Shekswess/llama3_medquad_instruct_dataset huggingface dataset:
Question: What is (are) Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?
Answer: Microscopic colitis is an inflammation of the colon that a health care provider can see only with a microscope. Inflammation is the bodys normal response to injury, irritation, or infection of tissues. Microscopic colitis is a type of inflammatory bowel diseasethe general name for diseases that cause irritation and inflammation in the intestines.
                
The two types of microscopic colitis are collagenous colitis and lymphocytic colitis. Health care providers often use the term microscopic colitis to describe both types because their symptoms and treatments are the same. Some scientists believe that collagenous colitis and lymphocytic colitis may be different phases of the same condition rather than separate conditions.
                
In both types of microscopic colitis, an increase in the number of lymphocytes, a type of white blood cell, can be seen in the epitheliumthe layer of cells that lines the colon. An increase in the number of white blood cells is a sign of inflammation. The two types of colitis affect the colon tissue in slightly different ways:
                
- Lymphocytic colitis. The number of lymphocytes is higher, and the tissues and lining of the colon are of normal thickness.  - Collagenous colitis. The layer of collagen, a threadlike protein, underneath the epithelium builds up and becomes thicker than normal.
                
When looking through a microscope, the health care provider may find variations in lymphocyte numbers and collagen thickness in different parts of the colon. These variations may indicate an overlap of the two types of microscopic colitis.
Question: What is (are) Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?
Answer: The colon is part of the gastrointestinal (GI) tract, a series of hollow organs joined in a long, twisting tube from the mouth to the anusa 1-inch-long opening through which stool leaves the body. Organs that make up the GI tract are the
                
- mouth  - esophagus  - stomach  - small intestine  - large intestine  - anus
                
The first part of the GI tract, called the upper GI tract, includes the mouth, esophagus, stomach, and small intestine. The last part of the GI tract, called the lower GI tract, consists of the large intestine and anus. The intestines are sometimes called the bowel.
                
The large intestine is about 5 feet long in adults and includes the colon and rectum. The large intestine changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is 6 to 8 inches long in adults and is between the last part of the coloncalled the sigmoid colonand the anus. During a bowel movement, stool moves from the rectum to the anus and out of the body.
Question: What are the symptoms of Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?
Answer: The most common symptom of microscopic colitis is chronic, watery, nonbloody diarrhea. Episodes of diarrhea can last for weeks, months, or even years. However, many people with microscopic colitis may have long periods without diarrhea. Other signs and symptoms of microscopic colitis can include
                
- a strong urgency to have a bowel movement or a need to go to the bathroom quickly  - pain, cramping, or bloating in the abdomenthe area between the chest and the hipsthat is usually mild  - weight loss  - fecal incontinenceaccidental passing of stool or fluid from the rectumespecially at night  - nausea  - dehydrationa condition that results from not taking in enough liquids to replace fluids lost through diarrhea
                
The symptoms of microscopic colitis can come and go frequently. Sometimes, the symptoms go away without treatment.
Question: What are the treatments for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?
Answer: Treatment depends on the severity of symptoms. The gastroenterologist will
                
- review the medications the person is taking  - make recommendations to change or stop certain medications  - recommend that the person quit smoking
                
The gastroenterologist may prescribe medications to help control symptoms. Medications are almost always effective in treating microscopic colitis. The gastroenterologist may recommend eating, diet, and nutrition changes. In rare cases, the gastroenterologist may recommend surgery.
                
Medications
                
The gastroenterologist may prescribe one or more of the following:
                
- antidiarrheal medications such as bismuth subsalicylate (Kaopectate, Pepto-Bismol), diphenoxylate/atropine (Lomotil), and loperamide  - corticosteroids such as budesonide (Entocort) and prednisone  - anti-inflammatory medications such as mesalamine and sulfasalazine (Azulfidine)  - cholestyramine resin (Locholest, Questran)a medication that blocks bile acids  - antibiotics such as metronidazole (Flagyl) and erythromycin  - immunomodulators such as mercaptopurine (Purinethol), azathioprine (Azasan, Imuran), and methotrexate (Rheumatrex, Trexall)  - anti-TNF therapies such as infliximab (Remicade) and adalimumab (Humira)
                
Corticosteroids are medications that decrease inflammation and reduce the activity of the immune system. These medications can have many side effects. Scientists have shown that budesonide is safer, with fewer side effects, than prednisone. Most health care providers consider budesonide the best medication for treating microscopic colitis.
                
