Question
stringlengths 16
191
| Answer
stringlengths 6
26.7k
|
|---|---|
What to do for Crohn's Disease ? | Researchers have not found that eating, diet, and nutrition cause Crohn's disease symptoms. Good nutrition is important in the management of Crohn's disease, however. Dietary changes can help reduce symptoms. A health care provider may recommend that a person make dietary changes such as avoiding carbonated drinks avoiding popcorn, vegetable skins, nuts, and other highfiber foods drinking more liquids eating smaller meals more often keeping a food diary to help identify troublesome foods Health care providers may recommend nutritional supplements and vitamins for people who do not absorb enough nutrients. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/probiotics. Depending on a person's symptoms or medications, a health care provider may recommend a specific diet, such as a highcalorie diet lactosefree diet lowfat diet lowfiber diet lowsalt diet People should speak with a health care provider about specific dietary recommendations and changes. |
What are the complications of Crohn's Disease ? | Complications of Crohn's disease can include bowel obstruction. Crohn's disease can thicken the wall of the intestine. Over time, the thickened areas of the intestine can narrow, which can block the intestine. A partial or complete obstruction, also called a bowel blockage, can block the movement of food or stool through the intestines. A complete bowel obstruction is life threatening and requires immediate medical attention and often surgery. fistulasabnormal passages, or tunnels, between two organs, or between an organ and the outside of the body. How a health care provider treats fistulas depends on their type and severity. For some people, fistulas heal with medication and diet changes, while other people will need to have surgery. anal fissuressmall tears in the anus that may cause itching, pain, or bleeding. Most anal fissures heal with medical treatment, including ointments, warm baths, and dietary changes. ulcers. Inflammation anywhere along the GI tract can lead to ulcers or open sores in a person's mouth, intestines, anus, and perineumthe area between the anus and the sex organs. In most cases, the treatment a health care provider prescribes for Crohn's disease will also treat the ulcers. malnutritiona condition that develops when the body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function. Some people may need IV fluids or feeding tubes to replace lost nutrients and fluids. inflammation in other areas of the body. The immune system can trigger inflammation in the joints eyes skin Health care providers can treat inflammation by adjusting medications or prescribing new medications. Crohn's Disease and Colon Cancer People with Crohn's disease in the large intestine may be more likely to develop colon cancer. People who receive ongoing treatment and remain in remission may reduce their chances of developing colon cancer. People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer. Screening can include colonoscopy with biopsies. Such screening does not reduce a person's chances of developing colon cancer. Instead, screening can help diagnose cancer early and improve chances for recovery. |
What to do for Crohn's Disease ? | Crohn's disease is a chronic, or long lasting, disease that causes inflammationirritation or swellingin the gastrointestinal (GI) tract. The exact cause of Crohn's disease is unknown. Researchers believe that factors such as an autoimmune reaction, genes, and environment may play a role in causing Crohn's disease. Crohn's disease can occur in people of any age. However, it is more likely to develop in people between the ages of 20 and 29 who have a family member, most often a sibling or parent, with inflammatory bowel disease (IBD) who smoke cigarettes The most common signs and symptoms of Crohn's disease are diarrhea, abdominal cramping and pain, and weight loss. 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 Which treatment a person needs depends on the severity of the disease and symptoms. Good nutrition is important in the management of Crohn's disease. A health care provider may recommend that a person make dietary changes. People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer. |
What is (are) Whipple Disease ? | Whipple disease is a rare bacterial infection that primarily affects the small intestine. The infection may spread to any organ in the body; however, it more commonly affects the joints central nervous system, which includes the brain, the spinal cord, and nerves located throughout the body heart eyes lungs Left untreated, Whipple disease gets worse and is usually life threatening. |
What is (are) Whipple Disease ? | The small intestine is part of the upper gastrointestinal (GI) tract and is a tubeshaped organ between the stomach and large intestine. The upper GI tract also includes the mouth, esophagus, stomach, and duodenum, or the first part of the small intestine. Most food digestion and nutrient absorption take place in the small intestine. The small intestine measures about 20 feet long and includes the duodenum, jejunum, and ileum. Villitiny, fingerlike protrusionsline the inside of the small intestine. Villi normally let nutrients from food be absorbed through the walls of the small intestine into the bloodstream. |
What causes Whipple Disease ? | Bacteria called Tropheryma whipplei (T. whipplei) cause Whipple disease. T. whipplei infection can cause internal sores, also called lesions, and thickening of tissues in the small intestine. The villi take on an abnormal, clublike appearance and the damaged intestinal lining does not properly absorb nutrients, causing diarrhea and malnutrition. Diarrhea is frequent, loose, and watery bowel movements. Malnutrition is a condition that develops when the body does not get the right amount of vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function. Over time, the infection spreads to other parts of the persons body and will damage other organs. |
What are the symptoms of Whipple Disease ? | Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are diarrhea weight loss caused by malabsorption A person may not have diarrhea. Instead, other signs and symptoms of Whipple disease may appear, such as abnormal yellow and white patches on the lining of the small intestine joint pain, with or without inflammation, that may appear off and on for years before other symptoms fatty or bloody stools abdominal cramps or bloating felt between the chest and groin enlarged lymph nodesthe small glands that make infectionfighting white blood cells loss of appetite fever fatigue, or feeling tired weakness darkening of the skin People with a more advanced stage of Whipple disease may have neurologic symptomsthose related to the central nervous systemsuch as vision problems. memory problems or personality changes. facial numbness. headaches. muscle weakness or twitching. difficulty walking. hearing loss or ringing in the ears. dementiathe name for a group of symptoms caused by disorders that affect the brain. People with dementia may not be able to think well enough to do normal activities such as getting dressed or eating. Less common symptoms of Whipple disease may include chronic cough. chest pain. pericarditisinflammation of the membrane surrounding the heart. heart failurea longlasting condition in which the heart cannot pump enough blood to meet the bodys needs. Heart failure does not mean the heart suddenly stops working. |
What are the complications of Whipple Disease ? | People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine. As a result of delayed diagnosis or treatment, people may experience the following complications in other areas of the body: longlasting nutritional deficiencies heart and heart valve damage brain damage A person with Whipple disease may experience a relapsea return of symptoms. Relapse can happen years after treatment and requires repeat treatments. |
How to diagnose Whipple Disease ? | A health care provider may use several tests and exams to diagnose Whipple disease, including the following: medical and family history physical exam blood tests upper GI endoscopy and enteroscopy A patient may be referred to a gastroenterologista doctor who specializes in digestive diseases. A health care provider may first try to rule out more common conditions with similar symptoms, including inflammatory rheumatic diseasecharacterized by inflammation and loss of function in one or more connecting or supporting structures of the body. celiac diseasea digestive disease that damages the small intestine and interferes with the absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. neurologic diseasesdisorders of the central nervous system. intraabdominal lymphomaabdominal cancer in part of the immune system called the lymphatic system. Mycobacterium avium complexan infection that affects people with AIDS. Medical and Family History Taking a family and medical history can help a health care provider diagnose Whipple disease. Physical Exam A physical exam may help diagnose Whipple disease. During a physical exam, a health care provider usually examines a patients body uses a stethoscope to listen to sounds related to the abdomen taps on specific areas of the patients body checking for pain or tenderness Blood Tests 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. The health care provider may use blood tests to check for malabsorption. When the damaged villi do not absorb certain nutrients from food, the body has a shortage of protein, calories, and vitamins. Blood tests can show shortages of protein, calories, and vitamins in the body. abnormal levels of electrolytes. Electrolyteschemicals in body fluids, including sodium, potassium, magnesium, and chlorideregulate a persons nerve and muscle function. A patient who has malabsorption or a lot of diarrhea may lose fluids and electrolytes, causing an imbalance in the body. anemia. Anemia is a condition in which the body has fewer red blood cells than normal. A patient with Whipple disease does not absorb the proper nutrients to make enough red blood cells in the body, leading to anemia. T. whipplei DNA. Although not yet approved, rapid polymerase chain reaction diagnostic tests have been developed to detect T. whipplei DNA and may be useful in diagnosis. Upper Gastrointestinal Endoscopy and Enteroscopy An upper GI endoscopy and enteroscopy are procedures that use an endoscopea small, flexible tube with a lightto see the upper GI tract. A health care provider performs these tests at a hospital or an outpatient center. The health care provider carefully feeds the endoscope down the esophagus and into the stomach and duodenum. Once the endoscope is in the duodenum, the health care provider will use smaller tools and a smaller scope to see more of the small intestine. These additional procedures may include push enteroscopy, which uses a long endoscope to examine the upper portion of the small intestine. doubleballoon enteroscopy, which uses balloons to help move the endoscope through the entire small intestine. capsule enteroscopy, during which the patient swallows a capsule containing a tiny camera. As the capsule passes through the GI tract, the camera will transmit images to a video monitor. Using this procedure, the health care provider can examine the entire digestive tract. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A health care provider will place an intravenous (IV) needle in a vein in the arm or hand to administer sedation. Sedatives help patients stay relaxed and comfortable. The test can show changes in the lining of the small intestine that can occur with Whipple disease. The health care provider can use tiny tools passed through the endoscope to perform biopsies. A biopsy is a procedure that involves taking a piece of tissue for examination with a microscope. A pathologista doctor who specializes in examining tissues to diagnose diseasesexamines the tissue from the stomach lining in a lab. The pathologist applies a special stain to the tissue and examines it for T. whippleiinfected cells with a microscope. Once the pathologist completes the examination of the tissue, he or she sends a report to the gastroenterologist for review. More information is provided in the NIDDK health topic, Upper GI Endoscopy. |
What are the treatments for Whipple Disease ? | The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease. Health care providers choose antibiotics that treat the infection in the small intestine and cross the bloodbrain barriera layer of tissue around the brain. Using antibiotics that cross the bloodbrain barrier ensures destruction of any bacteria that may have entered the patients brain and central nervous system. The health care provider usually prescribes IV antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two. A nurse or technician places an IV in the patients arm to give the antibiotics. IV antibiotics used to treat Whipple disease may include ceftriaxone (Rocephin) meropenem (Merrem I.V.) penicillin G (Pfizerpen) streptomycin (Streptomycin) After a patient completes the IV antibiotics, the health care provider will prescribe longterm oral antibiotics. Patients receive longterm treatmentat least 1 to 2 yearsto cure the infection anywhere in the body. Oral antibiotics may include trimethoprim/sulfamethoxazole (Septra, Bactrim)a combination antibiotic doxycycline (Vibramycin) Patients should finish the prescribed course of antibiotics to ensure the medication destroyed all T. whipplei bacteria in the body. Patients who feel better may still have the bacteria in the small intestine or other areas of the body for 1 to 2 years. A health care provider will monitor the patient closely, repeat the blood tests, and repeat the upper GI endoscopy with biopsy during and after treatment to determine whether T. whipplei is still present. People may relapse during or after treatment. A health care provider will prescribe additional or new antibiotics if a relapse occurs. Some people will relapse years after treatment, so it is important for patients to schedule routine followups with the health care provider. Most patients have good outcomes with an early diagnosis and complete treatment. Health care providers treat patients with neurologic symptoms at diagnosis or during relapse more aggressively. Treatment may include a combination of antibiotics hydroxychloroquine (Plaquenil)an antimalarial medication weekly injections of interferon gammaa substance made by the body that activates the immune system corticosteroidsmedications that decrease inflammation |
How to prevent Whipple Disease ? | Experts have not yet found a way to prevent Whipple disease. |
What to do for Whipple Disease ? | A person with Whipple disease and malabsorption may need a diet high in calories and protein vitamins nutritional supplements |
What to do for Whipple Disease ? | Whipple disease is a rare bacterial infection that primarily affects the small intestine. Left untreated, Whipple disease gets worse and is usually life threatening. Bacteria called Tropheryma whipplei (T. whipplei) cause Whipple disease. T. whipplei infection can cause internal sores, also called lesions, and thickening of tissues in the small intestine. Anyone can get Whipple disease. However, it is more common in Caucasian men between 40 and 60 years old. Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are diarrhea weight loss caused by malabsorption People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine. The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease. The health care provider usually prescribes intravenous (IV) antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two. After a patient completes the IV antibiotics, the health care provider will prescribe longterm oral antibiotics. Most patients have good outcomes with an early diagnosis and complete treatment. |
What is (are) What I need to know about Crohn's Disease ? | Crohn's disease is a disease that causes inflammation,* or swelling, and irritation of any part of the digestive tractalso called the gastrointestinal (GI) tract. The part most commonly affected is the end part of the small intestine, called the ileum. *See the Pronunciation Guide for tips on how to say the words in bold type. Crohns disease is one of two main forms of diseases of the GI tract named inflammatory bowel disease (IBD). The other form, called ulcerative colitis, affects the large intestine, which includes the colon and the rectumthe lower end of the large intestine, leading to the anus. With Crohns disease, chronicor long lastinginflammation may cause scar tissue to form in the lining of the intestine. When scar tissue builds up, the passage can become narrow, causing food and stool to move through the GI tract more slowlywhich can lead to pain, cramps, and diarrhea. |
