Druvith/medqa1 huggingface dataset:
Question:  What are the symptoms of Medullary Sponge Kidney ?
Answer: Many people with medullary sponge kidney have no symptoms. The first sign that a person has medullary sponge kidney is usually a UTI or a kidney stone. UTIs and kidney stones share many of the same signs and symptoms:
                
- burning or painful urination  - pain in the back, lower abdomen, or groin  - cloudy, dark, or bloody urine  - foul-smelling urine  - fever and chills  - vomiting
                
People who experience these symptoms should see or call a health care provider as soon as possible.
Question:  How to diagnose Medullary Sponge Kidney ?
Answer: A health care provider diagnoses medullary sponge kidney based on
                
- a medical and family history  - a physical exam  - imaging studies
                
Medical and Family History
                
Taking a medical and family history can help diagnose medullary sponge kidney. A health care provider will suspect medullary sponge kidney when a person has repeated UTIs or kidney stones.
                
Physical Exam
                
No physical signs are usually present in a patient with medullary sponge kidney, except for blood in the urine. Health care providers usually confirm a diagnosis of medullary sponge kidney with imaging studies.
                
Imaging Studies
                
Imaging is the medical term for tests that use different methods to see bones, tissues, and organs inside the body. Health care providers commonly choose one or more of three imaging techniques to diagnose medullary sponge kidney:
                
- intravenous pyelogram  - computerized tomography (CT) scan  - ultrasound
                
A radiologista doctor who specializes in medical imaginginterprets the images from these studies, and patients do not need anesthesia.
                
Intravenous Pyelogram
                
In an intravenous pyelogram, a health care provider injects a special dye, called contrast medium, into a vein in the patients arm. The contrast medium travels through the body to the kidneys. The kidneys excrete the contrast medium into urine, which makes the urine visible on an x-ray. An x-ray technician performs this procedure at a health care providers office, an outpatient center, or a hospital. An intravenous pyelogram can show any blockage in the urinary tract, and the cysts show up as clusters of light.
                
Computerized Tomography Scans
                
Computerized tomography scans use 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 tunnel-shaped device where the x-rays are taken. An x-ray technician performs the procedure in an outpatient center or a hospital. CT scans can show expanded or stretched tubules.
                
Ultrasound
                
Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital. Ultrasound can show kidney stones and calcium deposits within the kidney.
Question:  What are the treatments for Medullary Sponge Kidney ?
Answer: Scientists have not discovered a way to reverse medullary sponge kidney. Once a health care provider is sure a person has medullary sponge kidney, treatment focuses on
                
- curing an existing UTI  - removing any kidney stones
                
Curing an Existing Urinary Tract Infection
                
To treat a UTI, the health care provider may prescribe a medication called an antibiotic that kills bacteria. The choice of medication and length of treatment depend on the persons medical history and the type of bacteria causing the infection. More information is provided in the NIDDK health topic, Urinary Tract Infections in Adults.
                
Removing Kidney Stones
                
Treatment for kidney stones usually depends on their size and what they are made of, as well as whether they are causing pain or obstructing the urinary tract. Kidney stones may be treated by a general practitioner or by a urologista doctor who specializes in the urinary tract.
                
Small stones usually pass through the urinary tract without treatment. Still, the person may need pain medication and should drink lots of liquids to help move the stone along. Pain control may consist of oral or intravenous (IV) medication, depending on the duration and severity of the pain. People may need IV fluids if they become dehydrated from vomiting or an inability to drink.
                
A person with a larger stone, or one that blocks urine flow and causes great pain, may need more urgent treatment, such as
                
- shock wave lithotripsy. A machine called a lithotripter is used to break up the kidney stone into smaller pieces to pass more easily through the urinary tract. The patient may need local or general anesthesia.  - ureteroscopy. A ureteroscopea long, tubelike instrument with an eyepieceis used to find and retrieve the stone with a small basket or to break the stone up with laser energy. Local or general anesthesia may be required.  - percutaneous nephrolithotomy. In this procedure, a wire-thin viewing instrument, called a nephroscope, is used to locate and remove the stones. During the procedure, which requires general anesthesia, a tube is inserted directly into the kidney through a small incision in the patients back.
                