Patients with microscopic colitis generally achieve relief through treatment with medications, although relapses can occur. Some patients may need long-term treatment if they continue to have relapses.
Question: What to do for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?
Answer: To help reduce symptoms, a health care provider may recommend the following dietary changes:
                
- avoid foods and drinks that contain caffeine or artificial sugars  - drink plenty of liquids to prevent dehydration during episodes of diarrhea  - eat a milk-free diet if the person is also lactose intolerant  - eat a gluten-free diet
                
People should talk with their health care provider or dietitian about what type of diet is right for them.
                
Surgery
                
When the symptoms of microscopic colitis are severe and medications arent effective, a gastroenterologist may recommend surgery to remove the colon. Surgery is a rare treatment for microscopic colitis. The gastroenterologist will exclude other causes of symptoms before considering surgery.
Question: What is (are) Cyclic Vomiting Syndrome ?
Answer: Cyclic vomiting syndrome, sometimes referred to as CVS, is an increasingly recognized disorder with sudden, repeated attacksalso called episodesof severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. The episodes can last from a few hours to several days. Episodes can be so severe that a person has to stay in bed for days, unable to go to school or work. A person may need treatment at an emergency room or a hospital during episodes. After an episode, a person usually experiences symptom-free periods lasting a few weeks to several months. To people who have the disorder, as well as their family members and friends, cyclic vomiting syndrome can be disruptive and frightening.
                
The disorder can affect a person for months, years, or decades. Each episode of cyclic vomiting syndrome is usually similar to previous ones, meaning that episodes tend to start at the same time of day, last the same length of time, and occur with the same symptoms and level of intensity.
Question: What causes Cyclic Vomiting Syndrome ?
Answer: The cause of cyclic vomiting syndrome is unknown. However, some experts believe that some possible problems with bodily functions may contribute to the cause, such as the following:
                
- gastrointestinal motilitythe way food moves through the digestive system  - central nervous system functionincludes the brain, spinal cord, and nerves that control bodily responses  - autonomic nervous system functionnerves that control internal organs such as the heart  - hormone imbalanceshormones are a chemical produced in one part of the body and released into the blood to trigger or regulate particular bodily functions  - in children, an abnormal inherited gene may also contribute to the condition
                
Specific conditions or events may trigger an episode of cyclic vomiting:
                
- emotional stress, anxiety, or panic attacksfor example, in children, common triggers of anticipatory anxiety are school exams or events, birthday parties, holidays, family conflicts, or travel  - infections, such as a sinus infection, a respiratory infection, or the flu  - eating certain foods, such as chocolate or cheese, or additives such as caffeine, nitritescommonly found in cured meats such as hot dogsand monosodium glutamate, also called MSG  - hot weather  - menstrual periods  - motion sickness  - overeating, fasting, or eating right before bedtime  - physical exhaustion or too much exercise
Question: What are the symptoms of Cyclic Vomiting Syndrome ?
Answer: The main symptoms of cyclic vomiting syndrome are severe nausea and sudden vomiting lasting hours to days. A person may also experience one or more of the following symptoms:
                
- retching, or making an attempt to vomit  - heaving or gagging  - lack of appetite  - abdominal pain  - diarrhea  - fever  - dizziness  - headache  - sensitivity to light
                
Intensity of symptoms will vary as a person cycles through four distinct phases of an episode:
                
- Prodrome phase. During the prodrome phase, the person feels that an episode of nausea and vomiting is about to start. Often marked by intense sweating and nauseawith or without abdominal painthis phase can last from a few minutes to several hours. The person may appear unusually pale.  - Vomiting phase. This phase consists of intense nausea, vomiting, and retching. Periods of vomiting and retching can last 20 to 30 minutes at a time. The person may be subdued and responsive, immobile and unresponsive, or writhing and moaning with intense abdominal pain. An episode can last from hours to days.  - Recovery phase. This phase begins when the vomiting and retching stop and the nausea subsides. Improvement of symptoms during the recovery phase can vary. Healthy color, appetite, and energy return gradually or right away.  - Well phase. This phase occurs between episodes when no symptoms are present.
Question: What are the complications of Cyclic Vomiting Syndrome ?
Answer: The severe vomiting and retching that define cyclic vomiting syndrome increase the chance of developing several complications, including dehydration, esophagitis, a Mallory-Weiss tear, and tooth decay.
                
