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Health care providers will decide how to treat childhood nephrotic syndrome based on the type: - primary childhood nephrotic syndrome: medications - secondary childhood nephrotic syndrome: treat the underlying illness or disease - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, and transplantation Primary Childhood Nephrotic Syndrome Health care providers treat idiopathic childhood nephrotic syndrome with several types of medications that control the immune system, remove extra fluid, and lower blood pressure. - Control the immune system. Corticosteroids are a group of medications that reduce the activity of the immune system, decrease the amount of albumin lost in the urine, and decrease swelling. Health care providers commonly use prednisone or a related corticosteroid to treat idiopathic childhood nephrotic syndrome. About 90 percent of children achieve remission with daily corticosteroids for 6 weeks and then a slightly smaller dose every other day for 6 weeks.2 Remission is a period when the child is symptom-free. Many children relapse after initial therapy, and health care providers treat them with a shorter course of corticosteroids until the disease goes into remission again. Children may have multiple relapses; however, they most often recover without long-term kidney damage. When a child has frequent relapses or does not respond to treatment, a health care provider may prescribe other medications that reduce the activity of the immune system. These medications prevent the body from making antibodies that can damage kidney tissues. They include - cyclophosphamide - mycophenolate (CellCept, Myfortic) - cyclosporine - tacrolimus (Hecoria, Prograf) A health care provider may use these other immune system medications with corticosteroids or in place of corticosteroids. - Remove extra fluid. A health care provider may prescribe a diuretic, a medication that helps the kidneys remove extra fluid from the blood. Removing the extra fluid can often help to lower blood pressure. - Lower blood pressure. Some children with childhood nephrotic syndrome develop high blood pressure and may need to take additional medications to lower their blood pressure. Two types of blood pressure-lowering medications, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have the additional benefit of slowing the progression of kidney disease. Many children with nephrotic syndrome require two or more medications to control their blood pressure. Secondary Childhood Nephrotic Syndrome Health care providers treat secondary childhood nephrotic syndrome by treating the underlying cause of the primary illness. For example, a health care provider may treat children by - prescribing antibiotics for an infection - adjusting medications to treat lupus, HIV, or diabetes - changing or stopping medications that are known to cause secondary childhood nephrotic syndrome While treating the underlying cause, the health care provider will also treat the child to improve or restore kidney function with the same medications used to treat primary childhood nephrotic syndrome. Caretakers should make sure that children take all prescribed medications and follow the treatment plan recommended by their health care provider. More information about specific treatments for secondary childhood nephrotic syndrome is provided in the NIDDK health topic, Glomerular Diseases. Congenital Nephrotic Syndrome Researchers have found that medications are not effective in treating congenital nephrotic syndrome, and that most children will need a kidney transplant by the time they are 2 or 3 years old. 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 persons body to take over the job of the failing kidney. To keep the child healthy until the transplant, the health care provider may recommend the following: - albumin injections to make up for the albumin lost in urine - diuretics to help remove extra fluid that causes swelling - antibiotics to treat the first signs of infection - growth hormones to promote growth and help bones mature - removal of one or both kidneys to decrease the loss of albumin in the urine - dialysis to artificially filter wastes from the blood if the kidneys fail More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children.

What are the treatments for Childhood Nephrotic Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Childhood Nephrotic Syndrome ? [/INST] \n Health care providers will decide how to treat childhood nephrotic syndrome based on the type: - primary childhood nephrotic syndrome: medications - secondary childhood nephrotic syndrome: treat the underlying illness or disease - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, and transplantation Primary Childhood Nephrotic Syndrome Health care providers treat idiopathic childhood nephrotic syndrome with several types of medications that control the immune system, remove extra fluid, and lower blood pressure. - Control the immune system. Corticosteroids are a group of medications that reduce the activity of the immune system, decrease the amount of albumin lost in the urine, and decrease swelling. Health care providers commonly use prednisone or a related corticosteroid to treat idiopathic childhood nephrotic syndrome. About 90 percent of children achieve remission with daily corticosteroids for 6 weeks and then a slightly smaller dose every other day for 6 weeks.2 Remission is a period when the child is symptom-free. Many children relapse after initial therapy, and health care providers treat them with a shorter course of corticosteroids until the disease goes into remission again. Children may have multiple relapses; however, they most often recover without long-term kidney damage. When a child has frequent relapses or does not respond to treatment, a health care provider may prescribe other medications that reduce the activity of the immune system. These medications prevent the body from making antibodies that can damage kidney tissues. They include - cyclophosphamide - mycophenolate (CellCept, Myfortic) - cyclosporine - tacrolimus (Hecoria, Prograf) A health care provider may use these other immune system medications with corticosteroids or in place of corticosteroids. - Remove extra fluid. A health care provider may prescribe a diuretic, a medication that helps the kidneys remove extra fluid from the blood. Removing the extra fluid can often help to lower blood pressure. - Lower blood pressure. Some children with childhood nephrotic syndrome develop high blood pressure and may need to take additional medications to lower their blood pressure. Two types of blood pressure-lowering medications, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have the additional benefit of slowing the progression of kidney disease. Many children with nephrotic syndrome require two or more medications to control their blood pressure. Secondary Childhood Nephrotic Syndrome Health care providers treat secondary childhood nephrotic syndrome by treating the underlying cause of the primary illness. For example, a health care provider may treat children by - prescribing antibiotics for an infection - adjusting medications to treat lupus, HIV, or diabetes - changing or stopping medications that are known to cause secondary childhood nephrotic syndrome While treating the underlying cause, the health care provider will also treat the child to improve or restore kidney function with the same medications used to treat primary childhood nephrotic syndrome. Caretakers should make sure that children take all prescribed medications and follow the treatment plan recommended by their health care provider. More information about specific treatments for secondary childhood nephrotic syndrome is provided in the NIDDK health topic, Glomerular Diseases. Congenital Nephrotic Syndrome Researchers have found that medications are not effective in treating congenital nephrotic syndrome, and that most children will need a kidney transplant by the time they are 2 or 3 years old. 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 persons body to take over the job of the failing kidney. To keep the child healthy until the transplant, the health care provider may recommend the following: - albumin injections to make up for the albumin lost in urine - diuretics to help remove extra fluid that causes swelling - antibiotics to treat the first signs of infection - growth hormones to promote growth and help bones mature - removal of one or both kidneys to decrease the loss of albumin in the urine - dialysis to artificially filter wastes from the blood if the kidneys fail More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children.</s>

Researchers have not found a way to prevent childhood nephrotic syndrome when the cause is idiopathic or congenital.

How to prevent Childhood Nephrotic Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to prevent Childhood Nephrotic Syndrome ? [/INST] \n Researchers have not found a way to prevent childhood nephrotic syndrome when the cause is idiopathic or congenital.</s>

Children who have nephrotic syndrome may need to make changes to their diet, such as - limiting the amount of sodium, often from salt, they take in each day - reducing the amount of liquids they drink each day - eating a diet low in saturated fat and cholesterol to help control elevated cholesterol levels Parents or caretakers should talk with the childs health care provider before making any changes to the childs diet. More information is provided in the NIDDK health topic, Nutrition for Chronic Kidney Disease in Children.

What to do for Childhood Nephrotic Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Childhood Nephrotic Syndrome ? [/INST] \n Children who have nephrotic syndrome may need to make changes to their diet, such as - limiting the amount of sodium, often from salt, they take in each day - reducing the amount of liquids they drink each day - eating a diet low in saturated fat and cholesterol to help control elevated cholesterol levels Parents or caretakers should talk with the childs health care provider before making any changes to the childs diet. More information is provided in the NIDDK health topic, Nutrition for Chronic Kidney Disease in Children.</s>

- Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that - indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered - result in the release of too much protein from the body into the urine - The two types of childhood nephrotic syndrome are - primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys - secondarythe syndrome is caused by other diseases - The signs and symptoms of childhood nephrotic syndrome may include - edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face - albuminuriawhen a childs urine has high levels of albumin - hypoalbuminemiawhen a childs blood has low levels of albumin - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal - A health care provider may order urine tests to help determine if a child has kidney damage from childhood nephrotic syndrome. - Health care providers will decide how to treat childhood nephrotic syndrome based on the type: - primary childhood nephrotic syndrome: medications - secondary childhood nephrotic syndrome: treat the underlying illness or disease - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, or transplantation

What to do for Childhood Nephrotic Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Childhood Nephrotic Syndrome ? [/INST] \n - Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that - indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered - result in the release of too much protein from the body into the urine - The two types of childhood nephrotic syndrome are - primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys - secondarythe syndrome is caused by other diseases - The signs and symptoms of childhood nephrotic syndrome may include - edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face - albuminuriawhen a childs urine has high levels of albumin - hypoalbuminemiawhen a childs blood has low levels of albumin - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal - A health care provider may order urine tests to help determine if a child has kidney damage from childhood nephrotic syndrome. - Health care providers will decide how to treat childhood nephrotic syndrome based on the type: - primary childhood nephrotic syndrome: medications - secondary childhood nephrotic syndrome: treat the underlying illness or disease - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, or transplantation</s>

Mntriers disease causes the ridges along the inside of the stomach wallcalled rugaeto enlarge, forming giant folds in the stomach lining. The rugae enlarge because of an overgrowth of mucous cells in the stomach wall. In a normal stomach, mucous cells in the rugae release protein-containing mucus. The mucous cells in enlarged rugae release too much mucus, causing proteins to leak from the blood into the stomach. This shortage of protein in the blood is known as hypoproteinemia. Mntriers disease also reduces the number of acid-producing cells in the stomach, which decreases stomach acid. Mntriers disease is also called Mntrier disease or hypoproteinemic hypertrophic gastropathy.

What is (are) Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Mntriers Disease ? [/INST] \n Mntriers disease causes the ridges along the inside of the stomach wallcalled rugaeto enlarge, forming giant folds in the stomach lining. The rugae enlarge because of an overgrowth of mucous cells in the stomach wall. In a normal stomach, mucous cells in the rugae release protein-containing mucus. The mucous cells in enlarged rugae release too much mucus, causing proteins to leak from the blood into the stomach. This shortage of protein in the blood is known as hypoproteinemia. Mntriers disease also reduces the number of acid-producing cells in the stomach, which decreases stomach acid. Mntriers disease is also called Mntrier disease or hypoproteinemic hypertrophic gastropathy.</s>

Scientists are unsure about what causes Mntriers disease; however, researchers think that most people acquire, rather than inherit, the disease. In extremely rare cases, siblings have developed Mntriers disease as children, suggesting a genetic link. Studies suggest that people with Mntriers disease have stomachs that make abnormally high amounts of a protein called transforming growth factor-alpha (TGF-). TGF- binds to and activates a receptor called epidermal growth factor receptor. Growth factors are proteins in the body that tell cells what to do, such as grow larger, change shape, or divide to make more cells. Researchers have not yet found a cause for the overproduction of TGF-. Some studies have found cases of people with Mntriers disease who also had Helicobacter pylori (H. pylori) infection. H. pylori is a bacterium that is a cause of peptic ulcers, or sores on the lining of the stomach or the duodenum, the first part of the small intestine. In these cases, treatment for H. pylori reversed and improved the symptoms of Mntriers disease.1 Researchers have linked some cases of Mntriers disease in children to infection with cytomegalovirus (CMV). CMV is one of the herpes viruses. This group of viruses includes the herpes simplex viruses, which cause chickenpox, shingles, and infectious mononucleosis, also known as mono. Most healthy children and adults infected with CMV have no symptoms and may not even know they have an infection. However, in people with a weakened immune system, CMV can cause serious disease, such as retinitis, which can lead to blindness. Researchers are not sure how H. pylori and CMV infections contribute to the development of Mntriers disease.

