bowang0911/MedQuAD huggingface dataset:
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.
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.
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.
- Microscopic colitis is an inflammation of the colon that a health care provider can see only with a microscope.  - The two types of microscopic colitis are collagenous colitis and lymphocytic colitis.  - The exact cause of microscopic colitis is unknown.  - Microscopic colitis is most common in females age 50 years or older.  - The most common symptom of microscopic colitis is chronic, watery, nonbloody diarrhea.  - A pathologista doctor who specializes in diagnosing diseasesdiagnoses microscopic colitis based on the findings of multiple biopsies taken throughout the colon.  - Treatment depends on the severity of symptoms.  - 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.
Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into ones underwear without being aware of it happening. Stool, also called feces, is solid waste that is passed as a bowel movement and includes undigested food, bacteria, mucus, and dead cells. Mucus is a clear liquid that coats and protects tissues in the digestive system.
                
Fecal incontinence can be upsetting and embarrassing. Many people with fecal incontinence feel ashamed and try to hide the problem. However, people with fecal incontinence should not be afraid or embarrassed to talk with their health care provider. Fecal incontinence is often caused by a medical problem and treatment is available.
Nearly 18 million U.S. adultsabout one in 12have fecal incontinence.1 People of any age can have a bowel control problem, though fecal incontinence is more common in older adults. Fecal incontinence is slightly more common among women. Having any of the following can increase the risk:
                
- diarrhea, which is passing loose, watery stools three or more times a day  - urgency, or the sensation of having very little time to get to the toilet for a bowel movement  - a disease or injury that damages the nervous system  - poor overall health from multiple chronic, or long lasting, illnesses  - a difficult childbirth with injuries to the pelvic floorthe muscles, ligaments, and tissues that support the uterus, vagina, bladder, and rectum
The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestinewhich includes the appendix, cecum, colon, and rectumand anus. The intestines are sometimes called the bowel. The last part of the GI tractcalled the lower GI tractconsists of the large intestine and anus.
                
The large intestine absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine then changes waste from liquid to stool. Stool passes from the colon to the rectum. The rectum is located between the last part of the coloncalled the sigmoid colonand the anus. The rectum stores stool prior to a bowel movement. During a bowel movement, stool moves from the rectum to the anus, the opening through which stool leaves the body.
Fecal incontinence can cause embarrassment, fear, and loneliness. Taking steps to cope is important. The following tips can help:
                
- carrying a bag with cleanup supplies and a change of clothes when leaving the house.  - finding public restrooms before one is needed.  - using the toilet before leaving home.  - wearing disposable underwear or absorbent pads inserted in the underwear.  - using fecal deodorantspills that reduce the smell of stool and gas. Although fecal deodorants are available over the counter, a health care provider can help people find them.
                
Eating tends to trigger contractions of the large intestine that push stool toward the rectum and also cause the rectum to contract for 30 to 60 minutes. Both these events increase the likelihood that a person will pass gas and have a bowel movement soon after eating. This activity may increase if the person is anxious. People with fecal incontinence may want to avoid eating in restaurants or at social gatherings, or they may want to take antidiarrheal medications before eating in these situations.
                
Anal Discomfort   The skin around the anus is delicate and sensitive. Constipation and diarrhea or contact between skin and stool can cause pain or itching. The following steps can help relieve anal discomfort:   - Washing the anal area after a bowel movement. Washing with water, but not soap, can help prevent discomfort. Soap can dry out the skin, making discomfort worse. Ideally, the anal area should be washed in the shower with lukewarm water or in a sitz batha special plastic tub that allows a person to sit in a few inches of warm water. No-rinse skin cleansers, such as Cavilon, are a good alternative. Wiping with toilet paper further irritates the skin and should be avoided. Premoistened, alcohol-free towelettes are a better choice.   - Keeping the anal area dry. The anal area should be allowed to air dry after washing. If time doesnt permit air drying, the anal area can be gently patted dry with a lint-free cloth.   - Creating a moisture barrier. A moisture barrier cream that contains ingredients such as dimethiconea type of siliconecan help form a barrier between skin and stool. The anal area should be cleaned before applying barrier cream. However, people should talk with their health care provider before using anal creams and ointments because some can irritate the anus.   - Using nonmedicated powders. Nonmedicated talcum powder or cornstarch can also relieve anal discomfort. As with moisture barrier creams, the anal area should be clean and dry before use.   - Using wicking pads or disposable underwear. Pads and disposable underwear with a wicking layer can pull moisture away from the skin.   - Wearing breathable clothes and underwear. Clothes and underwear should allow air to flow and keep skin dry. Tight clothes or plastic or rubber underwear that blocks air can worsen skin problems.   - Changing soiled underwear as soon as possible.
- Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into ones underwear without being aware of it happening.  - Nearly 18 million U.S. adultsabout one in 12have fecal incontinence. People with fecal incontinence should not be afraid or embarrassed to talk with their health care provider.  - Fecal incontinence has many causes, including      - diarrhea    - constipation    - muscle damage or weakness    - nerve damage    - loss of stretch in the rectum    - childbirth by vaginal delivery    - hemorrhoids and rectal prolapse    - rectocele    - inactivity    - Health care providers diagnose fecal incontinence based on a persons medical history, physical exam, and medical test results.  - Treatment for fecal incontinence may include one or more of the following:      - eating, diet, and nutrition    - medications    - bowel training    - pelvic floor exercises and biofeedback    - surgery    - electrical stimulation    - A food diary can help identify foods that cause fecal incontinence.  - Fecal incontinence can occur in children because of a birth defect or disease, but in most cases it occurs because of constipation.
Diverticular* disease affects the colon. The colon is part of the large intestine that removes waste from your body. Diverticular disease is made up of two conditions: diverticulosis and diverticulitis. Diverticulosis occurs when pouches, called diverticula, form in the colon. These pouches bulge out like weak spots in a tire. Diverticulitis occurs if the pouches become inflamed.
                
