bowang0911/MedQuAD huggingface dataset:
Complications of Crohn's disease can include
                
- bowel obstruction. Crohn's disease can thicken the wall of the intestine. Over time, the thickened areas of the intestine can narrow, which can block the intestine. A partial or complete obstruction, also called a bowel blockage, can block the movement of food or stool through the intestines. A complete bowel obstruction is life threatening and requires immediate medical attention and often surgery.  - fistulasabnormal passages, or tunnels, between two organs, or between an organ and the outside of the body. How a health care provider treats fistulas depends on their type and severity. For some people, fistulas heal with medication and diet changes, while other people will need to have surgery.  - anal fissuressmall tears in the anus that may cause itching, pain, or bleeding. Most anal fissures heal with medical treatment, including ointments, warm baths, and dietary changes.  - ulcers. Inflammation anywhere along the GI tract can lead to ulcers or open sores in a person's mouth, intestines, anus, and perineumthe area between the anus and the sex organs. In most cases, the treatment a health care provider prescribes for Crohn's disease will also treat the ulcers.  - malnutritiona 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. Some people may need IV fluids or feeding tubes to replace lost nutrients and fluids.  - inflammation in other areas of the body. The immune system can trigger inflammation in the      - joints    - eyes    - skin
                
Health care providers can treat inflammation by adjusting medications or prescribing new medications.
                

                
Crohn's Disease and Colon Cancer   People with Crohn's disease in the large intestine may be more likely to develop colon cancer. People who receive ongoing treatment and remain in remission may reduce their chances of developing colon cancer.   People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer. Screening can include colonoscopy with biopsies. Such screening does not reduce a person's chances of developing colon cancer. Instead, screening can help diagnose cancer early and improve chances for recovery.
- Crohn's disease is a chronic, or long lasting, disease that causes inflammationirritation or swellingin the gastrointestinal (GI) tract.  - The exact cause of Crohn's disease is unknown. Researchers believe that factors such as an autoimmune reaction, genes, and environment may play a role in causing Crohn's disease.  - Crohn's disease can occur in people of any age. However, it is more likely to develop in people      - between the ages of 20 and 29    - who have a family member, most often a sibling or parent, with inflammatory bowel disease (IBD)    - who smoke cigarettes    - The most common signs and symptoms of Crohn's disease are diarrhea, abdominal cramping and pain, and weight loss.  - A health care provider diagnoses Crohn's disease with the following:      - medical and family history    - physical exam    - lab tests    - upper GI series    - computerized tomography (CT) scan    - intestinal endoscopy    - Which treatment a person needs depends on the severity of the disease and symptoms.  - Good nutrition is important in the management of Crohn's disease. A health care provider may recommend that a person make dietary changes.  - People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer.
Diabetes management and treatment is expensive. According to the American Diabetes Association (ADA), the average cost of health care for a person with diabetes is $13,741 a yearmore than twice the cost of health care for a person without diabetes.1
                
Many people who have diabetes need help paying for their care. For those who qualify, a variety of government and nongovernment programs can help cover health care expenses. This publication is meant to help people with diabetes and their family members find and access such resources.
Health insurance helps pay for medical care, including the cost of diabetes care. Health insurance options include the following:
                
- private health insurance, which includes group and individual health insurance  - government health insurance, such as Medicare, Medicaid, the Childrens Health Insurance Program (CHIP), TRICARE, and veterans health care programs
                
Starting in 2014, the Affordable Care Act (ACA) prevents insurers from denying coverage or charging higher premiums to people with preexisting conditions, such as diabetes. The ACA also requires most people to have health insurance or pay a fee. Some people may be exempt from this fee. Read more about the ACA at HealthCare.gov or call 18003182596, TTY 18558894325.
Medicaid is a state health insurance program for those with low incomes and few assets. Each state runs its own program. The Federal Government requires that Medicaid programs cover a specific set of services; however, states can choose to cover more services in addition to the ones required. A person may have Medicaid alone or Medicare and Medicaid. If a person has both types of coverage, Medicare pays first and Medicaid pays second. Medicaid may pay for things Medicare does not. A person can apply for Medicaid at a city or county department of social services office. The state medical assistance (Medicaid) office can help people find out whether they qualify for Medicaid and can provide more information about Medicaid programs. A social worker can also explain a states Medicaid program and help a person apply.
                