What causes Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What causes Mntriers Disease ? [/INST] \n Scientists are unsure about what causes Mntriers disease; however, researchers think that most people acquire, rather than inherit, the disease. In extremely rare cases, siblings have developed Mntriers disease as children, suggesting a genetic link. Studies suggest that people with Mntriers disease have stomachs that make abnormally high amounts of a protein called transforming growth factor-alpha (TGF-). TGF- binds to and activates a receptor called epidermal growth factor receptor. Growth factors are proteins in the body that tell cells what to do, such as grow larger, change shape, or divide to make more cells. Researchers have not yet found a cause for the overproduction of TGF-. Some studies have found cases of people with Mntriers disease who also had Helicobacter pylori (H. pylori) infection. H. pylori is a bacterium that is a cause of peptic ulcers, or sores on the lining of the stomach or the duodenum, the first part of the small intestine. In these cases, treatment for H. pylori reversed and improved the symptoms of Mntriers disease.1 Researchers have linked some cases of Mntriers disease in children to infection with cytomegalovirus (CMV). CMV is one of the herpes viruses. This group of viruses includes the herpes simplex viruses, which cause chickenpox, shingles, and infectious mononucleosis, also known as mono. Most healthy children and adults infected with CMV have no symptoms and may not even know they have an infection. However, in people with a weakened immune system, CMV can cause serious disease, such as retinitis, which can lead to blindness. Researchers are not sure how H. pylori and CMV infections contribute to the development of Mntriers disease.</s>

Mntriers disease is rare. The disease is more common in men than in women. The average age at diagnosis is 55.2

Who is at risk for Mntriers Disease? ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: Who is at risk for Mntriers Disease? ? [/INST] \n Mntriers disease is rare. The disease is more common in men than in women. The average age at diagnosis is 55.2</s>

The most common symptom of Mntriers disease is pain in the upper middle part of the abdomen. The abdomen is the area between the chest and hips. Other signs and symptoms of Mntriers disease may include - nausea and frequent vomiting - diarrhea - loss of appetite - extreme weight loss - malnutrition - low levels of protein in the blood - swelling of the face, abdomen, limbs, and feet due to low levels of protein in the blood - anemiatoo few red blood cells in the body, which prevents the body from getting enough oxygendue to bleeding in the stomach People with Mntriers disease have a higher chance of developing stomach cancer, also called gastric cancer.

What are the symptoms of Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the symptoms of Mntriers Disease ? [/INST] \n The most common symptom of Mntriers disease is pain in the upper middle part of the abdomen. The abdomen is the area between the chest and hips. Other signs and symptoms of Mntriers disease may include - nausea and frequent vomiting - diarrhea - loss of appetite - extreme weight loss - malnutrition - low levels of protein in the blood - swelling of the face, abdomen, limbs, and feet due to low levels of protein in the blood - anemiatoo few red blood cells in the body, which prevents the body from getting enough oxygendue to bleeding in the stomach People with Mntriers disease have a higher chance of developing stomach cancer, also called gastric cancer.</s>

Health care providers base the diagnosis of Mntriers disease on a combination of symptoms, lab findings, findings on upper gastrointestinal (GI) endoscopy, and stomach biopsy results. A health care provider will begin the diagnosis of Mntriers disease by taking a patients medical and family history and performing a physical exam. However, a health care provider will confirm the diagnosis of Mntriers disease through a computerized tomography (CT) scan, an upper GI endoscopy, and a biopsy of stomach tissue. A health care provider also may order blood tests to check for infection with H. pylori or CMV. Medical and family history. Taking a medical and family history is one of the first things a health care provider may do to help diagnose Mntriers disease. He or she will ask the patient to provide a medical and family history. Physical exam. A physical exam may help diagnose Mntriers disease. During a physical exam, a health care provider usually - examines a patients body - uses a stethoscope to listen to bodily sounds - taps on specific areas of the patients body CT scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where an x-ray technician takes x rays. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologista doctor who specializes in medical imaginginterprets them. The patient does not need anesthesia. CT scans can show enlarged folds in the stomach wall. Upper GI endoscopy. This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract, which includes the esophagus, stomach, and duodenum. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. The gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the stomach lining. The gastroenterologist also can take a biopsy of the stomach tissue during the endoscopy. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A health care provider will place an intravenous (IV) needle in a vein in the arm to administer sedation. Sedatives help patients stay relaxed and comfortable. The test can show enlarged folds in the stomach wall. Biopsy. Biopsy is a procedure that involves taking a piece of stomach tissue for examination with a microscope. A gastroenterologist performs the biopsy at the time of upper GI endoscopy. A pathologista doctor who specializes in diagnosing diseasesexamines the stomach tissue in a lab. The test can diagnose Mntriers disease by showing changes in the stomachs mucous cells and acid-producing cells. Blood test. A health care provider will take a blood sample that can show the presence of infection with H. pylori or CMV. 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.

How to diagnose Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to diagnose Mntriers Disease ? [/INST] \n Health care providers base the diagnosis of Mntriers disease on a combination of symptoms, lab findings, findings on upper gastrointestinal (GI) endoscopy, and stomach biopsy results. A health care provider will begin the diagnosis of Mntriers disease by taking a patients medical and family history and performing a physical exam. However, a health care provider will confirm the diagnosis of Mntriers disease through a computerized tomography (CT) scan, an upper GI endoscopy, and a biopsy of stomach tissue. A health care provider also may order blood tests to check for infection with H. pylori or CMV. Medical and family history. Taking a medical and family history is one of the first things a health care provider may do to help diagnose Mntriers disease. He or she will ask the patient to provide a medical and family history. Physical exam. A physical exam may help diagnose Mntriers disease. During a physical exam, a health care provider usually - examines a patients body - uses a stethoscope to listen to bodily sounds - taps on specific areas of the patients body CT scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where an x-ray technician takes x rays. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologista doctor who specializes in medical imaginginterprets them. The patient does not need anesthesia. CT scans can show enlarged folds in the stomach wall. Upper GI endoscopy. This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract, which includes the esophagus, stomach, and duodenum. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. The gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the stomach lining. The gastroenterologist also can take a biopsy of the stomach tissue during the endoscopy. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A health care provider will place an intravenous (IV) needle in a vein in the arm to administer sedation. Sedatives help patients stay relaxed and comfortable. The test can show enlarged folds in the stomach wall. Biopsy. Biopsy is a procedure that involves taking a piece of stomach tissue for examination with a microscope. A gastroenterologist performs the biopsy at the time of upper GI endoscopy. A pathologista doctor who specializes in diagnosing diseasesexamines the stomach tissue in a lab. The test can diagnose Mntriers disease by showing changes in the stomachs mucous cells and acid-producing cells. Blood test. A health care provider will take a blood sample that can show the presence of infection with H. pylori or CMV. 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.</s>

Treatment may include medications, IV protein, blood transfusions, and surgery. Medications Health care providers may prescribe the anticancer medication cetuximab (Erbitux) to treat Mntriers disease. Studies have shown that cetuximab blocks the activity of epidermal growth factor receptor and can significantly improve a persons symptoms, as well as decrease the thickness of the stomach wall from the overgrowth of mucous cells. A person receives cetuximab by IV in a health care providers office or an outpatient center. Studies to assess the effectiveness of cetuximab to treat Mntriers disease are ongoing. A health care provider also may prescribe medications to relieve nausea and abdominal pain. In people with Mntriers disease who also have H. pylori or CMV infection, treatment of the infection may improve symptoms. Health care providers prescribe antibiotics to kill H. pylori. Antibiotic regimens may differ throughout the world because some strains of H. pylori have become resistant to certain antibioticsmeaning that an antibiotic that once destroyed the bacterium is no longer effective. Health care providers use antiviral medications to treat CMV infection in a person with a weakened immune system in order to prevent a serious disease from developing as a result of CMV. Antiviral medications cannot kill CMV; however, they can slow down the virus reproduction. Intravenous Protein and Blood Transfusions A health care provider may recommend an IV treatment of protein and a blood transfusion to a person who is malnourished or anemic because of Mntriers disease. In most cases of children with Mntriers disease who also have had CMV infection, treatment with protein and a blood transfusion led to a full recovery. Surgery If a person has severe Mntriers disease with significant protein loss, a surgeon may need to remove part or all of the stomach in a surgery called gastrectomy. Surgeons perform gastrectomy in a hospital. The patient will require general anesthesia. Some surgeons perform a gastrectomy through laparoscopic surgery rather than through a wide incision in the abdomen. In laparoscopic surgery, the surgeon uses several smaller incisions and feeds special surgical tools through the incisions to remove the diseased part of the stomach. After gastrectomy, the surgeon may reconstruct the changed portions of the GI tract so that it may continue to function. Usually the surgeon attaches the small intestine to any remaining portion of the stomach or to the esophagus if he or she removed the entire stomach.

What are the treatments for Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Mntriers Disease ? [/INST] \n Treatment may include medications, IV protein, blood transfusions, and surgery. Medications Health care providers may prescribe the anticancer medication cetuximab (Erbitux) to treat Mntriers disease. Studies have shown that cetuximab blocks the activity of epidermal growth factor receptor and can significantly improve a persons symptoms, as well as decrease the thickness of the stomach wall from the overgrowth of mucous cells. A person receives cetuximab by IV in a health care providers office or an outpatient center. Studies to assess the effectiveness of cetuximab to treat Mntriers disease are ongoing. A health care provider also may prescribe medications to relieve nausea and abdominal pain. In people with Mntriers disease who also have H. pylori or CMV infection, treatment of the infection may improve symptoms. Health care providers prescribe antibiotics to kill H. pylori. Antibiotic regimens may differ throughout the world because some strains of H. pylori have become resistant to certain antibioticsmeaning that an antibiotic that once destroyed the bacterium is no longer effective. Health care providers use antiviral medications to treat CMV infection in a person with a weakened immune system in order to prevent a serious disease from developing as a result of CMV. Antiviral medications cannot kill CMV; however, they can slow down the virus reproduction. Intravenous Protein and Blood Transfusions A health care provider may recommend an IV treatment of protein and a blood transfusion to a person who is malnourished or anemic because of Mntriers disease. In most cases of children with Mntriers disease who also have had CMV infection, treatment with protein and a blood transfusion led to a full recovery. Surgery If a person has severe Mntriers disease with significant protein loss, a surgeon may need to remove part or all of the stomach in a surgery called gastrectomy. Surgeons perform gastrectomy in a hospital. The patient will require general anesthesia. Some surgeons perform a gastrectomy through laparoscopic surgery rather than through a wide incision in the abdomen. In laparoscopic surgery, the surgeon uses several smaller incisions and feeds special surgical tools through the incisions to remove the diseased part of the stomach. After gastrectomy, the surgeon may reconstruct the changed portions of the GI tract so that it may continue to function. Usually the surgeon attaches the small intestine to any remaining portion of the stomach or to the esophagus if he or she removed the entire stomach.</s>

Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Mntriers disease. In some cases, a health care provider may prescribe a high-protein diet to offset the loss of protein due to Mntriers disease. Some people with severe malnutrition may require IV nutrition, which is called total parenteral nutrition (TPN). TPN is a method of providing an IV liquid food mixture through a special tube in the chest.

What to do for Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Mntriers Disease ? [/INST] \n Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Mntriers disease. In some cases, a health care provider may prescribe a high-protein diet to offset the loss of protein due to Mntriers disease. Some people with severe malnutrition may require IV nutrition, which is called total parenteral nutrition (TPN). TPN is a method of providing an IV liquid food mixture through a special tube in the chest.</s>

- Mntriers disease causes the ridges along the inside of the stomach wallcalled rugaeto enlarge, forming giant folds in the stomach lining. The rugae enlarge because of an overgrowth of mucous cells in the stomach wall. - Scientists are unsure about what causes Mntriers disease; however, researchers think that most people acquire, rather than inherit, the disease. - Mntriers disease is rare. The disease is more common in men than in women. - The most common symptom of Mntriers disease is pain in the upper middle part of the abdomen. - Health care providers base the diagnosis of Mntriers disease on a combination of symptoms, lab findings, findings on upper gastrointestinal (GI) endoscopy, and stomach biopsy results. - Treatment may include medications, intravenous (IV) protein, blood transfusions, and surgery.

What to do for Mntriers Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Mntriers Disease ? [/INST] \n - Mntriers disease causes the ridges along the inside of the stomach wallcalled rugaeto enlarge, forming giant folds in the stomach lining. The rugae enlarge because of an overgrowth of mucous cells in the stomach wall. - Scientists are unsure about what causes Mntriers disease; however, researchers think that most people acquire, rather than inherit, the disease. - Mntriers disease is rare. The disease is more common in men than in women. - The most common symptom of Mntriers disease is pain in the upper middle part of the abdomen. - Health care providers base the diagnosis of Mntriers disease on a combination of symptoms, lab findings, findings on upper gastrointestinal (GI) endoscopy, and stomach biopsy results. - Treatment may include medications, intravenous (IV) protein, blood transfusions, and surgery.</s>

Diverticular disease is a condition that occurs when a person has problems from small pouches, or sacs, that have formed and pushed outward through weak spots in the colon wall. Each pouch is called a diverticulum. Multiple pouches are called diverticula. The colon is part of the large intestine. The large intestine absorbs water from stool and changes it from a liquid to a solid form. Diverticula are most common in the lower part of the colon, called the sigmoid colon. The problems that occur with diverticular disease include diverticulitis and diverticular bleeding. Diverticulitis occurs when the diverticula become inflamed, or irritated and swollen, and infected. Diverticular bleeding occurs when a small blood vessel within the wall of a diverticulum bursts.

