bowang0911/MedQuAD huggingface dataset:
Acute diarrhea is usually caused by a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to a functional disorder such as irritable bowel syndrome or an intestinal disease such as Crohns disease.
                
The most common causes of diarrhea include the following:
                
- Bacterial infections. Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli (E. coli).  - Viral infections. Many viruses cause diarrhea, including rotavirus, norovirus, cytomegalovirus, herpes simplex virus, and viral hepatitis. Infection with the rotavirus is the most common cause of acute diarrhea in children. Rotavirus diarrhea usually resolves in 3 to 7 days but can cause problems digesting lactose for up to a month or longer.  - Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.  - Functional bowel disorders. Diarrhea can be a symptom of irritable bowel syndrome.  - Intestinal diseases. Inflammatory bowel disease, ulcerative colitis, Crohns disease, and celiac disease often lead to diarrhea.  - Food intolerances and sensitivities. Some people have difficulty digesting certain ingredients, such as lactose, the sugar found in milk and milk products. Some people may have diarrhea if they eat certain types of sugar substitutes in excessive quantities.  - Reaction to medicines. Antibiotics, cancer drugs, and antacids containing magnesium can all cause diarrhea.
                
Some people develop diarrhea after stomach surgery, which may cause food to move through the digestive system more quickly.
                
People who visit certain foreign countries are at risk for travelers diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Travelers diarrhea can be a problem for people traveling to developing countries in Africa, Asia, Latin America, and the Caribbean. Visitors to Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for travelers diarrhea.
                
In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own within 1 to 2 days, finding the cause is not usually necessary.
Diarrhea may be accompanied by cramping, abdominal pain, nausea, an urgent need to use the bathroom, or loss of bowel control. Some infections that cause diarrhea can also cause a fever and chills or bloody stools.
                
Dehydration
                
Diarrhea can cause dehydration. Loss of electrolytes through dehydration affects the amount of water in the body, muscle activity, and other important functions.
                
Dehydration is particularly dangerous in children, older adults, and people with weakened immune systems. Dehydration must be treated promptly to avoid serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.
                
Signs of dehydration in adults include
                
- thirst  - less frequent urination than usual  - dark-colored urine  - dry skin  - fatigue  - dizziness  - light-headedness
                
Signs of dehydration in infants and young children include
                
- dry mouth and tongue  - no tears when crying  - no wet diapers for 3 hours or more  - sunken eyes, cheeks, or soft spot in the skull  - high fever  - listlessness or irritability
                
Also, when people are dehydrated, their skin does not flatten back to normal right away after being gently pinched and released.
                
Anyone with signs of dehydration should see a health care provider immediately. Severe dehydration may require hospitalization.
                
Although drinking plenty of water is important in preventing dehydration, water does not contain electrolytes. Adults can prevent dehydration by also drinking liquids that contain electrolytes, such as fruit juices, sports drinks, caffeine-free soft drinks, and broths. Children with diarrhea should be given oral rehydration solutions such as Pedialyte, Naturalyte, Infalyte, and CeraLyte to prevent dehydration.
If acute diarrhea lasts 2 days or less, diagnostic tests are usually not necessary. If diarrhea lasts longer or is accompanied by symptoms such as fever or bloody stools, a doctor may perform tests to determine the cause.
                
Diagnostic tests to find the cause of diarrhea may include the following:
                
- Medical history and physical examination. The doctor will ask about eating habits and medication use and will perform a physical examination to look for signs of illness.  - Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection.  - Blood tests. Blood tests can be helpful in ruling out certain diseases.  - Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask a person to avoid foods with lactose, carbohydrates, wheat, or other ingredients to see whether the diarrhea responds to a change in diet.  - Sigmoidoscopy or colonoscopy. These tests may be used to look for signs of intestinal diseases that cause chronic diarrhea. For sigmoidoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end to look at the inside of the rectum and lower part of the colon. Colonoscopy is similar to sigmoidoscopy, but it allows the doctor to view the entire colon.
In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration.
                
Over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol and Kaopectate) may help stop diarrhea in adults. However, people with bloody diarrheaa sign of bacterial or parasitic infectionshould not use these medicines. If diarrhea is caused by bacteria or parasites, over-the-counter medicines may prolong the problem, so doctors usually prescribe antibiotics instead.
                
Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctors guidance.
Until diarrhea subsides, avoiding caffeine and foods that are greasy, high in fiber, or sweet may lessen symptoms. These foods can aggravate diarrhea. Some people also have problems digesting lactose during or after a bout of diarrhea. Yogurt, which has less lactose than milk, is often better tolerated. Yogurt with active, live bacterial cultures may even help people recover from diarrhea more quickly.
                
As symptoms improve, soft, bland foods can be added to the diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the health care provider may also recommend a bland diet. Once the diarrhea stops, the health care provider will likely encourage children to return to a normal and healthy diet if it can be tolerated. Infants with diarrhea should be given breast milk or full-strength formula as usual, along with oral rehydration solutions. Some children recovering from viral diarrheas have problems digesting lactose for up to a month or more.
Two types of diarrhea can be preventedrotavirus diarrhea and travelers diarrhea.
                
Rotavirus Diarrhea
                
Two oral vaccines have been approved by the U.S. Food and Drug Administration to protect children from rotavirus infections: rotavirus vaccine, live, oral, pentavalent (RotaTeq); and rotavirus vaccine, live, oral (Rotarix). RotaTeq is given to infants in three doses at 2, 4, and 6 months of age. Rotarix is given in two doses. The first dose is given when infants are 6 weeks old, and the second is given at least 4 weeks later but before infants are 24 weeks old.
                
Parents of infants should discuss rotavirus vaccination with a health care provider. For more information, parents can visit the Centers for Disease Control and Prevention rotavirus vaccination webpage at www.cdc.gov/vaccines/vpd-vac/rotavirus.
                
Travelers Diarrhea
                
To prevent travelers diarrhea, people traveling from the United States to developing countries should avoid
                
- drinking tap water, using tap water to brush their teeth, or using ice made from tap water  - drinking unpasteurized milk or milk products  - eating raw fruits and vegetables, including lettuce and fruit salads, unless they peel the fruits or vegetables themselves  - eating raw or rare meat and fish  - eating meat or shellfish that is not hot when served  - eating food from street vendors
                
Travelers can drink bottled water, soft drinks, and hot drinks such as coffee or tea.
                
People concerned about travelers diarrhea should talk with a health care provider before traveling. The health care provider may recommend that travelers bring medicine with them in case they develop diarrhea during their trip. Health care providers may advise some peopleespecially people with weakened immune systemsto take antibiotics before and during a trip to help prevent travelers diarrhea. Early treatment with antibiotics can shorten a bout of travelers diarrhea.
- Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day.  - Diarrhea is a common problem that usually goes away on its own.  - The most common causes of diarrhea include bacterial, viral, and parasitic infections; functional bowel disorders; intestinal diseases; food intolerances and sensitivities; and reactions to medicines.  - Diarrhea can cause dehydration, which is particularly dangerous in children, older adults, and people with weakened immune systems.  - Treatment involves replacing lost fluids and electrolytes. Depending on the cause of the problem, medication may also be needed to stop the diarrhea or treat an infection.  - Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.  - Adults with any of the following symptoms should see a health care provider: signs of dehydration, diarrhea for more than 2 days, severe pain in the abdomen or rectum, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry.  - Children with any of the following symptoms should see a health care provider: signs of dehydration, diarrhea for more than 24 hours, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry.  - People can take steps to prevent two types of diarrhearotavirus diarrhea and travelers diarrhea.
If you have diabetes,* the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancyeven before you know you are pregnant. Blood glucose targets are different for women who are trying to get pregnant. Targets are numbers you aim for.
                
Pregnancy and new motherhood are times of great excitement and change for any woman. If you have type 1 or type 2 diabetes and are hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. If you have diabetes and are already pregnant, don't panic! Just make sure you are doing everything you can to take care of yourself and your diabetes during your pregnancy.
                
For Women with Gestational Diabetes   More information about gestational diabetes, a type of diabetes that develops only during pregnancy, is provided in the NIDDK health topic, What I need to know about Gestational Diabetes.
                
*See Pronunciation Guide for tips on how to say the words in bold type.
                
