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### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : What is attention-deficit hyperactivity disorder (ADHD)?

Attention-deficit hyperactivity disorder (ADHD), usually first diagnosed in childhood, can appear in a variety of forms and has many possible causes. People with ADHD probably have an underlying genetic vulnerability to developing it, but the severity of the problem is also influenced by the environment. Conflict and stress tend to make it worse. The main features of this disorder are found in its name. Attention problems include daydreaming, difficulty focusing and being easily distracted. Hyperactivity refers to fidgeting or restlessness. A person with the disorder may be disruptive or impulsive, may have trouble in relationships and may be accident-prone. Hyperactivity and impulsiveness often improve as a person matures, but attention problems tend to last into adulthood. ADHD is the most common problem seen in outpatient child and adolescent mental health settings. It is estimated that ADHD affects more than 5% of children. Boys are diagnosed with ADHD about twice as much as girls. ADHD can continue into adulthood. The activity component is less apparent in adults, who tend to have problems with memory and concentration. They may have trouble staying organized and meeting commitments at work or at home. The consequence of poor functioning may be anxiety, low self-esteem, or mood problems. Some people turn to substances to manage these feelings.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Symptoms of attention-deficit hyperactivity disorder (ADHD)

The symptoms of ADHD — inattention, hyperactivity or impulsive behavior — often show up first at school. A teacher may report to parents that their child won't listen, is "hyper," or causes trouble and is disruptive. A child with ADHD often wants to be a good student, but the symptoms get in the way. Teachers, parents and friends may be unsympathetic, because they see the child's behavior as bad or odd. A high level of activity and occasional impulsiveness or inattentiveness is often normal in a child. But the hyperactivity of ADHD is typically more haphazard, poorly organized and has no real purpose. And in children with ADHD, these behaviors are frequent enough that the child has a harder than average time learning, getting along with others or staying reasonably safe. ADHD symptoms can vary widely. Here are common characteristics of the disorder in the two major groups (inattention and hyperactivity).

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Diagnosing attention-deficit hyperactivity disorder (ADHD)

There is no single test to diagnose ADHD. For a child, a pediatrician may make the diagnosis, or may make a referral to a specialist. Parents and teachers may be alert to the problem and may have the child evaluated. For adults, a mental health professional generally performs the evaluation. The clinician will ask about symptoms related to ADHD. Since, in children, many of these characteristics are seen in a school setting, the clinician will also ask about behavior in school. To help collect this information, the evaluator will often interview parents, teachers and other caregivers or ask them to fill out special behavioral checklists. Since other conditions may cause the symptoms of ADHD, the medical history and physical examination are important. For example, the doctor may look for trouble hearing or vision, learning disabilities, speech problems, seizure disorders, anxiety, depression, or other behavior problems. In some cases, other medical or psychological testing may be useful to check for one or more of these conditions. These tests can sometimes help clinicians and teachers develop practical suggestions.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Expected duration of attention-deficit hyperactivity disorder (ADHD)

In most children with ADHD, symptoms begin before age 12 and last through adolescence. Symptoms of ADHD may continue into adulthood.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Risk factors and preventing attention-deficit hyperactivity disorder (ADHD)

The causes of ADHD are not fully understood. There are numerous factors that are associated with the development of ADHD. It may be difficult to avoid these factors, but addressing them may reduce the risk of developing the disorder.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Treating attention-deficit hyperactivity disorder (ADHD)

Although no treatment eliminates ADHD completely, many helpful options are available. The goal of treatment is to help children improve social relationships, do better in school, and keep their disruptive or harmful behaviors to a minimum. Medication can be very helpful, and it is often necessary. Drug treatment by itself is rarely the answer. Medication and psychotherapy together usually have the best results. For example, a behavioral program may be put in place where structured, realistic expectations are set. Stimulants, such as methylphenidate (Ritalin) and forms of amphetamine (Dexedrine), have been used for many decades. They are relatively safe and effective for most children to help them focus their thoughts and control their behavior. Long-acting forms of stimulants are usually preferred for children, because one dose in the morning can provide a day-long effect. Despite their name, stimulants do not cause increased hyperactivity or impulsivity. If the disorder has been properly diagnosed, the medication should have the opposite effect. Common mild side effects are decreased appetite, weight loss, stomachaches, sleep problems, headaches and jitteriness. Adjusting the dose can often help eliminate these problems. Stimulant drugs are associated with some serious concerns and side effects.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : When to call a professional

Call your doctor if your child shows symptoms of ADHD, or if teachers notify you that your child is having academic difficulties, behavioral problems or difficulty paying attention.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Prognosis

ADHD can cause significant emotional, social and educational problems. However, when ADHD is diagnosed early and treated properly, the condition can be managed effectively, so children can grow up to have productive, successful and fulfilling lives. Although some children appear to grow out of their ADHD as they reach their adolescent years, others have lifelong symptoms.

