xray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. CT scans can diagnose both Crohn's disease and the complications seen with the disease. Intestinal Endoscopy Intestinal endoscopies are the most accurate methods for diagnosing Crohn's disease and ruling out other possible conditions, such as ulcerative colitis, diverticular disease, or cancer. Intestinal endoscopies include upper GI endoscopy and enteroscopy capsule endoscopy colonoscopy Upper GI endoscopy and enteroscopy. An upper GI endoscopy is a procedure that uses an endoscopea small, flexible tube with a lightto directly visualize the lining of the upper GI tract. A health care provider performs the procedure at a hospital or an outpatient center. A nurse or technician may give the patient a liquid anesthetic to gargle or will spray the anesthetic on the back of a patient's throat. The anesthetic numbs the throat and calms the gag reflex. The nurse or technician will then place an intravenous (IV) needle in the person's arm or hand to provide a sedative. The health care provider carefully feeds the endoscope down the patient's esophagus and into the stomach. A small camera on the endoscope sends a video image to a monitor, allowing close examination of the GI tract. During an enteroscopy, the health care provider examines the small intestine with a special, longer endoscope. The health care provider carefully feeds the endoscope into the small intestine using one of the following procedures: push enteroscopy, which uses a long endoscope to examine the upper portion of the small intestine single or doubleballoon enteroscopy, which use small balloons to help move the endoscope into the small intestine spiral enteroscopy, which uses a tube attached to an endocope that acts as a cork screw to move the instrument into the small intestine The procedure most often takes between 15 and 60 minutes. The endoscope does not interfere with the patient's breathing, and many patients fall asleep during the procedure. Capsule endoscopy. Although this procedure can examine the entire digestive tract, health care providers use it mostly to examine the small intestine. The patient swallows a capsule containing a tiny camera. As the capsule passes through the GI tract, the camera will record and transmit images to a small receiver device worn by the patient. When the recording is done, the health care provider downloads the images and reviews them on a video monitor. The camera capsule leaves the patient's body during a bowel movement and is safely flushed down the toilet. Colonoscopy. Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside a patient's rectum and entire colon. In most cases, light anesthesia and pain medication help patients relax for the test. The medical staff will monitor a patient's vital signs and try to make him or her as comfortable as possible. A nurse or technician will place an IV needle in a vein in the patient's arm or hand to give anesthesia. For the test, the patient will lie on a table or stretcher while the gastroenterologist inserts a colonoscope into the patient's anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with air to give the gastroenterologist a better view. The camera sends a video image of the intestinal lining to a monitor, allowing the gastroenterologist to examine the tissues lining the colon and rectum. The gastroenterologist may move the patient several times and adjust the scope for better viewing. Once the scope has reached the opening to the small intestine, the gastroenterologist slowly withdraws it and examines the lining of the colon and rectum again. A colonoscopy can show inflamed and swollen tissue, ulcers, and abnormal growths such as polypsextra pieces of tissue that grow on the inner lining of the intestine. If the gastroenterologist suspects Crohn's disease, he or she will biopsy the patient's colon and rectum. A biopsy is a procedure that involves taking small pieces of tissue for examination with a microscope. A health care provider will give patients written bowel prep instructions to follow at home before the test. The health care provider will also give patients information about how to care for themselves following the procedure. |
What are the treatments for Crohn's Disease ? | A health care provider treats Crohn's disease with medications bowel rest surgery Which treatment a person needs depends on the severity of the disease and symptoms. Each person experiences Crohn's disease differently, so health care providers adjust treatments to improve the person's symptoms and induce, or bring about, remission. Medications While no medication cures Crohn's disease, many can reduce symptoms. The goals of medication therapy are inducing and maintaining remission improving the person's quality of life Many people with Crohn's disease require medication therapy. Health care providers will prescribe medications depending on the person's symptoms: aminosalicylates corticosteroids immunomodulators biologic therapies other medications Aminosalicylates are medications that contain 5aminosalicyclic acid (5ASA), which helps control inflammation. Health care providers use aminosalicylates to treat people newly diagnosed with Crohn's disease who have mild symptoms. Aminosalicylates include balsalazide mesalamine olsalazine sulfasalazinea combination of sulfapyridine and 5ASA Some of the common side effects of aminosalicylates include abdominal pain diarrhea headaches heartburn nausea and vomiting Corticosteroids, also known as steroids, help reduce the activity of the immune system and decrease inflammation. Health care providers prescribe corticosteroids for people with moderate to severe symptoms. Corticosteroids include budesonide hydrocortisone methylprednisone prednisone Side effects of corticosteroids include acne a higher chance of developing infections bone mass loss high blood glucose high blood pressure mood swings weight gain In most cases, health care providers do not prescribe corticosteroids for longterm use. Immunomodulators reduce immune system activity, resulting in less inflammation in the GI tract. These medications can take