If you have diabetes, your pregnancy is considered high risk, which means you have an increased risk of problems during your pregnancy. You need to pay special attention to your health, and you may need to see doctors who specialize in treating diabetes or its complications. Millions of high-risk pregnancies, such as those in which women are older than 35 or carrying two or more babies, produce perfectly healthy babies without affecting the mother's health.
- If you have diabetes, the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancyeven before you know you are pregnant.  - Keeping your blood glucose as close to normal as possible before and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby.  - Before you get pregnant, you can plan and prepare for having a healthy pregnancy and a healthy baby. If you have diabetes and are already pregnant, you can make sure you are doing everything you can to take care of yourself and your diabetes during your pregnancy.  - Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure you get the best care. Your health care team can help you learn how to use a healthy eating plan, physical activity, and medicines to reach your blood glucose targets before and during pregnancy.  - During pregnancy, the safest diabetes medicine is insulin. Your health care team will work with you to make a personalized insulin routine. Some medicines are not safe during pregnancy and should be stopped before you get pregnant. Your doctor can tell you which medicines to stop taking.  - You will have tests throughout your pregnancy to check your baby's health.  - You can give your baby a healthy start by breastfeeding.
Biliary atresia is a life-threatening condition in infants in which the bile ducts inside or outside the liver do not have normal openings.
                
Bile ducts in the liver, also called hepatic ducts, are tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. Bile is a fluid made by the liver that serves two main functions: carrying toxins and waste products out of the body and helping the body digest fats and absorb the fat-soluble vitamins A, D, E, and K.
                
With biliary atresia, bile becomes trapped, builds up, and damages the liver. The damage leads to scarring, loss of liver tissue, and cirrhosis. Cirrhosis is a chronic, or long lasting, liver condition caused by scar tissue and cell damage that makes it hard for the liver to remove toxins from the blood. These toxins build up in the blood and the liver slowly deteriorates and malfunctions. Without treatment, the liver eventually fails and the infant needs a liver transplant to stay alive.
                
The two types of biliary atresia are fetal and perinatal. Fetal biliary atresia appears while the baby is in the womb. Perinatal biliary atresia is much more common and does not become evident until 2 to 4 weeks after birth. Some infants, particularly those with the fetal form, also have birth defects in the heart, spleen, or intestines.
The first symptom of biliary atresia is jaundicewhen the skin and whites of the eyes turn yellow. Jaundice occurs when the liver does not remove bilirubin, a reddish-yellow substance formed when hemoglobin breaks down. Hemoglobin is an iron-rich protein that gives blood its red color. Bilirubin is absorbed by the liver, processed, and released into bile. Blockage of the bile ducts forces bilirubin to build up in the blood.
                
Other common symptoms of biliary atresia include
                
- dark urine, from the high levels of bilirubin in the blood spilling over into the urine  - gray or white stools, from a lack of bilirubin reaching the intestines  - slow weight gain and growth
Biliary atresia likely has multiple causes, though none are yet proven. Biliary atresia is not an inherited disease, meaning it does not pass from parent to child. Therefore, survivors of biliary atresia are not at risk for passing the disorder to their children.
                
Biliary atresia is most likely caused by an event in the womb or around the time of birth. Possible triggers of the event may include one or more of the following:
                
- a viral or bacterial infection after birth, such as cytomegalovirus, reovirus, or rotavirus  - an immune system problem, such as when the immune system attacks the liver or bile ducts for unknown reasons  - a genetic mutation, which is a permanent change in a genes structure  - a problem during liver and bile duct development in the womb  - exposure to toxic substances
Biliary atresia is treated with surgery, called the Kasai procedure, or a liver transplant.
                
Kasai Procedure
                
The Kasai procedure, named after the surgeon who invented the operation, is usually the first treatment for biliary atresia. During a Kasai procedure, the pediatric surgeon removes the infants damaged bile ducts and brings up a loop of intestine to replace them. As a result, bile flows straight to the small intestine.
                
While this operation doesnt cure biliary atresia, it can restore bile flow and correct many problems caused by biliary atresia. Without surgery, infants with biliary atresia are unlikely to live past age 2. This procedure is most effective in infants younger than 3 months old, because they usually havent yet developed permanent liver damage. Some infants with biliary atresia who undergo a successful Kasai procedure regain good health and no longer have jaundice or major liver problems.
                