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : Additional info

American Academy of Child and Adolescent Psychiatry (AACAP) https://www.aacap.org/

### Instruction: Disease name: Attention-deficit hyperactivity disorder (ADHD) : About the Reviewer

### Instruction: Disease name: Autism (Autism Spectrum Disorder) : What is autism (Autism Spectrum Disorder)?

Autism is a developmental disorder of the brain. People with autism have problems communicating and interacting socially. They also may have unusual patterns of behavior, interests and activities. Doctors use the term autism spectrum disorder (ASD). In the past, there were different kinds of autism disorders, but in 2013 the criteria for autism were updated to include all of them under a single diagnosis. The criteria for a diagnosis of autism include:

### Instruction: Disease name: Back pain : What is back pain?

Back pain can be a symptom of many different illnesses and conditions. The main cause of the pain can be a problem with the back itself or by a problem in another part of the body. In many cases, doctors can't find a cause for the pain. When a cause is found, common explanations include:

### Instruction: Disease name: Back pain : Symptoms of back pain

Back pain varies widely. Some symptoms (often called "red flag" symptoms) may suggest that the back pain has a more serious cause. These include fever, recent trauma, weight loss, a history of cancer and neurological symptoms, such as numbness, weakness or incontinence (involuntary loss of urine or stool). Back pain is often accompanied by other symptoms that may help point to its cause. For example:

### Instruction: Disease name: Back pain : Diagnosing back pain

Your doctor will ask about your symptoms and your medical history. He or she will examine your back muscles and spine and will move you certain ways to check for pain, muscle tenderness or weakness, stiffness, numbness or abnormal reflexes. For example, if you have a disk problem, you may have pain in your lower back when the doctor raises your straightened leg. Your symptoms and the physical examination may give your doctor enough information to diagnose the problem. However, with back pain, your doctor may only be able to tell you that the problem is not serious. If your doctor determines that your back pain is caused by muscle strain, obesity, pregnancy or another cause that is not urgent, you may not need any additional tests. However, if he or she suspects a more serious problem involving your vertebrae or spinal nerves, especially if your back pain has lasted longer than 12 weeks, you may need one or more of the following tests:

### Instruction: Disease name: Back pain : Expected duration of back pain

How long back pain lasts depends on its cause. For example, if your pain is caused by strain from overexertion, symptoms usually subside over days or weeks and you may be able to return gradually to your normal activities. However, you should avoid heavy lifting, prolonged sitting or sudden bending or twisting until your back gets better. Women who have back pain caused by the added weight of pregnancy almost always will get better after delivery. People who are obese may need to lose weight before back pain eases. People with back pain caused by pyelonephritis often begin to feel better within days after they start taking antibiotics, although they usually need to continue taking antibiotics for up to two weeks. People with more serious forms of back pain caused by problems with the vertebrae or spinal nerves may have more persistent back pain that lasts for months and may last for years.

### Instruction: Disease name: Back pain : Preventing back pain

You can help prevent some forms of back pain by strengthening your back with exercises and by avoiding activities that lead to back injury. Measures that may help prevent back pain include:

### Instruction: Disease name: Back pain : Treating back pain

Most episodes of back pain are not serious and may be treated with:

### Instruction: Disease name: Back pain : When to call a professional

Contact your doctor if:

### Instruction: Disease name: Back pain : Prognosis

More than 90% of people with back pain get better after conservative treatment. Only 5% of people with back pain will have symptoms for more than 12 weeks and even among these people, the cause is usually not serious.

### Instruction: Disease name: Back pain : Additional info

American College of Rheumatology http://www.rheumatology.org/ Arthritis Foundation http://www.arthritis.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

### Instruction: Disease name: Back pain : About the Reviewer

### Instruction: Disease name: Bacterial vaginosis (Gardnerella vaginitis) : What is it?

Bacterial vaginosis is the most common cause of abnormal vaginal odor and discharge. It is caused by a change in the type of bacteria found in the vagina. Normally, bacteria belonging mostly to the Lactobacillus family live harmlessly in the vagina and produce chemicals that keep the vagina mildly acidic. In bacterial vaginosis, Lactobacillus bacteria are replaced by other types of bacteria that normally are present in smaller concentrations in the vagina. Bacterial vaginosis often occurs during pregnancy. It may cause premature labor and delivery, premature rupture of membranes, and postpartum uterine infections. This is why pregnant women with a history of premature labor or other complications may be checked for bacterial vaginosis even when they don't have any symptoms.

### Instruction: Disease name: Balanitis : What is balanitis?

Balanitis is an infection or inflammation of the skin on the head (glans) of the penis. In men who are not circumcised, this area is covered by a flap of skin known as the foreskin, or prepuce. Balanitis can occur in both circumcised and uncircumcised men, although it occurs more commonly in men who are not circumcised. Young boys generally are affected only if they have a very tight foreskin that is difficult to pull back. A variety of infections and skin conditions can cause balanitis. These include:

### Instruction: Disease name: Balanitis : Symptoms of balanitis

Symptoms include:

### Instruction: Disease name: Balanitis : Diagnosing balanitis

Your doctor usually can recognize balanitis immediately. Occasionally, a swab or scraping of skin may be examined under the microscope, or may be sent to the laboratory for further testing to confirm the diagnosis. When balanitis does not respond to treatment or appears different from a typical infection, your doctor may recommend that you see a dermatologist (skin specialist) or that a skin biopsy be done. In a biopsy, a small piece of skin is removed and examined in the laboratory. This is done to determine if you have an unusual type of infection or other type of skin condition that is causing your symptoms.

