bowang0911/MedQuAD huggingface dataset:
Short bowel syndrome is a group of problems related to poor absorption of nutrients. Short bowel syndrome typically occurs in people who have
                
- had at least half of their small intestine removed and sometimes all or part of their large intestine removed  - significant damage of the small intestine  - poor motility, or movement, inside the intestines
                
Short bowel syndrome may be mild, moderate, or severe, depending on how well the small intestine is working.
                
People with short bowel syndrome cannot absorb enough water, vitamins, minerals, protein, fat, calories, and other nutrients from food. What nutrients the small intestine has trouble absorbing depends on which section of the small intestine has been damaged or removed.
The small intestine is the tube-shaped organ between the stomach and large intestine. Most food digestion and nutrient absorption take place in the small intestine. The small intestine is about 20 feet long and includes the duodenum, jejunum, and ileum:
                
duodenumthe first part of the small intestine, where iron and other minerals are absorbed
                
jejunumthe middle section of the small intestine, where carbohydrates, proteins, fat, and most vitamins are absorbed
                
ileumthe lower end of the small intestine, where bile acids and vitamin B12 are absorbed
The main cause of short bowel syndrome is surgery to remove a portion of the small intestine. This surgery can treat intestinal diseases, injuries, or birth defects.
                
Some children are born with an abnormally short small intestine or with part of their bowel missing, which can cause short bowel syndrome. In infants, short bowel syndrome most commonly occurs following surgery to treat necrotizing enterocolitis, a condition in which part of the tissue in the intestines is destroyed.1
                
Short bowel syndrome may also occur following surgery to treat conditions such as
                
- cancer and damage to the intestines caused by cancer treatment  - Crohn's disease, a disorder that causes inflammation, or swelling, and irritation of any part of the digestive tract  - gastroschisis, which occurs when the intestines stick out of the body through one side of the umbilical cord  - internal hernia, which occurs when the small intestine is displaced into pockets in the abdominal lining  - intestinal atresia, which occurs when a part of the intestines doesn't form completely  - intestinal injury from loss of blood flow due to a blocked blood vessel  - intestinal injury from trauma  - intussusception, in which one section of either the large or small intestine folds into itself, much like a collapsible telescope  - meconium ileus, which occurs when the meconium, a newborn's first stool, is thicker and stickier than normal and blocks the ileum  - midgut volvulus, which occurs when blood supply to the middle of the small intestine is completely cut off  - omphalocele, which occurs when the intestines, liver, or other organs stick out through the navel, or belly button
                
Even if a person does not have surgery, disease or injury can damage the small intestine.
The main symptom of short bowel syndrome is diarrhealoose, watery stools. Diarrhea can lead to dehydration, malnutrition, and weight loss. Dehydration means the body lacks enough fluid and electrolyteschemicals in salts, including sodium, potassium, and chlorideto work properly. Malnutrition is a condition that develops when the body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function. Loose stools contain more fluid and electrolytes than solid stools. These problems can be severe and can be life threatening without proper treatment.
                
Other signs and symptoms may include
                
- bloating  - cramping  - fatigue, or feeling tired  - foul-smelling stool  - heartburn  - too much gas  - vomiting  - weakness
                
People with short bowel syndrome are also more likely to develop food allergies and sensitivities, such as lactose intolerance. Lactose intolerance is a condition in which people have digestive symptomssuch as bloating, diarrhea, and gasafter eating or drinking milk or milk products.
                
More information is provided in the NIDDK health topic, Lactose Intolerance.
The complications of short bowel syndrome may include
                
- malnutrition  - peptic ulcerssores on the lining of the stomach or duodenum caused by too much gastric acid  - kidney stonessolid pieces of material that form in the kidneys  - small intestinal bacterial overgrowtha condition in which abnormally large numbers of bacteria grow in the small intestine
                

                
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 and children are most likely to become dehydrated. Parents or caretakers should watch for the following signs and symptoms of dehydration:   - 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:   - organ damage   - shockwhen low blood pressure prevents blood and oxygen from getting to organs   - comaa sleeplike state in which a person is not conscious
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 and children are most likely to become dehydrated. Parents or caretakers should watch for the following signs and symptoms of dehydration:
                
- 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:
                
- organ damage  - shockwhen low blood pressure prevents blood and oxygen from getting to organs  - comaa sleeplike state in which a person is not conscious
- Short bowel syndrome is a group of problems related to poor absorption of nutrients.  - People with short bowel syndrome cannot absorb enough water, vitamins, minerals, protein, fat, calories, and other nutrients from food.  - The main symptom of short bowel syndrome is diarrhealoose, watery stools. Diarrhea can lead to dehydration, malnutrition, and weight loss.  - A health care provider will recommend treatment for short bowel syndrome based on a patient's nutritional needs. Treatment may include      - nutritional support    - medications    - surgery    - intestinal transplant
Diabetes is when your blood glucose, also called blood sugar, is too high. Blood glucose is the main type of sugar found in your blood and your main source of energy. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries glucose to all of your bodys cells to use for energy.
                
Your pancreasan organ, located between your stomach and spine, that helps with digestionreleases a hormone it makes, called insulin, into your blood. Insulin helps your blood carry glucose to all your bodys cells. Sometimes your body doesnt make enough insulin or the insulin doesnt work the way it should. Glucose then stays in your blood and doesnt reach your cells. Your blood glucose levels get too high and can cause diabetes or prediabetes.
                