Who is at risk for What I need to know about Crohn's Disease? ? | Both men and women can get Crohn's disease, and it can run in families. People with Crohns disease may have a blood relative with the disease or another type of IBD. Crohns disease most commonly starts between the ages of 13 and 30. |
What causes What I need to know about Crohn's Disease ? | Researchers are studying the possible causes of Crohns disease. Your bodys natural defense system, called the immune system, protects you from infection by fighting against bacteria, viruses, and other things that can make you sick. Researchers believe that with Crohns disease, the immune system attacks harmless bacteria and viruses. During the attack, white blood cells gather in the intestinal lining. The white blood cells cause chronic inflammation, which leads to ulcers, or sores, and damage to the intestines. Other factors associated with Crohns disease are genesthe traits passed down from your parents unknown triggers caused by the environment |
What are the symptoms of What I need to know about Crohn's Disease ? | Crohn's disease symptoms can be different for each person. The most common symptoms of Crohns disease are abdominal painoften in the lower right area of the abdomen diarrhea bleeding in the rectum, which can be seen in a persons underwear, in the toilet, or in a bowel movement; rectal bleeding can be serious and may not stop without medical help weight loss fever |
How to diagnose What I need to know about Crohn's Disease ? | A doctor will perform a physical exam and tests to diagnose Crohns disease. During your visit, the doctor will ask about your symptoms and medical history. The doctor may order blood tests, which involve drawing blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. Blood tests can show anemia caused by bleeding. Anemia is a condition in which red blood cells are fewer or smaller than normal, which means less oxygen is carried to the bodys cells. Blood tests can also show a high white blood cell count, a sign of chronic inflammation. You may also be asked for a stool sample. A stool test is commonly used to rule out other causes of GI diseases, such as infections. The doctor will give you a container for catching and storing the stool. The sample is returned to the doctor or a commercial facility and sent to a lab for analysis. A stool sample can also be used to check if you have bleeding or inflammation. Other tests may be needed to diagnose Crohn's disease. The following tests are all performed at a hospital or outpatient center. Colonoscopy. Colonoscopy is the most commonly used test to specifically diagnose Crohns disease. This test is used to look inside your rectum, entire colon, and ileum. The health care provider will give you written bowel prep instructions to follow at home before the test. You may need to follow a clear liquid diet for 1 to 3 days before the test. You will need to take laxatives and enemas the evening before the test, and you will likely have one or more enemas about 2 hours before the test. A laxative is medicine that loosens stool and increases bowel movements. An enema involves flushing water, laxative, or sometimes a mild soap solution into the anus using a special squirt bottle. For the test, you will lie on a table while the doctor inserts a flexible tube into your anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The doctor can see inflammation, ulcers, or bleeding. The doctor may also perform a biopsy. The doctor will look at the tissue with a microscope to confirm the diagnosis of Crohns disease. In most cases, youll be given a light sedative, and possibly pain medicine, to help you relax. You will not feel the biopsy. Cramping or bloating may occur during the first hour after the test. Driving is not permitted for 24 hours after the test to allow the sedative time to wear off. Before the appointment, you should make plans for a ride home. By the next day, you should fully recover and go back to your normal diet. Flexible sigmoidoscopy. This test is used to look inside the rectum and lower colon. The health care provider will give you written bowel prep instructions to follow at home before the test. You may need to follow a clear liquid diet for 1 to 3 days before the test. You may also need a laxative or enema the night before the test. And youll have one or more enemas about 2 hours before the procedure. For the test, you will lie on a table while the doctor inserts a flexible tube into your anus. You will not need a sedative for the test. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The doctor can see inflammation, ulcers, or bleeding. The doctor may also perform a biopsy by snipping a bit of tissue from the intestinal lining. The doctor will look at the tissue with a microscope to confirm the diagnosis of Crohns disease. You will not feel the biopsy. You can usually go back to your normal diet after the test, though you may have cramping or bloating during the first hour after the test. Computerized tomography (CT) scan. A CT scan uses x rays and computers to create images of the inside of the body. For the test, you will lie on a table that slides into a tunnelshaped device where the x rays are taken. The technician may give you a solution to drink and an injection of a special dye through a needle inserted into an arm vein. You will not need a sedative for the test. CT scans can be used to help diagnose Crohn's disease. Upper GI series (x rays). An upper GI series may be done to look at the small intestine. No eating or drinking is allowed for 8 hours before the procedure. You will not need a sedative for the test. During the procedure, you will stand or sit in front of an xray machine and drink barium, a chalky liquid. The barium coats the small intestine, making signs of the disease show up more clearly on x rays. After the test, you may go back to your normal diet, though you may have nausea or bloating for a short time. Traces of barium in the GI tract cause stools to be white or light colored for a few days after the test. Lower GI series (x rays). A lower GI series may be done to look at the large intestine. The health care provider will give you written bowel prep instructions to follow at home before the test. You will be asked to follow a clear liquid diet for 1 to 3 days before the test. A laxative or enema is usually used the evening before a lower GI series. Enemas are sometimes repeated the morning of the test. For the test, you will lie on a table while the doctor inserts a flexible tube into your anus. You will not need a sedative for the test. The large intestine is filled with barium, making signs of the disease show up more clearly on x rays. After the test, you may go back to your normal diet, though you may have bloating. You also may have some soreness of the anus. Traces of barium in the GI tract cause stools to be white or light colored for a few days after the test. |
What is (are) What I need to know about Crohn's Disease ? | Intestinal blockage can occur in people with Crohns disease when scar tissue blocks the intestinal passage. A narrow intestinal passage is called a stricture. When the passage blocks completely, food and stool stop moving, causing abdominal cramps and vomiting. If you have these symptoms, you should see a health care provider right away. Ulcers from Crohns disease can cause tunnels to form through the inflamed areas, or even the healthy parts, of the intestine. These tunnels are called fistulas. Fistulas are seen most often in the areas around the rectum and anus. Sometimes a pocket of infection, called an abscess, can form in and around the fistulas. Most fistulas can be treated with medicines, but sometimes surgery is needed. People with Crohns disease often have anemia, which can be caused by the disease itself or by iron deficiency. Anemia may make a person feel tired. People with Crohns disease, particularly if they have been treated with steroid medicines, may have weakness of their bonescalled osteoporosis or osteomalacia. People with Crohns disease may also have arthritis, skin problems, swelling in the eyes or mouth, kidney stones, gallstones, and liver problems. Some people with Crohns disease may have restless legs syndromeextreme leg discomfort the person feels while sitting or lying down. These problems may go away during treatment, but some must be treated with medicines. People who have Crohns disease may not get enough nutrition, such as protein, vitamins, or calories, because they have an upset stomach that keeps them from eating enough calories may not be able to absorb nutrients in the intestine Children with Crohns disease may fail to grow normally and may have low height for their age. |
What are the treatments for What I need to know about Crohn's Disease ? | Treatment for Crohns disease depends on where the disease is located in the GI tract what problems you already have from the disease what past treatments you have had for the disease The goals of treatment are to decrease the inflammation relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding correct nutritional problems Treatment may include medicines surgery eating, diet, and nutrition Medicines One or more of the following medicines may be used to treat Crohns disease: Antiinflammation medicines may be used first to treat your Crohn's disease. These medicines help lower inflammation in the intestine and relieve the pain and diarrhea. Sometimes antiinflammation medicines cause side effects, so you should talk with your health care provider about what to expect. Steroids also help lower inflammation. Steroids are similar to natural chemicals in the body. However, steroids are used only for a short time because longterm use can lead to serious side effects. Immune system suppressors. Azathioprine and 6mercaptopurine work by keeping your immune system from attacking harmless foreign substances. Immune system suppressors also cause side effects, so you should talk with your health care provider about what to expect. Biological therapies. Biological therapies are medicines that are given by an injection in the vein, infliximab (Remicade), or an injection in the skin, adalimumab (HUMIRA). Your health care provider may treat you with these medicines if others are not helping to decrease inflammation, or if you have fistulas with abscesses. The goals for using these medicines are to get you better, keep you better, and avoid longterm steroid use. Antibiotics. Antibiotics are used to treat bacterial overgrowth in the small intestine caused by stricture, fistulas, or surgery. For this common problem, the doctor may prescribe one or more of the following antibiotics: ampicillin, sulfonamide, cephalosporin, tetracycline, or metronidazole. Antidiarrheal medicines and fluid replacements. Diarrhea and abdominal cramps are often relieved when the inflammation improves, but more medicine may be needed. Antidiarrheal medicines include diphenoxylate, loperamide, and codeine. People with diarrhea should drink plenty of fluids to prevent dehydrationloss of fluids from the body. If diarrhea does not improve, the person should see the doctor promptly for possible treatment with fluids given through a small tube inserted into an arm vein. Surgery Some people with Crohns disease need surgery if medicines are no longer working to control blockage, fistulas, abscesses, and bleeding. A surgeon performs the procedure in a hospital, where you will receive medicine to make you sleep during the surgery. One or more of the following surgeries may be needed: Intestinal resection. The surgeon removes the diseased section of intestine and puts the ends of the intestine back together. Proctocolectomy. Proctocolectomy is surgery to remove the rectum and part or all of the colon. An ileostomy is performed with a proctocolectomy. Ileostomy. Ileostomy is an operation to create an openingcalled a stomafor the stool to exit the body when the ends of the intestine cannot be put back together. To create a stoma, an end of the intestine is brought out through a small opening made on the lower right part of the abdomen near the beltline. The stoma is about the size of a quarter. An ostomy pouch is worn outside the body over the stoma to collect waste, and it is emptied several times a day. Your health care provider may refer you to an ostomy nursea specialist who cares for people with an ostomy pouch. Surgery usually does not cure Crohn's disease forever. Sometimes you need to have more than one surgery because the disease returns next to where the intestine was removed. Because Crohns disease can return after surgery, you can talk with your health care provider and other patients to get as much information as possible before having surgery. |
What to do for What I need to know about Crohn's Disease ? | Your health care provider may start you on a special diet, so you get extra nutrition and calories. Highcalorie liquid supplements are often used to give you the extra calories and right amount of vitamins and minerals to keep you healthy. During acute phases of the disease, you may need to receive intravenous nutrition to give the intestine a rest. No foods are known to cause injury or inflammation to the intestine. But foods such as hot spices, alcohol, greasy foods, and milk products may make diarrhea and cramping worse. You should eat a healthy diet and avoid foods that make symptoms worse. Your health care provider may refer you to a dietitian to help you with meal planning. |
What to do for What I need to know about Crohn's Disease ? | Crohn's disease is a disease that causes inflammation, or swelling, and irritation of any part of the digestive tractalso called the gastrointestinal (GI) tract. People with Crohns disease may have a blood relative with the disease or another type of inflammatory bowel disease (IBD). Symptoms of Crohns disease include abdominal pain, diarrhea, bleeding, weight loss, and fever. A physical exam, blood tests, stool tests, and other tests are needed to diagnose Crohns disease. Problems of Crohns disease include intestinal blockage, fistulas, abscesses, anemia, and slower growth in children. Doctors treat Crohns disease with medicines, surgery, diet, and nutrition. People with Crohns disease should eat a healthy diet and avoid foods that make symptoms worse. Quitting smoking can help make Crohns disease less severe. Ask your health care provider if you need help quitting smoking. Support groups may help lower stress for people with Crohns disease. Most people with Crohns disease are able to work, raise families, and live full lives. Many women with Crohns disease can become pregnant and have a baby. You should talk with your health care provider before getting pregnant. |
What is (are) What I need to know about Diarrhea ? | Diarrhea is frequent, loose, and watery bowel movements. Bowel movements, also called stools, are body wastes passed through the rectum and anus. Stools contain what is left after your digestive system absorbs nutrients and fluids from what you eat and drink. If your body does not absorb the fluids, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools contain more water, salts, and minerals and weigh more than solid stools. Diarrhea that lasts a short time is called acute diarrhea. Acute diarrhea is a common problem and usually lasts only 1 or 2 days, but it may last longer. Diarrhea that lasts for at least 4 weeks is called chronic diarrhea. Chronic diarrhea symptoms may be continual or they may come and go. *See the Pronunciation Guide for tips on how to say the words in bold type. |
What causes What I need to know about Diarrhea ? | Causes of diarrhea include bacteria from contaminated food or water viruses that cause illnesses such as the flu parasites, which are tiny organisms found in contaminated food or water medicines such as antibiotics problems digesting certain foods diseases that affect the stomach, small intestine, or colon, such as Crohns disease problems with how the colon functions, caused by disorders such as irritable bowel syndrome Sometimes no cause can be found. As long as diarrhea goes away within 1 to 2 days, finding the cause is not usually necessary. |