### Instruction: Disease name: Balanitis : Expected duration of balanitis

Most cases of balanitis respond to treatment within three to five days.

### Instruction: Disease name: Balanitis : Preventing balanitis

Men who are uncircumcised should practice good hygiene, including fully retracting the foreskin during bathing. People with diabetes can help to prevent balanitis by carefully controlling their blood sugar.

### Instruction: Disease name: Balanitis : Treating balanitis

Treatment depends on the cause. If your problem is caused by a yeast infection, you will be advised to use an antifungal cream. Clotrimazole (Lotrimin, Mycelex) is a very effective over-the-counter medication, which is also used for treating vaginal yeast infections and athlete's foot. Apply it to the affected area two to three times daily for 10 days. Your doctor also may recommend a prescription antifungal treatment, either in a cream or pill form. If you have an infection with skin bacteria, you will be told to use an antibiotic cream, and to make sure you clean the area thoroughly. Occasionally antibiotic pills may be necessary. When the skin is inflamed, but not infected, you will be advised to keep the area clean and dry and to avoid any soaps or skin lotions that may be aggravating the condition. Sometimes a cortisone cream can help to improve the problem more quickly. However, cortisone can make certain infections worse, so it is best to avoid this type of medication unless it is prescribed by a physician. Once effective treatment begins, you usually do not need to avoid sex, although sexual contact can chafe or inflame the affected area. Rarely, sexual contact can pass an infection back and forth between partners. If this occurs, both partners may require treatment at the same time to prevent further episodes. In uncircumcised men, circumcision often prevents repeated infections, especially in men who have a tight, difficult-to-retract foreskin.

### Instruction: Disease name: Balanitis : When to call a professional

Contact your physician if:

### Instruction: Disease name: Balanitis : Prognosis

The outlook is excellent if the problem is treated.

### Instruction: Disease name: Balanitis : Additional info

National Library of Medicine (NLM) https://www.nlm.nih.gov/ American Urological Association https://www.urologyhealth.org/

### Instruction: Disease name: Balanitis : About the Reviewer

### Instruction: Disease name: Barium enema : What is a barium enema?

A barium enema is a procedure used to examine the lining of the colon and rectum. The procedure is also called a lower gastrointestinal series. Barium refers to barium sulfate, a chalky chemical that appears white on X-ray film. Enema refers to any fluid pumped into the rectum through the anus. After the barium sulfate liquid makes its way to your intestines, a series of X-ray pictures are taken. In these X-rays, the white barium fluid allows some abnormalities in the lining of the intestines to appear dark. Air may be pumped into the intestine during this procedure to help sharpen the outline of the intestinal wall.

### Instruction: Disease name: Barium enema : What a barium enema is used for

Barium enema is sometimes used to check for tumors of the colon and rectum. It also can check for polyps (abnormal growths attached to the intestinal lining by a stalk), diverticulosis or other problems. It is rarely ordered today because other tests, such as colonoscopy and virtual colonoscopy (a type of contrast enema using a CT scanner), provide much better detail.

### Instruction: Disease name: Barium enema : Preparing for a barium enema

Your colon and rectum need to be empty for the procedure. Your doctor will give you instructions about using laxatives and/or enemas before the procedure. Your doctor will also tell you when to stop eating and what you can drink.

### Instruction: Disease name: Barium enema : How a barium enema is done

You will remove your clothing and put on a hospital gown. You will lie on your side on an X-ray table. A tube will be inserted into your rectum and you will be given an enema of barium fluid. As the fluid flows into your intestines, you may feel a little discomfort, pressure or the urge to move your bowels. While you hold the fluid inside your bowels, the X-ray technician will take a series of pictures. To allow the barium fluid to flow into different parts of your bowels, you will change position on the table, and the table itself may be rotated. Once the X-rays are complete, you will go to a nearby bathroom (or be given a bedpan) to pass the barium fluid from your bowels. You will then have a second series of X-rays. This time, air is gently pumped into your rectum. This air, together with the thin film of barium fluid still in your intestines, will help to enhance the images of your intestinal lining.

### Instruction: Disease name: Barium enema : Follow-up of a barium enema

A radiologist will examine your X-rays and give the results to your doctor. Your doctor can then share the results with you. To help clear the remaining barium fluid from your bowel, your doctor will give you instructions about drinking water, taking laxatives or using an enema at home. For a few days, while the barium clears, you will notice that your stools are an unusually light color.

### Instruction: Disease name: Barium enema : Risks of a barium enema

Barium enema is a safe X-ray examination. There is a small risk of your intestines becoming blocked if the barium fluid does not clear from your bowel. This can be prevented by following your doctor's directions for cleansing the bowel after the procedure.

### Instruction: Disease name: Barium enema : When to call a professional

Call your doctor if you have abdominal or rectal pain, nausea, vomiting or blood in your stool after your barium enema. Call your doctor if your stools do not return to a normal color, if you have trouble moving your bowels, or if your stools become very narrow (as thin as a pencil).