Over time, having too much glucose in your blood can cause health problems.
                
*See the Pronunciation Guide for tips on how to say the the words in bold type.
The signs and symptoms of diabetes are
                
- being very thirsty  - urinating often  - feeling very hungry  - feeling very tired  - losing weight without trying  - sores that heal slowly  - dry, itchy skin  - feelings of pins and needles in your feet  - losing feeling in your feet  - blurry eyesight
                
Some people with diabetes dont have any of these signs or symptoms. The only way to know if you have diabetes is to have your doctor do a blood test.
Hashimotos disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an autoimmune disease. An autoimmune disease is a disorder in which the bodys immune system attacks the bodys own cells and organs. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances.
                
In Hashimotos disease, the immune system attacks the thyroid gland, causing inflammation and interfering with its ability to produce thyroid hormones. Large numbers of white blood cells called lymphocytes accumulate in the thyroid. Lymphocytes make the antibodies that start the autoimmune process.
                
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. Thyroid hormones regulate metabolismthe way the body uses energyand affect nearly every organ in the body. Without enough thyroid hormone, many of the bodys functions slow down. Hashimotos disease is the most common cause of hypothyroidism in the United States.1
                
More information is provided in the NIDDK health topic, Hypothyroidism.
The thyroid is a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on either side of the windpipe.
                
The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce and store hormones and release them into the bloodstream. The hormones then travel through the body and direct the activity of the bodys cells.
                
The thyroid makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is the active hormone and is made from T4. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.
                
Thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain, regulates thyroid hormone production. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary decreases TSH production.
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. After many years, or even decades, damage to the thyroid causes it to shrink and the goiter to disappear.
                
Not everyone with Hashimotos disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinicalmild and without symptoms, especially early in its course. With progression to hypothyroidism, people may have one or more of the following symptoms:
                
- fatigue  - weight gain  - cold intolerance  - joint and muscle pain  - constipation, or fewer than three bowel movements a week  - dry, thinning hair  - heavy or irregular menstrual periods and problems becoming pregnant  - depression  - memory problems  - a slowed heart rate
Diagnosis begins with a physical exam and medical history. A goiter, nodules, or growths may be found during a physical exam, and symptoms may suggest hypothyroidism. Health care providers will then perform blood tests to confirm the diagnosis. A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. Diagnostic blood tests may include the
                
- TSH test. The ultrasensitive TSH test is usually the first test performed. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available. Generally, a TSH reading above normal means a person has hypothyroidism.  - T4 test. The T4 test measures the actual amount of thyroid hormone circulating in the blood. In hypothyroidism, the level of T4 in the blood is lower than normal.  - antithyroid antibody test. This test looks for the presence of thyroid autoantibodies, or molecules produced by a persons body that mistakenly attack the bodys own tissues. Two principal types of antithyroid antibodies are      - anti-TG antibodies, which attack a protein in the thyroid called thyroglobulin    - anti-thyroperoxidase (TPO) antibodies, which attack an enzyme called thyroperoxidase in thyroid cells that helps convert T4 to T3. Having TPO autoantibodies in the blood means the bodys immune system attacked the thyroid tissue in the past. Most people with Hashimotos disease have these antibodies, although people whose hypothyroidism is caused by other conditions do not.
                
A health care provider may also order imaging tests, including an ultrasound or a computerized tomography (CT) scan.
                
- Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images; a patient does not need anesthesia.
                
- The images can show the size and texture of the thyroid, as well as a pattern of typical autoimmune inflammation, helping the health care provider confirm Hashimotos disease. The images can also show nodules or growths within the gland that suggest a malignant tumor.
                
- CT scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the x rays are taken. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. In some cases of Hashimotos disease, a CT scan is used to examine the placement and extent of a large goiter, and to show a goiters effect on nearby structures.
                
More information is provided in the NIDDK health topic, Thyroid Tests.
Treatment generally depends on whether the thyroid is damaged enough to cause hypothyroidism. In the absence of hypothyroidism, some health care providers treat Hashimotos disease to reduce the size of the goiter. Others choose not to treat the disease and simply monitor their patients for disease progression.
                
Hashimotos disease, with or without hypothyroidism, is treated with synthetic thyroxine, which is man-made T4. Health care providers prefer to use synthetic T4, such as Synthroid, rather than synthetic T3, because T4 stays in the body longer, ensuring a steady supply of thyroid hormone throughout the day. The thyroid preparations made with animal thyroid are not considered as consistent as synthetic thyroid (Levothyroxine) and rarely prescribed today.
                
Health care providers routinely test the blood of patients taking synthetic thyroid hormone and adjust the dose as necessary, typically based on the result of the TSH test. Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed.
Iodine is an essential mineral for the thyroid. However, people with Hashimotos disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hypothyroidism. Read more in Iodine in diet at www.nlm.nih.gov/medlineplus/ency/article/002421.htm.
                
Women need more iodine when they are pregnantabout 220 micrograms a daybecause the baby gets iodine from the mothers diet. Women who are breastfeeding need about 290 micrograms a day. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Pregnant women should choose iodized saltsalt supplemented with iodineover plain salt and take prenatal vitamins containing iodine to ensure this need is met.
                
To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health.
- 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.
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.
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
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.