bowang0911/MedQuAD huggingface dataset:
Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications.
                
Growth and Development
                
As children mature
                
- bladder capacity increases  - natural body alarms become activated  - an overactive bladder settles down  - production of ADH becomes normal  - response to the bodys signal that it is time to void improves
                
Bladder Training and Related Strategies
                
Bladder training consists of exercises to strengthen the bladder muscles to better control urination. Gradually lengthening the time between trips to the bathroom can also help by stretching the bladder so it can hold more urine. Additional techniques that may help control daytime UI include
                
- urinating on a scheduletimed voidingsuch as every 2 hours  - avoiding food or drinks with caffeine  - following suggestions for healthy urination, such as relaxing muscles and taking enough time to allow the bladder to empty completely
                
Waking children up to urinate can help decrease nighttime UI. Ensuring children drink enough fluids throughout the day so they do not drink a lot of fluids close to bedtime may also help. A health care provider can give guidance about how much a child needs to drink each day, as the amount depends on a childs age, physical activity, and other factors.
                
Moisture Alarms
                
At night, moisture alarms can wake children when they begin to urinate. These devices use a water-sensitive pad connected to an alarm that sounds when moisture is first detected. A small pad can clip to the pajamas, or a larger pad can be placed on the bed. For the alarm to be effective, children must awaken as soon as the alarm goes off, stop the urine stream, and go to the bathroom. Children using moisture alarms may need to have someone sleep in the same room to help wake them up.
                
Medications
                
Nighttime UI may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin (DDAVP), which is available in pill form, nasal spray, and nose drops. DDAVP is approved for use in children. Another medication, called imipramine (Tofranil), is also used to treat nighttime UI, though the way this medication prevents bedwetting is not known. Although both of these medications may help children achieve short-term success, relapse is common once the medication is withdrawn.
                
UI resulting from an overactive bladder may be treated with oxybutynin (Ditropan), a medication that helps calm the bladder muscle and control muscle spasms.
- Urinary incontinence (UI) 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. Although UI affects many children, it usually disappears naturally over time.  - By 5 years of age, more than 98 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 exact cause of most cases of nighttime UI is not known. Though a few cases are caused by structural problems in the urinary tract, most cases result from more than one factor including slower physical development, an overproduction of urine at night, and the inability to recognize bladder filling when asleep.  - Nighttime UI has also been associated with attention deficit hyperactivity disorder (ADHD), obstructive sleep apnea (OSA), and anxiety. Certain genes have been found to contribute to UI.  - Daytime UI that is not associated with urinary tract infection (UTI) or structural problems in the urinary tract may be due to an overactive bladder or infrequent or incomplete voiding problems.  - Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications.
Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more than 4 weeks. Children with chronic diarrhea may have loose, watery stools continually, or diarrhea may come and go. Chronic diarrhea may go away without treatment, or it may be a symptom of a chronic disease or disorder. Treating the disease or disorder can relieve chronic diarrhea.
                
Chronic diarrhea can affect children of any age:
                
- infantsages 0 to 12 months  - toddlersages 1 to 3 years  - preschool-age childrenages 3 to 5 years  - grade school-age childrenages 5 to 12 years  - adolescentsages 12 to 18 years
                
Diarrhea that lasts only a short time is called acute diarrhea. Acute diarrhea, a common problem, usually lasts a few days and goes away on its own. More information about acute diarrhea is provided in the NIDDK health topics:
                
- Diarrhea  - What I need to know about Diarrhea
Symptoms that accompany chronic diarrhea in children depend on the cause of the diarrhea. Symptoms can include
                
- cramping  - abdominal pain  - nausea or vomiting  - fever  - chills  - bloody stools
                
Children with chronic diarrhea who have malabsorption can experience
                
- bloating and swelling, also called distention, of the abdomen  - changes in appetite  - weight loss or poor weight gain
                

                
Consult a Health Care Provider   A childs parent or caretaker should consult a health care provider if the child   - has diarrhea for more than 24 hours   - is younger than 6 months old   - has received treatment and the diarrhea persists    Children with any of the following symptoms should see a health care provider right away:   - signs of malabsorptionbloating and swelling of the abdomen, changes in appetite, and weight loss or poor weight gain   - severe abdominal or rectal pain   - a fever of 102 degrees or higher   - stools containing blood or pus    More information is provided in the NIDDK health topics:   - Diarrhea   - What I need to know about Diarrhea
The treatment for chronic diarrhea will depend on the cause. Some common causes of chronic diarrhea are treated as follows:
                
- Infections. If a child has prolonged problems digesting certain carbohydrates or proteins after an acute infection, a health care provider may recommend changes in diet. A child may need antibiotics or medications that target parasites to treat infections that do not go away on their own. A health care provider may also prescribe antibiotics to treat small intestinal bacterial overgrowth.    - Functional GI disorders. For toddlers diarrhea, treatment is usually not needed. Most children outgrow toddlers diarrhea by the time they start school. In many children, limiting fruit juice intake and increasing the amount of fiber and fat in the diet may improve symptoms of toddlers diarrhea.  A health care provider may treat IBS with      - changes in diet.    - medication.    - probioticslive microorganisms, usually bacteria, that are similar to microorganisms normally found in the GI tract. Studies have found that probiotics, specifically Bifidobacteria and certain probiotic combinations, improve symptoms of IBS when taken in large enough amounts. However, researchers are still studying the use of probiotics to treat IBS.    - psychological therapy.
                