### Instruction: Disease name: Barium enema : Additional info

American College of Gastroenterology (ACG) http://www.gi.org/ American Gastroenterological Association http://www.gastro.org/

### Instruction: Disease name: Barium enema : About the Reviewer

### Instruction: Disease name: Barotrauma : What is barotrauma?

Barotrauma refers to injuries caused by increased air or water pressure, such as during airplane flights or scuba diving. Barotrauma of the ear is common. Generalized barotraumas, also called decompression sickness, affects the entire body.  Your middle ear includes the eardrum and the space behind it. The only connection between your middle ear and the "outside world" is a thin canal called the Eustachian tube. This connects your ear with the back of your mouth. When you swallow, you may notice a small click in your ears. This is a bubble of air being moved through the Eustachian tube. These bubbles are constantly moving into the middle ear, where they balance the ear's inner pressure. Ear barotrauma can occur when these tubes become blocked or partially blocked.  On an airplane, barotrauma to the ear – also called aero-otitis or barotitis – can happen as the plane descends for landing. Barotrauma of the ear also can happen when scuba divers descend. The pressure change can create a vacuum in the middle ear that pulls the eardrum inward. This can cause pain and can muffle sounds. Your ear will feel stuffed and you may feel as if you need to "pop" it.   In more severe cases of barotrauma, the middle ear can fill with clear fluid as the body tries to equalize the pressure on both sides of the eardrum. This fluid is drawn out of blood vessels in the lining of the inner ear, and can only drain if the Eustachian tube is open. Fluid behind the eardrum is called serous otitis media. It can create pain and hearing difficulty similar to a middle ear infection.

### Instruction: Disease name: Barotrauma : Symptoms of barotrauma

Common symptoms of ear barotrauma include:

### Instruction: Disease name: Barotrauma : Diagnosing barotrauma

You can diagnose a mild case of ear barotrauma yourself, and you do not need to see a doctor. If you are uncertain about your symptoms or if your symptoms last a long time, a doctor can examine your middle ear with a lighted magnifying tool called an otoscope to see if the eardrum is pulled inward. Clear fluid behind the eardrum sometimes can be difficult to see. If a collection of fluid is not visible, your doctor may squeeze a puff of air into your ear canal. If the eardrum does not move well, you probably have fluid behind the eardrum. A perforated eardrum can be diagnosed by looking at the ear with an otoscope.

### Instruction: Disease name: Barotrauma : Expected duration of barotrauma

Symptoms usually occur only during the change in pressure, and perhaps for a short time afterward. More severe cases, including serous otitis media, can last longer, perhaps weeks or months. Perforations of the eardrum often heal on their own, but this can take weeks. You may not be able to hear as well until the ear is fully healed. If your perforation has not healed after two months, you may need surgery to prevent permanent hearing loss.

### Instruction: Disease name: Barotrauma : Preventing barotrauma

To prevent barotrauma, your Eustachian tubes must stay open. If you have a cold, ear infection or allergy, you may want to reschedule airplane travel until you are better. If you or your child must fly with a cold, infection or allergy, take a decongestant about one hour before your flight. Continue taking the medication during the flight according to the package directions. You also can use a decongestant nasal spray. Antihistamines may also be helpful. Ear plugs have been developed that can slow down the pressure change that affects the ear. These might give your ears some additional time to adjust to pressure changes. These plugs can be used for air travel but they are not useful for diving.   During a flight, make sure you are awake for the landing so you can "pop" your ears if necessary. (If you ask, a flight attendant will wake you.) Infants should be kept awake during a flight's descent and can be given a bottle or pacifier to suck on to help keep their Eustachian tubes open. Keep the child upright as the plane descends.

### Instruction: Disease name: Barotrauma : Treating barotrauma

If you experience the symptoms of barotrauma during a flight, there are several things you can do:

### Instruction: Disease name: Barotrauma : When to call a professional

If you experience dizziness that includes a feeling of spinning or falling (vertigo) and your symptoms occur right after flying or diving, you need to be evaluated by a doctor immediately because there is a small chance you may need emergency ear surgery. If you have severe pain, bleeding or drainage of fluid from your ears, see a doctor within several days because you may have a ruptured eardrum. If you have mild ear pain or hearing difficulty that continues after flying or diving, you should see a doctor for help if your symptoms are slow to go away.

### Instruction: Disease name: Barotrauma : Prognosis

Most cases of barotrauma get better quickly without complications.

### Instruction: Disease name: Barotrauma : Additional info

American Academy of Otolaryngology Head and Neck Surgery http://www.entnet.org/

### Instruction: Disease name: Bartholin's Gland Cyst : What are Bartholin's gland cysts?

A cyst is a sac filled with liquid or semisolid material that forms under the skin or somewhere inside the body. The Bartholin's gland is one of two small glands on each side of the labia minora, just outside of the opening to the vagina. During sexual arousal, the Bartholin's gland releases a lubricating fluid. A Bartholin's gland cyst develops when the gland becomes blocked. The Bartholin's gland can become blocked for a variety of reasons, such as infection, inflammation or long-term irritation.

