Dipak-001/mistril_dataset huggingface dataset:
user: What is (are) What I need to know about Preparing for Pregnancy if I Have Diabetes ?

assistant: If you have diabetes,* the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancyeven before you know you are pregnant. Blood glucose targets are different for women who are trying to get pregnant. Targets are numbers you aim for.
                
Pregnancy and new motherhood are times of great excitement and change for any woman. If you have type 1 or type 2 diabetes and are hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. If you have diabetes and are already pregnant, don't panic! Just make sure you are doing everything you can to take care of yourself and your diabetes during your pregnancy.
                
For Women with Gestational Diabetes   More information about gestational diabetes, a type of diabetes that develops only during pregnancy, is provided in the NIDDK health topic, What I need to know about Gestational Diabetes.
                
*See Pronunciation Guide for tips on how to say the words in bold type.
                
If you have diabetes, your pregnancy is considered high risk, which means you have an increased risk of problems during your pregnancy. You need to pay special attention to your health, and you may need to see doctors who specialize in treating diabetes or its complications. Millions of high-risk pregnancies, such as those in which women are older than 35 or carrying two or more babies, produce perfectly healthy babies without affecting the mother's health.
user: What to do for What I need to know about Preparing for Pregnancy if I Have Diabetes ?

assistant: - If you have diabetes, the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancyeven before you know you are pregnant.  - Keeping your blood glucose as close to normal as possible before and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby.  - Before you get pregnant, you can plan and prepare for having a healthy pregnancy and a healthy baby. If you have diabetes and are already pregnant, you can make sure you are doing everything you can to take care of yourself and your diabetes during your pregnancy.  - Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure you get the best care. Your health care team can help you learn how to use a healthy eating plan, physical activity, and medicines to reach your blood glucose targets before and during pregnancy.  - During pregnancy, the safest diabetes medicine is insulin. Your health care team will work with you to make a personalized insulin routine. Some medicines are not safe during pregnancy and should be stopped before you get pregnant. Your doctor can tell you which medicines to stop taking.  - You will have tests throughout your pregnancy to check your baby's health.  - You can give your baby a healthy start by breastfeeding.
user: What is (are) Fecal Incontinence ?

assistant: Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into ones underwear without being aware of it happening. Stool, also called feces, is solid waste that is passed as a bowel movement and includes undigested food, bacteria, mucus, and dead cells. Mucus is a clear liquid that coats and protects tissues in the digestive system.
                
Fecal incontinence can be upsetting and embarrassing. Many people with fecal incontinence feel ashamed and try to hide the problem. However, people with fecal incontinence should not be afraid or embarrassed to talk with their health care provider. Fecal incontinence is often caused by a medical problem and treatment is available.
user: Who is at risk for Fecal Incontinence? ?

assistant: Nearly 18 million U.S. adultsabout one in 12have fecal incontinence.1 People of any age can have a bowel control problem, though fecal incontinence is more common in older adults. Fecal incontinence is slightly more common among women. Having any of the following can increase the risk:
                
- diarrhea, which is passing loose, watery stools three or more times a day  - urgency, or the sensation of having very little time to get to the toilet for a bowel movement  - a disease or injury that damages the nervous system  - poor overall health from multiple chronic, or long lasting, illnesses  - a difficult childbirth with injuries to the pelvic floorthe muscles, ligaments, and tissues that support the uterus, vagina, bladder, and rectum
user: What is (are) Fecal Incontinence ?

assistant: The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestinewhich includes the appendix, cecum, colon, and rectumand anus. The intestines are sometimes called the bowel. The last part of the GI tractcalled the lower GI tractconsists of the large intestine and anus.
                
The large intestine absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine then changes waste from liquid to stool. Stool passes from the colon to the rectum. The rectum is located between the last part of the coloncalled the sigmoid colonand the anus. The rectum stores stool prior to a bowel movement. During a bowel movement, stool moves from the rectum to the anus, the opening through which stool leaves the body.
user: What are the treatments for Fecal Incontinence ?

assistant: Treatment for fecal incontinence may include one or more of the following:
                
- eating, diet, and nutrition  - medications  - bowel training  - pelvic floor exercises and biofeedback  - surgery  - electrical stimulation
user: What is (are) Fecal Incontinence ?

assistant: Fecal incontinence can cause embarrassment, fear, and loneliness. Taking steps to cope is important. The following tips can help:
                
- carrying a bag with cleanup supplies and a change of clothes when leaving the house.  - finding public restrooms before one is needed.  - using the toilet before leaving home.  - wearing disposable underwear or absorbent pads inserted in the underwear.  - using fecal deodorantspills that reduce the smell of stool and gas. Although fecal deodorants are available over the counter, a health care provider can help people find them.
                