What are the symptoms of What I need to know about Diarrhea ? | In addition to passing frequent, loose stools, other possible symptoms include cramps or pain in the abdomenthe area between the chest and hips an urgent need to use the bathroom loss of bowel control You may feel sick to your stomach or become dehydrated. If a virus or bacteria is the cause of your diarrhea, you may have fever and chills and bloody stools. Dehydration Being dehydrated means your body does not have enough fluid to work properly. Every time you have a bowel movement, you lose fluids. Diarrhea causes you to lose even more fluids. You also lose salts and minerals such as sodium, chloride, and potassium. These salts and minerals affect the amount of water that stays in your body. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems. Signs of dehydration in adults are being thirsty urinating less often than usual having darkcolored urine having dry skin feeling tired feeling dizzy or fainting Signs of dehydration in babies and young children are having a dry mouth and tongue crying without tears having no wet diapers for 3 hours or more having sunken eyes, cheeks, or soft spot in the skull having a high fever being more cranky or drowsy than usual Also, when people are dehydrated, their skin does not flatten back to normal right away after being gently pinched and released. |
How to diagnose What I need to know about Diarrhea ? | To find the cause of diarrhea, the health care provider may perform a physical exam ask about any medicines you are taking test your stool or blood to look for bacteria, parasites, or other signs of disease or infection ask you to stop eating certain foods to see whether your diarrhea goes away If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease. |
What are the treatments for What I need to know about Diarrhea ? | Diarrhea is treated by replacing lost fluids, salts, and minerals to prevent dehydration. Taking medicine to stop diarrhea can be helpful in some cases. Medicines you can buy over the counter without a prescription include loperamide (Imodium) and bismuth subsalicylate (PeptoBismol, Kaopectate). Stop taking these medicines if symptoms get worse or if the diarrhea lasts more than 2 days. If you have bloody diarrhea, you should not use overthecounter diarrhea medicines. These medicines may make diarrhea last longer. The health care provider will usually prescribe antibiotics instead. Overthecounter medicines for diarrhea may be dangerous for babies and children. Talk with the health care provider before giving your child these medicines. |
What to do for What I need to know about Diarrhea ? | To prevent dehydration when you have diarrhea, it is important to drink plenty of water, but you also need to drink fluids that contain sodium, chloride, and potassium. Adults should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. Children should drink oral rehydration solutionsspecial drinks that contain salts and minerals to prevent dehydration. These drinks include Pedialyte, Naturalyte, Infalyte, and CeraLyte. These drinks are sold in most grocery stores and drugstores. bananas plain rice boiled potatoes toast crackers cooked carrots baked chicken without the skin or fat If a certain food is the cause of diarrhea, try to avoid it. drinks with caffeine, such as coffee and cola highfat or greasy foods, such as fried foods foods with a lot of fiber, such as citrus fruits sweet foods, such as cakes and cookies During or after an episode of diarrhea, some people have trouble digesting lactose, the sugar in milk and milk products. However, you may be able to digest yogurt. Eating yogurt with active, live bacterial cultures may even help you feel better faster. When babies have diarrhea, continue breastfeeding or formula feeding as usual. After you have had diarrhea caused by a virus, problems digesting lactose may last up to 4 to 6 weeks. You may have diarrhea for a short time after you eat or drink milk or milk products. |
How to prevent What I need to know about Diarrhea ? | Two types of diarrhea can be preventedrotavirus diarrhea and travelers diarrhea. Rotavirus Diarrhea Two vaccines, RotaTeq and Rotarix, protect against rotavirusa common virus that causes diarrhea in babies and children. RotaTeq is given to babies in three doses at 2, 4, and 6 months of age. Rotarix is given in two doses. The first dose is given when the baby is 6 weeks old, and the second is given at least 4 weeks later but before the baby is 24 weeks old. To learn more about rotavirus vaccines, talk with your childs health care provider. You can also find more information at the Centers for Disease Control and Prevention rotavirus vaccination webpage at www.cdc.gov/vaccines/vpdvac/rotavirus. RotaTeq and Rotarix only prevent diarrhea caused by rotavirus. Children who have been vaccinated may still get diarrhea from another cause. Travelers Diarrhea People may develop travelers diarrhea while visiting developing areas of the world such as Latin America, Africa, and southern Asia. Travelers diarrhea is caused by eating food or drinking water that contains harmful bacteria, viruses, or parasites. You can prevent travelers diarrhea by being careful: Do not drink tap water, use tap water to brush your teeth, or use ice cubes made from tap water. Do not eat or drink unpasteurized milk or milk products. Do not eat raw fruits and vegetables unless they can be peeled and you peel them yourself. Do not eat raw or rare meat and fish. Do not eat meat or shellfish that is not hot when served to you. Do not eat food sold by street vendors. You can drink bottled water, carbonated soft drinks, and hot drinks such as coffee and tea. Before traveling outside the United States, talk with your health care provider. Your health care provider may suggest taking medicine with you. In some cases, taking antibiotics before traveling can help prevent travelers diarrhea. And early treatment with antibiotics can shorten an episode of travelers diarrhea. |
What to do for What I need to know about Diarrhea ? | Diarrhea is frequent, loose, and watery bowel movements. Acute diarrhea is a common problem. It usually lasts only 1 or 2 days, but it may last longer. Being dehydrated means your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems. Diarrhea is treated by replacing lost fluids, salts, and minerals. See your health care provider if you have signs of dehydration, diarrhea for more than 2 days, severe pain in your abdomen or rectum, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry. Take your child to a health care provider right away if your child has 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. Two types of diarrhea can be prevented rotavirus diarrhea and travelers diarrhea. |
What is (are) Wilson Disease ? | Wilson disease is a genetic disease that prevents the body from removing extra copper. The body needs a small amount of copper from food to stay healthy; however, too much copper is poisonous. Normally, the liver filters extra copper and releases it into bile. Bile is a fluid made by the liver that carries toxins and wastes out of the body through the gastrointestinal tract. In Wilson disease, the liver does not filter copper correctly and copper builds up in the liver, brain, eyes, and other organs. Over time, high copper levels can cause lifethreatening organ damage. |
What is (are) Wilson Disease ? | The liver is the bodys largest internal organ. The liver is called the bodys metabolic factory because of the important role it plays in metabolismthe way cells change food into energy after food is digested and absorbed into the blood. The liver has many important functions, including taking up, storing, and processing nutrients from foodincluding fat, sugar, and proteinand delivering them to the rest of the body when needed. making new proteins, such as clotting factors and immune factors. producing bile. In addition to carrying toxins and waste products out of the body, bile helps the body digest fats and the fatsoluble vitamins A, D, E, and K. removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications. A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete and the liver creates scar tissue. |
What causes Wilson Disease ? | Wilson disease is caused by an inherited autosomal recessive mutation, or change, in the ATP7B gene. In an autosomal recessive disease, the child has to inherit the gene mutation from both parents to have an increased likelihood for the disease. The chance of a child inheriting autosomal recessive mutations from both parents with a gene mutation is 25 percent, or one in four. If only one parent carries the mutated gene, the child will not get the disease, although the child may inherit one copy of the gene mutation. The child is called a carrier of the disease and can pass the gene mutation to the next generation. Genetic testing is a procedure that identifies changes in a patients genes and can show whether a parent or child is a carrier of a mutated gene. Autosomal recessive diseases are typically not seen in every generation of an affected family. The following chart shows the chance of inheriting an autosomal recessive mutation from parents who both carry the mutated gene. Genetic Diseases Each cell contains thousands of genes that provide the instructions for making proteins for growth and repair of the body. If a gene has a mutation, the protein made by that gene may not function properly. Not all gene mutations cause a disease. People have two copies of most genes; they inherit one copy from each parent. A genetic disease occurs when one or both parents pass a mutated gene to a child at conception. A genetic disease can also occur through a spontaneous gene mutation, meaning neither parent carries a copy of the mutated gene. Once a spontaneous gene mutation has occurred in a person, that person can pass the gene mutation on to a child. Read more about genes and genetic conditions in the U.S. National Library of Medicines Genetics Home Reference at www.ghr.nlm.nih.gov. |
What are the symptoms of Wilson Disease ? | The signs and symptoms of Wilson disease vary, depending on what organs of the body are affected. Wilson disease is present at birth; however, the signs and symptoms of the disease do not appear until the copper builds up in the liver, the brain, or other organs. When people have signs and symptoms, they usually affect the liver, the central nervous system, or both. The central nervous system includes the brain, the spinal cord, and nerves throughout the body. Sometimes a person does not have symptoms and a health care provider discovers the disease during a routine physical exam or blood test, or during an illness. Children can have Wilson disease for several years before any signs and symptoms occur. People with Wilson disease may have liverrelated signs and symptoms central nervous systemrelated signs and symptoms mental healthrelated signs and symptoms other signs and symptoms Liverrelated Signs and Symptoms People with Wilson disease may develop signs and symptoms of chronic, or long lasting, liver disease: weakness fatigue, or feeling tired loss of appetite nausea vomiting weight loss pain and bloating from fluid accumulating in the abdomen edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face itching spiderlike blood vessels, called spider angiomas, near the surface of the skin muscle cramps jaundice, a condition that causes the skin and whites of the eyes to turn yellow Some people with Wilson disease may not develop signs or symptoms of liver disease until they develop acute liver failurea condition that develops suddenly. Central Nervous Systemrelated Signs and Symptoms Central nervous systemrelated symptoms usually appear in people after the liver has retained a lot of copper; however, signs and symptoms of liver disease may not be present. Central nervous systemrelated symptoms occur most often in adults and sometimes occur in children.1 Signs and symptoms include tremors or uncontrolled movements muscle stiffness problems with speech, swallowing, or physical coordination A health care provider may refer people with these symptoms to a neurologista doctor who specializes in nervous system diseases. Mental Healthrelated Signs and Symptoms Some people will have mental healthrelated signs and symptoms when copper builds up in the central nervous system. Signs and symptoms may include personality changes depression feeling anxious, or nervous, about most things psychosiswhen a person loses contact with reality Other Signs and Symptoms Other signs and symptoms of Wilson disease may include anemia, a condition in which red blood cells are fewer or smaller than normal, which prevents the bodys cells from getting enough oxygen arthritis, a condition in which a person has pain and swelling in one or more joints high levels of amino acids, protein, uric acid, and carbohydrates in urine low platelet or white blood cell count osteoporosis, a condition in which the bones become less dense and more likely to fracture |
What are the complications of Wilson Disease ? | People who have Wilson disease that is not treated or diagnosed early can have serious complications, such as cirrhosisscarring of the liver kidney damageas liver function decreases, the kidneys may be damaged persistent nervous system problems when nervous system symptoms do not resolve liver cancerhepatocellular carcinoma is a type of liver cancer that can occur in people with cirrhosis liver failurea condition in which the liver stops working properly death, if left untreated |
How to diagnose Wilson Disease ? | A health care provider may use several tests and exams to diagnose Wilson disease, including the following: medical and family history physical exam blood tests urine tests liver biopsy imaging tests Health care providers typically see the same symptoms of Wilson disease in other conditions, and the symptoms of Wilson disease do not occur together often, making the disease difficult to diagnose. Medical and Family History A health care provider may take a medical and family history to help diagnose Wilson disease. Physical Exam A physical exam may help diagnose Wilson disease. During a physical exam, a health care provider usually examines a patients body uses a stethoscope to listen to sounds related to the abdomen A health care provider will use a special light called a slit lamp to look for KayserFleischer rings in the eyes. Blood Tests A nurse or technician will draw blood samples at a health care providers office or a commercial facility and send the samples to a lab for analysis. A health care provider may perform liver enzyme or function testsblood tests that may indicate liver abnormalities. check copper levels in the blood. Since the copper is deposited into the organs and is not circulating in the blood, most people with Wilson disease have a lowerthannormal level of copper in the blood. In cases of acute liver failure caused by Wilson disease, the level of blood copper is often higher than normal. check the level of ceruloplasmina protein that carries copper in the bloodstream. Most people with Wilson disease have a lowerthannormal ceruloplasmin level. conduct genetic testing. A health care provider may recommend genetic testing in cases of a known family history of Wilson disease. Urine Tests 24hour urine collection. A patient will collect urine at home in a special container provided by a health care providers office or a commercial facility. A health care provider sends the sample to a lab for analysis. A 24hour urine collection will show increased copper in the urine in most patients who have symptoms due to Wilson disease. Liver Biopsy A liver biopsy is a procedure that involves taking a small piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to stop taking certain medications temporarily before the liver biopsy. He or she may also ask the patient to fasteat or drink nothingfor 8 hours before the procedure. During the procedure, the patient lies on a table, right hand resting above the head. The health care provider applies a local anesthetic to the area where he or she will insert the biopsy needle. If needed, a health care provider will also give sedatives and pain medication. The health care provider uses the needle to take a small piece of liver tissue. He or she may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home. A pathologista doctor who specializes in diagnosing diseasesexamines the liver tissue in a lab. The test can show cirrhosis of the liver. Sometimes the liver biopsy will show copper buildup in the liver cells; however, the results can vary because the copper does not always deposit evenly into the liver. Therefore, health care providers often find it more useful to analyze a piece of liver tissue for copper content. Most patients with Wilson disease have high levels of copper in the liver tissue when compared with carriers or with people who do not have Wilson disease. More information is provided in the NIDDK health topic, Liver Biopsy. Imaging Tests A health care provider may order imaging tests to evaluate brain abnormalities in patients who have nervous system symptoms often seen with Wilson disease, or in patients diagnosed with Wilson disease. Health care providers do not use brain imaging tests to diagnose Wilson disease, though certain findings may suggest the patient has the disease. Magnetic resonance imaging (MRI). An 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 radiologista doctor who specializes in medical imaginginterprets the images. The patient 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 a special dye, called contrast medium. With most MRI machines, the patient 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 patient to lie in a more open space. The technician will take a sequence of images from different angles to create a detailed picture of the brain. During sequencing, the patient will hear loud mechanical knocking and humming noises. MRI can show if other diseases or conditions are causing the patients neurological symptoms. Computerized tomography (CT) scan. A CT scan uses a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of contrast medium. CT scans require the patient to lie on a table that slides into a tunnelshaped device where a technician takes the x rays. An xray technician performs the procedure in an outpatient center or a hospital. A radiologist interprets the images. The patient does not need anesthesia. A CT scan can show if other diseases or conditions are causing the patients neurological symptoms. |