### Instruction: Disease name: Bartholin's Gland Cyst : Symptoms of Bartholin's gland cysts

Many Bartholin's gland cysts don't cause any symptoms. They usually are discovered when a woman notices a small, painless mass just outside the opening to the vagina, or when a physician notices it during a routine pelvic examination. However, if the cyst grows larger than 1 inch in diameter, it can cause discomfort when sitting, or during intercourse. If a cyst becomes infected, it fills with pus, and becomes firm, swollen, and very painful, making it difficult for a woman to sit, walk or have intercourse. The pus-filled cyst is called an abscess.

### Instruction: Disease name: Basal cell carcinoma : What is basal cell carcinoma?

Basal cell cancer is the most common form of skin cancer diagnosed in the United States. Basal cells are small, round skin cells normally found in the upper part of your skin. When these cells become cancerous, they usually turn into small skin tumors that can destroy skin and nearby tissues. They can grow large over time, causing damage around and under them. Basal cell tumors rarely spread beyond the original cancer site. Basal cell cancer can grow on any part of the body. However, most basal cell cancers are found on some part of the face. This can cause disfigurement, and can interfere with the function of the eyelids, nose, and mouth.

### Instruction: Disease name: Basal cell carcinoma : Symptoms of basal cell carcinoma

Basal cell skin cancer usually appears as a tiny, painless bump with a pink, pearly surface. As the cancer slowly grows, the center of the bump may become sore and develop into a crater that bleeds, crusts, or forms a scab.

### Instruction: Disease name: Basal cell carcinoma : Diagnosing basal cell carcinoma

Your doctor will examine your skin. He or she will do a biopsy, which involves removing skin so it can be examined in a laboratory. The doctor may remove some, or all, of the abnormal skin for the biopsy.

### Instruction: Disease name: Basal cell carcinoma : Expected duration of basal cell carcinoma

Once a basal cell cancer develops on the skin, it usually grows slowly. It can become very large, especially if it is on your lower back, the back of your shoulder or some other area that you do not usually see in the mirror.

### Instruction: Disease name: Basal cell carcinoma : Preventing basal cell carcinoma

Unprotected exposure to sunlight increases your risk of developing basal cell cancer. You can help to reduce this risk in several ways:

### Instruction: Disease name: Basal cell carcinoma : Treating basal cell carcinoma

Determining the right treatment depends on many factors, including:

### Instruction: Disease name: Basal cell carcinoma : When to call a professional

Call your doctor or a dermatologist (a doctor who specializes in skin problems) if you notice:

### Instruction: Disease name: Basal cell carcinoma : Prognosis

The outlook is usually excellent. Most basal cell cancers are cured if they are treated early.

### Instruction: Disease name: Basal cell carcinoma : Additional info

National Cancer Institute (NCI) https://www.cancer.gov/ American Cancer Society (ACS) https://www.cancer.org/ American Academy of Dermatology https://www.aad.org/ The Skin Cancer Foundation https://www.skincancer.org/

### Instruction: Disease name: Basal cell carcinoma : About the Reviewer

### Instruction: Disease name: Bedsores (decubitus ulcers) : What is a bedsore (decubitus ulcer)?

Bedsores, also called pressure ulcers or decubitus ulcers, are areas of broken skin that can develop in people who:

### Instruction: Disease name: Bedsores (decubitus ulcers) : Symptoms of a bedsore

Bedsores are classified into stages, depending on the severity of skin damage:

### Instruction: Disease name: Bedsores (decubitus ulcers) : Diagnosing a bedsore

A doctor or nurse can diagnose a bedsore by examining the skin. Testing is usually unnecessary unless there are symptoms of infection. If a person with bedsores develops an infection, a doctor may order tests to find out if the infection has moved into the soft tissues, into bones, into the bloodstream or to another site. Tests may include blood tests, a laboratory examination of tissue or secretions from the bedsore, and an x-ray, a magnetic resonance imaging scan (MRI scan) or a bone scan to look for evidence of a bone infection called osteomyelitis. If you care for a family member who is in a bed or wheelchair, your doctor or home care nurse can teach you how to identify the earliest signs of bedsores. You'll learn which areas of skin are particularly vulnerable and what to look for. When you find signs of skin damage, you can take steps to prevent areas of redness from becoming full-blown ulcers.

### Instruction: Disease name: Bedsores (decubitus ulcers) : Expected duration of a bedsore

Many factors influence how long a bedsore lasts, including the severity of the sore and the type of treatment, as well as the person's age, overall health, nutrition and ability to move. For example, there is a good chance that a Stage II bedsore will heal within one to six weeks in a relatively healthy older person who eats well and is able to move. Stage III and Stage IV ulcers can take longer than six months to heal. Some never heal. Bedsores can be an ongoing problem in chronically ill people who have multiple risk factors, such as incontinence, the inability to move and circulatory problems.

