shaneperry0101/health-chatbot huggingface dataset:
Question: What are the treatments for Hemorrhoids ?
Answer: At-home Treatments
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining.
Fiber is a substance found in plants. The human body cannot digest fiber, but fiber helps improve digestion and prevent constipation. Good sources of dietary fiber are fruits, vegetables, and whole grains. On average, Americans eat about 15 grams of fiber each day.3 The American Dietetic Association recommends 25 grams of fiber per day for women and 38 grams of fiber per day for men.3
Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
Other changes that may help relieve hemorrhoid symptoms include
- drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day - sitting in a tub of warm water for 10 minutes several times a day - exercising to prevent constipation - not straining during bowel movements
Over-the-counter creams and suppositories may temporarily relieve the pain and itching of hemorrhoids. These treatments should only be used for a short time because long-term use can damage the skin.
Medical Treatment
If at-home treatments do not relieve symptoms, medical treatments may be needed. Outpatient treatments can be performed in a doctor's office or a hospital. Outpatient treatments for internal hemorrhoids include the following:
- Rubber band ligation. The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink. This procedure should be performed only by a doctor. - Sclerotherapy. The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid. - Infrared coagulation. The doctor uses heat to shrink the hemorrhoid tissue.
Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed.
Question: What is (are) Growth Failure in Children with Chronic Kidney Disease ?
Answer: Growth failure is a complication of CKD in which children do not grow as expected. When a child is below the third percentilemeaning 97 percent of children the same age and gender are tallerhe or she has growth failure.1 CKD is kidney disease that does not go away with treatment and tends to get worse over time.
Health care providers use charts to monitor the growth of children with CKD and look for signs of growth failure. Growth charts for children use percentiles to compare a particular childs height with the height of children the same age and gender. For example, a child whose height is at the 50th percentile on a growth chart means half the children in the United States are taller than that child and half the children are shorter.
About one-third of children with CKD have growth failure.1 Children diagnosed with CKD at a younger age
- have a higher chance of developing growth failure - have more health issues related to growth failure and CKD
Question: What causes Growth Failure in Children with Chronic Kidney Disease ?
Answer: Researchers have found that many factors cause growth failure in children with CKD. In addition to removing wastes and extra fluid from the blood, the kidneys perform important functions for a childs growth. Understanding normal kidney function and growth helps families understand what causes growth failure in children with CKD.
Normal kidney function helps maintain the
- balance of nutrients and minerals, such as calcium and phosphorus, in the blood. These minerals are essential for normal bone growth. The kidneys use a hormone called calcitriol, a form of vitamin D, to help bones absorb the right amount of calcium from the blood. The kidneys also remove extra phosphorus, helping balance phosphorus and calcium levels in the blood. - bodys ability to use growth hormone. Growth hormone is necessary during childhood to help bones grow and stay healthy. The pituitary gland naturally produces growth hormone, which acts as a messenger to help the body grow. Growth hormone tells the liver to produce another hormone, called insulin-like growth factor, that travels to muscles, organs, and bones and tells them to grow. - correct levels of erythropoietin in the body. Erythropoietin is a hormone that helps bone marrow make red blood cells. - proper balance of sodium, also called salt; potassium; and acid-base levels in the blood. Acid-base balance refers to the amount of acid in the blood.
Damaged kidneys can slow a childs growth by
- causing mineral and bone disorder, which occurs when - vitamin D is not turned into calcitriol, which starves the bones of calcium. - phosphorus levels rise in the blood and draw calcium out of the bones and into the blood, causing the bones to weaken. - creating an imbalance of sodium, potassium, and acid-base levels in the blood, also called acidosis. When blood is not balanced, the body slows growth to focus energy on restoring the balance. - decreasing appetite. A child with CKD may not be hungry, or he or she may not have the energy to eat, which may lead to poor nutrition and slower growth. - decreasing the production of erythropoietin. When erythropoietin levels are low, a child may develop anemiaa condition that develops when the blood does not have enough healthy red blood cells to carry oxygen to cells throughout the body. Anemia can cause growth to slow or stop. - making an abnormally large amount of urine, called polyuria, which disrupts the bodys fluid balance. A child with polyuria loses minerals as well. The body slows growth to make up for the lost fluid and minerals. - preventing the body from correctly using growth hormone. When the kidneys are damaged, waste builds up in the blood and the body does not properly process growth hormone.
Question: What are the treatments for Growth Failure in Children with Chronic Kidney Disease ?