What is (are) Diverticular Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diverticular Disease ? [/INST] \n Diverticular disease is a condition that occurs when a person has problems from small pouches, or sacs, that have formed and pushed outward through weak spots in the colon wall. Each pouch is called a diverticulum. Multiple pouches are called diverticula. The colon is part of the large intestine. The large intestine absorbs water from stool and changes it from a liquid to a solid form. Diverticula are most common in the lower part of the colon, called the sigmoid colon. The problems that occur with diverticular disease include diverticulitis and diverticular bleeding. Diverticulitis occurs when the diverticula become inflamed, or irritated and swollen, and infected. Diverticular bleeding occurs when a small blood vessel within the wall of a diverticulum bursts.</s>

When a person has diverticula that do not cause diverticulitis or diverticular bleeding, the condition is called diverticulosis. Most people with diverticulosis do not have symptoms. Some people with diverticulosis have constipation or diarrhea. People may also have chronic - cramping or pain in the lower abdomenthe area between the chest and hips - bloating Other conditions, such as irritable bowel syndrome and stomach ulcers, cause similar problems, so these symptoms do not always mean a person has diverticulosis. People with these symptoms should see their health care provider.

What is (are) Diverticular Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diverticular Disease ? [/INST] \n When a person has diverticula that do not cause diverticulitis or diverticular bleeding, the condition is called diverticulosis. Most people with diverticulosis do not have symptoms. Some people with diverticulosis have constipation or diarrhea. People may also have chronic - cramping or pain in the lower abdomenthe area between the chest and hips - bloating Other conditions, such as irritable bowel syndrome and stomach ulcers, cause similar problems, so these symptoms do not always mean a person has diverticulosis. People with these symptoms should see their health care provider.</s>

Scientists are not certain what causes diverticulosis and diverticular disease. For more than 50 years, the most widely accepted theory was that a low-fiber diet led to diverticulosis and diverticular disease. Diverticulosis and diverticular disease were first noticed in the United States in the early 1900s, around the time processed foods were introduced into the American diet. Consumption of processed foods greatly reduced Americans fiber intake. Diverticulosis and diverticular disease are common in Western and industrialized countriesparticularly the United States, England, and Australiawhere low-fiber diets are common. The condition is rare in Asia and Africa, where most people eat high-fiber diets.1 Two large studies also indicate that a low-fiber diet may increase the chance of developing diverticular disease.2 However, a recent study found that a low-fiber diet was not associated with diverticulosis and that a high-fiber diet and more frequent bowel movements may be linked to an increased rather than decreased chance of diverticula.3 Other studies have focused on the role of decreased levels of the neurotransmitter serotonin in causing decreased relaxation and increased spasms of the colon muscle. A neurotransmitter is a chemical that helps brain cells communicate with nerve cells. However, more studies are needed in this area. Studies have also found links between diverticular disease and obesity, lack of exercise, smoking, and certain medications including nonsteroidal anti-inflammatory drugs, such as aspirin, and steroids.3 Scientists agree that with diverticulitis, inflammation may begin when bacteria or stool get caught in a diverticulum. In the colon, inflammation also may be caused by a decrease in healthy bacteria and an increase in disease-causing bacteria. This change in the bacteria may permit chronic inflammation to develop in the colon. What is fiber? Fiber is a substance in foods that comes from plants. Fiber helps soften stool so it moves smoothly through the colon and is easier to pass. Soluble fiber dissolves in water and is found in beans, fruit, and oat products. Insoluble fiber does not dissolve in water and is found in whole-grain products and vegetables. Both kinds of fiber help prevent constipation. Constipation is a condition in which an adult has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass. High-fiber foods also have many benefits in preventing and controlling chronic diseases, such as cardiovascular disease, obesity, diabetes, and cancer.2

What causes Diverticular Disease ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What causes Diverticular Disease ? [/INST] \n Scientists are not certain what causes diverticulosis and diverticular disease. For more than 50 years, the most widely accepted theory was that a low-fiber diet led to diverticulosis and diverticular disease. Diverticulosis and diverticular disease were first noticed in the United States in the early 1900s, around the time processed foods were introduced into the American diet. Consumption of processed foods greatly reduced Americans fiber intake. Diverticulosis and diverticular disease are common in Western and industrialized countriesparticularly the United States, England, and Australiawhere low-fiber diets are common. The condition is rare in Asia and Africa, where most people eat high-fiber diets.1 Two large studies also indicate that a low-fiber diet may increase the chance of developing diverticular disease.2 However, a recent study found that a low-fiber diet was not associated with diverticulosis and that a high-fiber diet and more frequent bowel movements may be linked to an increased rather than decreased chance of diverticula.3 Other studies have focused on the role of decreased levels of the neurotransmitter serotonin in causing decreased relaxation and increased spasms of the colon muscle. A neurotransmitter is a chemical that helps brain cells communicate with nerve cells. However, more studies are needed in this area. Studies have also found links between diverticular disease and obesity, lack of exercise, smoking, and certain medications including nonsteroidal anti-inflammatory drugs, such as aspirin, and steroids.3 Scientists agree that with diverticulitis, inflammation may begin when bacteria or stool get caught in a diverticulum. In the colon, inflammation also may be caused by a decrease in healthy bacteria and an increase in disease-causing bacteria. This change in the bacteria may permit chronic inflammation to develop in the colon. What is fiber? Fiber is a substance in foods that comes from plants. Fiber helps soften stool so it moves smoothly through the colon and is easier to pass. Soluble fiber dissolves in water and is found in beans, fruit, and oat products. Insoluble fiber does not dissolve in water and is found in whole-grain products and vegetables. Both kinds of fiber help prevent constipation. Constipation is a condition in which an adult has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass. High-fiber foods also have many benefits in preventing and controlling chronic diseases, such as cardiovascular disease, obesity, diabetes, and cancer.2</s>

Fiber is a substance in foods that comes from plants. Fiber helps soften stool so it moves smoothly through the colon and is easier to pass. Soluble fiber dissolves in water and is found in beans, fruit, and oat products. Insoluble fiber does not dissolve in water and is found in whole-grain products and vegetables. Both kinds of fiber help prevent constipation. Constipation is a condition in which an adult has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass. High-fiber foods also have many benefits in preventing and controlling chronic diseases, such as cardiovascular disease, obesity, diabetes, and cancer.2

What is (are) Diverticular Disease ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diverticular Disease ? [/INST] \n Fiber is a substance in foods that comes from plants. Fiber helps soften stool so it moves smoothly through the colon and is easier to pass. Soluble fiber dissolves in water and is found in beans, fruit, and oat products. Insoluble fiber does not dissolve in water and is found in whole-grain products and vegetables. Both kinds of fiber help prevent constipation. Constipation is a condition in which an adult has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass. High-fiber foods also have many benefits in preventing and controlling chronic diseases, such as cardiovascular disease, obesity, diabetes, and cancer.2</s>

Diverticulosis becomes more common as people age, particularly in people older than age 50.3 Some people with diverticulosis develop diverticulitis, and the number of cases is increasing. Although diverticular disease is generally thought to be a condition found in older adults, it is becoming more common in people younger than age 50, most of whom are male.1

Who is at risk for Diverticular Disease? ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: Who is at risk for Diverticular Disease? ? [/INST] \n Diverticulosis becomes more common as people age, particularly in people older than age 50.3 Some people with diverticulosis develop diverticulitis, and the number of cases is increasing. Although diverticular disease is generally thought to be a condition found in older adults, it is becoming more common in people younger than age 50, most of whom are male.1</s>

People with diverticulitis may have many symptoms, the most common of which is pain in the lower left side of the abdomen. The pain is usually severe and comes on suddenly, though it can also be mild and then worsen over several days. The intensity of the pain can fluctuate. Diverticulitis may also cause - fevers and chills - nausea or vomiting - a change in bowel habitsconstipation or diarrhea - diverticular bleeding In most cases, people with diverticular bleeding suddenly have a large amount of red or maroon-colored blood in their stool. Diverticular bleeding may also cause - weakness - dizziness or light-headedness - abdominal cramping

What are the symptoms of Diverticular Disease ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the symptoms of Diverticular Disease ? [/INST] \n People with diverticulitis may have many symptoms, the most common of which is pain in the lower left side of the abdomen. The pain is usually severe and comes on suddenly, though it can also be mild and then worsen over several days. The intensity of the pain can fluctuate. Diverticulitis may also cause - fevers and chills - nausea or vomiting - a change in bowel habitsconstipation or diarrhea - diverticular bleeding In most cases, people with diverticular bleeding suddenly have a large amount of red or maroon-colored blood in their stool. Diverticular bleeding may also cause - weakness - dizziness or light-headedness - abdominal cramping</s>

Diverticulosis Health care providers often find diverticulosis during a routine x ray or a colonoscopy, a test used to look inside the rectum and entire colon to screen for colon cancer or polyps or to evaluate the source of rectal bleeding. Diverticular Disease Based on symptoms and severity of illness, a person may be evaluated and diagnosed by a primary care physician, an emergency department physician, a surgeon, or a gastroenterologista doctor who specializes in digestive diseases. The health care provider will ask about the persons health, symptoms, bowel habits, diet, and medications, and will perform a physical exam, which may include a rectal exam. A rectal exam is performed in the health care providers office; anesthesia is not needed. To perform the exam, the health care provider asks the person to bend over a table or lie on one side while holding the knees close to the chest. The health care provider slides a gloved, lubricated finger into the rectum. The exam is used to check for pain, bleeding, or a blockage in the intestine. The health care provider may schedule one or more of the following tests: - Blood test. A blood test involves drawing a persons blood at a health care providers office, a commercial facility, or a hospital and sending the sample to a lab for analysis. The blood test can show the presence of inflammation or anemiaa condition in which red blood cells are fewer or smaller than normal, which prevents the bodys cells from getting enough oxygen. - Computerized tomography (CT) scan. A CT scan of the colon is the most common test used to diagnose diverticular disease. CT scans use a combination of x rays and computer technology to create three-dimensional (3D) images. For a CT scan, the person may be given a solution to drink and an injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. The procedure is performed in an outpatient center or a hospital by an x-ray technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Anesthesia is not needed. CT scans can detect diverticulosis and confirm the diagnosis of diverticulitis. - Lower gastrointestinal (GI) series. A lower GI series is an x-ray exam that is used to look at the large intestine. The test is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. The health care provider may provide written bowel prep instructions to follow at home before the test. The person may be asked to follow a clear liquid diet for 1 to 3 days before the procedure. A laxative or enema may be used before the test. A laxative is medication that loosens stool and increases bowel movements. An enema involves flushing water or laxative into the rectum using a special squirt bottle. These medications cause diarrhea, so the person should stay close to a bathroom during the bowel prep. - For the test, the person will lie on a table while the radiologist inserts a flexible tube into the persons anus. The colon is filled with barium, making signs of diverticular disease show up more clearly on x rays. - For several days, traces of barium in the large intestine can cause stools to be white or light colored. Enemas and repeated bowel movements may cause anal soreness. A health care provider will provide specific instructions about eating and drinking after the test. - Colonoscopy. The test is performed at a hospital or an outpatient center by a gastroenterologist. Before the test, the persons health care provider will provide written bowel prep instructions to follow at home. The person may need to follow a clear liquid diet for 1 to 3 days before the test. The person may also need to take laxatives and enemas the evening before the test. - In most cases, light anesthesia, and possibly pain medication, helps people relax for the test. The person will lie on a table while the gastroenterologist inserts a flexible tube into the anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The test can show diverticulosis and diverticular disease. - Cramping or bloating may occur during the first hour after the test. Driving is not permitted for 24 hours after the test to allow the anesthesia time to wear off. Before the appointment, people should make plans for a ride home. Full recovery is expected by the next day, and people should be able to go back to their normal diet.