To contact a state Medicaid office, people can
                
- search for Medicaid information for a state at www.medicaid.gov or call 18772672323  - search online or check the government pages of the phone book for the local department of human services or department of social services
                
CHIP gives free or low-cost Medicaid to children whose parents earn too much for Medicaid, though not enough to pay for a health plan. CHIP may also provide assistance to parents. CHIP is a federal and state program. Read more at www.insurekidsnow.gov or call 18775437669.
Assistive technology is any device that assists, adapts, or helps to rehabilitate someone with a disability so he or she may function more safely, effectively, and independently at home, at work, and in the community. Assistive technology may include
                
- computers with features that make them accessible to people with disabilities  - adaptive equipment, such as wheelchairs  - bathroom modifications, such as grab bars or shower seats
                
The following organizations may be able to provide information, awareness, and training in the use of technology to assist people with disabilities:
                
Alliance for Technology Access 1119 Old Humboldt Road Jackson, TN 38305 Phone: 18009143017 or 7315545ATA (7315545282) TTY: 7315545284 Fax: 7315545283 Email: atainfo@ataccess.org Internet: www.ataccess.org
                
National Assistive Technology Technical Assistance Partnership 1700 North Moore Street, Suite 1540 Arlington, VA 222091903 Phone: 7035246686 Fax: 7035246630 TTY: 7035246639 Email: resnaTA@resna.org Internet: www.resnaprojects.org/nattap
                
United Cerebral Palsy 1825 K Street NW, Suite 600 Washington, D.C. 20006 Phone: 18008725827 or 2027760406 Internet: www.ucp.org/resources/assistive-technology
- Diabetes management and treatment is expensive. Many people who have diabetes need help paying for their care. For those who qualify, a variety of government and nongovernment programs can help cover health care expenses.  - Health insurance helps pay for medical care, including the cost of diabetes care. Health insurance options include private health insurance and government health insurance.  - Insurance companies sell private health insurance plans. Two types of private health insurance are group health insurance and individual health insurance.  - Medicare is a federal health insurance program that pays health care costs for eligible people who are age 65 or older, under age 65 with certain disabilities, or of any age with end-stage renal disease.  - Medicaid is a state health insurance program for those with low incomes and few assets. Each state runs its own program.  - The Childrens Health Insurance Program (CHIP) gives free or low-cost Medicaid to children whose parents earn too much for Medicaid, though not enough to pay for a health plan.  - Many local governments have public health departments that can help people who need medical care. Local resources such as charitable groups may offer financial help for some expenses related to diabetes.  - People should talk with their health care providers if they have problems paying for diabetes medications. Less expensive generic medications for diabetes, blood pressure, and cholesterol are available. If a health care provider prescribes medications that a person cannot afford, the person should ask the health care provider about cheaper alternatives.  - Health care providers may also be able to assist people who need help paying for their medications and diabetes testing supplies, such as glucose test strips, by providing free samples or referring them to local programs. Drug companies that sell insulin or diabetes medications often have patient assistance programs.
Viral hepatitis is inflammation of the liver caused by a virus. Several different viruses, named the hepatitis A, B, C, D, and E viruses, cause viral hepatitis.
                
All of these viruses cause acute, or short-term, viral hepatitis. The hepatitis B, C, and D viruses can also cause chronic hepatitis, in which the infection is prolonged, sometimes lifelong. Chronic hepatitis can lead to cirrhosis, liver failure, and liver cancer.
                
Researchers are looking for other viruses that may cause hepatitis, but none have been identified with certainty. Other viruses that less often affect the liver include cytomegalovirus; Epstein-Barr virus, also called infectious mononucleosis; herpesvirus; parvovirus; and adenovirus.
- Viral hepatitis is inflammation of the liver caused by the hepatitis A, B, C, D, or E viruses.  - Depending on the type of virus, viral hepatitis is spread through contaminated food or water, contact with infected blood, sexual contact with an infected person, or from mother to child during childbirth.  - Vaccines offer protection from hepatitis A and hepatitis B.  - No vaccines are available for hepatitis C, D, and E. Reducing exposure to the viruses offers the best protection.  - Hepatitis A and E usually resolve on their own. Hepatitis B, C, and D can be chronic and serious. Drugs are available to treat chronic hepatitis.
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.
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
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.
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
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.
Proximal neuropathy, sometimes called lumbosacral plexus neuropathy, femoral neuropathy, or diabetic amyotrophy, starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and in older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The length of the recovery period varies, depending on the type of nerve damage.
Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg. Focal neuropathy may cause
                
- inability to focus the eye  - double vision  - aching behind one eye  - paralysis on one side of the face, called Bell's palsy  - severe pain in the lower back or pelvis  - pain in the front of a thigh  - pain in the chest, stomach, or side  - pain on the outside of the shin or inside of the foot  - chest or abdominal pain that is sometimes mistaken for heart disease, a heart attack, or appendicitis
                
Focal neuropathy is painful and unpredictable and occurs most often in older adults with diabetes. However, it tends to improve by itself over weeks or months and does not cause long-term damage.
                