More information is provided in the NIDDK health topic, Kidney Stones in Adults.
Question:  How to prevent Medullary Sponge Kidney ?
Answer: Scientists have not yet found a way to prevent medullary sponge kidney. However, health care providers can recommend medications and dietary changes to prevent future UTIs and kidney stones.
Question:  How to prevent Medullary Sponge Kidney ?
Answer: Health care providers may prescribe certain medications to prevent UTIs and kidney stones:
                
- A person with medullary sponge kidney may need to continue taking a low-dose antibiotic to prevent recurrent infections.  - Medications that reduce calcium in the urine may help prevent calcium kidney stones. These medications may include      - potassium citrate    - thiazide
Question:  What to do for Medullary Sponge Kidney ?
Answer: The following changes in diet may help prevent UTIs and kidney stone formation:
                
- Drinking plenty of water and other liquids can help flush bacteria from the urinary tract and dilute urine so kidney stones cannot form. A person should drink enough liquid to produce about 2 to 2.5 quarts of urine every day.3  - Reducing sodium intake, mostly from salt, may help prevent kidney stones. Diets high in sodium can increase the excretion of calcium into the urine and thus increase the chance of calciumcontaining kidney stones forming.  - Foods rich in animal proteins such as meat, eggs, and fish can increase the chance of uric acid stones and calcium stones forming. People who form stones should limit their meat consumption to 6 to 8 ounces a day.4  - People who are more likely to develop calcium oxalate stones should include 1,000 milligrams of calcium in their diet every day. Adults older than 50 years should consume 1,200 milligrams of calcium daily.3 Calcium in the digestive tract binds to oxalate from food and keeps it from entering the blood and the urinary tract, where it can form stones.
                
People with medullary sponge kidney should talk with their health care provider or a dietitian before making any dietary changes. A dietitian can help a person plan healthy meals.
Question:  What to do for Medullary Sponge Kidney ?
Answer: - Medullary sponge kidney, also known as Cacchi-Ricci disease, is a birth defect where changes occur in the tubules, or tiny tubes, inside a fetus kidneys.  - Symptoms of medullary sponge kidney do not usually appear until the teenage years or the 20s. Medullary sponge kidney can affect one or both kidneys.  - Complications of medullary sponge kidney include      - hematuria, or blood in the urine    - kidney stones    - urinary tract infections (UTIs)    - Many people with medullary sponge kidney have no symptoms. The first sign that a person has medullary sponge kidney is usually a UTI or a kidney stone. UTIs and kidney stones share many of the same signs and symptoms:      - burning or painful urination    - pain in the back, lower abdomen, or groin    - cloudy, dark, or bloody urine    - foul-smelling urine    - fever and chills    - vomiting    - Health care providers commonly choose one or more of three imaging techniques to diagnose medullary sponge kidney:      - intravenous pyelogram    - computerized tomography (CT) scan    - ultrasound    - Scientists have not discovered a way to reverse medullary sponge kidney. Once a health care provider is sure a person has medullary sponge kidney, treatment focuses on      - curing an existing UTI    - removing any kidney stones    - Scientists have not yet found a way to prevent medullary sponge kidney. However, health care providers can recommend medications and dietary changes to prevent future UTIs and kidney stones.
Question:  What is (are) Vesicoureteral Reflux ?
Answer: Vesicoureteral reflux is the abnormal flow of urine from the bladder to the upper urinary tract. The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. Blood flows through the kidneys, and the kidneys filter out wastes and extra water, making urine. The urine travels down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.
                
In VUR, urine may flow backrefluxinto one or both ureters and, in some cases, to one or both kidneys. VUR that affects only one ureter and kidney is called unilateral reflux, and VUR that affects both ureters and kidneys is called bilateral reflux.
Question:  Who is at risk for Vesicoureteral Reflux? ?
Answer: Vesicoureteral reflux is more common in infants and young children, but older children and even adults can be affected. About 10 percent of children have VUR.1 Studies estimate that VUR occurs in about 32 percent of siblings of an affected child. This rate may be as low as 7 percent in older siblings and as high as 100 percent in identical twins. These findings indicate that VUR is an inherited condition.2
Question:  What is (are) Vesicoureteral Reflux ?
Answer: The two types of VUR are primary and secondary. Most cases of VUR are primary and typically affect only one ureter and kidney. With primary VUR, a child is born with a ureter that did not grow long enough during the childs development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine refluxes from the bladder to the ureter and eventually to the kidney. This type of VUR can get better or disappear as a child gets older. As a child grows, the ureter gets longer and function of the valve improves.
                
Secondary VUR occurs when a blockage in the urinary tract causes an increase in pressure and pushes urine back up into the ureters. Children with secondary VUR often have bilateral reflux. VUR caused by a physical defect typically results from an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder.
                