several weeks to 3 months to start working. Immunomodulators include 6mercaptopurine, or 6MP azathioprine cyclosporine methotrexate Health care providers prescribe these medications to help people with Crohn's disease go into remission or to help people who do not respond to other treatments. People taking these medications may have the following side effects: a low white blood cell count, which can lead to a higher chance of infection fatigue, or feeling tired nausea and vomiting pancreatitis Health care providers most often prescribe cyclosporine only to people with severe Crohn's disease because of the medication's serious side effects. People should talk with their health care provider about the risks and benefits of cyclosporine. Biologic therapies are medications that target a protein made by the immune system. Neutralizing this protein decreases inflammation in the intestine. Biologic therapies work quickly to bring on remission, especially in people who do not respond to other medications. Biologic therapies include adalimumab certolizumab infliximab natalizumab vedolizumab Health care providers most often give patients infliximab every 6 to 8 weeks at a hospital or an outpatient center. Side effects may include a toxic reaction to the medication and a higher chance of developing infections, particularly tuberculosis. Other medications to treat symptoms or complications may include acetaminophen for mild pain. People with Crohn's disease should avoid using ibuprofen, naproxen, and aspirin since these medications can make symptoms worse. antibiotics to prevent or treat infections and fistulas. loperamide to help slow or stop severe diarrhea. In most cases, people only take this medication for short periods of time since it can increase the chance of developing megacolon. Bowel Rest Sometimes Crohn's disease symptoms are severe and a person may need to rest his or her bowel for a few days to several weeks. Bowel rest involves drinking only clear liquids or having no oral intake. To provide the patient with nutrition, a health care provider will deliver IV nutrition through a special catheter, or tube, inserted into a vein in the patient's arm. Some patients stay in the hospital, while other patients are able to receive the treatment at home. In most cases, the intestines are able to heal during bowel rest. Surgery Even with medication treatments, up to 20 percent of people will need surgery to treat their Crohn's disease.1 Although surgery will not cure Crohn's disease, it can treat complications and improve symptoms. Health care providers most often recommend surgery to treat fistulas bleeding that is life threatening bowel obstructions side effects from medications when they threaten a person's health symptoms when medications do not improve a person's condition A surgeon can perform different types of operations to treat Crohn's disease: small bowel resection subtotal colectomy proctocolectomy and ileostomy Patients will receive general anesthesia. Most patients will stay in the hospital for 3 to 7 days after the surgery. Full recovery may take 4 to 6 weeks. Small bowel resection. Small bowel resection is surgery to remove part of a patient's small intestine. When a patient with Crohn's disease has a blockage or severe disease in the small intestine, a surgeon may need to remove that section of intestine. The two types of small bowel resection are laparoscopicwhen a surgeon makes several small, halfinch incisions in the patient's abdomen. The surgeon inserts a laparoscopea thin tube with a tiny light and video camera on the endthrough the small incisions. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a closeup view of the small intestine. While watching the monitor, the surgeon inserts tools through the small incisions and removes the diseased or blocked section of small intestine. The surgeon will reconnect the ends of the intestine. open surgerywhen a surgeon makes one incision about 6 inches long in the patient's abdomen. The surgeon will locate the diseased or blocked section of small intestine and remove or repair that section. The surgeon will reconnect the ends of the intestine. Subtotal colectomy. A subtotal colectomy, also called a large bowel resection, is surgery to remove part of a patient's large intestine. When a patient with Crohn's disease has a blockage, a fistula, or severe disease in the large intestine, a surgeon may need to remove that section of intestine. A surgeon can perform a subtotal colectomy by laparoscopic colectomywhen a surgeon makes several small, halfinch incisions in the abdomen. While watching the monitor, the surgeon removes the diseased or blocked section of the large intestine. The surgeon will reconnect the ends of the intestine. open surgerywhen a surgeon makes one incision about 6 to 8 inches long in the abdomen. The surgeon will locate the diseased or blocked section of small intestine and remove that section. The surgeon will reconnect the ends of the intestine. Proctocolectomy and ileostomy. A proctocolectomy is surgery to remove a patient's entire colon and rectum. An ileostomy is a stoma, or opening in the abdomen, that a surgeon creates from a part of the ileumthe last section of the small intestine. The surgeon brings the end of the ileum through an opening in the patient's abdomen and attaches it to the skin, creating an opening outside of the patient's body. The stoma is about threefourths of an inch to a little less than 2 inches wide and is most often located in the lower part of the patient's abdomen, just below the beltline. A removable external collection pouch, called an ostomy pouch or ostomy appliance, connects to the stoma and collects intestinal contents outside the patient's body. Intestinal contents pass through the stoma instead of passing through the anus. The stoma has no muscle, so it cannot control the flow of intestinal contents, and the flow occurs whenever peristalsis occurs. Peristalsis is the movement of the organ walls that propels food and liquid through the GI tract. People who have this type of surgery will have the ileostomy for the rest of their lives. |