- Dehydration may occur when a person does not replace fluids that were lost because of vomiting and diarrhea. When dehydrated, the body lacks enough fluid and electrolytesminerals in salts, including sodium, potassium, and chlorideto function properly. Severe dehydration may require intravenous (IV) fluids and hospitalization.  - Esophagitisinflammation or irritation of the esophaguscan result from the stomach acid that exits through the esophagus during vomiting.  - A Mallory-Weiss teara tear in the lower end of the esophagusis caused by severe vomiting. A person with bloody vomit and stool should see a health care provider right away.  - Tooth decay or corroding tooth enamel is damage caused by stomach acid.
                

                
Seek Help for Signs or Symptoms of Severe Dehydration   People who have any signs or symptoms of severe dehydration should call or see a health care provider right away:   - excessive thirst   - dark-colored urine   - infrequent urination   - lethargy, dizziness, or faintness   - dry skin    Infants, children, older adults, and people with weak immune systems have the greatest chance of becoming dehydrated. People should watch for the following signs and symptoms of dehydration in infants, young children, and people who are unable to communicate their symptoms:   - dry mouth and tongue   - lack of tears when crying   - infants with no wet diapers for 3 hours or more   - infants with a sunken soft spot   - unusually cranky or drowsy behavior   - sunken eyes or cheeks   - fever    If left untreated, severe dehydration can cause serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.
Question: What are the symptoms of Cyclic Vomiting Syndrome ?
Answer: People who have any signs or symptoms of severe dehydration should call or see a health care provider right away:
                
- excessive thirst  - dark-colored urine  - infrequent urination  - lethargy, dizziness, or faintness  - dry skin
                
Infants, children, older adults, and people with weak immune systems have the greatest chance of becoming dehydrated. People should watch for the following signs and symptoms of dehydration in infants, young children, and people who are unable to communicate their symptoms:
                
- dry mouth and tongue  - lack of tears when crying  - infants with no wet diapers for 3 hours or more  - infants with a sunken soft spot  - unusually cranky or drowsy behavior  - sunken eyes or cheeks  - fever
                
If left untreated, severe dehydration can cause serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.
Question: What are the treatments for Cyclic Vomiting Syndrome ?
Answer: A health care provider may refer patients to a gastroenterologist for treatment.
                
People with cyclic vomiting syndrome should get plenty of rest and take medications to prevent a vomiting episode, stop an episode in progress, speed up recovery, or relieve associated symptoms.
                
The health care team tailors treatment to the symptoms experienced during each of the four cyclic vomiting syndrome phases:
                
- Prodrome phase treatment. The goal during the prodrome phase is to stop an episode before it progresses. Taking medication early in the phase can help stop an episode from moving to the vomiting phase or becoming severe; however, people do not always realize an episode is coming. For example, a person may wake up in the morning and begin vomiting. A health care provider may recommend the following medications for both children and adults:      - ondansetron (Zofran) or lorazepam (Ativan) for nausea    - ibuprofen for abdominal pain    - ranitidine (Zantac), lansoprazole (Prevacid), or omeprazole (Prilosec, Zegerid) to control stomach acid production    - sumatriptan (Imitrex)prescribed as a nasal spray, an injection, or a pill that dissolves under the tonguefor migraines    - Vomiting phase treatment. Once vomiting begins, people should call or see a health care provider as soon as possible. Treatment usually requires the person to stay in bed and sleep in a dark, quiet room. A health care provider may recommend the following for both children and adults:      - medication for pain, nausea, and reducing stomach acid and anxiety    - anti-migraine medications such as sumatriptan to stop symptoms of a migraine or possibly stop an episode in progress    - hospitalization for severe nausea and vomiting    - IV fluids and medications to prevent dehydration and treat symptoms    - IV nutrition if an episode continues for several days    - Recovery phase treatment. During the recovery phase, drinking and eating will replace lost electrolytes. A person may need IV fluids for a period of time. Some people find their appetite returns to normal right away, while others start by drinking clear liquids and then moving slowly to other liquids and solid food. A health care provider may prescribe medications during the recovery phase and well phase to prevent future episodes.  - Well phase treatment. During the well phase, a health care provider may use medications to treat people whose episodes are frequent and long lasting in an effort to prevent or ease future episodes. A person may need to take a medication daily for 1 to 2 months before evaluating whether it helps prevent episodes. A health care provider may prescribe the following medications for both children and adults during the well phase to prevent cyclic vomiting syndrome episodes, lessen their severity, and reduce their frequency:      - amitriptyline (Elavil)    - propranolol (Inderal)    - cyproheptadine (Periactin)
Question: How to prevent Cyclic Vomiting Syndrome ?
Answer: A person should stay away from known triggers, especially during the well phase, as well as
                
