Shekswess/llama3_medquad_instruct_dataset huggingface dataset:
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: 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 causes Cystocele ?
Answer: A cystocele occurs when the muscles and supportive tissues between a womans bladder and vagina weaken and stretch, letting the bladder sag from its normal position and bulge into the vagina or through the vaginal opening. In a cystocele, the bladder tissue remains covered by the vaginal skin. A cystocele may result from damage to the muscles and tissues that hold the pelvic organs up inside the pelvis. A womans pelvic organs include the vagina, cervix, uterus, bladder, urethra, and small intestine. Damage to or weakening of the pelvic muscles and supportive tissues may occur after vaginal childbirth and with conditions that repeatedly strain or increase pressure in the pelvic area, such as
                
- repetitive straining for bowel movements  - constipation  - chronic or violent coughing  - heavy lifting  - being overweight or obese
                
A womans chances of developing a cystocele increase with age, possibly because of weakening muscles and supportive tissues from aging. Whether menopause increases a womans chances of developing a cystocele is unclear.
Question: What are the symptoms of Cystocele ?
Answer: The symptoms of a cystocele may include
                
- a vaginal bulge  - the feeling that something is falling out of the vagina  - the sensation of pelvic heaviness or fullness  - difficulty starting a urine stream  - a feeling of incomplete urination  - frequent or urgent urination
                
Women who have a cystocele may also leak some urine as a result of movements that put pressure on the bladder, called stress urinary incontinence. These movements can include coughing, sneezing, laughing, or physical activity, such as walking. Urinary retentionthe inability to empty the bladder completelymay occur with more severe cystoceles if the cystocele creates a kink in the womans urethra and blocks urine flow.
                
Women with mild cystoceles often do not have any symptoms.
Question: How to diagnose Cystocele ?
Answer: Diagnosing a cystocele requires medical tests and a physical exam of the vagina. Medical tests take place in a health care providers office, an outpatient center, or a hospital. The health care provider will ask about symptoms and medical history. A health care provider uses a grading system to determine the severity of a womans cystocele. A cystocele receives one of three grades depending on how far a womans bladder has dropped into her vagina:
                
- grade 1mild, when the bladder drops only a short way into the vagina  - grade 2moderate, when the bladder drops far enough to reach the opening of the vagina  - grade 3most advanced, when the bladder bulges out through the opening of the vagina
                
If a woman has difficulty emptying her bladder, a health care provider may measure the amount of urine left in the womans bladder after she urinates. The remaining urine is called the postvoid residual. A health care provider can measure postvoid residual with a bladder ultrasound. A bladder ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off the bladder to create an image and show the amount of remaining urine. A specially trained technician performs the procedure, and a radiologista doctor who specializes in medical imaginginterprets the images. A woman does not need anesthesia.
                
A health care provider can also use a cathetera thin, flexible tubeto measure a womans postvoid residual. The health care provider inserts the catheter through the womans urethra into her bladder to remove and measure the amount of remaining urine after the woman has urinated. A postvoid residual of 100 mL or more is a sign that the woman is not completely emptying her bladder. A woman receives local anesthesia.
                
A health care provider may use a voiding cystourethrograman x-ray exam of the bladderto diagnose a cystocele as well. A woman gets a voiding cystourethrogram while urinating. The x-ray images show the shape of the womans bladder and let the health care provider see any problems that might block normal urine flow. An x-ray technician performs a voiding cystourethrogram, and a radiologist interprets the images. A woman does not need anesthesia; however, some women may receive sedation. A health care provider may order additional tests to rule out problems in other parts of a womans urinary tract.
Question: What are the treatments for Cystocele ?
Answer: Cystocele treatment depends on the severity of the cystocele and whether a woman has symptoms. If a womans cystocele does not bother her, a health care provider may recommend only that she avoid heavy lifting or straining, which could worsen her cystocele. If a woman has symptoms that bother her and wants treatment, the health care provider may recommend pelvic muscle exercises, a vaginal pessary, or surgery.
                
Pelvic floor, or Kegel, exercises involve strengthening pelvic floor muscles. Strong pelvic floor muscles more effectively hold pelvic organs in place. A woman does not need special equipment for Kegel exercises.
                
The exercises involve tightening and relaxing the muscles that support pelvic organs. A health care provider can help a woman learn proper technique.
                
More information about pelvic muscle exercises is provided in the NIDDK health topic, Kegel Exercise Tips.
                
A vaginal pessary is a small, silicone medical device placed in the vagina that supports the vaginal wall and holds the bladder in place. Pessaries come in a number of shapes and sizes. A health care provider has many options to choose from to find the most comfortable pessary for a woman.
                