What are the treatments for Wilson Disease ? | A health care provider will treat Wilson disease with a lifelong effort to reduce and control the amount of copper in the body. Treatment may include medications changes in eating, diet, and nutrition a liver transplant Medications A health care provider will prescribe medications to treat Wilson disease. The medications have different actions that health care providers use during different phases of the treatment. Chelating agents. Chelating agents are medications that remove extra copper from the body by releasing it from organs into the bloodstream. Once the cooper is in the bloodstream, the kidneys then filter the copper and pass it into the urine. A health care provider usually recommends chelating agents at the beginning of treatment. A potential side effect of chelating agents is that nervous system symptoms may become worse during treatment. The two medications available for this type of treatment include trientine (Syprine)the risk for side effects and worsening nervous system symptoms appears to be lower with trientine than dpenicillamine. Researchers are still studying the side effects; however, some health care providers prefer to prescribe trientine as the first treatment of choice because it appears to be safer. dpenicillaminepeople taking dpenicillamine may have other reactions or side effects, such as fever a rash kidney problems bone marrow problems A health care provider will prescribe a lower dose of a chelating agent to women who are pregnant to reduce the risk of birth defects. A health care provider should consider future screening on any newborn whose parent has Wilson disease. Zinc. A health care provider will prescribe zinc for patients who do not have symptoms, or after a person has completed successful treatment using a chelating agent and symptoms begin to improve. Zinc, taken by mouth as zinc salts such as zinc acetate (Galzin), blocks the digestive tracts absorption of copper from food. Although most people taking zinc usually do not experience side effects, some people may experience stomach upset. A health care provider may prescribe zinc for children with Wilson disease who show no symptoms. Women may take the full dosage of zinc safely during pregnancy. Maintenance, or long term, treatment begins when symptoms improve and tests show that copper is at a safe level. Maintenance treatment typically includes taking zinc or a lower dose of a chelating agent. A health care provider closely monitors the person and reviews regular blood and urine tests to ensure maintenance treatment controls the copper level in the body. Treatment for people with Wilson disease who have no symptoms may include a chelating agent or zinc in order to prevent symptoms from developing and stop or slow disease progression. People with Wilson disease will take medications for the rest of their lives. Followup and adherence to the health care providers treatment plan is necessary to manage symptoms and prevent organ damage. |
What to do for Wilson Disease ? | People with Wilson disease should reduce their dietary copper intake by avoiding foods that are high in copper, such as shellfish liver mushrooms nuts chocolate People should not eat these foods during the initial treatment and talk with the health care provider to discuss if they are safe to eat in moderation during maintenance treatment. People with Wilson disease whose tap water runs through copper pipes or comes from a well should check the copper levels in the tap water. Water that sits in copper pipes may pick up copper residue, but running water lowers the level to within acceptable limits. People with Wilson disease should not use copper containers or cookware to store or prepare food or drinks. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of vitamins and dietary supplements, with their health care provider. Read more at www.nccam. nih.gov/health. If the health care provider recommends taking any type of supplement or vitamin, a pharmacist can recommend types that do not contain copper. People should talk with a health care provider about diet changes to reduce copper intake. Liver Transplant A liver transplant may be necessary in people when cirrhosis leads to liver failure acute liver failure happens suddenly treatment is not effective A liver transplant is an operation to remove a diseased or an injured liver and replace it with a healthy one from another person, called a donor. A successful transplant is a lifesaving treatment for people with liver failure. Most liver transplants are successful. About 85 percent of transplanted livers are functioning after 1 year.2 Liver transplant surgery provides a cure for Wilson disease in most cases. More information is provided in the NIDDK health topic, Liver Transplantation. |
How to prevent Wilson Disease ? | A person cannot prevent Wilson disease; however, people with a family history of Wilson disease, especially those with an affected sibling or parent, should talk with a health care provider about testing. A health care provider may be able to diagnose Wilson disease before symptoms appear. Early diagnosis and treatment of Wilson disease can reduce or even prevent organ damage. People with a family history of the disease may also benefit from genetic testing that can identify one or more gene mutations. A health care provider may refer a person with a family history of Wilson disease to a geneticista doctor who specializes in genetic diseases. |
What to do for Wilson Disease ? | Wilson disease is a genetic disease that prevents the body from removing extra copper. Normally, the liver filters extra copper and releases it into bile. In Wilson disease, the liver does not filter copper correctly and copper builds up in the liver, brain, eyes, and other organs. Wilson disease is caused by an inherited autosomal recessive mutation, or change, in the ATP7B gene. In an autosomal recessive disease, the child has to inherit the gene mutation from both parents to have an increased likelihood for the disease. The signs and symptoms of Wilson disease vary, depending on what organs of the body are affected. People with Wilson disease may have liverrelated signs and symptoms central nervous systemrelated signs and symptoms mental healthrelated signs and symptoms other signs and symptoms A health care provider will treat Wilson disease with a lifelong effort to reduce and control the amount of copper in the body. Treatment may include medications changes in eating, diet, and nutrition a liver transplant People with Wilson disease should reduce their dietary copper intake by avoiding foods that are high in copper, such as shellfish liver mushrooms nuts chocolate A person cannot prevent Wilson disease; however, people with a family history of Wilson disease, especially those with an affected sibling or parent, should talk with a health care provider about testing. |
What is (are) Hyperthyroidism ? | Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. Hyperthyroidism is sometimes called thyrotoxicosis, the technical term for too much thyroid hormone in the blood. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body. Hyperthyroidism causes many of the bodys functions to speed up. About 1 percent of the U.S. population has hyperthyroidism.1 |
What is (are) Hyperthyroidism ? | The thyroid is a 2inchlong, butterflyshaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on each side of the windpipe. The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce, store, and release hormones into the bloodstream. The hormones then travel through the body and direct the activity of the bodys cells. The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is made from T4 and is the more active hormone, directly affecting the tissues. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Thyroid hormone production is regulated by thyroidstimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production. |
What causes Hyperthyroidism ? | Hyperthyroidism has several causes, including Graves disease thyroid nodules thyroiditis, or inflammation of the thyroid consuming too much iodine overmedicating with synthetic thyroid hormone, which is used to treat underactive thyroid Rarely, hyperthyroidism is caused by a pituitary adenoma, which is a noncancerous tumor of the pituitary gland. In this case, hyperthyroidism is due to too much TSH. Graves Disease Graves disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States. Graves disease is an autoimmune disorder. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the bodys own cells and organs. With Graves disease, the immune system makes an antibody called thyroid stimulating immunoglobulin (TSI) that attaches to thyroid cells. TSI mimics the action of TSH and stimulates the thyroid to make too much thyroid hormone. More information is provided in the NIDDK health topic, Graves' disease. Thyroid Nodules Thyroid nodules, also called adenomas, are lumps in the thyroid. Thyroid nodules are common and usually noncancerous. About 3 to 7 percent of the U.S. population has them.2 However, nodules may become overactive and produce too much hormone. A single overactive nodule is called a toxic adenoma. Multiple overactive nodules are called toxic multinodular goiter. Often found in older adults, toxic multinodular goiter can produce a large amount of excess thyroid hormone. Thyroiditis Thyroiditis is an inflammation of the thyroid that causes stored thyroid hormone to leak out of the thyroid gland. At first, the leakage raises hormone levels in the blood, leading to hyperthyroidism that lasts for 1 or 2 months. Most people then develop hypothyroidismwhen thyroid hormone levels are too lowbefore the thyroid is completely healed. Several types of thyroiditis can cause hyperthyroidism followed by hypothyroidism: Subacute thyroiditis. This condition involves painful inflammation and enlargement of the thyroid. Experts are not sure what causes subacute thyroiditis, but it may be related to a viral or bacterial infection. The condition usually goes away on its own in a few months. Postpartum thyroiditis. This type of thyroiditis develops after a woman gives birth. For more information, see the section titled What happens with pregnancy and thyroid conditions? Silent thyroiditis. This type of thyroiditis is called silent because it is painless, as is postpartum thyroiditis, even though the thyroid may be enlarged. Like postpartum thyroiditis, silent thyroiditis is probably an autoimmune condition and sometimes develops into permanent hypothyroidism. Consuming Too Much Iodine The thyroid uses iodine to make thyroid hormone, so the amount of iodine consumed influences the amount of thyroid hormone the thyroid makes. In some people, consuming large amounts of iodine may cause the thyroid to make excess thyroid hormone. Sometimes significant amounts of iodine are contained in medicationssuch as amiodarone, which is used to treat heart problemsor in supplements containing seaweed. Some cough syrups also contain large amounts of iodine. See Eating, Diet, and Nutrition for more information on iodine. Overmedicating with Synthetic Thyroid Hormone Some people who take synthetic thyroid hormone for hypothyroidism may take too much. People who take synthetic thyroid hormone should see their health care provider at least once a year to have their thyroid hormone levels checked and follow the health care providers instructions about the dosage. Some other medications may also interact with synthetic thyroid hormone to raise hormone levels in the blood. People who take synthetic thyroid hormone should ask their health care provider about interactions when starting new medications. |
What are the symptoms of Hyperthyroidism ? | Hyperthyroidism has many symptoms that can vary from person to person. Some common symptoms of hyperthyroidism are nervousness or irritability fatigue or muscle weakness heat intolerance trouble sleeping hand tremors rapid and irregular heartbeat frequent bowel movements or diarrhea weight loss mood swings goiter, which is an enlarged thyroid that may cause the neck to look swollen and can interfere with normal breathing and swallowing |
How to diagnose Hyperthyroidism ? | Many symptoms of hyperthyroidism are the same as those of other diseases, so hyperthyroidism usually cannot be diagnosed based on symptoms alone. With suspected hyperthyroidism, health care providers take a medical history and perform a thorough physical exam. Health care providers may then use several blood tests, such as the following, to confirm a diagnosis of hyperthyroidism and find its cause: TSH test. The ultrasensitive TSH test is usually the first test a health care provider performs. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available. The TSH test is especially useful in detecting mild hyperthyroidism. Generally, a TSH reading below normal means a person has hyperthyroidism and a reading above normal means a person has hypothyroidism. Health care providers may conduct additional tests to help confirm the diagnosis or determine the cause of hyperthyroidism. T3 and T4 test. This test shows the levels of T3 and T4 in the blood. With hyperthyroidism, the levels of one or both of these hormones in the blood are higher than normal. Thyroidstimulating immunoglobulin (TSI) test. This test, also called a thyroidstimulating antibody test, measures the level of TSI in the blood. Most people with Graves disease have this antibody, but people whose hyperthyroidism is caused by other conditions do not. Radioactive iodine uptake test. The radioactive iodine uptake test measures the amount of iodine the thyroid collects from the bloodstream. Measuring the amount of iodine in a persons thyroid helps the health care provider determine what is causing a persons hyperthyroidism. For example, low levels of iodine uptake might be a sign of thyroiditis, whereas high levels could indicate Graves disease. Thyroid scan. A thyroid scan shows how and where iodine is distributed in the thyroid. The images of nodules and other possible irregularities help the health care provider diagnose the cause of a persons hyperthyroidism. More information is provided in the NIDDK health topic, Thyroid Tests. |
