Druvith/medqa1 huggingface dataset:
Question:  What to do for Mineral and Bone Disorder in Chronic Kidney Disease ?
Answer: - Mineral and bone disorder in chronic kidney disease (CKD) occurs when damaged kidneys and abnormal hormone levels cause calcium and phosphorus levels in a persons blood to be out of balance. Mineral and bone disorder commonly occurs in people with CKD and affects most people with kidney failure receiving dialysis.  - Chronic kidney disease is kidney damage that occurs slowly over many years, often due to diabetes or high blood pressure. Once damaged, the kidneys cant filter blood as they should.  - Hormones and minerals are important because they help bones stay strong. If a persons hormones and minerals are out of balance, his or her bones can become weak and malformed.   - Parathyroid hormone plays an important role in controlling calcium levels in the blood. When kidneys do not function properly, extra parathyroid hormone is released in the blood to move calcium from inside the bones into the blood.  - Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body. The kidneys stop activating calcitriol and do not remove the phosphorus in the blood properly.  - The complications of mineral and bone disorder in CKD include slowed bone growth and deformities, and heart and blood vessel problems.   - Treating mineral and bone disorder in CKD includes preventing damage to bones by controlling parathyroid hormone levels through changes in eating, diet, and nutrition; medications and supplements; and dialysis.   - Reducing dietary intake of phosphorus is one of the most important steps in preventing bone disease.  - If diet, medications, and dialysis cant control parathyroid hormone levels, a surgeon can remove one or more of the parathyroid glands.
Question:  What is (are) Zollinger-Ellison Syndrome ?
Answer: Zollinger-Ellison syndrome is a rare disorder that occurs when one or more tumors form in the pancreas and duodenum. The tumors, called gastrinomas, release large amounts of gastrin that cause the stomach to produce large amounts of acid. Normally, the body releases small amounts of gastrin after eating, which triggers the stomach to make gastric acid that helps break down food and liquid in the stomach. The extra acid causes peptic ulcers to form in the duodenum and elsewhere in the upper intestine.
                
The tumors seen with Zollinger-Ellison syndrome are sometimes cancerous and may spread to other areas of the body.
Question:  What is (are) Zollinger-Ellison Syndrome ?
Answer: The stomach, duodenum, and pancreas are digestive organs that break down food and liquid.
                
- The stomach stores swallowed food and liquid. The muscle action of the lower part of the stomach mixes the food and liquid with digestive juice. Partially digested food and liquid slowly move into the duodenum and are further broken down.  - The duodenum is the first part of the small intestinethe tube-shaped organ between the stomach and the large intestinewhere digestion of the food and liquid continues.  - The pancreas is an organ that makes the hormone insulin and enzymes for digestion. A hormone is a natural chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body. Insulin helps cells throughout the body remove glucose, also called sugar, from blood and use it for energy. The pancreas is located behind the stomach and close to the duodenum.
Question:  What causes Zollinger-Ellison Syndrome ?
Answer: Experts do not know the exact cause of Zollinger-Ellison syndrome. About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1).1 MEN1 causes hormone-releasing tumors in the endocrine glands and the duodenum. Symptoms of MEN1 include increased hormone levels in the blood, kidney stones, diabetes, muscle weakness, weakened bones, and fractures.
                
More information about MEN1 is provided in the NIDDK health topic, Multiple Endocrine Neoplasia Type 1.
Question:  How many people are affected by Zollinger-Ellison Syndrome ?
Answer: Zollinger-Ellison syndrome is rare and only occurs in about one in every 1 million people.1 Although anyone can get Zollinger-Ellison syndrome, the disease is more common among men 30 to 50 years old. A child who has a parent with MEN1 is also at increased risk for Zollinger-Ellison syndrome.2
Question:  What are the symptoms of Zollinger-Ellison Syndrome ?
Answer: Zollinger-Ellison syndrome signs and symptoms are similar to those of peptic ulcers. A dull or burning pain felt anywhere between the navel and midchest is the most common symptom of a peptic ulcer. This discomfort usually
                
- occurs when the stomach is emptybetween meals or during the nightand may be briefly relieved by eating food  - lasts for minutes to hours  - comes and goes for several days, weeks, or months
                
Other symptoms include
                
- diarrhea  - bloating  - burping  - nausea  - vomiting  - weight loss  - poor appetite
                