VUR is usually classified as grade I through V, with grade I being the least severe and grade V being the most severe.
Question:  What are the symptoms of Vesicoureteral Reflux ?
Answer: In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI). VUR can lead to infection because urine that remains in the childs urinary tract provides a place for bacteria to grow. Studies estimate that 30 percent of children and up to 70 percent of infants with a UTI have VUR.2
Question:  What are the complications of Vesicoureteral Reflux ?
Answer: When a child with VUR gets a UTI, bacteria can move into the kidney and lead to scarring. Scarring of the kidney can be associated with high blood pressure and kidney failure. However, most children with VUR who get a UTI recover without long-term complications.
Question:  How to diagnose Vesicoureteral Reflux ?
Answer: The most common tests used to diagnose VUR include
                
- Voiding cystourethrogram (VCUG). VCUG is an x-ray image of the bladder and urethra taken during urination, also called voiding. The bladder and urethra are filled with a special dye, called contrast medium, to make the urethra clearly visible. The x-ray machine captures a video of the contrast medium when the child urinates. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician supervised by a radiologista doctor who specializes in medical imagingwho then interprets the images. Anesthesia is not needed, but sedation may be used for some children. This test can show abnormalities of the inside of the urethra and bladder.  - Radionuclide cystogram (RNC). RNC is a type of nuclear scan that involves placing radioactive material into the bladder. A scanner then detects the radioactive material as the child urinates or after the bladder is empty. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist. Anesthesia is not needed, but sedation may be used for some children. RNC is more sensitive than VCUG but does not provide as much detail of the bladder anatomy.  - Abdominal ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract, including the kidneys and bladder. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. Ultrasound may be used before VCUG or RNC if the childs family or health care provider wants to avoid exposure to x-ray radiation or radioactive material.
                
Testing is usually done on
                
- infants diagnosed during pregnancy with urine blockage affecting the kidneys  - children younger than 5 years of age with a UTI  - children with a UTI and fever, called febrile UTI, regardless of age  - males with a UTI who are not sexually active, regardless of age or fever  - children with a family history of VUR, including an affected sibling
                
More information about urine blockage in infants is provided in the NIDDK health topic, Urine Blockage in Newborns.
                
VUR is an unlikely cause of UTI in some children, so these tests are not done until other causes of UTI are ruled out for
                
- children 5 years of age and older with a UTI  - children with a UTI but no fever  - sexually active males with a UTI
Question:  How to diagnose Vesicoureteral Reflux ?
Answer: Following diagnosis, children with VUR should have a general medical evaluation that includes blood pressure measurement, as high blood pressure is an indicator of kidney damage. If both kidneys are affected, a childs blood should be tested for creatininea waste product of normal muscle breakdown. Healthy kidneys remove creatinine from the blood; when the kidneys are damaged, creatinine builds up in the blood. The urine may be tested for the presence of protein and bacteria. Protein in the urine is another indication of damaged kidneys.
                
- having to urinate often or suddenly  - long periods of time between bathroom visits  - daytime wetting  - pain in the penis or perineumthe area between the anus and genitals  - posturing to prevent wetting  - constipationa condition in which a child has fewer than two bowel movements in a week; the bowel movements may be painful  - fecal incontinenceinability to hold stool in the colon and rectum, which are parts of the large intestine
Question:  What are the treatments for Vesicoureteral Reflux ?
Answer: The standard treatment for primary VUR has included prompt treatment of UTIs and long-term use of antibiotics to prevent UTIs, also called antimicrobial prophylaxis, until VUR goes away on its own. Antibiotics are bacteria-fighting medications. Surgery has also been used in certain cases.
                
Several studies have raised questions about long-term use of antibiotics for prevention of UTIs. The studies found little or no effect on prevention of kidney damage. Long-term use may also make the child resistant to the antibiotic, meaning the medication does not work as well, and the child may be sicker longer and may need to take medications that are even stronger.
                