Eating tends to trigger contractions of the large intestine that push stool toward the rectum and also cause the rectum to contract for 30 to 60 minutes. Both these events increase the likelihood that a person will pass gas and have a bowel movement soon after eating. This activity may increase if the person is anxious. People with fecal incontinence may want to avoid eating in restaurants or at social gatherings, or they may want to take antidiarrheal medications before eating in these situations.
                
Anal Discomfort   The skin around the anus is delicate and sensitive. Constipation and diarrhea or contact between skin and stool can cause pain or itching. The following steps can help relieve anal discomfort:   - Washing the anal area after a bowel movement. Washing with water, but not soap, can help prevent discomfort. Soap can dry out the skin, making discomfort worse. Ideally, the anal area should be washed in the shower with lukewarm water or in a sitz batha special plastic tub that allows a person to sit in a few inches of warm water. No-rinse skin cleansers, such as Cavilon, are a good alternative. Wiping with toilet paper further irritates the skin and should be avoided. Premoistened, alcohol-free towelettes are a better choice.   - Keeping the anal area dry. The anal area should be allowed to air dry after washing. If time doesnt permit air drying, the anal area can be gently patted dry with a lint-free cloth.   - Creating a moisture barrier. A moisture barrier cream that contains ingredients such as dimethiconea type of siliconecan help form a barrier between skin and stool. The anal area should be cleaned before applying barrier cream. However, people should talk with their health care provider before using anal creams and ointments because some can irritate the anus.   - Using nonmedicated powders. Nonmedicated talcum powder or cornstarch can also relieve anal discomfort. As with moisture barrier creams, the anal area should be clean and dry before use.   - Using wicking pads or disposable underwear. Pads and disposable underwear with a wicking layer can pull moisture away from the skin.   - Wearing breathable clothes and underwear. Clothes and underwear should allow air to flow and keep skin dry. Tight clothes or plastic or rubber underwear that blocks air can worsen skin problems.   - Changing soiled underwear as soon as possible.
user: What to do for Fecal Incontinence ?

assistant: - Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into ones underwear without being aware of it happening.  - Nearly 18 million U.S. adultsabout one in 12have fecal incontinence. People with fecal incontinence should not be afraid or embarrassed to talk with their health care provider.  - Fecal incontinence has many causes, including      - diarrhea    - constipation    - muscle damage or weakness    - nerve damage    - loss of stretch in the rectum    - childbirth by vaginal delivery    - hemorrhoids and rectal prolapse    - rectocele    - inactivity    - Health care providers diagnose fecal incontinence based on a persons medical history, physical exam, and medical test results.  - Treatment for fecal incontinence may include one or more of the following:      - eating, diet, and nutrition    - medications    - bowel training    - pelvic floor exercises and biofeedback    - surgery    - electrical stimulation    - A food diary can help identify foods that cause fecal incontinence.  - Fecal incontinence can occur in children because of a birth defect or disease, but in most cases it occurs because of constipation.
user: What is (are) Abdominal Adhesions ?

assistant: Abdominal adhesions are bands of  fibrous tissue that can form between abdominal tissues and organs. Normally, internal tissues and organs have slippery surfaces, preventing them from sticking together as the body moves. However, abdominal adhesions cause tissues and organs in the abdominal cavity to stick together.
user: What is (are) Abdominal Adhesions ?

assistant: The abdominal cavity is the internal area of the body between the chest and hips that contains the lower part of the esophagus, stomach, small intestine, and large intestine. The esophagus carries food and liquids from the mouth to the stomach, which slowly pumps them into the small and large intestines. Abdominal adhesions can kink, twist, or pull the small and large intestines out of place, causing an intestinal obstruction. Intestinal obstruction, also called a bowel obstruction, results in the partial or complete blockage of movement of food or stool through the intestines.
user: What causes Abdominal Adhesions ?

assistant: Abdominal surgery is the most frequent cause of abdominal adhesions. Surgery-related causes include
                
- cuts involving internal organs   - handling of internal organs  - drying out of internal organs and tissues  - contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches  - blood or blood clots that were not rinsed away during surgery
                
Abdominal adhesions can also result from inflammation not related to surgery, including
                