### Instruction: Disease name: Bedsores (decubitus ulcers) : Preventing a bedsore

Bedsores can still form even if a patient is receiving excellent medical care or household care — they are not necessarily a sign of neglected needs. To help prevent bedsores in a person who is confined to a bed or chair, the plan of care includes these strategies:

### Instruction: Disease name: Bedsores (decubitus ulcers) : Treating a bedsore

If you care for someone with bedsores, your doctor or home care nurse may ask you to help with the treatment by following preventive steps that should stop further damage to vulnerable skin and increase the chances of healing. Additional treatments, usually done by health care professionals, depend on the stage of the bedsore. First, areas of unbroken skin near the bedsore are covered with a protective film or a lubricant to protect them from injury. Next, special dressings are applied to the injured area to promote healing or to help remove small areas of dead tissue. If necessary, larger areas of dead tissue may be trimmed away surgically or dissolved with a special medication. Deep craters may need skin grafting and other forms of reconstructive surgery. If the person's skin shows any signs of possible infection, the doctor may prescribe antibiotics, which may be applied as an ointment, taken as a pill or given intravenously (into a vein).

### Instruction: Disease name: Bedsores (decubitus ulcers) : When to call a professional

If you find a suspicious area of redness or blistering on a person you are caring for, contact the person's nurse or doctor promptly.

### Instruction: Disease name: Bedsores (decubitus ulcers) : Prognosis

In many cases, the outlook for bedsores is good. Simple bedside treatments can heal most stage II bedsores within a few weeks. If conservative methods fail to heal a stage III or stage IV bedsore, reconstructive surgery often can repair the damaged area.

### Instruction: Disease name: Bedsores (decubitus ulcers) : Additional info

National Institute of Arthritis and Musculoskeletal and Skin Diseases https://www.niams.nih.gov/ National Institute on Aging https://www.nia.nih.gov/ American Academy of Dermatology https://www.aad.org/

### Instruction: Disease name: Bedsores (decubitus ulcers) : About the Reviewer

### Instruction: Disease name: Bedwetting (Enuresis) : What is bedwetting (enuresis)?

Bedwetting, also called nocturnal enuresis, means that a child accidentally passes urine at night during sleep. Because this is normal in infants and very young children, bedwetting is not considered a medical problem unless it happens in a child who is already in elementary school or who was completely dry day and night and then began to wet the bed again during the night.   By age 5, 80% to 85% of children are consistently dry throughout the night. After age 5, the number of children who continue to wet the bed decreases by about 15% per year, even without treatment. Only 1% of children still wet the bed by the time they are 15 years old.  To help make diagnosis and treatment easier, doctors sometimes classify bedwetting into two types, primary and secondary nocturnal enuresis. In primary nocturnal enuresis, the child has never been consistently dry at night. In secondary nocturnal enuresis, the child has been dry at night for at least three to six months (or one year, according to some experts) and has begun to wet the bed again. It is very important to remember that in both types, the child is not wetting the bed on purpose.   Primary Nocturnal Enuresis This is the most common type of nocturnal enuresis, pediatricians think is caused by several developmental, genetic and hormonal factors acting together.

### Instruction: Disease name: Bedwetting (Enuresis) : Symptoms of bedwetting

In most children with bedwetting, soaked sheets and wet pajamas are all that parents will see. In rare cases caused by a medical illness, such as urinary tract infection or diabetes, there may be other symptoms. It is especially important to watch for such symptoms in an older child who starts wetting the bed after having been dry in the past:

### Instruction: Disease name: Bedwetting (Enuresis) : Diagnosing bedwetting

The doctor will ask about any family history of bedwetting. If one or both parents were affected during childhood, the doctor will want to know the age when a parent's bedwetting stopped. In many cases, a child's bedwetting will stop around the same age.  The doctor will ask about your child's eating and drinking habits, especially about drinking right before bedtime and eating snacks that melt into liquids, such as ice cream or gelatin desserts. In a child who has been dry in the past, your doctor will want to know about any unusual stresses, either at home or at school, that might be triggering the bedwetting.  To rule out medical illnesses and conditions as a cause of your child's bedwetting, the doctor will ask about additional symptoms related to a urinary tract infection or diabetes. The doctor will ask whether there is anything unusual about the way your child urinates, including straining during urination or changes in his or her urine stream.   The doctor will examine your child, paying special attention to your child's belly (abdomen), genital area and lower spine, looking for any physical changes in these areas. The doctor will order a test of your child's urine (urinalysis) to look for signs of a urinary tract infection or diabetes. In most cases, your doctor can make a correct diagnosis based on your child's age, the history of bedwetting, any additional symptoms, and the results of the physical examination and urine test.  If your child has symptoms that suggest a urinary tract infection, diabetes or other problems, additional tests may be needed. Children with primary nocturnal enuresis do not routinely need X-rays or other tests that measure bladder size, shape or function.

### Instruction: Disease name: Bedwetting (Enuresis) : Expected duration of bedwetting

Almost all children stop wetting the bed by the time they reach their mid-teens, even without treatment. By age 15, only one out of 100 children is not completely dry at night.

### Instruction: Disease name: Bedwetting (Enuresis) : Preventing bedwetting

To help your child achieve his or her first dry night, try these suggestions:

### Instruction: Disease name: Bedwetting (Enuresis) : Treating bedwetting

When bedwetting is caused by a medical problem, treatment depends on the specific diagnosis.  If your child has no specific medical problem causing him or her to wet the bed, but has never been dry at night, there are several treatment options:

### Instruction: Disease name: Bedwetting (Enuresis) : When to call a professional

Call your doctor immediately if your child starts wetting the bed after being dry for several months or if your child has symptoms of a urinary tract infection or diabetes.   Call your doctor to discuss whether treatment would be recommended for your child who has never been dry at night and has started elementary school.