*See the Pronunciation Guide for tips on how to say the words in bold type.
Doctors are not sure what causes diverticular disease. Many think a diet low in fiber is the main cause. Fiber is a part of food that your body cannot digest. It is found in many fruits and vegetables. Fiber stays in the colon and absorbs water, which makes bowel movements easier to pass. Diets low in fiber may cause constipation, which occurs when stools are hard and difficult to pass. Constipation causes your muscles to strain when you pass stool. Straining may cause diverticula to form in the colon. If stool or bacteria get caught in the pouches, diverticulitis can occur.
The symptoms for diverticulosis and diverticulitis are different.
                
Diverticulosis. Many people don't have symptoms, but some people have cramping, bloating, and constipation. Some people also have bleeding, inflammation, and fistulas. If you are bleeding, bright red blood will pass through your rectum. The rectum is the end of the colon that connects to the anus. The rectum and anus are part of the gastrointestinal tract, which is the passage that food goes through. Rectal bleeding is usually painless, but it can be dangerous. You should see a doctor right away.
                
Diverticulitis. People with diverticulitis can have many symptoms. Often pain is felt in the lower part of the abdomen. If you have diverticulitis, you may have fevers, feel sick to your stomach, vomit, or have a change in your bowel habits.
A doctor may prescribe antibiotics and recommend following a liquid diet. Most people get better with this treatment. Some people may need surgery and other treatments.
                
- Surgery. Serious problems from diverticulitis are treated with surgery. Surgeons can clean the abdomen after infections and remove bleeding pouches and fistulas.  - Colon resection. If you get diverticulitis many times, your doctor might suggest taking out the part of the colon with diverticula. The healthy sections can be joined together. With the diverticula gone, you may avoid other infections.  - Emergency surgery. If you have severe problems, you may need emergency surgery to clear the infection and remove part of the colon. Later, a second surgery rejoins the healthy sections of the colon. The colon is separated for a brief time between surgeries, because rejoining the colon during the first surgery is not always safe. A temporary colostomy is needed between the two surgeries. A colostomy is an opening made on the abdomen where a plastic bag is connected to collect stool after food is digested. The surgeon makes the opening, called a stoma, and connects it to the end of the colon.
Eat a high-fiber diet to help prevent problems. Talk to your doctor about using fiber products like Benefiber, Citrucel, or Metamucil. Daily use can help you get the fiber you need if you do not get it through your diet.
                
Ask your doctor about which food choices are right for you.
                
Eating foods high in fiber is simple and can help reduce diverticular disease symptoms and problems.
                
Try eating more of the following:
                
- Fruit. Raw apples, peaches, pears, and tangerines.  - Vegetables. Fresh broccoli, squash, carrots, and brussels sprouts.  - Starchy vegetables. Potatoes, baked beans, kidney beans, and lima beans.  - Grains. Whole-wheat bread, brown rice, bran flake cereal, and oatmeal.
                
Talk with your doctor about making diet changes. Learn what to eat and how to put more of these high-fiber foods in your diet.
- Diverticular disease is more common in people as they grow older.  - A low-fiber diet is the most likely cause of the disease.  - Most people are treated with a high-fiber diet and pain medication.  - Add whole grain foods, high-fiber fruits, and vegetables to your diet.  - Contact a doctor if you notice symptoms such as fever, chills, nausea, vomiting, abdominal pain, rectal bleeding, or change in bowel habits.
If you have advanced chronic kidney disease (CKD), you may soon need treatment to do the work your kidneys can no longer do. Learning about your treatment options for kidney failure will help you make the best choice for you. Each treatment has pros and cons. Your choice of treatment will have a big effect on your daily life, such as continuing to work if you do so currently. Talking with your doctor ahead of time about your options can help you take control of your care. Understanding the treatment you choose and getting used to the idea that you need to have this treatment takes time. If you find your choice of treatment does not fit your lifestyle, talk with your doctor about picking another treatment that fits your needs better.
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of the bladder. The bladder stores urine. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men the urethra is long, while in women it is short.
You have three treatment options to choose from to filter your blood. A fourth option offers care without replacing the work of the kidneys. None of these treatments helps the kidneys get better. However, they all can help you feel better.
                