Answer: Health care providers treat growth failure in children with CKD with
- changes in eating, diet, and nutrition - medications - growth hormone therapy
Most children with growth failure grow to about one-third of their adult height within the first two years of life; therefore, it is important to start treatment for growth failure early.1
Question: What is (are) Mineral and Bone Disorder in Chronic Kidney Disease ?
Answer: Mineral and bone disorder in CKD occurs when damaged kidneys and abnormal hormone levels cause calcium and phosphorus levels in a persons blood to be out of balance. Mineral and bone disorder commonly occurs in people with CKD and affects most people with kidney failure receiving dialysis.
In the past, health care providers used the term renal osteodystrophy to describe mineral and hormone disturbances caused by kidney disease. Today, renal osteodystrophy only describes bone problems that result from mineral and bone disorder in CKD. Health care providers might use the phrase chronic kidney disease mineral and bone disorder, or CKD-MBD, to describe the condition that affects the bones, heart, and blood vessels.
Question: What causes Mineral and Bone Disorder in Chronic Kidney Disease ?
Answer: Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body. The kidneys
- stop activating calcitriol. The low levels of calcitriol in the body create an imbalance of calcium in the blood. - do not remove the phosphorus in the blood properly, so phosphorus levels rise in the blood. The extra phosphorus pulls calcium out of the bones, causing them to weaken.
Another factor contributes to the cause of mineral and bone disorder. When the kidneys are damaged, the parathyroid gland releases parathyroid hormone into the blood to pull calcium from the bones and raise blood calcium levels. This response restores the balance of phosphorus and calcium; however, it also starves the bones of much-needed calcium.
Question: What are the symptoms of Mineral and Bone Disorder in Chronic Kidney Disease ?
Answer: In adults, symptoms of mineral and bone disorder in CKD may not appear until bone changes have taken place for many years. For this reason, people often refer to the disease as a silent crippler. Eventually, a person with the condition may begin to feel bone and joint pain.
Mineral and Bone Disorder in Children with Chronic Kidney Disease Mineral and bone disorder in CKD is most serious when it occurs in children because their bones are still developing and growing. Growing children can show symptoms of mineral and bone disorder even in the early stages of CKD. Slowed bone growth leads to short stature, which may remain with a child into adulthood. One deformity caused by mineral and bone disorder in CKD occurs when the legs bend inward or outward, a condition often referred to as "renal rickets." More information is provided in the NIDDK health topic, Growth Failure in Children with Kidney Disease. Find more about childrens bone health on the Eunice Kennedy Shriver National Institute of Child Health and Human Development website at www.nichd.nih.gov.
Question: What are the complications of Mineral and Bone Disorder in Chronic Kidney Disease ?
Answer: The complications of mineral and bone disorder in CKD include slowed bone growth and deformities, and heart and blood vessel problems.
Slowed Bone Growth and Deformities
Damaged kidneys must work harder to clear phosphorus from the body. High levels of phosphorus cause lower levels of calcium in the blood, resulting in the following series of events:
- When a persons blood calcium level becomes too low, the parathyroid glands release parathyroid hormone. - Parathyroid hormone removes calcium from bones and places it into the blood, raising a persons blood calcium level at the risk of harming bones. - A low calcitriol level also leads to an increased level of parathyroid hormone.
If mineral and bone disorder in CKD remains untreated in adults, bones gradually become thin and weak, and a person with the condition may begin to feel bone and joint pain. Mineral and bone disorder in CKD also increases a persons risk of bone fractures.
Heart and Blood Vessel Problems
In addition to harming bones, mineral and bone disorder in CKD can cause problems in the heart and blood vessels:
- High levels of blood calcium can damage blood vessels and lead to heart problems. - High phosphorus levels also can cause blood vessels to become like bone, leading to hardening of the arteries. - High phosphorus levels also cause abnormal hormone regulation, even if the calcium level is acceptable.
Parathyroid hormone and another hormone made in the bones called FGF23 can also affect bone and heart health, leading to the following series of problems:
- When parathyroid hormone or FGF23 levels are high, a person can have heart problems. - The complex hormone abnormalities that cause bone deformities can also harm a persons heart and blood vessels.
Question: How to diagnose Mineral and Bone Disorder in Chronic Kidney Disease ?
Answer: A health care provider diagnoses mineral and bone disorder in CKD with
- a family and medical history - a physical exam - a blood test - a bone biopsy - an x-ray
Family and Medical History
Taking a medical and family history is one of the first things a health care provider may do to help diagnose mineral and bone disorder in CKD. He or she will ask the patient or caretaker questions about when the patient was first diagnosed with CKD and whether any family members have also had mineral and bone disorder with or without CKD.