Some people with Zollinger-Ellison syndrome have only diarrhea, with no other symptoms. Others develop gastroesophageal reflux (GER), which occurs when stomach contents flow back up into the esophagusa muscular tube that carries food and liquids to the stomach. In addition to nausea and vomiting, reflux symptoms include a painful, burning feeling in the midchest. More information about GER is provided in the NIDDK health topic, Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults.
Question:  What are the symptoms of Zollinger-Ellison Syndrome ?
Answer: A person who has any of the following emergency symptoms should call or see a health care provider right away:
                
- chest pain  - sharp, sudden, persistent, and severe stomach pain  - red blood in stool or black stools  - red blood in vomit or vomit that looks like coffee grounds
                
These symptoms could be signs of a serious problem, such as
                
- internal bleedingwhen gastric acid or a peptic ulcer breaks a blood vessel  - perforationwhen a peptic ulcer forms a hole in the duodenal wall  - obstructionwhen a peptic ulcer blocks the path of food trying to leave the stomach
Question:  What are the treatments for Zollinger-Ellison Syndrome ?
Answer: A health care provider treats Zollinger-Ellison syndrome with medications to reduce gastric acid secretion and with surgery to remove gastrinomas. A health care provider sometimes uses chemotherapymedications to shrink tumorswhen tumors are too widespread to remove with surgery.
                
Medications
                
A class of medications called proton pump inhibitors (PPIs) includes
                
- esomeprazole (Nexium)  - lansoprazole (Prevacid)  - pantoprazole (Protonix)   - omeprazole (Prilosec or Zegerid)  - dexlansoprazole (Dexilant)
                
PPIs stop the mechanism that pumps acid into the stomach, helping to relieve peptic ulcer pain and promote healing. A health care provider may prescribe people who have Zollinger-Ellison syndrome higher-than-normal doses of PPIs to control the acid production. Studies show that PPIs may increase the risk of hip, wrist, and spine fractures when a person takes them long term or in high doses, so its important for people to discuss risks versus benefits with their health care provider.
                
Surgery
                
Surgical removal of gastrinomas is the only cure for Zollinger-Ellison syndrome. Some gastrinomas spread to other parts of the body, especially the liver and bones. Finding and removing all gastrinomas before they spread is often challenging because many of the tumors are small.
                
Chemotherapy
                
Health care providers sometimes use chemotherapy drugs to treat gastrinomas that cannot be surgically removed, including
                
- streptozotocin (Zanosar)  - 5-fluorouracil (Adrucil)  - doxorubicin (Doxil)
Question:  What to do for Zollinger-Ellison Syndrome ?
Answer: Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Zollinger-Ellison syndrome.
Question:  What to do for Zollinger-Ellison Syndrome ?
Answer: - Zollinger-Ellison syndrome is a rare disorder that occurs when one or more tumors form in the pancreas and duodenum.  - Experts do not know the exact cause of Zollinger-Ellison syndrome.  - About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1).  - Although anyone can get Zollinger-Ellison syndrome, the disease is more common among men 30 to 50 years old.  - Zollinger-Ellison syndrome signs and symptoms are similar to those of peptic ulcers.  - Some people with Zollinger-Ellison syndrome have only diarrhea, with no other symptoms. Others develop gastroesophageal reflux (GER).  - A health care provider diagnoses Zollinger-Ellison syndrome based on the following:      - medical history    - physical exam    - signs and symptoms    - blood tests    - upper gastrointestinal (GI) endoscopy    - imaging tests to look for gastrinomas    - measurement of stomach acid    - A health care provider treats Zollinger-Ellison syndrome with medications to reduce gastric acid secretion and with surgery to remove gastrinomas. A health care provider sometimes uses chemotherapymedications to shrink tumorswhen tumors are too widespread to remove with surgery.
Question:  What is (are) Hemolytic Uremic Syndrome in Children ?
Answer: Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys' filtering system. Red blood cells contain hemoglobinan iron-rich protein that gives blood its red color and carries oxygen from the lungs to all parts of the body.
                
When the kidneys and glomerulithe tiny units within the kidneys where blood is filteredbecome clogged with the damaged red blood cells, they are unable to do their jobs. If the kidneys stop functioning, a child can develop acute kidney injurythe sudden and temporary loss of kidney function. Hemolytic uremic syndrome is the most common cause of acute kidney injury in children.
Question:  What is (are) Hemolytic Uremic Syndrome in Children ?
Answer: The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder.
Question:  What causes Hemolytic Uremic Syndrome in Children ?
Answer: The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system. The digestive system is made up of the gastrointestinal, or GI, tracta series of hollow organs joined in a long, twisting tube from the mouth to the anusand other organs that help the body break down and absorb food.
                
Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream. The toxins travel through the bloodstream and can destroy the red blood cells. E.coli O157:H7 can be found in
                
- undercooked meat, most often ground beef  - unpasteurized, or raw, milk  - unwashed, contaminated raw fruits and vegetables  - contaminated juice  - contaminated swimming pools or lakes
                
Less common causes, sometimes called atypical hemolytic uremic syndrome, can include
                
- taking certain medications, such as chemotherapy  - having other viral or bacterial infections  - inheriting a certain type of hemolytic uremicsyndrome that runs in families
                
More information about foodborne illnesses and the digestive system is provided in the NIDDK health topic, foodborne illnesses.
Question:  What are the symptoms of Hemolytic Uremic Syndrome in Children ?
Answer: A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritisan inflammation of the lining of the stomach, small intestine, and large intestine such as
                
- vomiting  - bloody diarrhea  - abdominal pain  - fever and chills  - headache
                
As the infection progresses, the toxins released in the intestine begin to destroy red blood cells. When the red blood cells are destroyed, the child may experience the signs and symptoms of anemiaa condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygen.
                
Signs and symptoms of anemia may include
                
- fatigue, or feeling tired  - weakness  - fainting  - paleness
                
As the damaged red blood cells clog the glomeruli, the kidneys may become damaged and make less urine. When damaged, the kidneys work harder to remove wastes and extra fluid from the blood, sometimes leading to acute kidney injury.
                
Other signs and symptoms of hemolytic uremic syndrome may include bruising and seizures.
                
When hemolytic uremic syndrome causes acute kidney injury, a child may have the following signs and symptoms:
                
- edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face  - albuminuriawhen a child's urine has high levels of albumin, the main protein in the blood  - decreased urine output  - hypoalbuminemiawhen a child's blood has low levels of albumin  - blood in the urine
                

                
Seek Immediate Care   Parents or caretakers should seek immediate care for a child experiencing any urgent symptoms, such as   - unusual bleeding   - swelling   - extreme fatigue   - decreased urine output   - unexplained bruises
Question:  What are the complications of Hemolytic Uremic Syndrome in Children ?
Answer: Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.1
                
However, children with hemolytic uremic syndrome may have serious and sometimes life-threatening complications, including
                
- acute kidney injury  - high blood pressure  - blood-clotting problems that can lead to bleeding  - seizures  - heart problems  - chronic, or long lasting, kidney disease  - stroke  - coma
Question:  What are the treatments for Hemolytic Uremic Syndrome in Children ?
Answer: A health care provider will treat a child with hemolytic uremic syndrome by addressing
                
- urgent symptoms and preventing complications  - acute kidney injury  - chronic kidney disease (CKD)
                
In most cases, health care providers do not treat children with hemolytic uremic syndrome with antibiotics unless they have infections in other areas of the body. With proper management, most children recover without long-term health problems.2
                
Treating Urgent Symptoms and Preventing Complications
                
A health care provider will treat a child's urgent symptoms and try to prevent complications by
                
- observing the child closely in the hospital  - replacing minerals, such as potassium and salt, and fluids through an intravenous (IV) tube  - giving the child red blood cells and platelets cells in the blood that help with clottingthrough an IV  - giving the child IV nutrition  - treating high blood pressure with medications
                
Treating Acute Kidney Injury
                
If necessary, a health care provider will treat acute kidney injury with dialysisthe process of filtering wastes and extra fluid from the body with an artificial kidney. The two forms of dialysis are hemodialysis and peritoneal dialysis. Most children with acute kidney injury need dialysis for a short time only.
                
Treating Chronic Kidney Disease
                
Some children may sustain significant kidney damage that slowly develops into CKD. Children who develop CKD must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation.
                
In most cases, health care providers treat CKD with a kidney transplant. A kidney transplant is surgery to place a healthy kidney from someone who has just died or a living donor, most often a family member, into a person's body to take over the job of the failing kidney. Though some children receive a kidney transplant before their kidneys fail completely, many children begin with dialysis to stay healthy until they can have a transplant.
                