If the Kasai procedure is not successful, infants usually need a liver transplant within 1 to 2 years. Even after a successful surgery, most infants with biliary atresia slowly develop cirrhosis over the years and require a liver transplant by adulthood.
                
Liver Transplant
                
Liver transplantation is the definitive treatment for biliary atresia, and the survival rate after surgery has increased dramatically in recent years. As a result, most infants with biliary atresia now survive. Progress in transplant surgery has also increased the availability and efficient use of livers for transplantation in children, so almost all infants requiring a transplant can receive one.
                
In years past, the size of the transplanted liver had to match the size of the infants liver. Thus, only livers from recently deceased small children could be transplanted into infants with biliary atresia. New methods now make it possible to transplant a portion of a deceased adults liver into an infant. This type of surgery is called a reduced-size or split-liver transplant.
                
Part of a living adult donors liver can also be used for transplantation. Healthy liver tissue grows quickly; therefore, if an infant receives part of a liver from a living donor, both the donor and the infant can grow complete livers over time.
                
Infants with fetal biliary atresia are more likely to need a liver transplantand usually soonerthan infants with the more common perinatal form. The extent of damage can also influence how soon an infant will need a liver transplant.
After the Kasai procedure, some infants continue to have liver problems and, even with the return of bile flow, some infants develop cirrhosis. Possible complications after the Kasai procedure include ascites, bacterial cholangitis, portal hypertension, and pruritus.
                
Ascites. Problems with liver function can cause fluid to build up in the abdomen, called ascites. Ascites can lead to spontaneous bacterial peritonitis, a serious infection that requires immediate medical attention. Ascites usually only lasts a few weeks. If ascites lasts more than 6 weeks, cirrhosis is likely present and the infant will probably need a liver transplant.
                
Bacterial cholangitis. Bacterial cholangitis is an infection of the bile ducts that is treated with bacteria-fighting medications called antibiotics.
                
Portal hypertension. The portal vein carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver. In cirrhosis, scar tissue partially blocks and slows the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension. Portal hypertension can cause gastrointestinal bleeding that may require surgery and an eventual liver transplant.
                
Pruritus. Pruritus is caused by bile buildup in the blood and irritation of nerve endings in the skin. Prescription medication may be recommended for pruritus, including resins that bind bile in the intestines and antihistamines that decrease the skins sensation of itching.
Infants with biliary atresia often have nutritional deficiencies and require special diets as they grow up. They may need a higher calorie diet, because biliary atresia leads to a faster metabolism. The disease also prevents them from digesting fats and can lead to protein and vitamin deficiencies. Vitamin supplements may be recommended, along with adding medium-chain triglyceride oil to foods, liquids, and infant formula. The oil adds calories and is easier to digest without bile than other types of fats. If an infant or child is too sick to eat, a feeding tube may be recommended to provide high-calorie liquid meals.
                
After a liver transplant, most infants and children can go back to their usual diet. Vitamin supplements may still be needed because the medications used to keep the body from rejecting the new liver can affect calcium and magnesium levels.
- Biliary atresia is a life-threatening condition in infants in which the bile ducts inside or outside the liver do not have normal openings.  - The first symptom of biliary atresia is jaundicewhen the skin and whites of the eyes turn yellow. Other symptoms include dark urine, gray or white stools, and slow weight gain and growth.  - Biliary atresia likely has multiple causes, though none is yet proven.  - No single test can definitively diagnose biliary atresia, so a series of tests is needed, including a blood test, abdominal x ray, ultrasound, liver scans, liver biopsy, and diagnostic surgery.  - Initial treatment for biliary atresia is usually the Kasai procedure, an operation where the bile ducts are removed and a loop of intestine is brought up to replace them.  - The definitive treatment for biliary atresia is liver transplant.  - After a liver transplant, a regimen of medications is used to prevent the immune system from rejecting the new liver. Health care providers may also prescribe blood pressure medications and antibiotics, along with special diets and vitamin supplements.
The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every day, the two kidneys process about 200 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra water. Children produce less urine than adults. The amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called the ureters. The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.