How to diagnose Diverticular Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to diagnose Diverticular Disease ? [/INST] \n Diverticulosis Health care providers often find diverticulosis during a routine x ray or a colonoscopy, a test used to look inside the rectum and entire colon to screen for colon cancer or polyps or to evaluate the source of rectal bleeding. Diverticular Disease Based on symptoms and severity of illness, a person may be evaluated and diagnosed by a primary care physician, an emergency department physician, a surgeon, or a gastroenterologista doctor who specializes in digestive diseases. The health care provider will ask about the persons health, symptoms, bowel habits, diet, and medications, and will perform a physical exam, which may include a rectal exam. A rectal exam is performed in the health care providers office; anesthesia is not needed. To perform the exam, the health care provider asks the person to bend over a table or lie on one side while holding the knees close to the chest. The health care provider slides a gloved, lubricated finger into the rectum. The exam is used to check for pain, bleeding, or a blockage in the intestine. The health care provider may schedule one or more of the following tests: - Blood test. A blood test involves drawing a persons blood at a health care providers office, a commercial facility, or a hospital and sending the sample to a lab for analysis. The blood test can show the presence of inflammation or anemiaa condition in which red blood cells are fewer or smaller than normal, which prevents the bodys cells from getting enough oxygen. - Computerized tomography (CT) scan. A CT scan of the colon is the most common test used to diagnose diverticular disease. CT scans use a combination of x rays and computer technology to create three-dimensional (3D) images. For a CT scan, the person may be given a solution to drink and an injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. The procedure is performed in an outpatient center or a hospital by an x-ray technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Anesthesia is not needed. CT scans can detect diverticulosis and confirm the diagnosis of diverticulitis. - Lower gastrointestinal (GI) series. A lower GI series is an x-ray exam that is used to look at the large intestine. The test is performed at a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. The health care provider may provide written bowel prep instructions to follow at home before the test. The person may be asked to follow a clear liquid diet for 1 to 3 days before the procedure. A laxative or enema may be used before the test. A laxative is medication that loosens stool and increases bowel movements. An enema involves flushing water or laxative into the rectum using a special squirt bottle. These medications cause diarrhea, so the person should stay close to a bathroom during the bowel prep. - For the test, the person will lie on a table while the radiologist inserts a flexible tube into the persons anus. The colon is filled with barium, making signs of diverticular disease show up more clearly on x rays. - For several days, traces of barium in the large intestine can cause stools to be white or light colored. Enemas and repeated bowel movements may cause anal soreness. A health care provider will provide specific instructions about eating and drinking after the test. - Colonoscopy. The test is performed at a hospital or an outpatient center by a gastroenterologist. Before the test, the persons health care provider will provide written bowel prep instructions to follow at home. The person may need to follow a clear liquid diet for 1 to 3 days before the test. The person may also need to take laxatives and enemas the evening before the test. - In most cases, light anesthesia, and possibly pain medication, helps people relax for the test. The person will lie on a table while the gastroenterologist inserts a flexible tube into the anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The test can show diverticulosis and diverticular disease. - Cramping or bloating may occur during the first hour after the test. Driving is not permitted for 24 hours after the test to allow the anesthesia time to wear off. Before the appointment, people should make plans for a ride home. Full recovery is expected by the next day, and people should be able to go back to their normal diet.</s>

A health care provider may treat the symptoms of diverticulosis with a high-fiber diet or fiber supplements, medications, and possibly probiotics. Treatment for diverticular disease varies, depending on whether a person has diverticulitis or diverticular bleeding. Diverticulosis High-fiber diet. Studies have shown that a high-fiber diet can help prevent diverticular disease in people who already have diverticulosis.2 A health care provider may recommend a slow increase in dietary fiber to minimize gas and abdominal discomfort. For more information about fiber-rich foods, see Eating, Diet, and Nutrition. Fiber supplements. A health care provider may recommend taking a fiber product such as methylcellulose (Citrucel) or psyllium (Metamucil) one to three times a day. These products are available as powders, pills, or wafers and provide 0.5 to 3.5 grams of fiber per dose. Fiber products should be taken with at least 8 ounces of water. Medications. A number of studies suggest the medication mesalazine (Asacol), given either continuously or in cycles, may be effective at reducing abdominal pain and GI symptoms of diverticulosis. Research has also shown that combining mesalazine with the antibiotic rifaximin (Xifaxan) can be significantly more effective than using rifaximin alone to improve a persons symptoms and maintain periods of remission, which means being free of symptoms.4 Probiotics. Although more research is needed, probiotics may help treat the symptoms of diverticulosis, prevent the onset of diverticulitis, and reduce the chance of recurrent symptoms. Probiotics are live bacteria, like those normally found in the GI tract. Probiotics can be found in dietary supplementsin capsules, tablets, and powdersand in some foods, such as yogurt. 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. Tips for talking with health care providers are available at www.nccam.nih.gov/timetotalk. Diverticular Bleeding Diverticular bleeding is rare. Bleeding can be severe; however, it may stop by itself and not require treatment. A person who has bleeding from the rectumeven a small amountshould see a health care provider right away. To treat the bleeding, a colonoscopy may be performed to identify the location of and stop the bleeding. A CT scan or angiogram also may be used to identify the site of the bleeding. A traditional angiogram is a special kind of x ray in which a thin, flexible tube called a catheter is threaded through a large artery, often from the groin, to the area of bleeding. Contrast medium is injected through the catheter so the artery shows up more clearly on the x ray. The procedure is performed in a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed, though a sedative may be given to lessen anxiety during the procedure. If the bleeding does not stop, abdominal surgery with a colon resection may be necessary. In a colon resection, the surgeon removes the affected part of the colon and joins the remaining ends of the colon together; general anesthesia is used. A blood transfusion may be needed if the person has lost a significant amount of blood. Diverticulitis Diverticulitis with mild symptoms and no complications usually requires a person to rest, take oral antibiotics, and be on a liquid diet for a period of time. If symptoms ease after a few days, the health care provider will recommend gradually adding solid foods back into the diet. Severe cases of diverticulitis with acute pain and complications will likely require a hospital stay. Most cases of severe diverticulitis are treated with intravenous (IV) antibiotics and a few days without food or drink to help the colon rest. If the period without food or drink is longer, the person may be given parenteral nutritiona method of providing an IV liquid food mixture through a special tube in the chest. The mixture contains proteins, carbohydrates, fats, vitamins, and minerals.

What are the treatments for Diverticular Disease ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Diverticular Disease ? [/INST] \n A health care provider may treat the symptoms of diverticulosis with a high-fiber diet or fiber supplements, medications, and possibly probiotics. Treatment for diverticular disease varies, depending on whether a person has diverticulitis or diverticular bleeding. Diverticulosis High-fiber diet. Studies have shown that a high-fiber diet can help prevent diverticular disease in people who already have diverticulosis.2 A health care provider may recommend a slow increase in dietary fiber to minimize gas and abdominal discomfort. For more information about fiber-rich foods, see Eating, Diet, and Nutrition. Fiber supplements. A health care provider may recommend taking a fiber product such as methylcellulose (Citrucel) or psyllium (Metamucil) one to three times a day. These products are available as powders, pills, or wafers and provide 0.5 to 3.5 grams of fiber per dose. Fiber products should be taken with at least 8 ounces of water. Medications. A number of studies suggest the medication mesalazine (Asacol), given either continuously or in cycles, may be effective at reducing abdominal pain and GI symptoms of diverticulosis. Research has also shown that combining mesalazine with the antibiotic rifaximin (Xifaxan) can be significantly more effective than using rifaximin alone to improve a persons symptoms and maintain periods of remission, which means being free of symptoms.4 Probiotics. Although more research is needed, probiotics may help treat the symptoms of diverticulosis, prevent the onset of diverticulitis, and reduce the chance of recurrent symptoms. Probiotics are live bacteria, like those normally found in the GI tract. Probiotics can be found in dietary supplementsin capsules, tablets, and powdersand in some foods, such as yogurt. 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. Tips for talking with health care providers are available at www.nccam.nih.gov/timetotalk. Diverticular Bleeding Diverticular bleeding is rare. Bleeding can be severe; however, it may stop by itself and not require treatment. A person who has bleeding from the rectumeven a small amountshould see a health care provider right away. To treat the bleeding, a colonoscopy may be performed to identify the location of and stop the bleeding. A CT scan or angiogram also may be used to identify the site of the bleeding. A traditional angiogram is a special kind of x ray in which a thin, flexible tube called a catheter is threaded through a large artery, often from the groin, to the area of bleeding. Contrast medium is injected through the catheter so the artery shows up more clearly on the x ray. The procedure is performed in a hospital or an outpatient center by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed, though a sedative may be given to lessen anxiety during the procedure. If the bleeding does not stop, abdominal surgery with a colon resection may be necessary. In a colon resection, the surgeon removes the affected part of the colon and joins the remaining ends of the colon together; general anesthesia is used. A blood transfusion may be needed if the person has lost a significant amount of blood. Diverticulitis Diverticulitis with mild symptoms and no complications usually requires a person to rest, take oral antibiotics, and be on a liquid diet for a period of time. If symptoms ease after a few days, the health care provider will recommend gradually adding solid foods back into the diet. Severe cases of diverticulitis with acute pain and complications will likely require a hospital stay. Most cases of severe diverticulitis are treated with intravenous (IV) antibiotics and a few days without food or drink to help the colon rest. If the period without food or drink is longer, the person may be given parenteral nutritiona method of providing an IV liquid food mixture through a special tube in the chest. The mixture contains proteins, carbohydrates, fats, vitamins, and minerals.</s>

Diverticulitis can attack suddenly and cause complications, such as - an abscessa painful, swollen, pus-filled area just outside the colon wallcaused by infection - a perforationa small tear or hole in the diverticula - peritonitisinflammation of tissues inside the abdomen from pus and stool that leak through a perforation - a fistulaan abnormal passage, or tunnel, between two organs, or between an organ and the outside of the body - intestinal obstructionpartial or total blockage of movement of food or stool through the intestines These complications need to be treated to prevent them from getting worse and causing serious illness. In some cases, surgery may be needed. Abscess, perforation, and peritonitis. Antibiotic treatment of diverticulitis usually prevents or treats an abscess. If the abscess is large or does not clear up with antibiotics, it may need to be drained. After giving the person numbing medication, a radiologist inserts a needle through the skin to the abscess and then drains the fluid through a catheter. The procedure is usually guided by an abdominal ultrasound or a CT scan. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A person with a perforation usually needs surgery to repair the tear or hole. Sometimes, a person needs surgery to remove a small part of the intestine if the perforation cannot be repaired. A person with peritonitis may be extremely ill, with nausea, vomiting, fever, and severe abdominal tenderness. This condition requires immediate surgery to clean the abdominal cavity and possibly a colon resection at a later date after a course of antibiotics. A blood transfusion may be needed if the person has lost a significant amount of blood. Without prompt treatment, peritonitis can be fatal. Fistula. Diverticulitis-related infection may lead to one or more fistulas. Fistulas usually form between the colon and the bladder, small intestine, or skin. The most common type of fistula occurs between the colon and the bladder. Fistulas can be corrected with a colon resection and removal of the fistula. Intestinal obstruction. Diverticulitis-related inflammation or scarring caused by past inflammation may lead to intestinal obstruction. If the intestine is completely blocked, emergency surgery is necessary, with possible colon resection. Partial blockage is not an emergency, so the surgery or other procedures to correct it can be scheduled. When urgent surgery with colon resection is necessary for diverticulitis, two procedures may be needed because it is not safe to rejoin the colon right away. During the colon resection, the surgeon performs a temporary colostomy, creating an opening, or stoma, in the abdomen. The end of the colon is connected to the opening to allow normal eating while healing occurs. Stool is collected in a pouch attached to the stoma on the abdominal wall. In the second surgery, several months later, the surgeon rejoins the ends of the colon and closes the stoma.