People with diabetes also tend to develop nerve compressions, also called entrapment syndromes. One of the most common is carpal tunnel syndrome, which causes numbness and tingling of the hand and sometimes muscle weakness or pain. Other nerves susceptible to entrapment may cause pain on the outside of the shin or the inside of the foot.
Doctors diagnose neuropathy on the basis of symptoms and a physical exam. During the exam, the doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch.
                
Foot Exams
                
Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam assesses the skin, muscles, bones, circulation, and sensation of the feet. The doctor may assess protective sensation or feeling in the feet by touching them with a nylon monofilamentsimilar to a bristle on a hairbrushattached to a wand or by pricking them with a pin. People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly. The doctor may also check temperature perception or use a tuning fork, which is more sensitive than touch pressure, to assess vibration perception.
                
Other Tests
                
The doctor may perform other tests as part of the diagnosis.
                
- Nerve conduction studies or electromyography are sometimes used to help determine the type and extent of nerve damage. Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles respond to electrical signals transmitted by nearby nerves. These tests are rarely needed to diagnose neuropathy.  - A check of heart rate variability shows how the heart responds to deep breathing and to changes in blood pressure and posture.  - Ultrasound uses sound waves to produce an image of internal organs. An ultrasound of the bladder and other parts of the urinary tract, for example, can be used to assess the structure of these organs and show whether the bladder empties completely after urination.
- Diabetic neuropathies are nerve disorders caused by many of the abnormalities common to diabetes, such as high blood glucose.  - Neuropathy can affect nerves throughout the body, causing numbness and sometimes pain in the hands, arms, feet, or legs, and problems with the digestive tract, heart, sex organs, and other body systems.  - Treatment first involves bringing blood glucose levels within the normal range. Good blood glucose control may help prevent or delay the onset of further problems.  - Foot care is an important part of treatment. People with neuropathy need to inspect their feet daily for any injuries. Untreated injuries increase the risk of infected foot sores and amputation.  - Treatment also includes pain relief and other medications as needed, depending on the type of nerve damage.  - Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting.
Most people do not have any symptoms of hepatitis A. If symptoms of hepatitis A occur, they include
                
- feeling tired  - muscle soreness  - upset stomach  - fever  - loss of appetite  - stomach pain  - diarrhea  - dark-yellow urine  - light-colored stools  - yellowish eyes and skin, called jaundice
                
Symptoms of hepatitis A can occur 2 to 7 weeks after coming into contact with the virus. Children younger than age 6 may have no symptoms. Older children and adults often get mild, flulike symptoms. See a doctor right away if you or a child in your care has symptoms of hepatitis A.
Hepatitis A usually gets better in a few weeks without treatment. However, some people can have symptoms for up to 6 months. Your doctor may suggest medicines to help relieve your symptoms. Talk with your doctor before taking prescription and over-the-counter medicines.
                
See your doctor regularly to make sure your body has fully recovered. If symptoms persist after 6 months, then you should see your doctor again.
                
When you recover, your body will have learned to fight off a future hepatitis A infection. However, you can still get other kinds of hepatitis.
- Hepatitis A is a virus, or infection, that causes inflammation of the liver.  - Anyone can get hepatitis A, but some people are more likely to than others.  - You could get hepatitis A through contact with an infected persons stool.  - Most people do not have any symptoms of hepatitis A.  - Children younger than age 6 may have no symptoms of hepatitis A.  - Hepatitis A may cause mild, flulike symptoms in older children and adults.  - See a doctor right away if you or a child in your care has symptoms of hepatitis A.  - A blood test will show if you have hepatitis A.  - Hepatitis A usually gets better in a few weeks without treatment.  - You can avoid getting hepatitis A by receiving the hepatitis A vaccine.  - Tell your doctor and your dentist if you have hepatitis A.  - See your doctor right away if you think you have been in contact with the hepatitis A virus.
Before scientists learned how to make synthetic hormones, many animal hormones, such as insulin, were used to treat human disorders. Growth hormone from animals did not work in humans. Human growth hormone (pituitary hGH) was therefore made from human pituitary glands by the National Hormone and Pituitary Program (NHPP), funded by the U.S. Department of Health and Human Services (HHS). From 1963 to 1985, the NHPP sent pituitary hGH to hundreds of doctors across the country. As a part of research studies, doctors used the hormone to treat nearly 7,700 children for failure to grow.
                
In 1985, the HHS learned that three young men treated with pituitary hGH died of Creutzfeldt-Jakob disease (CJD), a rare and incurable brain disease. The HHS believed these illnesses were related to pituitary hGH. The HHS immediately stopped the distribution of the hormone and began a national study to learn more about how pituitary hGH treatment may have caused this problem. The HHS continues to monitor individuals who received pituitary hGH through the NHPP for CJD.