- children younger than 1 year of age continuous antibiotics should be used if a child has a history of febrile UTI or VUR grade III through V that was identified through screening  - children older than 1 year of age with BBDcontinuous antibiotics should be used while BBD is being treated  - children older than 1 year of age without BBDcontinuous antibiotics can be used at the discretion of the health care provider but is not automatically recommended; however, UTIs should be promptly treated
                
Deflux, a gellike liquid containing complex sugars, is an alternative to surgery for treatment of VUR. A small amount of Deflux is injected into the bladder wall near the opening of the ureter. This injection creates a bulge in the tissue that makes it harder for urine to flow back up the ureter. The health care provider uses a special tube to see inside the bladder during the procedure. Deflux injection is an outpatient procedure done under general anesthesia, so the child can go home the same day.
Question:  What are the treatments for Vesicoureteral Reflux ?
Answer: Secondary VUR is treated by removing the blockage causing the reflux. Treatment may involve
                
- surgery  - antibiotics  - intermittent catheterizationdraining the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder
Question:  What to do for Vesicoureteral Reflux ?
Answer: Eating, diet, and nutrition have not been shown to play a role in causing or preventing VUR.
Question:  What to do for Vesicoureteral Reflux ?
Answer: - Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder to the upper urinary tract.  - VUR is more common in infants and young children, but older children and even adults can be affected. About 10 percent of children have VUR.  - In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI).  - When a child with VUR gets a UTI, bacteria can move into the kidney and lead to scarring. Scarring of the kidney can be associated with high blood pressure and kidney failure.  - Voiding cystourethrogram (VCUG), radionuclide cystogram (RNC), and abdominal ultrasound are used to diagnose VUR.  - Children with VUR should also be assessed for bladder/bowel dysfunction (BBD). Children who have VUR along with any BBD symptoms are at greater risk of kidney damage due to infection.  - The standard treatment for primary VUR has included prompt treatment of UTIs and long-term use of antibiotics to prevent UTIs, also called antimicrobial prophylaxis, until VUR goes away on its own. Surgery has also been used in certain cases.  - Secondary VUR is treated by removing the blockage causing the reflux.
Question:  What is (are) Ulcerative Colitis ?
Answer: Ulcerative colitis is a chronic, or long lasting, disease that causes inflammationirritation or swellingand sores called ulcers on the inner lining of the large intestine.
                
Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal (GI) tract, called inflammatory bowel disease (IBD). Crohn's disease and microscopic colitis are the other common IBDs. More information is provided in the NIDDK health topics, Crohn's Disease and Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis.
                
Ulcerative colitis most often begins gradually and can become worse over time. Symptoms can be mild to severe. Most people have periods of remissiontimes when symptoms disappearthat can last for weeks or years. The goal of care is to keep people in remission long term.
                
Most people with ulcerative colitis receive care from a gastroenterologist, a doctor who specializes in digestive diseases.
Question:  What is (are) Ulcerative Colitis ?
Answer: The large intestine is part of the GI tract, a series of hollow organs joined in a long, twisting tube from the mouth to the anusan opening through which stool leaves the body. The last part of the GI tract, called the lower GI tract, consists of the large intestinewhich includes the appendix, cecum, colon, and rectumand anus. The intestines are sometimes called the bowel.
                
The large intestine is about 5 feet long in adults and absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is located between the lower, or sigmoid, colon and the anus. The rectum stores stool prior to a bowel movement, when stool moves from the rectum to the anus and out of a person's body.
Question:  What causes Ulcerative Colitis ?
Answer: The exact cause of ulcerative colitis is unknown. Researchers believe the following factors may play a role in causing ulcerative colitis:
                
- overactive intestinal immune system  - genes  - environment
                
Overactive intestinal immune system. Scientists believe one cause of ulcerative colitis may be an abnormal immune reaction in the intestine. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Researchers believe bacteria or viruses can mistakenly trigger the immune system to attack the inner lining of the large intestine. This immune system response causes the inflammation, leading to symptoms.
                
Genes. Ulcerative colitis sometimes runs in families. Research studies have shown that certain abnormal genes may appear in people with ulcerative colitis. However, researchers have not been able to show a clear link between the abnormal genes and ulcerative colitis.
                
Environment. Some studies suggest that certain things in the environment may increase the chance of a person getting ulcerative colitis, although the overall chance is low. Nonsteroidal anti-inflammatory drugs,1 antibiotics,1 and oral contraceptives2 may slightly increase the chance of developing ulcerative colitis. A high-fat diet may also slightly increase the chance of getting ulcerative colitis.3
                
Some people believe eating certain foods, stress, or emotional distress can cause ulcerative colitis. Emotional distress does not seem to cause ulcerative colitis. A few studies suggest that stress may increase a person's chance of having a flare-up of ulcerative colitis. Also, some people may find that certain foods can trigger or worsen symptoms.