What are the treatments for Diverticular Disease ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Diverticular Disease ? [/INST] \n Diverticulitis can attack suddenly and cause complications, such as - an abscessa painful, swollen, pus-filled area just outside the colon wallcaused by infection - a perforationa small tear or hole in the diverticula - peritonitisinflammation of tissues inside the abdomen from pus and stool that leak through a perforation - a fistulaan abnormal passage, or tunnel, between two organs, or between an organ and the outside of the body - intestinal obstructionpartial or total blockage of movement of food or stool through the intestines These complications need to be treated to prevent them from getting worse and causing serious illness. In some cases, surgery may be needed. Abscess, perforation, and peritonitis. Antibiotic treatment of diverticulitis usually prevents or treats an abscess. If the abscess is large or does not clear up with antibiotics, it may need to be drained. After giving the person numbing medication, a radiologist inserts a needle through the skin to the abscess and then drains the fluid through a catheter. The procedure is usually guided by an abdominal ultrasound or a CT scan. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A person with a perforation usually needs surgery to repair the tear or hole. Sometimes, a person needs surgery to remove a small part of the intestine if the perforation cannot be repaired. A person with peritonitis may be extremely ill, with nausea, vomiting, fever, and severe abdominal tenderness. This condition requires immediate surgery to clean the abdominal cavity and possibly a colon resection at a later date after a course of antibiotics. A blood transfusion may be needed if the person has lost a significant amount of blood. Without prompt treatment, peritonitis can be fatal. Fistula. Diverticulitis-related infection may lead to one or more fistulas. Fistulas usually form between the colon and the bladder, small intestine, or skin. The most common type of fistula occurs between the colon and the bladder. Fistulas can be corrected with a colon resection and removal of the fistula. Intestinal obstruction. Diverticulitis-related inflammation or scarring caused by past inflammation may lead to intestinal obstruction. If the intestine is completely blocked, emergency surgery is necessary, with possible colon resection. Partial blockage is not an emergency, so the surgery or other procedures to correct it can be scheduled. When urgent surgery with colon resection is necessary for diverticulitis, two procedures may be needed because it is not safe to rejoin the colon right away. During the colon resection, the surgeon performs a temporary colostomy, creating an opening, or stoma, in the abdomen. The end of the colon is connected to the opening to allow normal eating while healing occurs. Stool is collected in a pouch attached to the stoma on the abdominal wall. In the second surgery, several months later, the surgeon rejoins the ends of the colon and closes the stoma.</s>

The Dietary Guidelines for Americans, 2010, recommends a dietary fiber intake of 14 grams per 1,000 calories consumed. For instance, for a 2,000-calorie diet, the fiber recommendation is 28 grams per day. The amount of fiber in a food is listed on the foods nutrition facts label. Some of the best sources of fiber include fruits; vegetables, particularly starchy ones; and whole grains. A health care provider or dietitian can help a person learn how to add more high-fiber foods into the diet. Fiber-rich Foods Beans, cereals, and breads Amount of fiber 1/2 cup of navy beans 9.5 grams 1/2 cup of kidney beans 8.2 grams 1/2 cup of black beans 7.5 grams Whole-grain cereal, cold 1/2 cup of All-Bran 9.6 grams 3/4 cup of Total 2.4 grams 3/4 cup of Post Bran Flakes 5.3 grams 1 packet of whole-grain cereal, hot (oatmeal, Wheatena) 3.0 grams 1 whole-wheat English muffin 4.4 grams Fruits 1 medium apple, with skin 3.3 grams 1 medium pear, with skin 4.3 grams 1/2 cup of raspberries 4.0 grams 1/2 cup of stewed prunes 3.8 grams Vegetables 1/2 cup of winter squash 2.9 grams 1 medium sweet potato, with skin 4.8 grams 1/2 cup of green peas 4.4 grams 1 medium potato, with skin 3.8 grams 1/2 cup of mixed vegetables 4.0 grams 1 cup of cauliflower 2.5 grams 1/2 cup of spinach 3.5 grams 1/2 cup of turnip greens 2.5 grams Scientists now believe that people with diverticular disease do not need to eliminate certain foods from their diet. In the past, health care providers recommended that people with diverticular disease avoid nuts, popcorn, and sunflower, pumpkin, caraway, and sesame seeds because they thought food particles could enter, block, or irritate the diverticula. However, recent data suggest that these foods are not harmful.5 The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, as well as poppy seeds, are also fine to eat. Nonetheless, people with diverticular disease may differ in the amounts and types of foods that worsen their symptoms.

What to do for Diverticular Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Diverticular Disease ? [/INST] \n The Dietary Guidelines for Americans, 2010, recommends a dietary fiber intake of 14 grams per 1,000 calories consumed. For instance, for a 2,000-calorie diet, the fiber recommendation is 28 grams per day. The amount of fiber in a food is listed on the foods nutrition facts label. Some of the best sources of fiber include fruits; vegetables, particularly starchy ones; and whole grains. A health care provider or dietitian can help a person learn how to add more high-fiber foods into the diet. Fiber-rich Foods Beans, cereals, and breads Amount of fiber 1/2 cup of navy beans 9.5 grams 1/2 cup of kidney beans 8.2 grams 1/2 cup of black beans 7.5 grams Whole-grain cereal, cold 1/2 cup of All-Bran 9.6 grams 3/4 cup of Total 2.4 grams 3/4 cup of Post Bran Flakes 5.3 grams 1 packet of whole-grain cereal, hot (oatmeal, Wheatena) 3.0 grams 1 whole-wheat English muffin 4.4 grams Fruits 1 medium apple, with skin 3.3 grams 1 medium pear, with skin 4.3 grams 1/2 cup of raspberries 4.0 grams 1/2 cup of stewed prunes 3.8 grams Vegetables 1/2 cup of winter squash 2.9 grams 1 medium sweet potato, with skin 4.8 grams 1/2 cup of green peas 4.4 grams 1 medium potato, with skin 3.8 grams 1/2 cup of mixed vegetables 4.0 grams 1 cup of cauliflower 2.5 grams 1/2 cup of spinach 3.5 grams 1/2 cup of turnip greens 2.5 grams Scientists now believe that people with diverticular disease do not need to eliminate certain foods from their diet. In the past, health care providers recommended that people with diverticular disease avoid nuts, popcorn, and sunflower, pumpkin, caraway, and sesame seeds because they thought food particles could enter, block, or irritate the diverticula. However, recent data suggest that these foods are not harmful.5 The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, as well as poppy seeds, are also fine to eat. Nonetheless, people with diverticular disease may differ in the amounts and types of foods that worsen their symptoms.</s>

- Diverticular disease is a condition that occurs when a person has problems from small pouches, or sacs, that have formed and pushed outward through weak spots in the colon wall. The problems that occur with diverticular disease include diverticulitis and diverticular bleeding. - When a person has diverticula that do not cause diverticulitis or diverticular bleeding, the condition is called diverticulosis. - Scientists are not certain what causes diverticulosis and diverticular disease. - Although diverticular disease is generally thought to be a condition found in older adults, it is becoming more common in people younger than age 50, most of whom are male. - Health care providers often find diverticulosis during a routine x ray or a colonoscopy, a test used to look inside the rectum and entire colon to screen for colon cancer or polyps or to evaluate the source of rectal bleeding. - To diagnose diverticular disease, a health care provider may schedule one or more of the following tests: blood test; computerized tomography (CT) scan; lower gastrointestinal (GI) series; colonoscopy. - A health care provider may treat the symptoms of diverticulosis with a high-fiber diet or fiber supplements, medications, and possibly probiotics. - Diverticular bleeding is rare. Bleeding can be severe; however, it may stop by itself and not require treatment. If the bleeding does not stop, abdominal surgery with a colon resection may be necessary. - Diverticulitis with mild symptoms and no complications usually requires a person to rest, take oral antibiotics, and be on a liquid diet for a period of time. - Diverticulitis can attack suddenly and cause complications, such as an abscess, a perforation, peritonitis, a fistula, or intestinal obstruction. These complications need to be treated to prevent them from getting worse and causing serious illness.

What to do for Diverticular Disease ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Diverticular Disease ? [/INST] \n - Diverticular disease is a condition that occurs when a person has problems from small pouches, or sacs, that have formed and pushed outward through weak spots in the colon wall. The problems that occur with diverticular disease include diverticulitis and diverticular bleeding. - When a person has diverticula that do not cause diverticulitis or diverticular bleeding, the condition is called diverticulosis. - Scientists are not certain what causes diverticulosis and diverticular disease. - Although diverticular disease is generally thought to be a condition found in older adults, it is becoming more common in people younger than age 50, most of whom are male. - Health care providers often find diverticulosis during a routine x ray or a colonoscopy, a test used to look inside the rectum and entire colon to screen for colon cancer or polyps or to evaluate the source of rectal bleeding. - To diagnose diverticular disease, a health care provider may schedule one or more of the following tests: blood test; computerized tomography (CT) scan; lower gastrointestinal (GI) series; colonoscopy. - A health care provider may treat the symptoms of diverticulosis with a high-fiber diet or fiber supplements, medications, and possibly probiotics. - Diverticular bleeding is rare. Bleeding can be severe; however, it may stop by itself and not require treatment. If the bleeding does not stop, abdominal surgery with a colon resection may be necessary. - Diverticulitis with mild symptoms and no complications usually requires a person to rest, take oral antibiotics, and be on a liquid diet for a period of time. - Diverticulitis can attack suddenly and cause complications, such as an abscess, a perforation, peritonitis, a fistula, or intestinal obstruction. These complications need to be treated to prevent them from getting worse and causing serious illness.</s>

Microscopic colitis is an inflammation of the colon that a health care provider can see only with a microscope. Inflammation is the bodys normal response to injury, irritation, or infection of tissues. Microscopic colitis is a type of inflammatory bowel diseasethe general name for diseases that cause irritation and inflammation in the intestines. The two types of microscopic colitis are collagenous colitis and lymphocytic colitis. Health care providers often use the term microscopic colitis to describe both types because their symptoms and treatments are the same. Some scientists believe that collagenous colitis and lymphocytic colitis may be different phases of the same condition rather than separate conditions. In both types of microscopic colitis, an increase in the number of lymphocytes, a type of white blood cell, can be seen in the epitheliumthe layer of cells that lines the colon. An increase in the number of white blood cells is a sign of inflammation. The two types of colitis affect the colon tissue in slightly different ways: - Lymphocytic colitis. The number of lymphocytes is higher, and the tissues and lining of the colon are of normal thickness. - Collagenous colitis. The layer of collagen, a threadlike protein, underneath the epithelium builds up and becomes thicker than normal. When looking through a microscope, the health care provider may find variations in lymphocyte numbers and collagen thickness in different parts of the colon. These variations may indicate an overlap of the two types of microscopic colitis.

What is (are) Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n Microscopic colitis is an inflammation of the colon that a health care provider can see only with a microscope. Inflammation is the bodys normal response to injury, irritation, or infection of tissues. Microscopic colitis is a type of inflammatory bowel diseasethe general name for diseases that cause irritation and inflammation in the intestines. The two types of microscopic colitis are collagenous colitis and lymphocytic colitis. Health care providers often use the term microscopic colitis to describe both types because their symptoms and treatments are the same. Some scientists believe that collagenous colitis and lymphocytic colitis may be different phases of the same condition rather than separate conditions. In both types of microscopic colitis, an increase in the number of lymphocytes, a type of white blood cell, can be seen in the epitheliumthe layer of cells that lines the colon. An increase in the number of white blood cells is a sign of inflammation. The two types of colitis affect the colon tissue in slightly different ways: - Lymphocytic colitis. The number of lymphocytes is higher, and the tissues and lining of the colon are of normal thickness. - Collagenous colitis. The layer of collagen, a threadlike protein, underneath the epithelium builds up and becomes thicker than normal. When looking through a microscope, the health care provider may find variations in lymphocyte numbers and collagen thickness in different parts of the colon. These variations may indicate an overlap of the two types of microscopic colitis.</s>

The colon is part of the gastrointestinal (GI) tract, a series of hollow organs joined in a long, twisting tube from the mouth to the anusa 1-inch-long opening through which stool leaves the body. Organs that make up the GI tract are the - mouth - esophagus - stomach - small intestine - large intestine - anus The first part of the GI tract, called the upper GI tract, includes the mouth, esophagus, stomach, and small intestine. The last part of the GI tract, called the lower GI tract, consists of the large intestine and anus. The intestines are sometimes called the bowel. The large intestine is about 5 feet long in adults and includes the colon and rectum. The large intestine changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is 6 to 8 inches long in adults and is between the last part of the coloncalled the sigmoid colonand the anus. During a bowel movement, stool moves from the rectum to the anus and out of the body.

