Druvith/medqa1 huggingface dataset:
Question:  What to do for Hashimoto's Disease ?
Answer: - Hashimotos disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an autoimmune disease.  - Hashimotos disease often leads to reduced thyroid function, or hypothyroidism. Hypothyroidism is a disorder that occurs when the thyroid doesnt make enough thyroid hormone for the bodys needs.  - Hashimotos disease is the most common cause of hypothyroidism in the United States. Many people with Hashimotos disease have no symptoms at first. As the disease slowly progresses, the thyroid usually enlarges and may cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in the throat, though it is usually not painful.  - Not everyone with Hashimotos disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinicalmild and without symptoms, especially early in its course.  - Hashimotos disease is much more common in women than men. Although the disease often occurs in adolescent or young women, it more commonly appears between 30 and 50 years of age.  - Hashimotos disease, with or without hypothyroidism, is treated with synthetic thyroxine, which is man-made T4.  - Women with Hashimotos disease should discuss their condition with their health care provider before becoming pregnant.  - Pregnant women should choose iodized saltsalt supplemented with iodineover plain salt and take prenatal vitamins containing iodine.  - People should discuss their use of dietary supplements, such as iodine, with their health care provider.
Question:  What is (are) Urinary Incontinence in Children ?
Answer: Urinary incontinence is the loss of bladder control, which results in the accidental loss of urine. A child with UI may not stay dry during the day or night. Some UI is caused by a health problem such as
                
- a urinary tract infection (UTI)  - diabetes, a condition where blood glucose, also called blood sugar, is too high  - kidney problems  - nerve problems  - constipation, a condition in which a child has fewer than two bowel movements a week and stools can be hard, dry, small, and difficult to pass  - obstructive sleep apnea (OSA), a condition in which breathing is interrupted during sleep, often because of inflamed or enlarged tonsils  - a structural problem in the urinary tract
                
Most of the time, the exact cause of UI is not known, but it is often the result of more than one factor.
                
Although UI affects many children, it usually disappears naturally over time. UI after age 3the age when most children achieve daytime drynessmay cause great distress and embarrassment. Many children experience occasional UI, and treatment is available for most children who have a hard time controlling their bladder. Thus, caregivers of children who wet the bed or have accidents during the day should approach this problem with understanding and patience.
                
The age at which children achieve dryness varies. Wetting in younger children is common and not considered UI, so daytime UI is not usually diagnosed until age 5 or 6, and nighttime UI is not usually diagnosed until age 7.
                
Enuresis   Urinary incontinence is also called enuresis. Types of enuresis include the following:   - Primary enuresis is wetting in a child who has never been consistently dry.   - Secondary enuresis is wetting that begins after at least 6 months of dryness.   - Nocturnal enuresis is wetting that usually occurs during sleep, also called nighttime UI.   - Diurnal enuresis is wetting when awake, also called daytime UI.
Question:  How many people are affected by Urinary Incontinence in Children ?
Answer: By 5 years of age, more than 90 percent of children can control urination during the day. Nighttime wetting is more common than daytime wetting in children, affecting 30 percent of 4-year-olds. The condition resolves itself in about 15 percent of children each year; about 10 percent of 7-year-olds, 3 percent of 12-year-olds, and 1 percent of 18-year-olds continue to experience nighttime wetting.1
Question:  What causes Urinary Incontinence in Children ?
Answer: Daytime UI can be caused by a UTI or structural problems in the urinary tract. Daytime UI that is not associated with UTI or structural problems is less common and tends to disappear much earlier than nighttime UI. Overactive bladder and infrequent or incomplete voiding, or urination, are common causes of daytime UI.
                
Overactive Bladder
                
Overactive bladder is a condition in which a child experiences at least two of the following conditions:
                
- urinary urgencyinability to delay urination  - urge urinary incontinenceurinary leakage when the bladder contracts unexpectedly  - urinary frequencyurination eight or more times a day or more than twice at night
                
Infrequent or Incomplete Voiding
                
Infrequent voiding is when children voluntarily hold urine for prolonged periods of time. For example, children may not want to use the toilets at school or may not want to interrupt enjoyable activities, so they ignore the bodys signal of a full bladder. In these cases, the bladder can overfill and leak urine. In addition, these children often develop UTIs, leading to an irritated or overactive bladder.
                