- appendix rupture  - radiation treatment  - gynecological infections  - abdominal infections
                
Rarely, abdominal adhesions form without apparent cause.
user: Who is at risk for Abdominal Adhesions? ?

assistant: Of patients who undergo abdominal surgery, 93 percent develop abdominal adhesions.1 Surgery in the lower abdomen and pelvis, including bowel and gynecological operations, carries an even greater chance of abdominal adhesions. Abdominal adhesions can become larger and tighter as time passes, sometimes causing problems years after surgery.
user: What are the symptoms of Abdominal Adhesions ?

assistant: In most cases, abdominal adhesions do not cause symptoms. When symptoms are present, chronic abdominal pain is the most common.
user: What are the complications of Abdominal Adhesions ?

assistant: Abdominal adhesions can cause intestinal obstruction and female infertilitythe inability to become pregnant after a year of trying.
                
Abdominal adhesions can lead to female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Women with abdominal adhesions in or around their fallopian tubes have an increased chance of ectopic pregnancya fertilized egg growing outside the uterus. Abdominal adhesions inside the uterus may result in repeated miscarriagesa pregnancy failure before 20 weeks.
                

                
Seek Help for Emergency Symptoms   A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery. Symptoms of an intestinal obstruction include   - severe abdominal pain or cramping   - nausea   - vomiting   - bloating    - loud bowel sounds   - abdominal swelling   - the inability to have a bowel movement or pass gas   - constipationa condition in which a person has fewer than three bowel movements a week; the bowel movements may be painful     A person with these symptoms should seek medical attention immediately.
user: What are the symptoms of Abdominal Adhesions ?

assistant: A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery. Symptoms of an intestinal obstruction include
                
- severe abdominal pain or cramping  - nausea  - vomiting  - bloating   - loud bowel sounds  - abdominal swelling  - the inability to have a bowel movement or pass gas  - constipationa condition in which a person has fewer than three bowel movements a week; the bowel movements may be painful
                
A person with these symptoms should seek medical attention immediately.
user: How to diagnose Abdominal Adhesions ?

assistant: Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. Most abdominal adhesions are found during surgery performed to examine the abdomen. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.
                
- Abdominal x rays use a small amount of radiation to create an image that is recorded on  film or a computer. An x ray is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. An x ray does not require anesthesia. The person will lie on a table or stand during the x ray. The x-ray machine is positioned over the abdominal area. The person will hold his or her breath as the picture is taken so that the picture will not be blurry. The person may be asked to change position for additional pictures.   - A lower GI series is an x-ray exam that is used to look at the large intestine. The test is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. The health care provider may provide written bowel prep instructions to follow at home before the test. The person may be asked to follow a clear liquid diet for 1 to 3 days before the procedure. A laxative or an enema may be used before the test. A laxative is medication that loosens stool and increases bowel movements. An enema involves fl ushing water or laxative into the rectum using a special squirt bottle.  For the test, the person will lie on a table while the radiologist inserts a flexible tube into the persons anus. The large intestine is fi lled with barium, making signs of underlying problems show up more clearly on x rays.   - CT scans use a combination of x rays and computer technology to create images. The procedure is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. A CT scan may include the injection of a special dye, called contrast medium. The person will lie on a table that slides into a tunnel-shaped device where the x rays are taken.
user: What are the treatments for Abdominal Adhesions ?

assistant: Abdominal adhesions that do not cause symptoms generally do not require treatment. Surgery is the only way to treat abdominal adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional abdominal adhesions. People should speak with their health care provider about the best way to treat their abdominal adhesions.
                
Complete intestinal obstructions usually require immediate surgery to clear the blockage. Most partial intestinal obstructions can be managed without surgery.
user: How to prevent Abdominal Adhesions ?

assistant: Abdominal adhesions are diffi cult to prevent; however, certain surgical techniques can minimize abdominal adhesions.
                
Laparoscopic surgery decreases the potential for abdominal adhesions because several tiny incisions are made in the lower abdomen instead of one large incision. The surgeon inserts a laparoscopea thin tube with a tiny video camera attachedinto one of the small incisions. The camera sends a magnified image from inside the body to a video monitor. Patients will usually receive general anesthesia during this surgery.
                
If laparoscopic surgery is not possible and a large abdominal incision is required, at the end of surgery a special fi lmlike material can be inserted between organs or between the organs and the abdominal incision. The fi lmlike material, which looks similar to wax paper and is absorbed by the body in about a week, hydrates organs to help prevent abdominal adhesions.
                