What is (are) Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n The colon is part of the gastrointestinal (GI) tract, a series of hollow organs joined in a long, twisting tube from the mouth to the anusa 1-inch-long opening through which stool leaves the body. Organs that make up the GI tract are the - mouth - esophagus - stomach - small intestine - large intestine - anus The first part of the GI tract, called the upper GI tract, includes the mouth, esophagus, stomach, and small intestine. The last part of the GI tract, called the lower GI tract, consists of the large intestine and anus. The intestines are sometimes called the bowel. The large intestine is about 5 feet long in adults and includes the colon and rectum. The large intestine changes waste from liquid to a solid matter called stool. Stool passes from the colon to the rectum. The rectum is 6 to 8 inches long in adults and is between the last part of the coloncalled the sigmoid colonand the anus. During a bowel movement, stool moves from the rectum to the anus and out of the body.</s>

The exact cause of microscopic colitis is unknown. Several factors may play a role in causing microscopic colitis. However, most scientists believe that microscopic colitis results from an abnormal immune-system response to bacteria that normally live in the colon. Scientists have proposed other causes, including - autoimmune diseases - medications - infections - genetic factors - bile acid malabsorption Autoimmune Diseases Sometimes people with microscopic colitis also have autoimmune diseasesdisorders in which the bodys immune system attacks the bodys own cells and organs. Autoimmune diseases associated with microscopic colitis include - celiac diseasea condition in which people cannot tolerate gluten because it damages the lining of the small intestine and prevents absorption of nutrients. Gluten is a protein found in wheat, rye, and barley. - thyroid diseases such as - Hashimotos diseasea form of chronic, or long lasting, inflammation of the thyroid. - Graves diseasea disease that causes hyperthyroidism. Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. - rheumatoid arthritisa disease that causes pain, swelling, stiffness, and loss of function in the joints when the immune system attacks the membrane lining the joints. - psoriasisa skin disease that causes thick, red skin with flaky, silver-white patches called scales. More information is provided in the NIDDK health topics: - Celiac Disease - Hashimotos Disease - Graves Disease Medications Researchers have not found that medications cause microscopic colitis. However, they have found links between microscopic colitis and certain medications, most commonly - nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen - lansoprazole (Prevacid) - acarbose (Prandase, Precose) - ranitidine (Tritec, Zantac) - sertraline (Zoloft) - ticlopidine (Ticlid) Other medications linked to microscopic colitis include - carbamazepine - clozapine (Clozaril, FazaClo) - dexlansoprazole (Kapidex, Dexilant) - entacapone (Comtan) - esomeprazole (Nexium) - flutamide (Eulexin) - lisinopril (Prinivil, Zestril) - omeprazole (Prilosec) - pantoprazole (Protonix) - paroxetine (Paxil, Pexeva) - rabeprazole (AcipHex) - simvastatin (Zocor) - vinorelbine (Navelbine) Infections Bacteria. Some people get microscopic colitis after an infection with certain harmful bacteria. Harmful bacteria may produce toxins that irritate the lining of the colon. Viruses. Some scientists believe that viral infections that cause inflammation in the GI tract may play a role in causing microscopic colitis. Genetic Factors Some scientists believe that genetic factors may play a role in microscopic colitis. Although researchers have not yet found a gene unique to microscopic colitis, scientists have linked dozens of genes to other types of inflammatory bowel disease, including - Crohns diseasea disorder that causes inflammation and irritation of any part of the GI tract - ulcerative colitisa chronic disease that causes inflammation and ulcers in the inner lining of the large intestine More information is provided in the NIDDK health topics: - Crohns Disease - Ulcerative Colitis Bile Acid Malabsorption Some scientists believe that bile acid malabsorption plays a role in microscopic colitis. Bile acid malabsorption is the intestines inability to completely reabsorb bile acidsacids made by the liver that work with bile to break down fats. Bile is a fluid made by the liver that carries toxins and waste products out of the body and helps the body digest fats. Bile acids that reach the colon can lead to diarrhea.

What causes Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What causes Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n The exact cause of microscopic colitis is unknown. Several factors may play a role in causing microscopic colitis. However, most scientists believe that microscopic colitis results from an abnormal immune-system response to bacteria that normally live in the colon. Scientists have proposed other causes, including - autoimmune diseases - medications - infections - genetic factors - bile acid malabsorption Autoimmune Diseases Sometimes people with microscopic colitis also have autoimmune diseasesdisorders in which the bodys immune system attacks the bodys own cells and organs. Autoimmune diseases associated with microscopic colitis include - celiac diseasea condition in which people cannot tolerate gluten because it damages the lining of the small intestine and prevents absorption of nutrients. Gluten is a protein found in wheat, rye, and barley. - thyroid diseases such as - Hashimotos diseasea form of chronic, or long lasting, inflammation of the thyroid. - Graves diseasea disease that causes hyperthyroidism. Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. - rheumatoid arthritisa disease that causes pain, swelling, stiffness, and loss of function in the joints when the immune system attacks the membrane lining the joints. - psoriasisa skin disease that causes thick, red skin with flaky, silver-white patches called scales. More information is provided in the NIDDK health topics: - Celiac Disease - Hashimotos Disease - Graves Disease Medications Researchers have not found that medications cause microscopic colitis. However, they have found links between microscopic colitis and certain medications, most commonly - nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen - lansoprazole (Prevacid) - acarbose (Prandase, Precose) - ranitidine (Tritec, Zantac) - sertraline (Zoloft) - ticlopidine (Ticlid) Other medications linked to microscopic colitis include - carbamazepine - clozapine (Clozaril, FazaClo) - dexlansoprazole (Kapidex, Dexilant) - entacapone (Comtan) - esomeprazole (Nexium) - flutamide (Eulexin) - lisinopril (Prinivil, Zestril) - omeprazole (Prilosec) - pantoprazole (Protonix) - paroxetine (Paxil, Pexeva) - rabeprazole (AcipHex) - simvastatin (Zocor) - vinorelbine (Navelbine) Infections Bacteria. Some people get microscopic colitis after an infection with certain harmful bacteria. Harmful bacteria may produce toxins that irritate the lining of the colon. Viruses. Some scientists believe that viral infections that cause inflammation in the GI tract may play a role in causing microscopic colitis. Genetic Factors Some scientists believe that genetic factors may play a role in microscopic colitis. Although researchers have not yet found a gene unique to microscopic colitis, scientists have linked dozens of genes to other types of inflammatory bowel disease, including - Crohns diseasea disorder that causes inflammation and irritation of any part of the GI tract - ulcerative colitisa chronic disease that causes inflammation and ulcers in the inner lining of the large intestine More information is provided in the NIDDK health topics: - Crohns Disease - Ulcerative Colitis Bile Acid Malabsorption Some scientists believe that bile acid malabsorption plays a role in microscopic colitis. Bile acid malabsorption is the intestines inability to completely reabsorb bile acidsacids made by the liver that work with bile to break down fats. Bile is a fluid made by the liver that carries toxins and waste products out of the body and helps the body digest fats. Bile acids that reach the colon can lead to diarrhea.</s>

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.

What are the symptoms of Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the symptoms of Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n 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.</s>

A pathologista doctor who specializes in examining tissues to diagnose diseasesdiagnoses microscopic colitis based on the findings of multiple biopsies taken throughout the colon. Biopsy is a procedure that involves taking small pieces of tissue for examination with a microscope. The pathologist examines the colon tissue samples in a lab. Many patients can have both lymphocytic colitis and collagenous colitis in different parts of their colon. To help diagnose microscopic colitis, a gastroenterologista doctor who specializes in digestive diseasesbegins with - a medical and family history - a physical exam The gastroenterologist may perform a series of medical tests to rule out other bowel diseasessuch as irritable bowel syndrome, celiac disease, Crohns disease, ulcerative colitis, and infectious colitisthat cause symptoms similar to those of microscopic colitis. These medical tests include - lab tests - imaging tests of the intestines - endoscopy of the intestines Medical and Family History The gastroenterologist will ask the patient to provide a medical and family history, a review of the symptoms, a description of eating habits, and a list of prescription and over-the-counter medications in order to help diagnose microscopic colitis. The gastroenterologist will also ask the patient about current and past medical conditions. Physical Exam A physical exam may help diagnose microscopic colitis and rule out other diseases. During a physical exam, the gastroenterologist usually - examines the patients body - taps on specific areas of the patients abdomen Lab Tests Lab tests may include - blood tests - stool tests Blood tests. 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. A health care provider may use blood tests to help look for changes in red and white blood cell counts. - Red blood cells. When red blood cells are fewer or smaller than normal, a person may have anemiaa condition that prevents the bodys cells from getting enough oxygen. - White blood cells. When the white blood cell count is higher than normal, a person may have inflammation or infection somewhere in the body. Stool tests. A stool test is the analysis of a sample of stool. A health care provider will give the patient a container for catching and storing the stool. The patient returns the sample to the health care provider or a commercial facility that will send the sample to a lab for analysis. Health care providers commonly order stool tests to rule out other causes of GI diseases, such as different types of infectionsincluding bacteria or parasitesor bleeding, and help determine the cause of symptoms. Imaging Tests of the Intestines Imaging tests of the intestines may include the following: - computerized tomography (CT) scan - magnetic resonance imaging (MRI) - upper GI series Specially trained technicians perform these tests at an outpatient center or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images. A patient does not need anesthesia. Health care providers use imaging tests to show physical abnormalities and to diagnose certain bowel diseases, in some cases. CT scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the technician takes the x rays. MRI. MRI is a test that takes pictures of the bodys internal organs and soft tissues without using x rays. Although a patient does not need anesthesia for an MRI, some patients with a fear of confined spaces may receive light sedation, taken by mouth. An MRI may include a solution to drink and injection of contrast medium. With most MRI machines, the patient will lie on a table that slides into a tunnel-shaped device that may be open ended or closed at one end. Some machines allow the patient to lie in a more open space. During an MRI, the patient, although usually awake, must remain perfectly still while the technician takes the images, which usually takes only a few minutes. The technician will take a sequence of images to create a detailed picture of the intestines. During sequencing, the patient will hear loud mechanical knocking and humming noises. Upper GI series. This test is an x-ray exam that provides a look at the shape of the upper GI tract. A patient should not eat or drink before the procedure, as directed by the health care provider. Patients should ask their health care provider about how to prepare for an upper GI series. During the procedure, the patient will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the upper GI tract so the radiologist and gastroenterologist can see the organs shapes more clearly on x rays. A patient may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes white or light-colored stools. A health care provider will give the patient specific instructions about eating and drinking after the test. More information is provided in the NIDDK health topic, Upper GI Series. Endoscopy of the Intestines Endoscopy of the intestines may include - colonoscopy with biopsy - flexible sigmoidoscopy with biopsy - upper GI endoscopy with biopsy A gastroenterologist performs these tests at a hospital or an outpatient center. Colonoscopy with biopsy. Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside the rectum and entire colon. In most cases, light anesthesia and pain medication help patients relax for the test. The medical staff will monitor a patients vital signs and try to make him or her as comfortable as possible. A nurse or technician places an intravenous (IV) needle in a vein in the arm or hand to give anesthesia. For the test, the patient will lie on a table while the gastroenterologist inserts a colonoscope into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with air to give the gastroenterologist a better view. The camera sends a video image of the intestinal lining to a computer screen, allowing the gastroenterologist to carefully examine the tissues lining the colon and rectum. The gastroenterologist may move the patient several times and adjust the scope for better viewing. Once the scope has reached the opening to the small intestine, the gastroenterologist slowly withdraws it and examines the lining of the colon and rectum again. A colonoscopy can show irritated and swollen tissue, ulcers, and abnormal growths such as polypsextra pieces of tissue that grow on the lining of the intestine. If the lining of the rectum and colon appears normal, the gastroenterologist may suspect microscopic colitis and will biopsy multiple areas of the colon. A health care provider will provide written bowel prep instructions to follow at home before the test. The health care provider will also explain what the patient can expect after the test and give discharge instructions. Flexible sigmoidoscopy with biopsy. Flexible sigmoidoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end, called a sigmoidoscope or scope, to look inside the rectum and the sigmoid colon. A patient does not usually need anesthesia. For the test, the patient will lie on a table while the gastroenterologist inserts the sigmoidoscope into the anus and slowly guides it through the rectum and into the sigmoid colon. The scope inflates the large intestine with air to give the gastroenterologist a better view. The camera sends a video image of the intestinal lining to a computer screen, allowing the gastroenterologist to carefully examine the tissues lining the sigmoid colon and rectum. The gastroenterologist may ask the patient to move several times and adjust the scope for better viewing. Once the scope reaches the end of the sigmoid colon, the gastroenterologist slowly withdraws it while carefully examining the lining of the sigmoid colon and rectum again. The gastroenterologist will look for signs of bowel diseases and conditions such as irritated and swollen tissue, ulcers, and polyps. If the lining of the rectum and colon appears normal, the gastroenterologist may suspect microscopic colitis and will biopsy multiple areas of the colon. A health care provider will provide written bowel prep instructions to follow at home before the test. The health care provider will also explain what the patient can expect after the test and give discharge instructions. Upper GI endoscopy with biopsy. Upper GI endoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end, called an endoscope or a scope, to look inside the upper GI tract. The gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach and first part of the small intestine, called the duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A health care provider will place an IV needle in a vein in the arm or hand to administer sedation. Sedatives help patients stay relaxed and comfortable. This test can show blockages or other conditions in the upper small intestine. A gastroenterologist may biopsy the lining of the small intestine during an upper GI endoscopy.