Factors that may combine with infrequent voiding to produce daytime UI include
                
- small bladder capacity  - structural problems  - anxiety-causing events  - pressure from constipation  - drinks or foods that contain caffeine
                
Sometimes, overly demanding toilet training may make children unable to relax the sphincters enough to completely empty the bladder. Incomplete voiding may also lead to UTIs.
Question:  What are the treatments for Urinary Incontinence in Children ?
Answer: Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications.
                
Growth and Development
                
As children mature
                
- bladder capacity increases  - natural body alarms become activated  - an overactive bladder settles down  - production of ADH becomes normal  - response to the bodys signal that it is time to void improves
                
Bladder Training and Related Strategies
                
Bladder training consists of exercises to strengthen the bladder muscles to better control urination. Gradually lengthening the time between trips to the bathroom can also help by stretching the bladder so it can hold more urine. Additional techniques that may help control daytime UI include
                
- urinating on a scheduletimed voidingsuch as every 2 hours  - avoiding food or drinks with caffeine  - following suggestions for healthy urination, such as relaxing muscles and taking enough time to allow the bladder to empty completely
                
Waking children up to urinate can help decrease nighttime UI. Ensuring children drink enough fluids throughout the day so they do not drink a lot of fluids close to bedtime may also help. A health care provider can give guidance about how much a child needs to drink each day, as the amount depends on a childs age, physical activity, and other factors.
                
Moisture Alarms
                
At night, moisture alarms can wake children when they begin to urinate. These devices use a water-sensitive pad connected to an alarm that sounds when moisture is first detected. A small pad can clip to the pajamas, or a larger pad can be placed on the bed. For the alarm to be effective, children must awaken as soon as the alarm goes off, stop the urine stream, and go to the bathroom. Children using moisture alarms may need to have someone sleep in the same room to help wake them up.
                
Medications
                
Nighttime UI may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin (DDAVP), which is available in pill form, nasal spray, and nose drops. DDAVP is approved for use in children. Another medication, called imipramine (Tofranil), is also used to treat nighttime UI, though the way this medication prevents bedwetting is not known. Although both of these medications may help children achieve short-term success, relapse is common once the medication is withdrawn.
                
UI resulting from an overactive bladder may be treated with oxybutynin (Ditropan), a medication that helps calm the bladder muscle and control muscle spasms.
Question:  What to do for Urinary Incontinence in Children ?
Answer: Eating, diet, and nutrition have not been shown to play a role in causing or preventing UI in children, though ensuring sufficient fluid intake throughout the day and avoiding caffeine intake may be helpful.
Question:  What to do for Urinary Incontinence in Children ?
Answer: - Urinary incontinence (UI) is the loss of bladder control, which results in the accidental loss of urine. A child with UI may not stay dry during the day or night. Although UI affects many children, it usually disappears naturally over time.  - By 5 years of age, more than 98 percent of children can control urination during the day. Nighttime wetting is more common than daytime wetting in children, affecting 30 percent of 4-year-olds.  - The exact cause of most cases of nighttime UI is not known. Though a few cases are caused by structural problems in the urinary tract, most cases result from more than one factor including slower physical development, an overproduction of urine at night, and the inability to recognize bladder filling when asleep.  - Nighttime UI has also been associated with attention deficit hyperactivity disorder (ADHD), obstructive sleep apnea (OSA), and anxiety. Certain genes have been found to contribute to UI.  - Daytime UI that is not associated with urinary tract infection (UTI) or structural problems in the urinary tract may be due to an overactive bladder or infrequent or incomplete voiding problems.  - Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications.
Question:  What is (are) Chronic Diarrhea in Children ?
Answer: Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more than 4 weeks. Children with chronic diarrhea may have loose, watery stools continually, or diarrhea may come and go. Chronic diarrhea may go away without treatment, or it may be a symptom of a chronic disease or disorder. Treating the disease or disorder can relieve chronic diarrhea.
                