What are the treatments for Hyperthyroidism ? | Health care providers treat hyperthyroidism with medications, radioiodine therapy, or thyroid surgery. The aim of treatment is to bring thyroid hormone levels to a normal state, thus preventing longterm complications, and to relieve uncomfortable symptoms. No single treatment works for everyone. Treatment depends on the cause of hyperthyroidism and how severe it is. When choosing a treatment, health care providers consider a patients age, possible allergies to or side effects of the medications, other conditions such as pregnancy or heart disease, and the availability of an experienced thyroid surgeon. Finding the right specialist for treatment is an important first step. Some professional societies, listed under For More Information, and endocrinology departments in local teaching hospitals can provide the names of local specialists. Medications Beta blockers. Health care providers may prescribe a medication called a beta blocker to reduce symptoms until other treatments take effect. Beta blockers act quickly to relieve many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness, but do not stop thyroid hormone production. Most people feel better within hours of taking these medications. Antithyroid medications. Antithyroid therapy is the easiest way to treat hyperthyroidism. Antithyroid medications interfere with thyroid hormone production but dont usually have permanent results. Antithyroid medications are not used to treat thyroiditis. Once treatment with antithyroid medications begins, thyroid hormone levels may not move into the normal range for several weeks or months. The average treatment time is about 1 to 2 years, but treatment can continue for many years. Antithyroid medications can cause side effects in some people, including allergic reactions such as rashes and itching a decrease in the number of white blood cells in the body, which can lower resistance to infection liver failure, in rare cases Stop your antithyroid medication and call your health care provider right away if you develop any of the following while taking antithyroid medications: fatigue weakness vague abdominal pain loss of appetite skin rash or itching easy bruising yellowing of the skin or whites of the eyes, called jaundice persistent sore throat fever In the United States, health care providers prescribe the antithyroid medication methimazole (Tapazole, Northyx) for most types of hyperthyroidism. Antithyroid medications and pregnancy. Because pregnant and breastfeeding women cannot receive radioiodine therapy, they are usually treated with an antithyroid medication instead. However, experts agree that women in their first trimester of pregnancy should not take methimazole due to the rare occurrence of damage to the fetus. Another antithyroid medication, propylthiouracil (PTU), is available for women in this stage of pregnancy or for women who are allergic to or intolerant of methimazole and have no other treatment options. Health care providers may prescribe PTU for the first trimester of pregnancy and switch to methimazole for the second and third trimesters. Some women are able to stop taking antithyroid medications in the last 4 to 8 weeks of pregnancy due to the remission of hyperthyroidism that occurs during pregnancy. However these women should continue to be monitored for recurrence of thyroid problems following delivery. Studies have shown that mothers taking antithyroid medications may safely breastfeed. However, they should take only moderate doses, less than 1020 milligrams daily, of the antithyroid medication methimazole. Doses should be divided and taken after feedings, and the infants should be monitored for side effects.4 Women requiring higher doses of the antithyroid medication to control hyperthyroidism should not breastfeed. Radioiodine Therapy Radioactive iodine131 is a common and effective treatment for hyperthyroidism. In radioiodine therapy, patients take radioactive iodine131 by mouth. Because the thyroid gland collects iodine to make thyroid hormone, it will collect the radioactive iodine from the bloodstream in the same way. The radioactive iodine gradually destroys the cells that make up the thyroid gland but does not affect other body tissues. More than one round of radioiodine therapy may be needed to bring thyroid hormone production into the normal range. In the meantime, treatment with beta blockers can control symptoms. Almost everyone who receives radioactive iodine treatment eventually develops hypothyroidism. But health care providers consider this an acceptable outcome because hypothyroidism is easier to treat and has fewer longterm complications than hyperthyroidism. People who develop hypothyroidism must take synthetic thyroid hormone. Radioiodine and pregnancy. Although iodine131 is not known to cause birth defects or infertility, radioiodine therapy is not used in pregnant women or women who are breastfeeding. Radioactive iodine can be harmful to the fetus thyroid and can be passed from mother to child in breast milk. Experts recommend that women wait a year after treatment before becoming pregnant. Thyroid Surgery The leastused treatment is surgery to remove part or most of the thyroid gland. Sometimes surgery may be used to treat pregnant women who cannot tolerate antithyroid medications people with large goiters people who have cancerous thyroid nodules, though hyperthyroidism does not cause cancer Before surgery, the health care provider may prescribe antithyroid medications to temporarily bring a patients thyroid hormone levels into the normal range. This presurgical treatment prevents a condition called thyroid storma sudden, severe worsening of symptomsthat can occur when hyperthyroid patients have general anesthesia. When part of the thyroid is removedas a treatment for toxic nodules, for examplethyroid hormone levels may return to normal. But some surgical patients may still develop hypothyroidism and need to take synthetic thyroxine, a medication that is identical to the hormone, T4, made by the thyroid. If the entire thyroid is removed, lifelong thyroid hormone medication is necessary. After surgery, health care providers will continue to monitor patients thyroid hormone levels. Although uncommon, certain problems can occur in thyroid surgery. The parathyroid glands can be damaged because they are located very close to the thyroid. These glands help control calcium and phosphorus levels in the body. Damage to the laryngeal nerve, also located close to the thyroid, can lead to voice changes or breathing problems. But when surgery is performed by an experienced surgeon, less than 1 percent of patients have permanent complications.5 People who need help finding a surgeon can contact one of the organizations listed under For More Information. |
What to do for Hyperthyroidism ? | Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition is provided by the National Agricultural Library at www.nutrition.gov. Dietary Supplements Iodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet, available at www.nlm.nih.gov/medlineplus. Women need more iodine when they are pregnantabout 250 micrograms a daybecause the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.6 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met. To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health. |
What to do for Hyperthyroidism ? | Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. Hyperthyroidism is most often caused by Graves disease, an autoimmune disorder. Other causes include thyroid nodules, thyroiditis, consuming too much iodine, and overmedicating with synthetic thyroid hormone. Some symptoms of hyperthyroidism are nervousness or irritability, fatigue or muscle weakness, heat intolerance, trouble sleeping, hand tremors, rapid and irregular heartbeat, frequent bowel movements or diarrhea, weight loss, mood swings, and goiter. Hyperthyroidism is much more common in women than men. Hyperthyroidism is also more common in people older than age 60 and is often caused by thyroid nodules. Hyperthyroidism in this age group is sometimes misdiagnosed as depression or dementia. For people older than age 60, subclinical hyperthyroidism increases their chance of developing atrial fibrillation. Women with hyperthyroidism should discuss their condition with their health care provider before becoming pregnant. Hyperthyroidism is treated with medications, radioiodine therapy, or thyroid surgery. No single treatment works for everyone. |
What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbnessloss of feelingin the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight. |
What causes Diabetic Neuropathies: The Nerve Damage of Diabetes ? | The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors: metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves autoimmune factors that cause inflammation in nerves mechanical injury to nerves, such as carpal tunnel syndrome inherited traits that increase susceptibility to nerve disease lifestyle factors, such as smoking or alcohol use |
What are the symptoms of Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Symptoms depend on the type of neuropathy and which nerves are affected. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomicor involuntarynervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe. Symptoms of nerve damage may include numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers wasting of the muscles of the feet or hands indigestion, nausea, or vomiting diarrhea or constipation dizziness or faintness due to a drop in blood pressure after standing or sitting up problems with urination erectile dysfunction in men or vaginal dryness in women weakness Symptoms that are not due to neuropathy, but often accompany it, include weight loss and depression. |
What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways. Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms. Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels. Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs. Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected. Neuropathy Affects Nerves Throughout the Body Peripheral neuropathy affects toes feet legs hands arms Autonomic neuropathy affects heart and blood vessels digestive system urinary tract sex organs sweat glands eyes lungs Proximal neuropathy affects thighs hips buttocks legs Focal neuropathy affects eyes facial muscles ears pelvis and lower back chest abdomen thighs legs feet |
What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Feet and legs are likely to be affected before hands and arms. Many people with diabetes have signs of neuropathy that a doctor could note but feel no symptoms themselves. Symptoms of peripheral neuropathy may include numbness or insensitivity to pain or temperature a tingling, burning, or prickling sensation sharp pains or cramps extreme sensitivity to touch, even light touch loss of balance and coordination These symptoms are often worse at night. Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If an infection occurs and is not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Many amputations are preventable if minor problems are caught and treated in time. |
What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Autonomic neuropathy affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. Autonomic neuropathy also affects other internal organs, causing problems with digestion, respiratory function, urination, sexual response, and vision. In addition, the system that restores blood glucose levels to normal after a hypoglycemic episode may be affected, resulting in loss of the warning symptoms of hypoglycemia. Hypoglycemia Unawareness Normally, symptoms such as shakiness, sweating, and palpitations occur when blood glucose levels drop below 70 mg/dL. In people with autonomic neuropathy, symptoms may not occur, making hypoglycemia difficult to recognize. Problems other than neuropathy can also cause hypoglycemia unawareness. Heart and Blood Vessels The heart and blood vessels are part of the cardiovascular system, which controls blood circulation. Damage to nerves in the cardiovascular system interferes with the body's ability to adjust blood pressure and heart rate. As a result, blood pressure may drop sharply after sitting or standing, causing a person to feel lightheaded or even to faint. Damage to the nerves that control heart rate can mean that the heart rate stays high, instead of rising and falling in response to normal body functions and physical activity. Digestive System Nerve damage to the digestive system most commonly causes constipation. Damage can also cause the stomach to empty too slowly, a condition called gastroparesis. Severe gastroparesis can lead to persistent nausea and vomiting, bloating, and loss of appetite. Gastroparesis can also make blood glucose levels fluctuate widely, due to abnormal food digestion. Nerve damage to the esophagus may make swallowing difficult, while nerve damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. Problems with the digestive system can lead to weight loss. Urinary Tract and Sex Organs Autonomic neuropathy often affects the organs that control urination and sexual function. Nerve damage can prevent the bladder from emptying completely, allowing bacteria to grow in the bladder and kidneys and causing urinary tract infections. When the nerves of the bladder are damaged, urinary incontinence may result because a person may not be able to sense when the bladder is full or control the muscles that release urine. Autonomic neuropathy can also gradually decrease sexual response in men and women, although the sex drive may be unchanged. A man may be unable to have erections or may reach sexual climax without ejaculating normally. A woman may have difficulty with arousal, lubrication, or orgasm. Sweat Glands Autonomic neuropathy can affect the nerves that control sweating. When nerve damage prevents the sweat glands from working properly, the body cannot regulate its temperature as it should. Nerve damage can also cause profuse sweating at night or while eating. Eyes Finally, autonomic neuropathy can affect the pupils of the eyes, making them less responsive to changes in light. As a result, a person may not be able to see well when a light is turned on in a dark room or may have trouble driving at night. |
What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Proximal neuropathy, sometimes called lumbosacral plexus neuropathy, femoral neuropathy, or diabetic amyotrophy, starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and in older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The length of the recovery period varies, depending on the type of nerve damage. |
What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg. Focal neuropathy may cause inability to focus the eye double vision aching behind one eye paralysis on one side of the face, called Bell's palsy severe pain in the lower back or pelvis pain in the front of a thigh pain in the chest, stomach, or side pain on the outside of the shin or inside of the foot chest or abdominal pain that is sometimes mistaken for heart disease, a heart attack, or appendicitis Focal neuropathy is painful and unpredictable and occurs most often in older adults with diabetes. However, it tends to improve by itself over weeks or months and does not cause longterm damage. People with diabetes also tend to develop nerve compressions, also called entrapment syndromes. One of the most common is carpal tunnel syndrome, which causes numbness and tingling of the hand and sometimes muscle weakness or pain. Other nerves susceptible to entrapment may cause pain on the outside of the shin or the inside of the foot. |
How to prevent Diabetic Neuropathies: The Nerve Damage of Diabetes ? | The best way to prevent neuropathy is to keep blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout the body. |
How to diagnose Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Doctors diagnose neuropathy on the basis of symptoms and a physical exam. During the exam, the doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch. Foot Exams Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam assesses the skin, muscles, bones, circulation, and sensation of the feet. The doctor may assess protective sensation or feeling in the feet by touching them with a nylon monofilamentsimilar to a bristle on a hairbrushattached to a wand or by pricking them with a pin. People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly. The doctor may also check temperature perception or use a tuning fork, which is more sensitive than touch pressure, to assess vibration perception. Other Tests The doctor may perform other tests as part of the diagnosis. Nerve conduction studies or electromyography are sometimes used to help determine the type and extent of nerve damage. Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles respond to electrical signals transmitted by nearby nerves. These tests are rarely needed to diagnose neuropathy. A check of heart rate variability shows how the heart responds to deep breathing and to changes in blood pressure and posture. Ultrasound uses sound waves to produce an image of internal organs. An ultrasound of the bladder and other parts of the urinary tract, for example, can be used to assess the structure of these organs and show whether the bladder empties completely after urination. |