Physical Exam
A physical exam may help diagnose mineral and bone disorder in CKD. During a physical exam, a health care provider usually examines a patients body for changes in bone structure.
Blood Test
A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. The blood test shows levels of calcium, phosphorus, parathyroid hormone, and sometimes vitamin D.
Bone Biopsy
A bone biopsy is a procedure that removes a piece of bone tissue for examination with a microscope. A health care provider performs the biopsy in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the hip bone. A pathologista doctor who specializes in diagnosing diseasesexamines the bone tissue in a lab. The test can show whether a persons bone cells are building normal bone.
X-ray
An x-ray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. A radiographer performs the x-ray at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. Patients do not need anesthesia. The patient will lie on a table or stand during the x-ray. The technician will position the x-ray machine over the bone area. The patient will hold his or her breath as the x-ray machine takes the picture so that the picture will not be blurry. The radiographer may ask the patient to change position for additional pictures. An x-ray can show extra calcium in blood vessels.
Each of these tests can help the health care provider determine whether CKD or some other condition is causing the mineral and bone disorder and decide on a course of treatment.
Question: What is (are) Zollinger-Ellison Syndrome ?
Answer: Zollinger-Ellison syndrome is a rare disorder that occurs when one or more tumors form in the pancreas and duodenum. The tumors, called gastrinomas, release large amounts of gastrin that cause the stomach to produce large amounts of acid. Normally, the body releases small amounts of gastrin after eating, which triggers the stomach to make gastric acid that helps break down food and liquid in the stomach. The extra acid causes peptic ulcers to form in the duodenum and elsewhere in the upper intestine.
The tumors seen with Zollinger-Ellison syndrome are sometimes cancerous and may spread to other areas of the body.
Question: What causes Zollinger-Ellison Syndrome ?
Answer: Experts do not know the exact cause of Zollinger-Ellison syndrome. About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1).1 MEN1 causes hormone-releasing tumors in the endocrine glands and the duodenum. Symptoms of MEN1 include increased hormone levels in the blood, kidney stones, diabetes, muscle weakness, weakened bones, and fractures.
More information about MEN1 is provided in the NIDDK health topic, Multiple Endocrine Neoplasia Type 1.
Question: What are the symptoms of Zollinger-Ellison Syndrome ?
Answer: Zollinger-Ellison syndrome signs and symptoms are similar to those of peptic ulcers. A dull or burning pain felt anywhere between the navel and midchest is the most common symptom of a peptic ulcer. This discomfort usually
- occurs when the stomach is emptybetween meals or during the nightand may be briefly relieved by eating food - lasts for minutes to hours - comes and goes for several days, weeks, or months
Other symptoms include
- diarrhea - bloating - burping - nausea - vomiting - weight loss - poor appetite
Some people with Zollinger-Ellison syndrome have only diarrhea, with no other symptoms. Others develop gastroesophageal reflux (GER), which occurs when stomach contents flow back up into the esophagusa muscular tube that carries food and liquids to the stomach. In addition to nausea and vomiting, reflux symptoms include a painful, burning feeling in the midchest. More information about GER is provided in the NIDDK health topic, Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults.
Question: What are the treatments for Zollinger-Ellison Syndrome ?
Answer: A health care provider treats Zollinger-Ellison syndrome with medications to reduce gastric acid secretion and with surgery to remove gastrinomas. A health care provider sometimes uses chemotherapymedications to shrink tumorswhen tumors are too widespread to remove with surgery.
Medications
A class of medications called proton pump inhibitors (PPIs) includes
- esomeprazole (Nexium) - lansoprazole (Prevacid) - pantoprazole (Protonix) - omeprazole (Prilosec or Zegerid) - dexlansoprazole (Dexilant)
PPIs stop the mechanism that pumps acid into the stomach, helping to relieve peptic ulcer pain and promote healing. A health care provider may prescribe people who have Zollinger-Ellison syndrome higher-than-normal doses of PPIs to control the acid production. Studies show that PPIs may increase the risk of hip, wrist, and spine fractures when a person takes them long term or in high doses, so its important for people to discuss risks versus benefits with their health care provider.
Surgery
Surgical removal of gastrinomas is the only cure for Zollinger-Ellison syndrome. Some gastrinomas spread to other parts of the body, especially the liver and bones. Finding and removing all gastrinomas before they spread is often challenging because many of the tumors are small.
Chemotherapy
Health care providers sometimes use chemotherapy drugs to treat gastrinomas that cannot be surgically removed, including
- streptozotocin (Zanosar) - 5-fluorouracil (Adrucil) - doxorubicin (Doxil)
Question: What is (are) Hemolytic Uremic Syndrome in Children ?