- Hemodialysis uses a machine to move your blood through a filter outside your body, removing wastes.  - Peritoneal dialysis uses the lining of your belly to filter your blood inside your body, removing wastes.  - Kidney transplantation is surgery to place a healthy kidney from a person who has just died or a living person, usually a family member, into your body to take over the job of filtering your blood.  - Conservative management is the choice not to treat kidney failure with dialysis or a transplant. Instead, the focus is on using medicines to keep you comfortable, preserving kidney function through diet, and treating the problems of kidney failure, such as anemiaa shortage of red blood cells that can make you tiredand weak bones.
- You have three treatment options to choose from to filter your blood. A fourth option offers care without replacing the work of the kidneys.      - Hemodialysis    - Peritoneal dialysis    - Kidney transplantation    - Conservative management    - None of these treatments helps the kidneys get better. However, they all can help you feel better.  - Hemodialysis uses a machine to move your blood through a filter outside your body, removing wastes.  - Peritoneal dialysis uses the lining of your belly to filter your blood inside your body, removing wastes.  - Kidney transplantation is surgery to place a healthy kidney from a person who has just died or a living person, usually a family member, into your body to take over the job of filtering your blood.  - Conservative management is the choice not to treat kidney failure with dialysis or a transplant.  - All of the treatment options for kidney failure require changes and restrictions in your diet.
Hirschsprung* disease (HD) is a disease of the large intestine that causes severe constipation or intestinal obstruction. Constipation means stool moves through the intestines slower than usual. Bowel movements occur less often than normal and stools are difficult to pass. Some children with HD cant pass stool at all, which can result in the complete blockage of the intestines, a condition called intestinal obstruction. People with HD are born with it and are usually diagnosed when they are infants. Less severe cases are sometimes diagnosed when a child is older. An HD diagnosis in an adult is rare.
                
*See Pronunciation Guide for tips on how to say the words in bold type.
People with HD have constipation because they lack nerve cells in a part or all of the large intestine. The nerve cells signal muscles in the large intestine to push stool toward the anus. Without a signal to push stool along, stool will remain in the large intestine.
                
How severe HD is depends on how much of the large intestine is affected. Short-segment HD means only the last part of the large intestine lacks nerve cells. Long-segment HD means most or all of the large intestine, and sometimes the last part of the small intestine, lacks nerve cells.
                
In a person with HD, stool moves through the large intestine until it reaches the part lacking nerve cells. At that point, the stool moves slowly or stops, causing an intestinal obstruction.
The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. Constipation in infants and children is common and usually comes and goes, but if your child has had ongoing constipation since birth, HD may be the problem.
                
Symptoms in Newborns
                
Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. Other symptoms include
                
- green or brown vomit  - explosive stools after a doctor inserts a finger into the rectum  - swelling of the belly, also known as the abdomen  - lots of gas  - bloody diarrhea
                

                
Symptoms in Toddlers and Older Children
                
Symptoms of HD in toddlers and older children include
                
- not being able to pass stools without laxatives or enemas. A laxative is medicine that loosens stool and increases bowel movements. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle.  - swelling of the abdomen.  - lots of gas.  - bloody diarrhea.  - slow growth or development.  - lack of energy because of a shortage of red blood cells, called anemia.
HD is diagnosed based on symptoms and test results.
                
A doctor will perform a physical exam and ask questions about your childs bowel movements. HD is much less likely if parents can identify a time when their childs bowel habits were normal.
                
If HD is suspected, the doctor will do one or more tests.
                
X rays
                
An x ray is a black-and-white picture of the inside of the body. To make the large intestine show up better, the doctor may fill it with barium liquid. Barium liquid is inserted into the large intestine through the anus.
                
If HD is the problem, the last segment of the large intestine will look narrower than normal. Just before this narrow segment, the intestine will look bulged. The bulging is caused by blocked stool stretching the intestine.
                
Manometry
                
During manometry, the doctor inflates a small balloon inside the rectum. Normally, the rectal muscles will relax. If the muscles dont relax, HD may be the problem. This test is most often done in older children and adults.
                
Biopsy
                
Biopsy is the most accurate test for HD. The doctor removes a tiny piece of the large intestine and looks at it with a microscope. If nerve cells are missing, HD is the problem.