What are the treatments for Diabetic Neuropathies: The Nerve Damage of Diabetes ? | The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage. As described in the following sections, additional treatment depends on the type of nerve problem and symptom. Pain Relief Doctors usually treat painful diabetic neuropathy with oral medications, although other types of treatments may help some people. People with severe nerve pain may benefit from a combination of medications or treatments and should consider talking with a health care provider about treatment options. Medications used to help relieve diabetic nerve pain include tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane) other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa) anticonvulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal) opioids and opioidlike drugs, such as controlledrelease oxycodone, an opioid; and tramadol (Ultram), an opioid that also acts as an antidepressant Duloxetine and pregabalin are approved by the U.S. Food and Drug Administration specifically for treating painful diabetic peripheral neuropathy. People do not have to be depressed for an antidepressant to help relieve their nerve pain. All medications have side effects, and some are not recommended for use in older adults or those with heart disease. Because overthecounter pain medicines such as acetaminophen and ibuprofen may not work well for treating most nerve pain and can have serious side effects, some experts recommend avoiding these medications. Treatments that are applied to the skintypically to the feetinclude capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alphalipoic acid, an antioxidant, and evening primrose oil suggest they may help relieve symptoms and improve nerve function in some patients. A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials. Gastrointestinal Problems To relieve mild symptoms of gastroparesisindigestion, belching, nausea, or vomitingdoctors suggest eating small, frequent meals; avoiding fats; and eating less fiber. When symptoms are severe, doctors may prescribe erythromycin to speed digestion, metoclopramide to speed digestion and help relieve nausea, or other medications to help regulate digestion or reduce stomach acid secretion. To relieve diarrhea or other bowel problems, doctors may prescribe an antibiotic such as tetracycline, or other medications as appropriate. Dizziness and Weakness Sitting or standing slowly may help prevent the lightheadedness, dizziness, or fainting associated with blood pressure and circulation problems. Raising the head of the bed or wearing elastic stockings may also help. Some people benefit from increased salt in the diet and treatment with saltretaining hormones. Others benefit from high blood pressure medications. Physical therapy can help when muscle weakness or loss of coordination is a problem. Urinary and Sexual Problems To clear up a urinary tract infection, the doctor will probably prescribe an antibiotic. Drinking plenty of fluids will help prevent another infection. People who have incontinence should try to urinate at regular intervalsevery 3 hours, for examplebecause they may not be able to tell when the bladder is full. To treat erectile dysfunction in men, the doctor will first do tests to rule out a hormonal cause. Several methods are available to treat erectile dysfunction caused by neuropathy. Medicines are available to help men have and maintain erections by increasing blood flow to the penis. Some are oral medications and others are injected into the penis or inserted into the urethra at the tip of the penis. Mechanical vacuum devices can also increase blood flow to the penis. Another option is to surgically implant an inflatable or semirigid device in the penis. Vaginal lubricants may be useful for women when neuropathy causes vaginal dryness. To treat problems with arousal and orgasm, the doctor may refer women to a gynecologist. Foot Care People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers. Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting smoking. More than 60 percent of all nontraumatic lowerlimb amputations in the United States occur in people with diabetes. Nontraumatic amputations are those not caused by trauma such as severe injuries from an accident. In 2004, about 71,000 nontraumatic amputations were performed in people with diabetes. Comprehensive foot care programs can reduce amputation rates by 45 to 85 percent. Careful foot care involves cleaning the feet daily using warmnot hotwater and a mild soap. Soaking the feet should be avoided. A soft towel can be used to dry the feet and between the toes. inspecting the feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems. Using a mirrorhandheld or placed on the floormay be helpful in checking the bottoms of the feet, or another person can help check the feet. A health care provider should be notified of any problems. using lotion to moisturize the feet. Getting lotion between the toes should be avoided. filing corns and calluses gently with a pumice stone after a bath or shower. cutting toenails to the shape of the toes and filing the edges with an emery board each week or when needed. always wearing shoes or slippers to protect feet from injuries. Wearing thick, soft, seamless socks can prevent skin irritation. wearing shoes that fit well and allow the toes to move. New shoes can be broken in gradually by first wearing them for only an hour at a time. looking shoes over carefully before putting them on and feeling the insides to make sure the shoes are free of tears, sharp edges, or objects that might injure the feet. People who need help taking care of their feet should consider making an appointment to see a foot doctor, also called a podiatrist. |
What to do for Diabetic Neuropathies: The Nerve Damage of Diabetes ? | Diabetic neuropathies are nerve disorders caused by many of the abnormalities common to diabetes, such as high blood glucose. Neuropathy can affect nerves throughout the body, causing numbness and sometimes pain in the hands, arms, feet, or legs, and problems with the digestive tract, heart, sex organs, and other body systems. Treatment first involves bringing blood glucose levels within the normal range. Good blood glucose control may help prevent or delay the onset of further problems. Foot care is an important part of treatment. People with neuropathy need to inspect their feet daily for any injuries. Untreated injuries increase the risk of infected foot sores and amputation. Treatment also includes pain relief and other medications as needed, depending on the type of nerve damage. Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting. |
What is (are) Biliary Atresia ? | Biliary atresia is a lifethreatening condition in infants in which the bile ducts inside or outside the liver do not have normal openings. Bile ducts in the liver, also called hepatic ducts, are tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. Bile is a fluid made by the liver that serves two main functions: carrying toxins and waste products out of the body and helping the body digest fats and absorb the fatsoluble vitamins A, D, E, and K. With biliary atresia, bile becomes trapped, builds up, and damages the liver. The damage leads to scarring, loss of liver tissue, and cirrhosis. Cirrhosis is a chronic, or long lasting, liver condition caused by scar tissue and cell damage that makes it hard for the liver to remove toxins from the blood. These toxins build up in the blood and the liver slowly deteriorates and malfunctions. Without treatment, the liver eventually fails and the infant needs a liver transplant to stay alive. The two types of biliary atresia are fetal and perinatal. Fetal biliary atresia appears while the baby is in the womb. Perinatal biliary atresia is much more common and does not become evident until 2 to 4 weeks after birth. Some infants, particularly those with the fetal form, also have birth defects in the heart, spleen, or intestines. |
Who is at risk for Biliary Atresia? ? | Biliary atresia is rare and only affects about one out of every 18,000 infants.1 The disease is more common in females, premature babies, and children of Asian or African American heritage. |
What are the symptoms of Biliary Atresia ? | The first symptom of biliary atresia is jaundicewhen the skin and whites of the eyes turn yellow. Jaundice occurs when the liver does not remove bilirubin, a reddishyellow substance formed when hemoglobin breaks down. Hemoglobin is an ironrich protein that gives blood its red color. Bilirubin is absorbed by the liver, processed, and released into bile. Blockage of the bile ducts forces bilirubin to build up in the blood. Other common symptoms of biliary atresia include dark urine, from the high levels of bilirubin in the blood spilling over into the urine gray or white stools, from a lack of bilirubin reaching the intestines slow weight gain and growth |
What causes Biliary Atresia ? | Biliary atresia likely has multiple causes, though none are yet proven. Biliary atresia is not an inherited disease, meaning it does not pass from parent to child. Therefore, survivors of biliary atresia are not at risk for passing the disorder to their children. Biliary atresia is most likely caused by an event in the womb or around the time of birth. Possible triggers of the event may include one or more of the following: a viral or bacterial infection after birth, such as cytomegalovirus, reovirus, or rotavirus an immune system problem, such as when the immune system attacks the liver or bile ducts for unknown reasons a genetic mutation, which is a permanent change in a genes structure a problem during liver and bile duct development in the womb exposure to toxic substances |
How to diagnose Biliary Atresia ? | No single test can definitively diagnose biliary atresia, so a series of tests is needed. All infants who still have jaundice 2 to 3 weeks after birth, or who have gray or white stools after 2 weeks of birth, should be checked for liver damage.2 Infants with suspected liver damage are usually referred to a pediatric gastroenterologist, a doctor who specializes in childrens digestive diseases pediatric hepatologist, a doctor who specializes in childrens liver diseases pediatric surgeon, a doctor who specializes in operating on childrens livers and bile ducts The health care provider may order some or all of the following tests to diagnose biliary atresia and rule out other causes of liver problems. If biliary atresia is still suspected after testing, the next step is diagnostic surgery for confirmation. Blood test. A blood test involves drawing blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. High levels of bilirubin in the blood can indicate blocked bile ducts. Abdominal x rays. An x ray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. An x ray is performed at a hospital or outpatient center by an xray technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Anesthesia is not needed, but sedation may be used to keep infants still. The infant will lie on a table during the x ray. The xray machine is positioned over the abdominal area. Abdominal x rays are used to check for an enlarged liver and spleen. Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted a radiologist. Anesthesia is not needed, but sedation may be used to keep the infant still. The images can show whether the liver or bile ducts are enlarged and whether tumors or cysts are blocking the flow of bile. An ultrasound cannot be used to diagnose biliary atresia, but it does help rule out other common causes of jaundice. Liver scans. Liver scans are special x rays that use chemicals to create an image of the liver and bile ducts. Liver scans are performed at a hospital or outpatient facility, usually by a nuclear medicine technician. The infant will usually receive general anesthesia or be sedated before the procedure. Hepatobiliary iminodiacetic acid scanning, a type of liver scan, uses injected radioactive dye to trace the path of bile in the body. The test can show if and where bile flow is blocked. Blockage is likely to be caused by biliary atresia. Liver biopsy. A biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope. The biopsy is performed by a health care provider in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the liver. The liver tissue is examined in a lab by a pathologista doctor who specializes in diagnosing diseases. A liver biopsy can show whether biliary atresia is likely. A biopsy can also help rule out other liver problems, such as hepatitisan irritation of the liver that sometimes causes permanent damage. Diagnostic surgery. During diagnostic surgery, a pediatric surgeon makes an incision, or cut, in the abdomen to directly examine the liver and bile ducts. If the surgeon confirms that biliary atresia is the problem, a Kasai procedure will usually be performed immediately. Diagnostic surgery and the Kasai procedure are performed at a hospital or outpatient facility; the infant will be under general anesthesia during surgery. |
What are the treatments for Biliary Atresia ? | Biliary atresia is treated with surgery, called the Kasai procedure, or a liver transplant. Kasai Procedure The Kasai procedure, named after the surgeon who invented the operation, is usually the first treatment for biliary atresia. During a Kasai procedure, the pediatric surgeon removes the infants damaged bile ducts and brings up a loop of intestine to replace them. As a result, bile flows straight to the small intestine. While this operation doesnt cure biliary atresia, it can restore bile flow and correct many problems caused by biliary atresia. Without surgery, infants with biliary atresia are unlikely to live past age 2. This procedure is most effective in infants younger than 3 months old, because they usually havent yet developed permanent liver damage. Some infants with biliary atresia who undergo a successful Kasai procedure regain good health and no longer have jaundice or major liver problems. If the Kasai procedure is not successful, infants usually need a liver transplant within 1 to 2 years. Even after a successful surgery, most infants with biliary atresia slowly develop cirrhosis over the years and require a liver transplant by adulthood. Liver Transplant Liver transplantation is the definitive treatment for biliary atresia, and the survival rate after surgery has increased dramatically in recent years. As a result, most infants with biliary atresia now survive. Progress in transplant surgery has also increased the availability and efficient use of livers for transplantation in children, so almost all infants requiring a transplant can receive one. In years past, the size of the transplanted liver had to match the size of the infants liver. Thus, only livers from recently deceased small children could be transplanted into infants with biliary atresia. New methods now make it possible to transplant a portion of a deceased adults liver into an infant. This type of surgery is called a reducedsize or splitliver transplant. Part of a living adult donors liver can also be used for transplantation. Healthy liver tissue grows quickly; therefore, if an infant receives part of a liver from a living donor, both the donor and the infant can grow complete livers over time. Infants with fetal biliary atresia are more likely to need a liver transplantand usually soonerthan infants with the more common perinatal form. The extent of damage can also influence how soon an infant will need a liver transplant. |
What are the complications of Biliary Atresia ? | After the Kasai procedure, some infants continue to have liver problems and, even with the return of bile flow, some infants develop cirrhosis. Possible complications after the Kasai procedure include ascites, bacterial cholangitis, portal hypertension, and pruritus. Ascites. Problems with liver function can cause fluid to build up in the abdomen, called ascites. Ascites can lead to spontaneous bacterial peritonitis, a serious infection that requires immediate medical attention. Ascites usually only lasts a few weeks. If ascites lasts more than 6 weeks, cirrhosis is likely present and the infant will probably need a liver transplant. Bacterial cholangitis. Bacterial cholangitis is an infection of the bile ducts that is treated with bacteriafighting medications called antibiotics. Portal hypertension. The portal vein carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver. In cirrhosis, scar tissue partially blocks and slows the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension. Portal hypertension can cause gastrointestinal bleeding that may require surgery and an eventual liver transplant. Pruritus. Pruritus is caused by bile buildup in the blood and irritation of nerve endings in the skin. Prescription medication may be recommended for pruritus, including resins that bind bile in the intestines and antihistamines that decrease the skins sensation of itching. |