Answer: Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys' filtering system. Red blood cells contain hemoglobinan iron-rich protein that gives blood its red color and carries oxygen from the lungs to all parts of the body.
When the kidneys and glomerulithe tiny units within the kidneys where blood is filteredbecome clogged with the damaged red blood cells, they are unable to do their jobs. If the kidneys stop functioning, a child can develop acute kidney injurythe sudden and temporary loss of kidney function. Hemolytic uremic syndrome is the most common cause of acute kidney injury in children.
Question: What causes Hemolytic Uremic Syndrome in Children ?
Answer: The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system. The digestive system is made up of the gastrointestinal, or GI, tracta series of hollow organs joined in a long, twisting tube from the mouth to the anusand other organs that help the body break down and absorb food.
Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream. The toxins travel through the bloodstream and can destroy the red blood cells. E.coli O157:H7 can be found in
- undercooked meat, most often ground beef - unpasteurized, or raw, milk - unwashed, contaminated raw fruits and vegetables - contaminated juice - contaminated swimming pools or lakes
Less common causes, sometimes called atypical hemolytic uremic syndrome, can include
- taking certain medications, such as chemotherapy - having other viral or bacterial infections - inheriting a certain type of hemolytic uremicsyndrome that runs in families
More information about foodborne illnesses and the digestive system is provided in the NIDDK health topic, foodborne illnesses.
Question: What are the symptoms of Hemolytic Uremic Syndrome in Children ?
Answer: A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritisan inflammation of the lining of the stomach, small intestine, and large intestine such as
- vomiting - bloody diarrhea - abdominal pain - fever and chills - headache
As the infection progresses, the toxins released in the intestine begin to destroy red blood cells. When the red blood cells are destroyed, the child may experience the signs and symptoms of anemiaa condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygen.
Signs and symptoms of anemia may include
- fatigue, or feeling tired - weakness - fainting - paleness
As the damaged red blood cells clog the glomeruli, the kidneys may become damaged and make less urine. When damaged, the kidneys work harder to remove wastes and extra fluid from the blood, sometimes leading to acute kidney injury.
Other signs and symptoms of hemolytic uremic syndrome may include bruising and seizures.
When hemolytic uremic syndrome causes acute kidney injury, a child may have the following signs and symptoms:
- edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face - albuminuriawhen a child's urine has high levels of albumin, the main protein in the blood - decreased urine output - hypoalbuminemiawhen a child's blood has low levels of albumin - blood in the urine
Seek Immediate Care Parents or caretakers should seek immediate care for a child experiencing any urgent symptoms, such as - unusual bleeding - swelling - extreme fatigue - decreased urine output - unexplained bruises
Question: What are the complications of Hemolytic Uremic Syndrome in Children ?
Answer: Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.1
However, children with hemolytic uremic syndrome may have serious and sometimes life-threatening complications, including
- acute kidney injury - high blood pressure - blood-clotting problems that can lead to bleeding - seizures - heart problems - chronic, or long lasting, kidney disease - stroke - coma
Question: What are the treatments for Hemolytic Uremic Syndrome in Children ?
Answer: A health care provider will treat a child with hemolytic uremic syndrome by addressing
- urgent symptoms and preventing complications - acute kidney injury - chronic kidney disease (CKD)
In most cases, health care providers do not treat children with hemolytic uremic syndrome with antibiotics unless they have infections in other areas of the body. With proper management, most children recover without long-term health problems.2
Treating Urgent Symptoms and Preventing Complications
A health care provider will treat a child's urgent symptoms and try to prevent complications by
- observing the child closely in the hospital - replacing minerals, such as potassium and salt, and fluids through an intravenous (IV) tube - giving the child red blood cells and platelets cells in the blood that help with clottingthrough an IV - giving the child IV nutrition - treating high blood pressure with medications
Treating Acute Kidney Injury
If necessary, a health care provider will treat acute kidney injury with dialysisthe process of filtering wastes and extra fluid from the body with an artificial kidney. The two forms of dialysis are hemodialysis and peritoneal dialysis. Most children with acute kidney injury need dialysis for a short time only.
Treating Chronic Kidney Disease
Some children may sustain significant kidney damage that slowly develops into CKD. Children who develop CKD must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation.
In most cases, health care providers treat CKD with a kidney transplant. A kidney transplant is surgery to place a healthy kidney from someone who has just died or a living donor, most often a family member, into a person's body to take over the job of the failing kidney. Though some children receive a kidney transplant before their kidneys fail completely, many children begin with dialysis to stay healthy until they can have a transplant.
More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children.