More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children.
Question:  How to prevent Hemolytic Uremic Syndrome in Children ?
Answer: Parents and caregivers can help prevent childhood hemolytic uremic syndrome due to E. coli O157:H7 by
                
- avoiding unclean swimming areas  - avoiding unpasteurized milk, juice, and cider  - cleaning utensils and food surfaces often  - cooking meat to an internal temperature of at least 160 F  - defrosting meat in the microwave or refrigerator  - keeping children out of pools if they have had diarrhea  - keeping raw foods separate  - washing hands before eating  - washing hands well after using the restroom and after changing diapers
                
When a child is taking medications that may cause hemolytic uremic syndrome, it is important that the parent or caretaker watch for symptoms and report any changes in the child's condition to the health care provider as soon as possible.
Question:  What to do for Hemolytic Uremic Syndrome in Children ?
Answer: At the beginning of the illness, children with hemolytic uremic syndrome may need IV nutrition or supplements to help maintain fluid balance in the body. Some children may need to follow a low-salt diet to help prevent swelling and high blood pressure.
                
Health care providers will encourage children with hemolytic uremic syndrome to eat when they are hungry. Most children who completely recover and do not have permanent kidney damage can return to their usual diet.
Question:  What to do for Hemolytic Uremic Syndrome in Children ?
Answer: - Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys' filtering system.  - The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system.  - Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream.  - A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritis, an inflammation of the lining of the stomach, small intestine, and large intestine.  - Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.  - Some children may sustain significant kidney damage that slowly develops into chronic kidney disease (CKD).  - Parents and caregivers can help prevent childhood hemolytic uremic syndrome due to E. coli O157:H7 by      - avoiding unclean swimming areas    - avoiding unpasteurized milk, juice, and cider    - cleaning utensils and food surfaces often    - cooking meat to an internal temperature of at least 160 F    - defrosting meat in the microwave or refrigerator    - keeping children out of pools if they have had diarrhea    - keeping raw foods separate    - washing hands before eating    - washing hands well after using the restroom and after changing diapers
Question:  What is (are) Treatment Methods for Kidney Failure: Peritoneal Dialysis ?
Answer: Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. Doctors call this lining the peritoneum. A doctor will place a soft tube, called a catheter, in your belly a few weeks before you start treatment.
                
When you start peritoneal dialysis, dialysis solutionwater with salt and other additivesflows from a bag through the catheter into your belly. When the bag is empty, you can disconnect your catheter from the bag and cap it so you can move around and do your normal activities. While the dialysis solution is inside your belly, it soaks up wastes and extra fluid from your body. After a few hours, you drain the used dialysis solution into a drain bag. You can then dispose of the used dialysis solution, which is now full of wastes and extra fluid, in a toilet or down the drain of a sink or bathtub. Then you start over with a fresh bag of dialysis solution.
                
The process of first draining the used dialysis solution and then replacing it with fresh solution is called an exchange. Most people do four to six exchanges every day, or during the night using a machine that moves the fluid in and out. The process goes on continuously, so you always have dialysis solution in your belly soaking up wastes and extra fluid from your body. For the best results from peritoneal dialysis, it is important that you perform all of your exchanges as your doctor instructs.
Question:  What is (are) Treatment Methods for Kidney Failure: Peritoneal Dialysis ?
Answer: The two types of peritoneal dialysis are continuous ambulatory peritoneal dialysisalso called CAPDand automated peritoneal dialysiswhich doctors sometimes call APD or continuous cycler-assisted peritoneal dialysis. After learning about the types of peritoneal dialysis, you can choose the type that best fits your schedule and lifestyle. If one schedule or type of peritoneal dialysis does not suit you, you can talk with your doctor about trying another type.
                
- Continuous ambulatory peritoneal dialysis does not require a machine. You can do it in any clean, well-lit place. The time period that the dialysis solution is in your belly is called the dwell time. With continuous ambulatory peritoneal dialysis, the dialysis solution stays in your belly for a dwell time of 4 to 6 hours, or more. Each exchange takes about 30 to 40 minutes. During an exchange, you can read, talk, watch television, or sleep. Usually, you change the dialysis solution at least four times a day and sleep with solution in your belly at night. You do not have to wake up and perform exchanges during the night.  - Automated peritoneal dialysis uses a machine called a cycler to fill and empty your belly three to five times during the night while you sleep. In the morning, you begin one exchange with a daylong dwell time. You may do an additional exchange around the middle of the afternoon without the cycler to increase the amount of waste removed and reduce the amount of fluid left behind in your body.
                
If you weigh more than 175 pounds or if your peritoneum filters wastes slowly, you may need a combination of continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. For example, some people use a cycler at night and perform one exchange during the day. Your health care team will help you determine the best schedule for you.