Chronic diarrhea can affect children of any age:
                
- infantsages 0 to 12 months  - toddlersages 1 to 3 years  - preschool-age childrenages 3 to 5 years  - grade school-age childrenages 5 to 12 years  - adolescentsages 12 to 18 years
                
Diarrhea that lasts only a short time is called acute diarrhea. Acute diarrhea, a common problem, usually lasts a few days and goes away on its own. More information about acute diarrhea is provided in the NIDDK health topics:
                
- Diarrhea  - What I need to know about Diarrhea
Question:  What are the symptoms of Chronic Diarrhea in Children ?
Answer: Symptoms that accompany chronic diarrhea in children depend on the cause of the diarrhea. Symptoms can include
                
- cramping  - abdominal pain  - nausea or vomiting  - fever  - chills  - bloody stools
                
Children with chronic diarrhea who have malabsorption can experience
                
- bloating and swelling, also called distention, of the abdomen  - changes in appetite  - weight loss or poor weight gain
                

                
Consult a Health Care Provider   A childs parent or caretaker should consult a health care provider if the child   - has diarrhea for more than 24 hours   - is younger than 6 months old   - has received treatment and the diarrhea persists    Children with any of the following symptoms should see a health care provider right away:   - signs of malabsorptionbloating and swelling of the abdomen, changes in appetite, and weight loss or poor weight gain   - severe abdominal or rectal pain   - a fever of 102 degrees or higher   - stools containing blood or pus    More information is provided in the NIDDK health topics:   - Diarrhea   - What I need to know about Diarrhea
Question:  What are the treatments for Chronic Diarrhea in Children ?
Answer: The treatment for chronic diarrhea will depend on the cause. Some common causes of chronic diarrhea are treated as follows:
                
- Infections. If a child has prolonged problems digesting certain carbohydrates or proteins after an acute infection, a health care provider may recommend changes in diet. A child may need antibiotics or medications that target parasites to treat infections that do not go away on their own. A health care provider may also prescribe antibiotics to treat small intestinal bacterial overgrowth.    - Functional GI disorders. For toddlers diarrhea, treatment is usually not needed. Most children outgrow toddlers diarrhea by the time they start school. In many children, limiting fruit juice intake and increasing the amount of fiber and fat in the diet may improve symptoms of toddlers diarrhea.  A health care provider may treat IBS with      - changes in diet.    - medication.    - probioticslive microorganisms, usually bacteria, that are similar to microorganisms normally found in the GI tract. Studies have found that probiotics, specifically Bifidobacteria and certain probiotic combinations, improve symptoms of IBS when taken in large enough amounts. However, researchers are still studying the use of probiotics to treat IBS.    - psychological therapy.
                
To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/probiotics.
                

                
- Food allergies and intolerances. A health care provider will recommend changes in diet to manage symptoms of food allergies and intolerances. To treat food allergies, the childs parent or caretaker should remove the food that triggers the allergy from the childs diet.  For children with celiac disease, following a gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further damage.  The childs parent or caretaker can manage the symptoms of lactose intolerance with changes in the childs diet and by using products that contain the lactase enzyme. Most children with lactose intolerance can tolerate some amount of lactose in their diet. The amount of change needed in the diet depends on how much lactose a child can consume without symptoms.  For children with dietary fructose intolerance, reducing the amount of fructose in the diet can relieve symptoms.    - IBD. A health care provider may use medications, surgery, and changes in diet to treat IBD.
Question:  What to do for Chronic Diarrhea in Children ?
Answer: A health care provider may recommend changing a childs diet to treat the cause of chronic diarrhea. Making sure that children receive proper nutrition is important for growth and development. A childs parent or caretaker should talk with a health care provider about changing the childs diet to treat chronic diarrhea.
Question:  What to do for Chronic Diarrhea in Children ?
Answer: - Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more than 4 weeks.  - Many diseases and disorders can cause chronic diarrhea in children. Common causes include infections, functional gastrointestinal (GI) disorders, food allergies and intolerances, and inflammatory bowel disease (IBD).  - Symptoms that accompany chronic diarrhea in children depend on the cause of the diarrhea. Symptoms can include cramping, abdominal pain, nausea or vomiting, fever, chills, or bloody stools.  - Children with chronic diarrhea who have malabsorption can experience bloating and swelling of the abdomen, changes in appetite, or weight loss or poor weight gain.  - Children with any of the following symptoms should see a health care provider right away: signs of malabsorption, severe abdominal or rectal pain, a fever of 102 degrees or higher, or stools containing blood or pus.  - To determine the cause of chronic diarrhea, the health care provider will take a complete medical and family history and conduct a physical exam, and may perform tests.  - The treatment for chronic diarrhea will depend on the cause.  - A childs parent or caretaker should talk with a health care provider about changing the childs diet to treat chronic diarrhea.
Question:  What is (are) Irritable Bowel Syndrome in Children ?
Answer: Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning it is a problem caused by changes in how the GI tract works. Children with a functional GI disorder have frequent symptoms, but the GI tract does not become damaged. IBS is not a disease; it is a group of symptoms that occur together. The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes and is not a product of a persons imagination.
                