How to diagnose Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to diagnose Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n A pathologista doctor who specializes in examining tissues to diagnose diseasesdiagnoses microscopic colitis based on the findings of multiple biopsies taken throughout the colon. Biopsy is a procedure that involves taking small pieces of tissue for examination with a microscope. The pathologist examines the colon tissue samples in a lab. Many patients can have both lymphocytic colitis and collagenous colitis in different parts of their colon. To help diagnose microscopic colitis, a gastroenterologista doctor who specializes in digestive diseasesbegins with - a medical and family history - a physical exam The gastroenterologist may perform a series of medical tests to rule out other bowel diseasessuch as irritable bowel syndrome, celiac disease, Crohns disease, ulcerative colitis, and infectious colitisthat cause symptoms similar to those of microscopic colitis. These medical tests include - lab tests - imaging tests of the intestines - endoscopy of the intestines Medical and Family History The gastroenterologist will ask the patient to provide a medical and family history, a review of the symptoms, a description of eating habits, and a list of prescription and over-the-counter medications in order to help diagnose microscopic colitis. The gastroenterologist will also ask the patient about current and past medical conditions. Physical Exam A physical exam may help diagnose microscopic colitis and rule out other diseases. During a physical exam, the gastroenterologist usually - examines the patients body - taps on specific areas of the patients abdomen Lab Tests Lab tests may include - blood tests - stool tests Blood tests. 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. A health care provider may use blood tests to help look for changes in red and white blood cell counts. - Red blood cells. When red blood cells are fewer or smaller than normal, a person may have anemiaa condition that prevents the bodys cells from getting enough oxygen. - White blood cells. When the white blood cell count is higher than normal, a person may have inflammation or infection somewhere in the body. Stool tests. A stool test is the analysis of a sample of stool. A health care provider will give the patient a container for catching and storing the stool. The patient returns the sample to the health care provider or a commercial facility that will send the sample to a lab for analysis. Health care providers commonly order stool tests to rule out other causes of GI diseases, such as different types of infectionsincluding bacteria or parasitesor bleeding, and help determine the cause of symptoms. Imaging Tests of the Intestines Imaging tests of the intestines may include the following: - computerized tomography (CT) scan - magnetic resonance imaging (MRI) - upper GI series Specially trained technicians perform these tests at an outpatient center or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images. A patient does not need anesthesia. Health care providers use imaging tests to show physical abnormalities and to diagnose certain bowel diseases, in some cases. CT scan. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the technician takes the x rays. MRI. MRI is a test that takes pictures of the bodys internal organs and soft tissues without using x rays. Although a patient does not need anesthesia for an MRI, some patients with a fear of confined spaces may receive light sedation, taken by mouth. An MRI may include a solution to drink and injection of contrast medium. With most MRI machines, the patient will lie on a table that slides into a tunnel-shaped device that may be open ended or closed at one end. Some machines allow the patient to lie in a more open space. During an MRI, the patient, although usually awake, must remain perfectly still while the technician takes the images, which usually takes only a few minutes. The technician will take a sequence of images to create a detailed picture of the intestines. During sequencing, the patient will hear loud mechanical knocking and humming noises. Upper GI series. This test is an x-ray exam that provides a look at the shape of the upper GI tract. A patient should not eat or drink before the procedure, as directed by the health care provider. Patients should ask their health care provider about how to prepare for an upper GI series. During the procedure, the patient will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the upper GI tract so the radiologist and gastroenterologist can see the organs shapes more clearly on x rays. A patient may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes white or light-colored stools. A health care provider will give the patient specific instructions about eating and drinking after the test. More information is provided in the NIDDK health topic, Upper GI Series. Endoscopy of the Intestines Endoscopy of the intestines may include - colonoscopy with biopsy - flexible sigmoidoscopy with biopsy - upper GI endoscopy with biopsy A gastroenterologist performs these tests at a hospital or an outpatient center. Colonoscopy with biopsy. Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside the rectum and entire colon. In most cases, light anesthesia and pain medication help patients relax for the test. The medical staff will monitor a patients vital signs and try to make him or her as comfortable as possible. A nurse or technician places an intravenous (IV) needle in a vein in the arm or hand to give anesthesia. For the test, the patient will lie on a table while the gastroenterologist inserts a colonoscope into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with air to give the gastroenterologist a better view. The camera sends a video image of the intestinal lining to a computer screen, allowing the gastroenterologist to carefully examine the tissues lining the colon and rectum. The gastroenterologist may move the patient several times and adjust the scope for better viewing. Once the scope has reached the opening to the small intestine, the gastroenterologist slowly withdraws it and examines the lining of the colon and rectum again. A colonoscopy can show irritated and swollen tissue, ulcers, and abnormal growths such as polypsextra pieces of tissue that grow on the lining of the intestine. If the lining of the rectum and colon appears normal, the gastroenterologist may suspect microscopic colitis and will biopsy multiple areas of the colon. A health care provider will provide written bowel prep instructions to follow at home before the test. The health care provider will also explain what the patient can expect after the test and give discharge instructions. Flexible sigmoidoscopy with biopsy. Flexible sigmoidoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end, called a sigmoidoscope or scope, to look inside the rectum and the sigmoid colon. A patient does not usually need anesthesia. For the test, the patient will lie on a table while the gastroenterologist inserts the sigmoidoscope into the anus and slowly guides it through the rectum and into the sigmoid colon. The scope inflates the large intestine with air to give the gastroenterologist a better view. The camera sends a video image of the intestinal lining to a computer screen, allowing the gastroenterologist to carefully examine the tissues lining the sigmoid colon and rectum. The gastroenterologist may ask the patient to move several times and adjust the scope for better viewing. Once the scope reaches the end of the sigmoid colon, the gastroenterologist slowly withdraws it while carefully examining the lining of the sigmoid colon and rectum again. The gastroenterologist will look for signs of bowel diseases and conditions such as irritated and swollen tissue, ulcers, and polyps. If the lining of the rectum and colon appears normal, the gastroenterologist may suspect microscopic colitis and will biopsy multiple areas of the colon. A health care provider will provide written bowel prep instructions to follow at home before the test. The health care provider will also explain what the patient can expect after the test and give discharge instructions. Upper GI endoscopy with biopsy. Upper GI endoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end, called an endoscope or a scope, to look inside the upper GI tract. The gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach and first part of the small intestine, called the duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A health care provider will place an IV needle in a vein in the arm or hand to administer sedation. Sedatives help patients stay relaxed and comfortable. This test can show blockages or other conditions in the upper small intestine. A gastroenterologist may biopsy the lining of the small intestine during an upper GI endoscopy.</s>

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.

What are the treatments for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n 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.</s>

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.

What to do for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n 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.</s>

Researchers do not know how to prevent microscopic colitis. However, researchers do believe that people who follow the recommendations of their health care provider may be able to prevent relapses of microscopic colitis.

How to prevent Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to prevent Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n Researchers do not know how to prevent microscopic colitis. However, researchers do believe that people who follow the recommendations of their health care provider may be able to prevent relapses of microscopic colitis.</s>

No. Unlike the other inflammatory bowel diseases, such as Crohns disease and ulcerative colitis, microscopic colitis does not increase a persons risk of getting colon cancer.

Who is at risk for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis? ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: Who is at risk for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis? ? [/INST] \n No. Unlike the other inflammatory bowel diseases, such as Crohns disease and ulcerative colitis, microscopic colitis does not increase a persons risk of getting colon cancer.</s>

- 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.

What to do for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis ? [/INST] \n - 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.</s>

Cyclic vomiting syndrome, sometimes referred to as CVS, is an increasingly recognized disorder with sudden, repeated attacksalso called episodesof severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. The episodes can last from a few hours to several days. Episodes can be so severe that a person has to stay in bed for days, unable to go to school or work. A person may need treatment at an emergency room or a hospital during episodes. After an episode, a person usually experiences symptom-free periods lasting a few weeks to several months. To people who have the disorder, as well as their family members and friends, cyclic vomiting syndrome can be disruptive and frightening. The disorder can affect a person for months, years, or decades. Each episode of cyclic vomiting syndrome is usually similar to previous ones, meaning that episodes tend to start at the same time of day, last the same length of time, and occur with the same symptoms and level of intensity.

What is (are) Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Cyclic Vomiting Syndrome ? [/INST] \n Cyclic vomiting syndrome, sometimes referred to as CVS, is an increasingly recognized disorder with sudden, repeated attacksalso called episodesof severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. The episodes can last from a few hours to several days. Episodes can be so severe that a person has to stay in bed for days, unable to go to school or work. A person may need treatment at an emergency room or a hospital during episodes. After an episode, a person usually experiences symptom-free periods lasting a few weeks to several months. To people who have the disorder, as well as their family members and friends, cyclic vomiting syndrome can be disruptive and frightening. The disorder can affect a person for months, years, or decades. Each episode of cyclic vomiting syndrome is usually similar to previous ones, meaning that episodes tend to start at the same time of day, last the same length of time, and occur with the same symptoms and level of intensity.</s>

The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anusthe opening through which stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. Cyclic vomiting syndrome affects the upper GI tract, which includes the mouth, esophagus, stomach, small intestine, and duodenum, the first part of the small intestine. The esophagus is the muscular tube that carries food and liquids from the mouth to the stomach. The stomach slowly pumps the food and liquids through the duodenum and into the rest of the small intestine, which absorbs nutrients from food particles. This process is automatic and people are usually not aware of it, though people sometimes feel food in their esophagus when they swallow something too large, try to eat too quickly, or drink hot or cold liquids.

What is (are) Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Cyclic Vomiting Syndrome ? [/INST] \n The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anusthe opening through which stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. Cyclic vomiting syndrome affects the upper GI tract, which includes the mouth, esophagus, stomach, small intestine, and duodenum, the first part of the small intestine. The esophagus is the muscular tube that carries food and liquids from the mouth to the stomach. The stomach slowly pumps the food and liquids through the duodenum and into the rest of the small intestine, which absorbs nutrients from food particles. This process is automatic and people are usually not aware of it, though people sometimes feel food in their esophagus when they swallow something too large, try to eat too quickly, or drink hot or cold liquids.</s>

The cause of cyclic vomiting syndrome is unknown. However, some experts believe that some possible problems with bodily functions may contribute to the cause, such as the following: - gastrointestinal motilitythe way food moves through the digestive system - central nervous system functionincludes the brain, spinal cord, and nerves that control bodily responses - autonomic nervous system functionnerves that control internal organs such as the heart - hormone imbalanceshormones are a chemical produced in one part of the body and released into the blood to trigger or regulate particular bodily functions - in children, an abnormal inherited gene may also contribute to the condition Specific conditions or events may trigger an episode of cyclic vomiting: - emotional stress, anxiety, or panic attacksfor example, in children, common triggers of anticipatory anxiety are school exams or events, birthday parties, holidays, family conflicts, or travel - infections, such as a sinus infection, a respiratory infection, or the flu - eating certain foods, such as chocolate or cheese, or additives such as caffeine, nitritescommonly found in cured meats such as hot dogsand monosodium glutamate, also called MSG - hot weather - menstrual periods - motion sickness - overeating, fasting, or eating right before bedtime - physical exhaustion or too much exercise

What causes Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What causes Cyclic Vomiting Syndrome ? [/INST] \n The cause of cyclic vomiting syndrome is unknown. However, some experts believe that some possible problems with bodily functions may contribute to the cause, such as the following: - gastrointestinal motilitythe way food moves through the digestive system - central nervous system functionincludes the brain, spinal cord, and nerves that control bodily responses - autonomic nervous system functionnerves that control internal organs such as the heart - hormone imbalanceshormones are a chemical produced in one part of the body and released into the blood to trigger or regulate particular bodily functions - in children, an abnormal inherited gene may also contribute to the condition Specific conditions or events may trigger an episode of cyclic vomiting: - emotional stress, anxiety, or panic attacksfor example, in children, common triggers of anticipatory anxiety are school exams or events, birthday parties, holidays, family conflicts, or travel - infections, such as a sinus infection, a respiratory infection, or the flu - eating certain foods, such as chocolate or cheese, or additives such as caffeine, nitritescommonly found in cured meats such as hot dogsand monosodium glutamate, also called MSG - hot weather - menstrual periods - motion sickness - overeating, fasting, or eating right before bedtime - physical exhaustion or too much exercise</s>