Other steps taken during surgery to reduce abdominal adhesions include
                
- using starch- and latex-free gloves  - handling tissues and organs gently  - shortening surgery time   - using moistened drapes and swabs  - occasionally applying saline solution
user: What to do for Abdominal Adhesions ?

assistant: Researchers have not found that eating, diet, and nutrition play a role in causing or preventing abdominal adhesions. A person with a partial intestinal obstruction may relieve symptoms with a liquid or low- fiber diet, which is more easily broken down into smaller particles by the digestive system.
user: What to do for Abdominal Adhesions ?

assistant: - Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs. Abdominal adhesions cause tissues and organs in the abdominal cavity to stick together.  - Abdominal surgery is the most frequent cause of abdominal adhesions. Of patients who undergo abdominal surgery, 93 percent develop abdominal adhesions.  - In most cases, abdominal adhesions do not cause symptoms. When symptoms are present, chronic abdominal pain is the most common.  - A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.  - Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.  - Surgery is the only way to treat abdominal adhesions that cause pain, intestinal obstruction, or fertility problems.
user: What is (are) Porphyria ?

assistant: Porphyrias are rare disorders that affect mainly the skin or nervous system and may cause abdominal pain. These disorders are usually inherited, meaning they are caused by abnormalities in genes passed from parents to children. When a person has a porphyria, cells fail to change body chemicals called porphyrins and porphyrin precursors into heme, the substance that gives blood its red color. The body makes heme mainly in the bone marrow and liver. Bone marrow is the soft, spongelike tissue inside the bones; it makes stem cells that develop into one of the three types of blood cellsred blood cells, white blood cells, and platelets.
                
The process of making heme is called the heme biosynthetic pathway. One of eight enzymes controls each step of the process. The body has a problem making heme if any one of the enzymes is at a low level, also called a deficiency. Porphyrins and porphyrin precursors of heme then build up in the body and cause illness.
user: What is (are) Porphyria ?

assistant: Heme is a red pigment composed of iron linked to a chemical called protoporphyrin. Heme has important functions in the body. The largest amounts of heme are in the form of hemoglobin, found in red blood cells and bone marrow. Hemoglobin carries oxygen from the lungs to all parts of the body. In the liver, heme is a component of proteins that break down hormones, medications, and other chemicals and keep liver cells functioning normally. Heme is an important part of nearly every cell in the body.
user: What is (are) Porphyria ?

assistant: Each of the eight types of porphyria corresponds to low levels of a specific enzyme in the heme biosynthetic pathway. Experts often classify porphyrias as acute or cutaneous based on the symptoms a person experiences:
                
- Acute porphyrias affect the nervous system. They occur rapidly and last only a short time.  - Cutaneous porphyrias affect the skin.
                
Two types of acute porphyrias, hereditary coproporphyria and variegate porphyria, can also have cutaneous symptoms.
                
Experts also classify porphyrias as erythropoietic or hepatic:
                
- In erythropoietic porphyrias, the body overproduces porphyrins, mainly in the bone marrow.  - In hepatic porphyrias, the body overproduces porphyrins and porphyrin precursors, mainly in the liver.
                
Table 1 lists each type of porphyria, the deficient enzyme responsible for the disorder, and the main location of porphyrin buildup.
                
Table 1. Types of porphyria
                
Type of Porphyria    Deficient Enzyme    Main Location of Porphyrin Buildup                  delta-aminolevulinate-dehydratase deficiency porphyria    delta-aminolevulinic acid dehydratase    liver        acute intermittent porphyria    porphobilinogen deaminase    liver        hereditary coproporphyria    coproporphyrinogen oxidase    liver        variegate porphyria    protoporphyrinogen oxidase    liver                congenital erythropoietic porphyria    uroporphyrinogen III cosynthase    bone marrow        porphyria cutanea tarda    uroporphyrinogen decarboxylase (~75% deficiency)    liver        hepatoerythropoietic porphyria    uroporphyrinogen decarboxylase (~90% deficiency)    bone marrow        erythropoietic protoporphyria*    ferrochelatase (~75% deficiency)    bone marrow
                
*Protoporphyria XLPP is a variant of erythropoietic protoporphyria.
user: How many people are affected by Porphyria ?

assistant: The exact rates of porphyria are unknown and vary around the world. For example, porphyria cutanea tarda is most common in the United States, and variegate porphyria is most common in South America.1