### Instruction: Disease name: Bedwetting (Enuresis) : Prognosis

Because almost all children eventually outgrow bedwetting, the outlook is excellent, even without treatment.  With treatment, the success rate depends on the type of therapy. Motivational therapy succeeds in about 25% of children, behavioral therapy in about 70%, and bladder training in about 66%. The success rate of the drug, desmopressin acetate, may be as high as 70%, but varies widely in research studies.

### Instruction: Disease name: Bedwetting (Enuresis) : Additional info

National Institute of Diabetes & Digestive & Kidney Disorders https://www.niddk.nih.gov/ American Academy of Family Physicians (AAFP) https://www.familydoctor.org/ American Academy of Pediatrics (AAP) https://www.aap.org/

### Instruction: Disease name: Behcet's Disease : What is Behcet's disease?

Behçet's (bay-setz) syndrome is a rare disease that causes inflammation of many parts of the body. These include the skin of the genital area, lining of the mouth, eye, nervous system, joints and blood vessels. The most characteristic problems include ulcers in the mouth and genital areas, and serious eye inflammation. It is also called Behçet's syndrome. The exact cause of the disease remains unclear. But Behçet's disease is thought to involve an autoimmune response. This means the body's defense mechanism begins to attack its own tissues. Something in the environment may trigger this abnormal immune response in susceptible individuals. Genetic factors may also play a role.

### Instruction: Disease name: Bell's palsy : What is Bell's palsy?

Bell's palsy is a weakness of the muscles on one side of the face caused by problems with a facial nerve. The nerve becomes inflamed and swollen and stops functioning properly. There are two facial nerves, one for the right side of the face and one for the left. Each has several branches. The main branch controls most of the muscles on one side of the face, including the muscles that control facial expression and the muscles that close and open the eyes and the lips. Other smaller branches go to the tongue and ear.

### Instruction: Disease name: Bell's palsy : Symptoms of Bell's palsy

Usually, symptoms of Bell's palsy begin gradually and peak in 48 hours. Early symptoms include changed sensation in a portion of the face, pain in or around the ear, increased or decreased hearing, and impaired taste. As the condition progresses, a person typically has trouble closing his or her mouth and eye on one side of the face and may complain of being unable to hold food in the mouth. The eyes also may tear more or less than usual.

### Instruction: Disease name: Bell's palsy : Diagnosing Bell's palsy

Doctors usually can diagnose Bell's palsy based on a physical examination. Your doctor will test for weakness in the muscles of the face, paying special attention to your ability to close both eyes and hold them closed. He or she also will ask you to smile or whistle to look for a difference on the two sides of your face. Your doctor will ask whether you are having any symptoms of numbness or weakness in other body parts or difficulty walking. These symptoms are not associated with Bell's palsy, but this will help to rule out other causes of facial weakness. Your doctor will look for a shingles like rash on your face and ear. If you have this rash, especially if it is painful, your doctor will diagnose Ramsay-Hunt syndrome caused by reactivation of the herpes zoster virus. If there are no other symptoms, and the only problem is weakness in facial muscles, your doctor can diagnose Bell's palsy without further testing. A blood sugar test may be ordered if you have not had one recently, because people with diabetes are more likely to get Bell's palsy. A blood test for Lyme disease also may be done.

### Instruction: Disease name: Bell's palsy : Expected duration of Bell's palsy

Most people's symptoms peak at 48 hours, start to improve by 2 weeks, and they are back to normal by 6 months. In some cases, the symptoms do not go away completely and there is some permanent facial weakness.

### Instruction: Disease name: Bell's palsy : Preventing Bell's palsy

There is no way to prevent Bell's palsy.

### Instruction: Disease name: Bell's palsy : Treating Bell's palsy

If the symptoms are very mild, treatment may not be necessary. Most commonly, people with Bell's palsy are prescribed prednisone (Deltasone, Orasone and others), a corticosteroid, to reduce the inflammation and swelling in the nerve. Some doctors prescribe a combination of prednisone and an anti-herpes virus drug, such as valacyclovir (Valtrex) for 7 days. If the Bell's palsy is part of the Ramsay-Hunt syndrome, treatment should always include anti-herpes drug, usually valacyclovir, along with prednisone. Bell's palsy related to Lyme disease is treated with antibiotics active against the bacteria that cause Lyme disease. If Bell's palsy is affecting your ability to close your eyes, your cornea can become dry and possibly get scratched. To prevent this, you must protect your eyes from wind and dust by wearing glasses. You will need to keep your eyes moist by using artificial tears frequently during the day and lubricating your eyes at night with a sterile eye ointment.

### Instruction: Disease name: Bell's palsy : When to call a professional

Call your doctor immediately at the first sign of decreased strength in your face, difficulty eating or drinking, or a droopy eyelid. Also call your doctor if your ear suddenly hurts, especially if you see blisters around your ear or inside your ear canal. If you have been diagnosed with Bell's palsy, call your doctor immediately if your eye starts hurting or feels irritated. Call if your arms or legs feel weak, your vision changes, you get dizzy, have trouble swallowing, or get a headache that keeps getting worse. Contact your doctor promptly if any symptoms get worse.