- get adequate sleep to prevent exhaustion  - treat sinus problems or allergies  - seek help on reducing stress and anxiety  - avoid foods that trigger episodes or foods with additives
                
A health care provider may refer people with cyclic vomiting syndrome and anxiety to a stress management specialist for relaxation therapy or other treatments.
                
A health care provider may prescribe medications to prevent migraines for people with cyclic vomiting syndrome.
Question: What to do for Cyclic Vomiting Syndrome ?
Answer: During the prodrome and vomiting phases of cyclic vomiting syndrome, a person will generally take in little or no nutrition by mouth. During the recovery phase, the person may be quite hungry as soon as the vomiting stops. As eating resumes, a person or his or her family should watch for the return of nausea. In some cases, a person can start with clear liquids and proceed slowly to a regular diet.
                
During the well phase, a balanced diet and regular meals are important. People should avoid any trigger foods and foods with additives. Eating small, carbohydrate-containing snacks between meals, before exercise, and at bedtime may help prevent future attacks. A health care provider will assist with planning a return to a regular diet.
Question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?
Answer: Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbnessloss of feelingin the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.
                
About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.
Question: What causes Diabetic Neuropathies: The Nerve Damage of Diabetes ?
Answer: The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors:
                
- metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin  - neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves  - autoimmune factors that cause inflammation in nerves  - mechanical injury to nerves, such as carpal tunnel syndrome  - inherited traits that increase susceptibility to nerve disease  - lifestyle factors, such as smoking or alcohol use
Question: What are the symptoms of Diabetic Neuropathies: The Nerve Damage of Diabetes ?
Answer: Symptoms depend on the type of neuropathy and which nerves are affected. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomicor involuntarynervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe.
                
Symptoms of nerve damage may include
                
- numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers  - wasting of the muscles of the feet or hands  - indigestion, nausea, or vomiting  - diarrhea or constipation  - dizziness or faintness due to a drop in blood pressure after standing or sitting up  - problems with urination  - erectile dysfunction in men or vaginal dryness in women  - weakness
                
Symptoms that are not due to neuropathy, but often accompany it, include weight loss and depression.
Question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?
Answer: Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways.
                
- Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms.  - Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.  - Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs.  - Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.
                

                
Neuropathy Affects Nerves Throughout the Body  Peripheral neuropathy affects   - toes   - feet   - legs   - hands   - arms   Autonomic neuropathy affects   - heart and blood vessels   - digestive system   - urinary tract   - sex organs   - sweat glands   - eyes   - lungs   Proximal neuropathy affects   - thighs   - hips   - buttocks   - legs   Focal neuropathy affects   - eyes   - facial muscles   - ears   - pelvis and lower back   - chest   - abdomen   - thighs   - legs   - feet
Question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?
Answer: Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Feet and legs are likely to be affected before hands and arms. Many people with diabetes have signs of neuropathy that a doctor could note but feel no symptoms themselves. Symptoms of peripheral neuropathy may include
                
- numbness or insensitivity to pain or temperature  - a tingling, burning, or prickling sensation  - sharp pains or cramps  - extreme sensitivity to touch, even light touch  - loss of balance and coordination
                
These symptoms are often worse at night.
                
Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If an infection occurs and is not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Many amputations are preventable if minor problems are caught and treated in time.