What to do for Biliary Atresia ? | Infants with biliary atresia often have nutritional deficiencies and require special diets as they grow up. They may need a higher calorie diet, because biliary atresia leads to a faster metabolism. The disease also prevents them from digesting fats and can lead to protein and vitamin deficiencies. Vitamin supplements may be recommended, along with adding mediumchain triglyceride oil to foods, liquids, and infant formula. The oil adds calories and is easier to digest without bile than other types of fats. If an infant or child is too sick to eat, a feeding tube may be recommended to provide highcalorie liquid meals. After a liver transplant, most infants and children can go back to their usual diet. Vitamin supplements may still be needed because the medications used to keep the body from rejecting the new liver can affect calcium and magnesium levels. |
What to do for Biliary Atresia ? | Biliary atresia is a lifethreatening condition in infants in which the bile ducts inside or outside the liver do not have normal openings. The first symptom of biliary atresia is jaundicewhen the skin and whites of the eyes turn yellow. Other symptoms include dark urine, gray or white stools, and slow weight gain and growth. Biliary atresia likely has multiple causes, though none is yet proven. No single test can definitively diagnose biliary atresia, so a series of tests is needed, including a blood test, abdominal x ray, ultrasound, liver scans, liver biopsy, and diagnostic surgery. Initial treatment for biliary atresia is usually the Kasai procedure, an operation where the bile ducts are removed and a loop of intestine is brought up to replace them. The definitive treatment for biliary atresia is liver transplant. After a liver transplant, a regimen of medications is used to prevent the immune system from rejecting the new liver. Health care providers may also prescribe blood pressure medications and antibiotics, along with special diets and vitamin supplements. |
What is (are) Proteinuria ? | Proteinuriaalso called albuminuria or urine albuminis a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body. As blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys' filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged. Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease. If CKD progresses, it can lead to endstage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular bloodcleansing treatments called dialysis. |
Who is at risk for Proteinuria? ? | People with diabetes, hypertension, or certain family backgrounds are at risk for proteinuria. In the United States, diabetes is the leading cause of ESRD.1 In both type 1 and type 2 diabetes, albumin in the urine is one of the first signs of deteriorating kidney function. As kidney function declines, the amount of albumin in the urine increases. Another risk factor for developing proteinuria is hypertension, or high blood pressure. Proteinuria in a person with high blood pressure is an indicator of declining kidney function. If the hypertension is not controlled, the person can progress to full kidney failure. African Americans are more likely than Caucasians to have high blood pressure and to develop kidney problems from it, even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertensionrelated kidney failure.2 Other groups at risk for proteinuria are American Indians, Hispanics/Latinos, Pacific Islander Americans, older adults, and overweight people. These atrisk groups and people who have a family history of kidney disease should have their urine tested regularly. |
What are the symptoms of Proteinuria ? | Proteinuria has no signs or symptoms in the early stages. Large amounts of protein in the urine may cause it to look foamy in the toilet. Also, because protein has left the body, the blood can no longer soak up enough fluid, so swelling in the hands, feet, abdomen, or face may occur. This swelling is called edema. These are signs of large protein loss and indicate that kidney disease has progressed. Laboratory testing is the only way to find out whether protein is in a persons urine before extensive kidney damage occurs. Several health organizations recommend regular urine checks for people at risk for CKD. A 1996 study sponsored by the National Institutes of Health determined that proteinuria is the best predictor of progressive kidney failure in people with type 2 diabetes. The American Diabetes Association recommends regular urine testing for proteinuria for people with type 1 or type 2 diabetes. The National Kidney Foundation recommends that routine checkups include testing for excess protein in the urine, especially for people in highrisk groups. |
How to diagnose Proteinuria ? | Until recently, an accurate protein measurement required a 24hour urine collection. In a 24hour collection, the patient urinates into a container, which is kept refrigerated between trips to the bathroom. The patient is instructed to begin collecting urine after the first trip to the bathroom in the morning. Every drop of urine for the rest of the day is to be collected in the container. The next morning, the patient adds the first urination after waking and the collection is complete. In recent years, researchers have found that a single urine sample can provide the needed information. In the newer technique, the amount of albumin in the urine sample is compared with the amount of creatinine, a waste product of normal muscle breakdown. The measurement is called a urine albumintocreatinine ratio (UACR). A urine sample containing more than 30 milligrams of albumin for each gram of creatinine (30 mg/g) is a warning that there may be a problem. If the laboratory test exceeds 30 mg/g, another UACR test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, the person has persistent proteinuria, a sign of declining kidney function, and should have additional tests to evaluate kidney function. |
How to diagnose Proteinuria ? | Tests that measure the amount of creatinine in the blood will show whether a persons kidneys are removing wastes efficiently. Having too much creatinine in the blood is a sign that a person has kidney damage. The doctor can use the creatinine measurement to estimate how efficiently the kidneys are filtering the blood. This calculation is called the estimated glomerular filtration rate, or eGFR. CKD is present when the eGFR is less than 60 milliliters per minute (mL/min). |
What to do for Proteinuria ? | Proteinuria is a condition in which urine contains a detectable amount of protein. Proteinuria is a sign of chronic kidney disease (CKD). Groups at risk for proteinuria include African Americans, American Indians, Hispanics/Latinos, Pacific Islander Americans, older people, overweight people, people with diabetes or hypertension, and people who have a family history of kidney disease. Proteinuria may have no signs or symptoms. Laboratory testing is the only way to find out whether protein is in a person's urine. Several health organizations recommend regular checks for proteinuria so kidney disease can be detected and treated before it progresses. A person with diabetes, hypertension, or both should work to control blood glucose and blood pressure. |
What is (are) Kidney Dysplasia ? | Kidney dysplasia is a condition in which the internal structures of one or both of a fetus kidneys do not develop normally while in the womb. During normal development, two thin tubes of muscle called ureters grow into the kidneys and branch out to form a network of tiny structures called tubules. The tubules collect urine as the fetus grows in the womb. In kidney dysplasia, the tubules fail to branch out completely. Urine that would normally flow through the tubules has nowhere to go. Urine collects inside the affected kidney and forms fluidfilled sacs called cysts. The cysts replace normal kidney tissue and prevent the kidney from functioning. Kidney dysplasia can affect one kidney or both kidneys. Babies with severe kidney dysplasia affecting both kidneys generally do not survive birth. Those who do survive may need the following early in life: bloodfiltering treatments called dialysis a kidney transplant Children with dysplasia in only one kidney have normal kidney function if the other kidney is unaffected. Those with mild dysplasia of both kidneys may not need dialysis or a kidney transplant for several years. Kidney dysplasia is also called renal dysplasia or multicystic dysplastic kidney. |
What is (are) Kidney Dysplasia ? | The kidneys are two beanshaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, which is composed of wastes and extra fluid. Children produce less urine than adultsthe amount they produce depends on their age. The urine flows from the kidneys to the bladder through the two ureters, one on each side of the bladder. The bladder stores urine. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. The kidneys, ureters, bladder, and urethra are parts of the urinary tract. More information is provided in the NIDDK health topics, the kidneys and the urinary tract. |
What causes Kidney Dysplasia ? | Genetic factors can cause kidney dysplasia. Genes pass information from both parents to the child and determine the childs traits. Sometimes, parents may pass a gene that has changed, or mutated, causing kidney dysplasia. Genetic syndromes that affect multiple body systems can also cause kidney dysplasia. A syndrome is a group of symptoms or conditions that may seem unrelated yet are thought to have the same genetic cause. A baby with kidney dysplasia due to a genetic syndrome might also have problems of the digestive tract, nervous system, heart and blood vessels, muscles and skeleton, or other parts of the urinary tract. A baby may also develop kidney dysplasia if his or her mother takes certain prescription medications during pregnancy, such as some used to treat seizures and high blood pressure. A mothers use of illegal drugs, such as cocaine, during pregnancy may also cause kidney dysplasia in her unborn child. |
How many people are affected by Kidney Dysplasia ? | Kidney dysplasia is a common condition. Scientists estimate that kidney dysplasia affects about one in 4,000 babies.1 This estimate may be low because some people with kidney dysplasia are never diagnosed with the condition. About half of the babies diagnosed with this condition have other urinary tract defects.2 |
What are the symptoms of Kidney Dysplasia ? | Many babies with kidney dysplasia in only one kidney have no signs of the condition. In some cases, the affected kidney may be enlarged at birth and may cause pain. |
What are the complications of Kidney Dysplasia ? | The complications of kidney dysplasia can include hydronephrosis of the working kidney. A baby with kidney dysplasia in only one kidney might have other urinary tract defects. When other defects in the urinary tract block the flow of urine, the urine backs up and causes the kidneys and ureters to swell, a condition called hydronephrosis. If left untreated, hydronephrosis can damage the working kidney and reduce its ability to filter blood. Kidney damage may lead to chronic kidney disease (CKD) and kidney failure. a urinary tract infection (UTI). A urine blockage may increase a babys chance of developing a UTI. Recurring UTIs can also lead to kidney damage. high blood pressure. a slightly increased chance of developing kidney cancer. More information is provided in the NIDDK health topics, urine blockage in newbornsand UTIs in children. |
How to diagnose Kidney Dysplasia ? | Health care providers may be able to diagnose kidney dysplasia during a womans pregnancy using a fetal ultrasound, also called a fetal sonogram. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. Fetal ultrasound is a test done during pregnancy to create images of the fetus in the womb. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and an obstetrician or a radiologist interprets the images. An obstetrician is a doctor who specializes in pregnancy and childbirth. A radiologist is a doctor who specializes in medical imaging. The patientin this case, the fetus motherdoes not need anesthesia for this procedure. The images can show defects in the fetus kidneys and other parts of the urinary tract. Health care providers do not always diagnose kidney dysplasia before a baby is born. After birth, health care providers often diagnose kidney dysplasia during an evaluation of the child for a UTI or another medical condition. A health care provider uses ultrasound to diagnose kidney dysplasia after the baby is born. |
What are the treatments for Kidney Dysplasia ? | If the condition is limited to one kidney and the baby has no signs of kidney dysplasia, no treatment may be necessary. However, the baby should have regular checkups that include checking blood pressure. testing blood to measure kidney function. testing urine for albumin, a protein most often found in blood. Albumin in the urine may be a sign of kidney damage. performing periodic ultrasounds to monitor the damaged kidney and to make sure the functioning kidney continues to grow and remains healthy. |
How to prevent Kidney Dysplasia ? | Researchers have not found a way to prevent kidney dysplasia caused by genetic factors or certain genetic syndromes. Pregnant women can prevent kidney dysplasia by avoiding the use of certain prescription medications or illegal drugs during pregnancy. Pregnant women should talk with their health care provider before taking any medications during pregnancy. |
What is the outlook for Kidney Dysplasia ? | The longterm outlook for a child with kidney dysplasia in only one kidney is generally good. A person with one working kidney, a condition called solitary kidney, can grow normally and may have few, if any, health problems. The affected kidney may shrink as the child grows. By age 10,3 the affected kidney may no longer be visible on xray or ultrasound. Children and adults with only one working kidney should have regular checkups to test for high blood pressure and kidney damage. A child with urinary tract problems that lead to failure of the working kidney may eventually need dialysis or a kidney transplant. More information is provided in the NIDDK health topics, solitary kidney, dialysis, and kidney transplants. |
What is the outlook for Kidney Dysplasia ? | The longterm outlook for a child with kidney dysplasia in both kidneys is different from the longterm outlook for a child with one dysplastic kidney. A child with kidney dysplasia in both kidneys is more likely to develop CKD. needs close followup with a pediatric nephrologista doctor who specializes in caring for children with kidney disease. Children who live in areas that dont have a pediatric nephrologist available can see a nephrologist who cares for both children and adults. may eventually need dialysis or a kidney transplant. |
What to do for Kidney Dysplasia ? | Researchers have not found that eating, diet, and nutrition play a role in causing or preventing kidney dysplasia. |
What to do for Kidney Dysplasia ? | Kidney dysplasia is a condition in which the internal structures of one or both of a fetus kidneys do not develop normally while in the womb. Genetic factors can cause kidney dysplasia. Genetic syndromes that affect multiple body systems can also cause kidney dysplasia. A baby may also develop kidney dysplasia if his or her mother takes certain prescription medications during pregnancy, such as some used to treat seizures and high blood pressure. Many babies with kidney dysplasia in only one kidney have no signs of the condition. Health care providers may be able to diagnose kidney dysplasia during a womans pregnancy using a fetal ultrasound, also called a fetal sonogram. Health care providers do not always diagnose kidney dysplasia before a baby is born. If the condition is limited to one kidney and the baby has no signs of kidney dysplasia, no treatment may be necessary. Researchers have not found a way to prevent kidney dysplasia caused by genetic factors or certain genetic syndromes. Pregnant women can prevent kidney dysplasia by avoiding the use of certain prescription medications or illegal drugs during pregnancy. The longterm outlook for a child with kidney dysplasia in only one kidney is generally good. The longterm outlook for a child with kidney dysplasia in both kidneys is different from the longterm outlook for a child with one dysplastic kidney. A child with kidney dysplasia in both kidneys is more likely to develop chronic kidney disease (CKD) needs close followup with a pediatric nephrologist may eventually need dialysis or a kidney transplant |