### Instruction: Disease name: Bell's palsy : Prognosis

Although the symptoms of Bell's palsy are frightening, there's a good chance that the nerve will be able to work properly again. Eighty-five percent of people with Bell's palsy recover completely within a few months. Children almost always recover completely. Taste returns before facial strength. If taste returns within five to seven days after symptoms began, it's more likely you will recover completely. It's also more likely you will recover completely if your facial muscles were not fully paralyzed at the most severe point of the illness. Factors associated with a poorer outlook include a higher degree of impairment, a longer time before symptoms start to improve, advanced age, and severe pain in or around the ear. The prognosis for Ramsay-Hunt syndrome is not as good as the prognosis for Bell's palsy.

### Instruction: Disease name: Bell's palsy : Additional info

American Academy of Otolaryngology https://www.entnet.org/

### Instruction: Disease name: Bell's palsy : About the Reviewer

### Instruction: Disease name: Biliary colic : What is biliary colic?

Biliary colic is a steady or intermittent ache in the upper abdomen, usually under the right side of the rib cage. It happens when something blocks the normal flow of bile from the gallbladder. Bile is a liquid that helps to digest fats. Under normal circumstances, bile is made in the liver and stored in the gallbladder. When you eat a meal, bile passes from the gallbladder through the cystic duct and the common bile duct into the small intestine, where it mixes with partially digested food. Gallstones are the most common reason for biliary colic. If a gallstone blocks either of these ducts, the normal flow of bile into the intestine is disrupted. The muscle cells in the bile duct contract vigorously to try to move the stone, causing the pain of biliary colic. A stricture of the bile duct or a tumor also can block bile flow and cause biliary colic.

### Instruction: Disease name: Biliary colic : Symptoms of biliary colic

A person with biliary colic usually complains of an ache or a feeling of pressure in the upper abdomen. This pain can be in the center of the upper abdomen just below the breastbone, or in the upper right part of the abdomen near the gallbladder and liver. In some people, the abdominal pain spreads back toward the right shoulder blade. Many people also have nausea and vomiting. Because symptoms of biliary colic usually are triggered by the digestive system's demand for bile, they are especially common after fatty meals. The symptoms also can occur when a person who has been fasting suddenly breaks the fast and eats a very large meal.

### Instruction: Disease name: Biliary colic : Diagnosing biliary colic

After you describe your symptoms, your doctor will perform a physical examination, paying particular attention to the upper right portion of your abdomen (the area of your liver and gallbladder). Ultrasound, the same painless procedure used to produce pictures of babies in the womb, can be used to produce pictures of your abdomen so your doctor can look for gallstones. Blood tests also may be done, especially if you have any fever or if your pain persists.

### Instruction: Disease name: Biliary colic : Expected duration of biliary colic

Most episodes of biliary colic pass after 1 to 5 hours. After the most intense pain passes, your abdomen may continue to ache mildly for about 24 hours.

### Instruction: Disease name: Biliary colic : Preventing biliary colic

Because biliary colic is usually related to gallstones, it can be prevented by controlling the risk factors for gallstones. Some of these risk factors, such as heredity, increasing age and pregnancy, are a normal part of life. Others, such as obesity and a high-fat diet, are risk factors you can modify through a healthy lifestyle. Women going through menopause who take estrogen (hormone replacement therapy) are also more likely to develop gallstones and biliary colic.

### Instruction: Disease name: Biliary colic : Treating biliary colic

At first, your doctor may prescribe pain medication and encourage you to eat a fat-free diet. If the first episode of biliary colic is particularly severe, or episodes of colic keep retuning, surgery to remove the gallbladder (cholecystectomy) usually is recommended. This procedure can be done through small incisions using an instrument called a laparoscope. The procedure usually requires only a brief stay in the hospital, and some people can leave the hospital the same day they have their operation. It is the most widely used treatment in people troubled by painful gallstones, because it is very effective and safe, with no complications in more than 90 percent of cases. If surgery cannot be done and symptoms of biliary colic are lasting, medication that dissolves gallstones may be used. However, this medication is expensive and can take months or years to work. Also, only small stones will dissolve. Rarely, medication to dissolve gallstones is combined with a procedure called shock-wave lithotripsy, which uses carefully aimed shock waves to break up gallstones. However, in many people treated with medication or lithotripsy, gallstones tend to form again within a few years.

### Instruction: Disease name: Biliary colic : When to call a professional

Call your doctor whenever you have severe abdominal pain, with or without nausea and vomiting. If you have symptoms of biliary colic and you suddenly develop a fever and shaking chills, this may signal a gallbladder infection (cholecystitis), so call your doctor immediately.

### Instruction: Disease name: Biliary colic : Prognosis

As long as you have gallstones that can block your cystic duct or common bile duct, you are at risk for repeated episodes of biliary colic. There is also a 25 percent chance that you will develop acute cholecystitis, or some other complication of gallstones, within 10 to 20 years.