IBS is diagnosed when a child who is growing as expected has abdominal pain or discomfort once per week for at least 2 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or may be relieved by a bowel movement.
Question:  What is (are) Irritable Bowel Syndrome in Children ?
Answer: 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 a solid matter called 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.
Question:  How many people are affected by Irritable Bowel Syndrome in Children ?
Answer: Limited information is available about the number of children with IBS. Older studies have reported prevalence rates for recurrent abdominal pain in children of 10 to 20 percent.1 However, these studies did not differentiate IBS from functional abdominal pain, indigestion, and abdominal migraine. One study of children in North America found that 14 percent of high school students and 6 percent of middle school students have IBS. The study also found that IBS affects boys and girls equally.2
Question:  What are the symptoms of Irritable Bowel Syndrome in Children ?
Answer: The symptoms of IBS include abdominal pain or discomfort and changes in bowel habits. To meet the definition of IBS, the pain or discomfort should be associated with two of the following three symptoms:
                
- start with bowel movements that occur more or less often than usual  - start with stool that appears looser and more watery or harder and more lumpy than usual  - improve with a bowel movement
                
Other symptoms of IBS may include
                
- diarrheahaving loose, watery stools three or more times a day and feeling urgency to have a bowel movement  - constipationhaving hard, dry stools; two or fewer bowel movements in a week; or straining to have a bowel movement  - feeling that a bowel movement is incomplete  - passing mucus, a clear liquid made by the intestines that coats and protects tissues in the GI tract  - abdominal bloating
                
Symptoms may often occur after eating a meal. To meet the definition of IBS, symptoms must occur at least once per week for at least 2 months.
Question:  What causes Irritable Bowel Syndrome in Children ?
Answer: The causes of IBS are not well understood. Researchers believe a combination of physical and mental health problems can lead to IBS. The possible causes of IBS in children include the following:
                
- Brain-gut signal problems. Signals between the brain and nerves of the small and large intestines, also called the gut, control how the intestines work. Problems with brain-gut signals may cause IBS symptoms, such as changes in bowel habits and pain or discomfort.  - GI motor problems. Normal motility, or movement, may not be present in the colon of a child who has IBS. Slow motility can lead to constipation and fast motility can lead to diarrhea. Spasms, or sudden strong muscle contractions that come and go, can cause abdominal pain. Some children with IBS also experience hyperreactivity, which is an excessive increase in contractions of the bowel in response to stress or eating.  - Hypersensitivity. Children with IBS have greater sensitivity to abdominal pain than children without IBS. Affected children have been found to have different rectal tone and rectal motor response after eating a meal.  - Mental health problems. IBS has been linked to mental health, or psychological, problems such as anxiety and depression in children.  - Bacterial gastroenteritis. Some children who have bacterial gastroenteritisan infection or irritation of the stomach and intestines caused by bacteriadevelop IBS. Research has shown a connection between gastroenteritis and IBS in adults but not in children. But researchers believe postinfectious IBS does occur in children. Researchers do not know why gastroenteritis leads to IBS in some people and not others.  - Small intestinal bacterial overgrowth (SIBO). Normally, few bacteria live in the small intestine. SIBO is an increase in the number of bacteria or a change in the type of bacteria in the small intestine. These bacteria can produce excess gas and may also cause diarrhea and weight loss. Some researchers believe that SIBO may lead to IBS, and some studies have shown antibiotics to be effective in treating IBS. However, the studies were weak and more research is needed to show a link between SIBO and IBS.  - Genetics. Whether IBS has a genetic cause, meaning it runs in families, is unclear. Studies have shown that IBS is more common in people with family members who have a history of GI problems. However, the cause could be environmental or the result of heightened awareness of GI symptoms.
Question:  What are the treatments for Irritable Bowel Syndrome in Children ?
Answer: Though there is no cure for IBS, the symptoms can be treated with a combination of the following:
                
- changes in eating, diet, and nutrition  - medications  - probiotics  - therapies for mental health problems