What is (are) Mineral and Bone Disorder in Chronic Kidney Disease ? | Mineral and bone disorder in CKD occurs when damaged kidneys and abnormal hormone levels cause calcium and phosphorus levels in a persons blood to be out of balance. Mineral and bone disorder commonly occurs in people with CKD and affects most people with kidney failure receiving dialysis. In the past, health care providers used the term renal osteodystrophy to describe mineral and hormone disturbances caused by kidney disease. Today, renal osteodystrophy only describes bone problems that result from mineral and bone disorder in CKD. Health care providers might use the phrase chronic kidney disease mineral and bone disorder, or CKDMBD, to describe the condition that affects the bones, heart, and blood vessels. |
What is (are) Mineral and Bone Disorder in Chronic Kidney Disease ? | Chronic kidney disease is kidney damage that occurs slowly over many years, often due to diabetes or high blood pressure. Once damaged, the kidneys cant filter blood as they should. This damage can cause wastes to build up in the body and other problems that can harm a persons health, including mineral and bone disorder. |
What causes Mineral and Bone Disorder in Chronic Kidney Disease ? | Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body. The kidneys stop activating calcitriol. The low levels of calcitriol in the body create an imbalance of calcium in the blood. do not remove the phosphorus in the blood properly, so phosphorus levels rise in the blood. The extra phosphorus pulls calcium out of the bones, causing them to weaken. Another factor contributes to the cause of mineral and bone disorder. When the kidneys are damaged, the parathyroid gland releases parathyroid hormone into the blood to pull calcium from the bones and raise blood calcium levels. This response restores the balance of phosphorus and calcium; however, it also starves the bones of muchneeded calcium. |
What are the symptoms of Mineral and Bone Disorder in Chronic Kidney Disease ? | In adults, symptoms of mineral and bone disorder in CKD may not appear until bone changes have taken place for many years. For this reason, people often refer to the disease as a silent crippler. Eventually, a person with the condition may begin to feel bone and joint pain. Mineral and Bone Disorder in Children with Chronic Kidney Disease Mineral and bone disorder in CKD is most serious when it occurs in children because their bones are still developing and growing. Growing children can show symptoms of mineral and bone disorder even in the early stages of CKD. Slowed bone growth leads to short stature, which may remain with a child into adulthood. One deformity caused by mineral and bone disorder in CKD occurs when the legs bend inward or outward, a condition often referred to as "renal rickets." More information is provided in the NIDDK health topic, Growth Failure in Children with Kidney Disease. Find more about childrens bone health on the Eunice Kennedy Shriver National Institute of Child Health and Human Development website at www.nichd.nih.gov. |
What are the complications of Mineral and Bone Disorder in Chronic Kidney Disease ? | The complications of mineral and bone disorder in CKD include slowed bone growth and deformities, and heart and blood vessel problems. Slowed Bone Growth and Deformities Damaged kidneys must work harder to clear phosphorus from the body. High levels of phosphorus cause lower levels of calcium in the blood, resulting in the following series of events: When a persons blood calcium level becomes too low, the parathyroid glands release parathyroid hormone. Parathyroid hormone removes calcium from bones and places it into the blood, raising a persons blood calcium level at the risk of harming bones. A low calcitriol level also leads to an increased level of parathyroid hormone. If mineral and bone disorder in CKD remains untreated in adults, bones gradually become thin and weak, and a person with the condition may begin to feel bone and joint pain. Mineral and bone disorder in CKD also increases a persons risk of bone fractures. Heart and Blood Vessel Problems In addition to harming bones, mineral and bone disorder in CKD can cause problems in the heart and blood vessels: High levels of blood calcium can damage blood vessels and lead to heart problems. High phosphorus levels also can cause blood vessels to become like bone, leading to hardening of the arteries. High phosphorus levels also cause abnormal hormone regulation, even if the calcium level is acceptable. Parathyroid hormone and another hormone made in the bones called FGF23 can also affect bone and heart health, leading to the following series of problems: When parathyroid hormone or FGF23 levels are high, a person can have heart problems. The complex hormone abnormalities that cause bone deformities can also harm a persons heart and blood vessels. |
How to diagnose Mineral and Bone Disorder in Chronic Kidney Disease ? | A health care provider diagnoses mineral and bone disorder in CKD with a family and medical history a physical exam a blood test a bone biopsy an xray Family and Medical History Taking a medical and family history is one of the first things a health care provider may do to help diagnose mineral and bone disorder in CKD. He or she will ask the patient or caretaker questions about when the patient was first diagnosed with CKD and whether any family members have also had mineral and bone disorder with or without CKD. Physical Exam A physical exam may help diagnose mineral and bone disorder in CKD. During a physical exam, a health care provider usually examines a patients body for changes in bone structure. Blood Test A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. The blood test shows levels of calcium, phosphorus, parathyroid hormone, and sometimes vitamin D. Bone Biopsy A bone biopsy is a procedure that removes a piece of bone tissue for examination with a microscope. A health care provider performs the biopsy in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the hip bone. A pathologista doctor who specializes in diagnosing diseasesexamines the bone tissue in a lab. The test can show whether a persons bone cells are building normal bone. 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. A radiographer performs the xray at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. Patients do not need anesthesia. The patient will lie on a table or stand during the xray. The technician will position the xray machine over the bone area. The patient will hold his or her breath as the xray machine takes the picture so that the picture will not be blurry. The radiographer may ask the patient to change position for additional pictures. An xray can show extra calcium in blood vessels. Each of these tests can help the health care provider determine whether CKD or some other condition is causing the mineral and bone disorder and decide on a course of treatment. |
What are the treatments for Mineral and Bone Disorder in Chronic Kidney Disease ? | Treating mineral and bone disorder in CKD includes preventing damage to bones by controlling parathyroid hormone levels through changes in eating, diet, and nutrition; medications and supplements; and dialysis. If these treatments do not bring parathyroid hormone levels under control, a health care provider may remove a persons parathyroid glands surgically, a procedure called a parathyroidectomy. Eating, Diet, and Nutrition Changes in diet can treat mineral and bone disorder in CKD. Reducing dietary intake of phosphorus is one of the most important steps in preventing bone disease. Most foods contain phosphorus; however, processed and packaged foods contain especially high levels of phosphorus. Food producers use phosphorus as an additive to preserve the food on the shelf. People who have CKD or are on dialysis should avoid packaged foods containing ingredients that include the letters PHOS. A renal dietitian can help develop a dietary plan to control phosphorus levels in the blood. Some drinks and natural foods also contain high amounts of phosphorus, including beer cheese cocoa dark sodas dried beans milk nuts peanut butter peas More information is provided in the NIDDK health topics, How To Read a Food Label: Tips for People with Chronic Kidney Disease and Phosphorus: Tips for People with Chronic Kidney Disease. Medications and Supplements Medications protect the bones by restoring the proper balance of minerals and hormones. If the kidneys do not make adequate amounts of calcitriol, a health care provider may prescribe synthetic calcitriol as a pill (Rocaltrol) or, for dialysis patients, in an injectable form (Calcijex). Calcitriol helps reduce parathyroid hormone levels. Medications called doxercalciferol (Hectorol) and paricalcitol (Zemplar) act like calcitriol because they are also activated forms of vitamin D. A health care provider may prescribe a calcium supplement in addition to calcitriol or another activated form of vitamin D. Certain forms of vitamin Davailable by prescription or as overthecounter vitamin supplementsrequire activation by a persons kidneys before they can act as calcitriol does. However, the benefits of some of these notyetactivated forms of vitamin Dfor example, ergocalciferol (Calciferol, Drisdol) or cholecalciferol (Delta D3)are unclear. To help ensure coordinated and safe care, people should discuss their use of alternative medications, including use of vitamin and mineral supplements, with their health care provider. Cinacalcet hydrochloride (Sensipar) belongs to another class of prescription medications called calcimimetics. Cinacalcet lowers parathyroid hormone levels by imitating calciums effects on the parathyroid gland. Generally, this medication is used only in people on dialysis. Often, health care providers will prescribe medications called phosphate binderssuch as calcium carbonate (Tums), calcium acetate (PhosLo), sevelamer carbonate (Renvela), or lanthanum carbonate (Fosrenol)to take with meals and snacks to bind phosphorus in the bowel. These medications decrease the absorption of phosphorus into the blood. Dialysis Dialysis is the process of filtering wastes and extra fluid from the body by means other than the kidneys. The two forms of dialysis are hemodialysis and peritoneal dialysis: Hemodialysis uses a machine to circulate a persons blood through a filter outside the body. The blood passes from a patients body through a needle, at nearly 1 pint per minute. The blood then travels through a tube that takes it to the filter, called a dialyzer. Inside the dialyzer, the blood flows through thin fibers that filter out wastes and extra fluid. After the machine filters the blood, it passes back to the body through another tube. More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Hemodialysis. Peritoneal dialysis uses the lining of the abdomen to filter a persons blood inside the body. A soft tube called a catheter is placed in the patients abdomen a few weeks before peritoneal dialysis begins. A person uses the catheter to fill the empty space inside the abdomen with dialysis solutiona kind of salty waterfrom a plastic bag. While inside the body, the dialysis solution absorbs wastes and extra fluid. After a few hours, the person drains the used dialysis solution into another bag for disposal. The person then restarts the process with a fresh bag of dialysis solution. More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Peritoneal Dialysis. Increasing a persons dialysis dose can help control the blood phosphorus level. In hemodialysis, the health care provider can adjust the dose by increasing how quickly the blood flows to and from the dialyzer. Another way to adjust the dose involves increasing the time of a persons dialysis session or the number of sessions. In peritoneal dialysis, using more dialysis solution in each fill or increasing the number of fills each day increases the dose. More information is provided in the NIDDK health topics: Hemodialysis Dose and Adequacy Peritoneal Dialysis Dose and Adequacy Parathyroidectomy If diet, medications, and dialysis cant control parathyroid hormone levels, a surgeon can remove one or more of the parathyroid glands. He or she performs the procedure using general anesthesia. A good treatment program, including a lowphosphorus diet, appropriate medications, adequate dialysis, and, if necessary, surgery, can improve the bodys ability to repair bones damaged by mineral and bone disorder in CKD. Overall, people can improve their bone health by exercising and not smoking. People should consult a health care provider before beginning any exercise program. |
What to do for Mineral and Bone Disorder in Chronic Kidney Disease ? | Mineral and bone disorder in chronic kidney disease (CKD) occurs when damaged kidneys and abnormal hormone levels cause calcium and phosphorus levels in a persons blood to be out of balance. Mineral and bone disorder commonly occurs in people with CKD and affects most people with kidney failure receiving dialysis. Chronic kidney disease is kidney damage that occurs slowly over many years, often due to diabetes or high blood pressure. Once damaged, the kidneys cant filter blood as they should. Hormones and minerals are important because they help bones stay strong. If a persons hormones and minerals are out of balance, his or her bones can become weak and malformed. Parathyroid hormone plays an important role in controlling calcium levels in the blood. When kidneys do not function properly, extra parathyroid hormone is released in the blood to move calcium from inside the bones into the blood. Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body. The kidneys stop activating calcitriol and do not remove the phosphorus in the blood properly. The complications of mineral and bone disorder in CKD include slowed bone growth and deformities, and heart and blood vessel problems. Treating mineral and bone disorder in CKD includes preventing damage to bones by controlling parathyroid hormone levels through changes in eating, diet, and nutrition; medications and supplements; and dialysis. Reducing dietary intake of phosphorus is one of the most important steps in preventing bone disease. If diet, medications, and dialysis cant control parathyroid hormone levels, a surgeon can remove one or more of the parathyroid glands. |
What is (are) Ectopic Kidney ? | An ectopic kidney is a birth defect in which a kidney is located below, above, or on the opposite side of its usual position. About one in 900 people has an ectopic kidney.1 |
What is (are) Ectopic Kidney ? | The kidneys are two beanshaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine a person produces each day. The urine flows to the bladder through tubes called ureters where it is stored until being released through urination. |
What causes Ectopic Kidney ? | During fetal development, a babys kidneys first appear as buds inside the pelvisthe bowlshaped bone that supports the spine and holds up the digestive, urinary, and reproductive organsnear the bladder. As the kidneys develop, they move gradually toward their usual position in the back near the rib cage. Sometimes, one of the kidneys remains in the pelvis or stops moving before it reaches its usual position. In other cases, the kidney moves higher than the usual position. Rarely does a child have two ectopic kidneys. Most kidneys move toward the rib cage, but one may cross over so that both kidneys are on the same side of the body. When a crossover occurs, the two kidneys often grow together and become fused. Factors that may lead to an ectopic kidney include poor development of a kidney bud a defect in the kidney tissue responsible for prompting the kidney to move to its usual position genetic abnormalities the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects |
What are the symptoms of Ectopic Kidney ? | An ectopic kidney may not cause any symptoms and may function normally, even though it is not in its usual position. Many people have an ectopic kidney and do not discover it until they have tests done for other reasons. Sometimes, a health care provider may discover an ectopic kidney after feeling a lump in the abdomen during an examination. In other cases, an ectopic kidney may cause abdominal pain or urinary problems. |