To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/probiotics.
                

                
- Food allergies and intolerances. A health care provider will recommend changes in diet to manage symptoms of food allergies and intolerances. To treat food allergies, the childs parent or caretaker should remove the food that triggers the allergy from the childs diet.  For children with celiac disease, following a gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further damage.  The childs parent or caretaker can manage the symptoms of lactose intolerance with changes in the childs diet and by using products that contain the lactase enzyme. Most children with lactose intolerance can tolerate some amount of lactose in their diet. The amount of change needed in the diet depends on how much lactose a child can consume without symptoms.  For children with dietary fructose intolerance, reducing the amount of fructose in the diet can relieve symptoms.    - IBD. A health care provider may use medications, surgery, and changes in diet to treat IBD.
- Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more than 4 weeks.  - Many diseases and disorders can cause chronic diarrhea in children. Common causes include infections, functional gastrointestinal (GI) disorders, food allergies and intolerances, and inflammatory bowel disease (IBD).  - Symptoms that accompany chronic diarrhea in children depend on the cause of the diarrhea. Symptoms can include cramping, abdominal pain, nausea or vomiting, fever, chills, or bloody stools.  - Children with chronic diarrhea who have malabsorption can experience bloating and swelling of the abdomen, changes in appetite, or weight loss or poor weight gain.  - Children with any of the following symptoms should see a health care provider right away: signs of malabsorption, severe abdominal or rectal pain, a fever of 102 degrees or higher, or stools containing blood or pus.  - To determine the cause of chronic diarrhea, the health care provider will take a complete medical and family history and conduct a physical exam, and may perform tests.  - The treatment for chronic diarrhea will depend on the cause.  - A childs parent or caretaker should talk with a health care provider about changing the childs diet to treat chronic diarrhea.
Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning it is a problem caused by changes in how the GI tract works. Children with a functional GI disorder have frequent symptoms, but the GI tract does not become damaged. IBS is not a disease; it is a group of symptoms that occur together. The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes and is not a product of a persons imagination.
                
IBS is diagnosed when a child who is growing as expected has abdominal pain or discomfort once per week for at least 2 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or may be relieved by a bowel movement.
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 a solid matter called 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.
Limited information is available about the number of children with IBS. Older studies have reported prevalence rates for recurrent abdominal pain in children of 10 to 20 percent.1 However, these studies did not differentiate IBS from functional abdominal pain, indigestion, and abdominal migraine. One study of children in North America found that 14 percent of high school students and 6 percent of middle school students have IBS. The study also found that IBS affects boys and girls equally.2
The symptoms of IBS include abdominal pain or discomfort and changes in bowel habits. To meet the definition of IBS, the pain or discomfort should be associated with two of the following three symptoms:
                
- start with bowel movements that occur more or less often than usual  - start with stool that appears looser and more watery or harder and more lumpy than usual  - improve with a bowel movement
                
Other symptoms of IBS may include
                
- diarrheahaving loose, watery stools three or more times a day and feeling urgency to have a bowel movement  - constipationhaving hard, dry stools; two or fewer bowel movements in a week; or straining to have a bowel movement  - feeling that a bowel movement is incomplete  - passing mucus, a clear liquid made by the intestines that coats and protects tissues in the GI tract  - abdominal bloating
                
Symptoms may often occur after eating a meal. To meet the definition of IBS, symptoms must occur at least once per week for at least 2 months.
The causes of IBS are not well understood. Researchers believe a combination of physical and mental health problems can lead to IBS. The possible causes of IBS in children include the following:
                