A heath care provider may recommend surgery to repair the vaginal wall support and reposition the womans bladder to its normal position. The most common cystocele repair is an anterior vaginal repairor anterior colporrhaphy. The surgeon makes an incision in the wall of the womans vagina and repairs the defect by folding over and sewing together extra supportive tissue between the vagina and bladder. The repair tightens the layers of tissue that separate the organs, creating more support for the bladder. A surgeon who specializes in the urinary tract or female reproductive system performs an anterior vaginal repair in a hospital. The woman receives either regional or general anesthesia. The woman may stay overnight in the hospital, and full recovery may take up to 4 to 6 weeks.
Question: What is (are) Inguinal Hernia ?
Answer: An inguinal hernia happens when contents of the abdomenusually fat or part of the small intestinebulge through a weak area in the lower abdominal wall. The abdomen is the area between the chest and the hips. The area of the lower abdominal wall is also called the inguinal or groin region.
                
Two types of inguinal hernias are
                
- indirect inguinal hernias, which are caused by a defect in the abdominal wall that is congenital, or present at birth  - direct inguinal hernias, which usually occur only in male adults and are caused by a weakness in the muscles of the abdominal wall that develops over time
                
Inguinal hernias occur at the inguinal canal in the groin region.
Question: What causes Inguinal Hernia ?
Answer: The cause of inguinal hernias depends on the type of inguinal hernia.
                
Indirect inguinal hernias. A defect in the abdominal wall that is present at birth causes an indirect inguinal hernia.
                
During the development of the fetus in the womb, the lining of the abdominal cavity forms and extends into the inguinal canal. In males, the spermatic cord and testicles descend out from inside the abdomen and through the abdominal lining to the scrotum through the inguinal canal. Next, the abdominal lining usually closes off the entrance to the inguinal canal a few weeks before or after birth. In females, the ovaries do not descend out from inside the abdomen, and the abdominal lining usually closes a couple of months before birth.1
                
Sometimes the lining of the abdomen does not close as it should, leaving an opening in the abdominal wall at the upper part of the inguinal canal. Fat or part of the small intestine may slide into the inguinal canal through this opening, causing a hernia. In females, the ovaries may also slide into the inguinal canal and cause a hernia.
                
Indirect hernias are the most common type of inguinal hernia.2 Indirect inguinal hernias may appear in 2 to 3 percent of male children; however, they are much less common in female children, occurring in less than 1 percent.3
                
Direct inguinal hernias. Direct inguinal hernias usually occur only in male adults as aging and stress or strain weaken the abdominal muscles around the inguinal canal. Previous surgery in the lower abdomen can also weaken the abdominal muscles.
                
Females rarely form this type of inguinal hernia. In females, the broad ligament of the uterus acts as an additional barrier behind the muscle layer of the lower abdominal wall. The broad ligament of the uterus is a sheet of tissue that supports the uterus and other reproductive organs.
Question: What are the symptoms of Inguinal Hernia ?
Answer: The first sign of an inguinal hernia is a small bulge on one or, rarely, on both sides of the grointhe area just above the groin crease between the lower abdomen and the thigh. The bulge may increase in size over time and usually disappears when lying down.
                
Other signs and symptoms can include
                
- discomfort or pain in the groinespecially when straining, lifting, coughing, or exercisingthat improves when resting  - feelings such as weakness, heaviness, burning, or aching in the groin  - a swollen or an enlarged scrotum in men or boys
                
Indirect and direct inguinal hernias may slide in and out of the abdomen into the inguinal canal. A health care provider can often move them back into the abdomen with gentle massage.
Question: What are the complications of Inguinal Hernia ?
Answer: Inguinal hernias can cause the following complications:
                
- Incarceration. An incarcerated hernia happens when part of the fat or small intestine from inside the abdomen becomes stuck in the groin or scrotum and cannot go back into the abdomen. A health care provider is unable to massage the hernia back into the abdomen.  - Strangulation. When an incarcerated hernia is not treated, the blood supply to the small intestine may become obstructed, causing strangulation of the small intestine. This lack of blood supply is an emergency situation and can cause the section of the intestine to die.
                

                
Seek Immediate Care   People who have symptoms of an incarcerated or a strangulated hernia should seek emergency medical help immediately. A strangulated hernia is a life-threatening condition. Symptoms of an incarcerated or a strangulated hernia include   - extreme tenderness or painful redness in the area of the bulge in the groin   - sudden pain that worsens quickly and does not go away   - the inability to have a bowel movement and pass gas   - nausea and vomiting   - fever
Question: How to diagnose Inguinal Hernia ?
Answer: A health care provider diagnoses an inguinal hernia with
                
- a medical and family history  - a physical exam  - imaging tests, including x rays
                
Medical and family history. Taking a medical and family history may help a health care provider diagnose an inguinal hernia. Often the symptoms that the patient describes will be signs of an inguinal hernia.
                
Physical exam. A physical exam may help diagnose an inguinal hernia. During a physical exam, a health care provider usually examines the patients body. The health care provider may ask the patient to stand and cough or strain so the health care provider can feel for a bulge caused by the hernia as it moves into the groin or scrotum. The health care provider may gently try to massage the hernia back into its proper position in the abdomen.
                
Imaging tests. A health care provider does not usually use imaging tests, including x rays, to diagnose an inguinal hernia unless he or she
                
- is trying to diagnose a strangulation or an incarceration  - cannot feel the inguinal hernia during a physical exam, especially in patients who are overweight  - is uncertain if the hernia or another condition is causing the swelling in the groin or other symptoms
                
Specially trained technicians perform imaging tests at a health care providers office, an outpatient center, or a hospital.
                
A radiologista doctor who specializes in medical imaginginterprets the images. A patient does not usually need anesthesia.
                
Tests may include the following:
                
- Abdominal x ray. An x ray is a picture recorded on film or on a computer using a small amount of radiation. The patient will lie on a table or stand during the x ray. The technician positions the x-ray machine over the abdominal area. The patient will hold his or her breath as the technician takes the picture so that the picture will not be blurry. The technician may ask the patient to change position for additional pictures.  - Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, the technician may give the patient a solution to drink and an injection of a special dye, called contrast medium. A health care provider injects the contrast medium into a vein, and the injection will make the patient feel warm all over for a minute or two. The contrast medium allows the health care provider to see the blood vessels and blood flow on the x rays. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the technician takes the x rays. A health care provider may give children a sedative to help them fall asleep for the test.  - Abdominal ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure.
Question: How to prevent Inguinal Hernia ?
Answer: People cannot prevent the weakness in the abdominal wall that causes indirect inguinal hernias. However, people may be able to prevent direct inguinal hernias by maintaining a healthy weight and not smoking.
                
People can keep inguinal hernias from getting worse or keep inguinal hernias from recurring after surgery by
                
- avoiding heavy lifting  - using the legs, not the back, when lifting objects  - preventing constipation and straining during bowel movements  - maintaining a healthy weight  - not smoking
Question: What to do for Inguinal Hernia ?
Answer: Researchers have not found that eating, diet, and nutrition play a role in causing inguinal hernias. A person with an inguinal hernia may be able to prevent symptoms by eating high-fiber foods. Fresh fruits, vegetables, and whole grains are high in fiber and may help prevent the constipation and straining that cause some of the painful symptoms of a hernia.
                
The surgeon will provide instructions on eating, diet, and nutrition after inguinal hernia surgery. Most people drink liquids and eat a light diet the day of the operation and then resume their usual diet the next day.
Question: What are the treatments for What I need to know about Living with Kidney Failure ?
Answer: Kidney failure means your kidneys no longer work well enough to do their job. You need treatment to replace the work your damaged kidneys have stopped doing. The treatments for kidney failure are
                
- hemodialysis  - peritoneal dialysis  - a kidney transplant
                
Your kidneys filter wastes and extra fluid from your blood to keep you healthy. The wastes and extra fluid become urine that is stored in your bladder until you urinate. When your kidneys fail, dialysis can take over a small part of the work your damaged kidneys can no longer do. You can make treatments work better by
                
- sticking to your treatment schedule  - taking all medicines your doctor prescribes  - following a special diet that keeps wastes from building up in your blood  - being active most days of the week
                
Hemodialysis
                
Hemodialysis is a treatment for kidney failure. Hemodialysis uses a machine to filter your blood outside your body. First, a dialysis nurse places two needles into your arm. A pump on the hemodialysis machine draws your blood through one of the needles into a tube. The tube takes the blood to a filter, called a dialyzer. Inside the dialyzer, your blood flows through thin fibers that are like straws. The wastes and extra fluid leave the blood through tiny holes in the fibers. Then, a different tube carries the filtered blood back to your body through the second needle.
                
More information is provided in the NIDDK health topics, Treatment Methods for Kidney Failure: Hemodialysis and Home Hemodialysis.
                
Peritoneal Dialysis
                
catheter
                
Treatment Methods for Kidney Failure: Peritoneal Dialysis
                
Kidney Transplant
                
A kidney transplant places a healthy kidney from another person into your body. The kidney may come from someone who has just died. Your doctor will place your name on a waiting list for a kidney. A family member or friend might be able to give you a kidney. Then you dont have to wait.
                
The new kidney takes over filtering your blood. The damaged kidneys usually stay where they are. The new kidney is placed in the front lower abdomen, on one side of the bladder. Your body normally attacks anything that shouldnt be there, such as bacteria. Your body will think the new kidney shouldnt be there. You will take medicines called immunosuppressants to keep your body from attacking the new kidney.
                
More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Transplantation.
                
*See the Pronunciation Guide for tips on how to say the the words in bold type.