- Brain-gut signal problems. Signals between the brain and nerves of the small and large intestines, also called the gut, control how the intestines work. Problems with brain-gut signals may cause IBS symptoms, such as changes in bowel habits and pain or discomfort.  - GI motor problems. Normal motility, or movement, may not be present in the colon of a child who has IBS. Slow motility can lead to constipation and fast motility can lead to diarrhea. Spasms, or sudden strong muscle contractions that come and go, can cause abdominal pain. Some children with IBS also experience hyperreactivity, which is an excessive increase in contractions of the bowel in response to stress or eating.  - Hypersensitivity. Children with IBS have greater sensitivity to abdominal pain than children without IBS. Affected children have been found to have different rectal tone and rectal motor response after eating a meal.  - Mental health problems. IBS has been linked to mental health, or psychological, problems such as anxiety and depression in children.  - Bacterial gastroenteritis. Some children who have bacterial gastroenteritisan infection or irritation of the stomach and intestines caused by bacteriadevelop IBS. Research has shown a connection between gastroenteritis and IBS in adults but not in children. But researchers believe postinfectious IBS does occur in children. Researchers do not know why gastroenteritis leads to IBS in some people and not others.  - Small intestinal bacterial overgrowth (SIBO). Normally, few bacteria live in the small intestine. SIBO is an increase in the number of bacteria or a change in the type of bacteria in the small intestine. These bacteria can produce excess gas and may also cause diarrhea and weight loss. Some researchers believe that SIBO may lead to IBS, and some studies have shown antibiotics to be effective in treating IBS. However, the studies were weak and more research is needed to show a link between SIBO and IBS.  - Genetics. Whether IBS has a genetic cause, meaning it runs in families, is unclear. Studies have shown that IBS is more common in people with family members who have a history of GI problems. However, the cause could be environmental or the result of heightened awareness of GI symptoms.
- Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, meaning it is a problem caused by changes in how the GI tract works. Children with a functional GI disorder have frequent symptoms, but the GI tract does not become damaged.  - IBS is not a disease; it is a group of symptoms that occur together.  - The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both.  - The causes of IBS are not well understood. The possible causes of IBS in children include brain-gut signal problems, GI motor problems, hypersensitivity, mental health problems, bacterial gastroenteritis, small intestinal bacterial overgrowth, and genetics.  - To diagnose IBS, a health care provider will conduct a physical exam and take a complete medical history. The medical history will include questions about the childs symptoms, family members with GI disorders, recent infections, medications, and stressful events related to the onset of symptoms. IBS is diagnosed when the physical exam does not show any cause for the childs symptoms and the child meets all of the following criteria:      - has had symptoms at least once per week for at least 2 months    - is growing as expected    - is not showing any signs that suggest another cause for the symptoms    - Though there is no cure for IBS, the symptoms can be treated with a combination of the following:      - changes in eating, diet, and nutrition    - medications    - probiotics    - therapies for mental health problems
Gestational* diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. Your body uses glucose for energy. Too much glucose in your blood is not good for you or your baby.
                
Gestational diabetes is usually diagnosed during late pregnancy. If you are diagnosed with diabetes earlier in your pregnancy, you may have had diabetes before you became pregnant.
                
Treating gestational diabetes can help both you and your baby stay healthy. You can protect your baby and yourself by taking action right away to control your blood glucose levels.
                
If you have gestational diabetes, a health care team will likely be part of your care. In addition to your obstetrician-gynecologist, or OB/GYNthe doctor who will deliver your babyyour team might include a doctor who treats diabetes, a diabetes educator, and a dietitian to help you plan meals.
                
For Women with Type 1 or Type 2 Diabetes   If you already have type 1 or type 2 diabetes and are thinking about having a baby, talk with your doctor before you get pregnant. Untreated or poorly controlled diabetes can cause serious problems for your baby. More information is provided in the NIDDK health topic, What I need to know about Preparing for Pregnancy if I Have Diabetes or call 18008608747 and request a copy.
                
*See the Pronunciation Guide for tips on how to say the words in bold type.
Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels.
                
During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body's cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body's need for insulin. If your pancreas can't make enough insulin, you will have gestational diabetes.
                
All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.
                

                
What are my chances of getting gestational diabetes?   Your chances of getting gestational diabetes are higher if you   - are overweight   - have had gestational diabetes before   - have given birth to a baby weighing more than 9 pounds   - have a parent, brother, or sister with type 2 diabetes   - have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes   - are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American   - have a hormonal disorder called polycystic ovary syndrome, also known as PCOS
Your chances of getting gestational diabetes are higher if you
                
- are overweight  - have had gestational diabetes before  - have given birth to a baby weighing more than 9 pounds  - have a parent, brother, or sister with type 2 diabetes  - have prediabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes  - are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American  - have a hormonal disorder called polycystic ovary syndrome, also known as PCOS
Doctors use blood tests to diagnose gestational diabetes. All diabetes blood tests involve drawing blood at a doctor's office or a commercial facility. Blood samples are sent to a lab for analysis.
                

                
Screening Glucose Challenge Test
                
For this test, you will drink a sugary beverage and have your blood glucose level checked an hour later. This test can be done at any time of the day. If the results are above normal, you may need to have an oral glucose tolerance test.
                
Oral Glucose Tolerance Test
                
You will need to fast for at least 8 hours before the test. Fasting means having nothing to eat or drink except water. Your doctor will give you other instructions to follow before the test.
                
Your fasting blood glucose level will be checked before the test begins. Then you will drink a sugary beverage. Your blood glucose levels will be checked 1 hour, 2 hours, and possibly 3 hours later. Your doctor will use your test results to find out whether you have gestational diabetes.
If you have gestational diabetes, your doctor may recommend that you have some extra tests to check your baby's health, such as
                
- ultrasound exams, which use sound waves to make images that show your baby's growth and whether your baby is larger than normal  - a nonstress test, which uses a monitor placed on your abdomen to check whether your baby's heart rate increases as it should when your baby is active  - kick counts to check the time between your baby's movements