Cyclic vomiting syndrome is more common in children than adults, although reports of the syndrome in adults have increased in recent years.1 Usually, children are about 5 years old when diagnosed with cyclic vomiting syndrome, which occurs in every three out of 100,000 children.2

How many people are affected by Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How many people are affected by Cyclic Vomiting Syndrome ? [/INST] \n Cyclic vomiting syndrome is more common in children than adults, although reports of the syndrome in adults have increased in recent years.1 Usually, children are about 5 years old when diagnosed with cyclic vomiting syndrome, which occurs in every three out of 100,000 children.2</s>

The main symptoms of cyclic vomiting syndrome are severe nausea and sudden vomiting lasting hours to days. A person may also experience one or more of the following symptoms: - retching, or making an attempt to vomit - heaving or gagging - lack of appetite - abdominal pain - diarrhea - fever - dizziness - headache - sensitivity to light Intensity of symptoms will vary as a person cycles through four distinct phases of an episode: - Prodrome phase. During the prodrome phase, the person feels that an episode of nausea and vomiting is about to start. Often marked by intense sweating and nauseawith or without abdominal painthis phase can last from a few minutes to several hours. The person may appear unusually pale. - Vomiting phase. This phase consists of intense nausea, vomiting, and retching. Periods of vomiting and retching can last 20 to 30 minutes at a time. The person may be subdued and responsive, immobile and unresponsive, or writhing and moaning with intense abdominal pain. An episode can last from hours to days. - Recovery phase. This phase begins when the vomiting and retching stop and the nausea subsides. Improvement of symptoms during the recovery phase can vary. Healthy color, appetite, and energy return gradually or right away. - Well phase. This phase occurs between episodes when no symptoms are present.

What are the symptoms of Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the symptoms of Cyclic Vomiting Syndrome ? [/INST] \n The main symptoms of cyclic vomiting syndrome are severe nausea and sudden vomiting lasting hours to days. A person may also experience one or more of the following symptoms: - retching, or making an attempt to vomit - heaving or gagging - lack of appetite - abdominal pain - diarrhea - fever - dizziness - headache - sensitivity to light Intensity of symptoms will vary as a person cycles through four distinct phases of an episode: - Prodrome phase. During the prodrome phase, the person feels that an episode of nausea and vomiting is about to start. Often marked by intense sweating and nauseawith or without abdominal painthis phase can last from a few minutes to several hours. The person may appear unusually pale. - Vomiting phase. This phase consists of intense nausea, vomiting, and retching. Periods of vomiting and retching can last 20 to 30 minutes at a time. The person may be subdued and responsive, immobile and unresponsive, or writhing and moaning with intense abdominal pain. An episode can last from hours to days. - Recovery phase. This phase begins when the vomiting and retching stop and the nausea subsides. Improvement of symptoms during the recovery phase can vary. Healthy color, appetite, and energy return gradually or right away. - Well phase. This phase occurs between episodes when no symptoms are present.</s>

The severe vomiting and retching that define cyclic vomiting syndrome increase the chance of developing several complications, including dehydration, esophagitis, a Mallory-Weiss tear, and tooth decay. - Dehydration may occur when a person does not replace fluids that were lost because of vomiting and diarrhea. When dehydrated, the body lacks enough fluid and electrolytesminerals in salts, including sodium, potassium, and chlorideto function properly. Severe dehydration may require intravenous (IV) fluids and hospitalization. - Esophagitisinflammation or irritation of the esophaguscan result from the stomach acid that exits through the esophagus during vomiting. - A Mallory-Weiss teara tear in the lower end of the esophagusis caused by severe vomiting. A person with bloody vomit and stool should see a health care provider right away. - Tooth decay or corroding tooth enamel is damage caused by stomach acid. Seek Help for Signs or Symptoms of Severe Dehydration People who have any signs or symptoms of severe dehydration should call or see a health care provider right away: - excessive thirst - dark-colored urine - infrequent urination - lethargy, dizziness, or faintness - dry skin Infants, children, older adults, and people with weak immune systems have the greatest chance of becoming dehydrated. People should watch for the following signs and symptoms of dehydration in infants, young children, and people who are unable to communicate their symptoms: - dry mouth and tongue - lack of tears when crying - infants with no wet diapers for 3 hours or more - infants with a sunken soft spot - unusually cranky or drowsy behavior - sunken eyes or cheeks - fever If left untreated, severe dehydration can cause serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.

What are the complications of Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the complications of Cyclic Vomiting Syndrome ? [/INST] \n The severe vomiting and retching that define cyclic vomiting syndrome increase the chance of developing several complications, including dehydration, esophagitis, a Mallory-Weiss tear, and tooth decay. - Dehydration may occur when a person does not replace fluids that were lost because of vomiting and diarrhea. When dehydrated, the body lacks enough fluid and electrolytesminerals in salts, including sodium, potassium, and chlorideto function properly. Severe dehydration may require intravenous (IV) fluids and hospitalization. - Esophagitisinflammation or irritation of the esophaguscan result from the stomach acid that exits through the esophagus during vomiting. - A Mallory-Weiss teara tear in the lower end of the esophagusis caused by severe vomiting. A person with bloody vomit and stool should see a health care provider right away. - Tooth decay or corroding tooth enamel is damage caused by stomach acid. Seek Help for Signs or Symptoms of Severe Dehydration People who have any signs or symptoms of severe dehydration should call or see a health care provider right away: - excessive thirst - dark-colored urine - infrequent urination - lethargy, dizziness, or faintness - dry skin Infants, children, older adults, and people with weak immune systems have the greatest chance of becoming dehydrated. People should watch for the following signs and symptoms of dehydration in infants, young children, and people who are unable to communicate their symptoms: - dry mouth and tongue - lack of tears when crying - infants with no wet diapers for 3 hours or more - infants with a sunken soft spot - unusually cranky or drowsy behavior - sunken eyes or cheeks - fever If left untreated, severe dehydration can cause serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.</s>

People who have any signs or symptoms of severe dehydration should call or see a health care provider right away: - excessive thirst - dark-colored urine - infrequent urination - lethargy, dizziness, or faintness - dry skin Infants, children, older adults, and people with weak immune systems have the greatest chance of becoming dehydrated. People should watch for the following signs and symptoms of dehydration in infants, young children, and people who are unable to communicate their symptoms: - dry mouth and tongue - lack of tears when crying - infants with no wet diapers for 3 hours or more - infants with a sunken soft spot - unusually cranky or drowsy behavior - sunken eyes or cheeks - fever If left untreated, severe dehydration can cause serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.

What are the symptoms of Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the symptoms of Cyclic Vomiting Syndrome ? [/INST] \n People who have any signs or symptoms of severe dehydration should call or see a health care provider right away: - excessive thirst - dark-colored urine - infrequent urination - lethargy, dizziness, or faintness - dry skin Infants, children, older adults, and people with weak immune systems have the greatest chance of becoming dehydrated. People should watch for the following signs and symptoms of dehydration in infants, young children, and people who are unable to communicate their symptoms: - dry mouth and tongue - lack of tears when crying - infants with no wet diapers for 3 hours or more - infants with a sunken soft spot - unusually cranky or drowsy behavior - sunken eyes or cheeks - fever If left untreated, severe dehydration can cause serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.</s>

A specific test to diagnose cyclic vomiting syndrome does not exist; instead, a health care provider will rule out other conditions and diagnose the syndrome based upon - a medical and family history - a physical exam - a pattern or cycle of symptoms - blood tests - urine tests - imaging tests - upper GI endoscopy - a gastric emptying test Often, it is suspected that one of the following is causing their symptoms: - gastroparesisa disorder that slows or stops the movement of food from the stomach to the small intestine - gastroenteritisinflammation of the lining of the stomach, small intestine, and large intestine A diagnosis of cyclic vomiting syndrome may be difficult to make until the person sees a health care provider. A health care provider will suspect cyclic vomiting syndrome if the person suffers from repeat episodes of vomiting. Medical and Family History Taking a medical and family history is one of the first things a health care provider may do to help diagnose cyclic vomiting syndrome. He or she will ask the patient to provide a medical and family history. Physical Exam A physical exam may help diagnose other conditions besides cyclic vomiting syndrome. During a physical exam, a health care provider usually - examines a patients body - taps on specific areas of the patients body Pattern or Cycle of Symptoms in Children3 A health care provider will often suspect cyclic vomiting syndrome in a child when the child - has at least five separate episodes, or at least three separate episodes over 6 months - has episodes of intense nausea and vomiting lasting 1 hour to 10 days and occurring at least 1 week apart - has episodes that are similar to previous onesthey tend to start at the same time of day, last the same length of time, and occur with the same symptoms and level of intensity - vomits during episodes at least four times per hour for at least 1 hour - vomits and it is not attributed to another disorder - has absence of nausea and vomiting between episodes Pattern or Cycle of Symptoms in Adults4,5 A health care provider will often suspect cyclic vomiting syndrome in adults when the following is present for at least 3 months and the symptoms started more than 6 months ago: - Each episode of cyclic vomiting syndrome is usually similar to previous ones, meaning that episodes tend to start at the same time of day and last the same length of timeless than 1 week. - Three or more separate episodes in the past year. - Absence of nausea or vomiting between episodes. Blood Tests A nurse or technician will draw blood samples at a health care providers office or a commercial facility and send the samples to a lab for analysis. The blood test can tell the health care provider if the patient has any signs of dehydration or other problems. Urine Tests Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container in a health care providers office or a commercial facility. A health care provider tests the sample in the same location or sends the sample to a lab for analysis. A urinalysis can rule out kidney problems or an infection. Imaging Tests The health care provider decides which test to order based on the symptoms, medical history, and physical exam. Upper GI series. A health care provider may order an upper GI series to look at the upper GI tract. A radiologista doctor who specializes in medical imagingperforms this test at a hospital or an outpatient center. This test does not require anesthesia. The patient should not eat or drink for 8 hours before the procedure, if possible. During the procedure, the patient will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Infants lie on a table and a health care provider gives them barium through a tiny tube placed in the nose that runs into the stomach. Barium coats the GI tract, making signs of obstruction or other problems that can cause vomiting show up more clearly on x rays. A patient may experience bloating and nausea for a short time after the test. The upper GI series can show other problems that may be causing symptoms, such as an ulcer or obstruction. Abdominal ultrasound. A health care provider may order an ultrasound to look at the organs in the abdomen. A technician uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The technician performs the procedure in a health care providers office, an outpatient center, or a hospital. A radiologist interprets the images. A patient does not need anesthesia. The abdominal ultrasound can show other problems that may be causing symptoms, such as gallstones. Upper Gastrointestinal Endoscopy This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A nurse or technician will place an IV needle in a vein in the arm to administer sedation or anesthesia. Sedatives or anesthesia help a patient stay relaxed and comfortable. The gastroenterologist carefully inserts the endoscope into the mouth and feeds the endoscope down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. The upper GI endoscopy can show other problems that may be causing symptoms, such as an ulcer. A gastroenterologist may obtain a biopsya procedure that involves taking a small piece of tissue for examination with a microscopeof the small-intestinal lining during an upper GI endoscopy. The patient will not feel the biopsy. Gastric Emptying Test Also called gastric emptying scintigraphy, this test involves eating a bland mealsuch as eggs or an egg substitutethat contains a small amount of radioactive material. A specially trained technician performs the test in a radiology center or hospital, and a radiologist interprets the results; the patient does not need anesthesia. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal.

How to diagnose Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to diagnose Cyclic Vomiting Syndrome ? [/INST] \n A specific test to diagnose cyclic vomiting syndrome does not exist; instead, a health care provider will rule out other conditions and diagnose the syndrome based upon - a medical and family history - a physical exam - a pattern or cycle of symptoms - blood tests - urine tests - imaging tests - upper GI endoscopy - a gastric emptying test Often, it is suspected that one of the following is causing their symptoms: - gastroparesisa disorder that slows or stops the movement of food from the stomach to the small intestine - gastroenteritisinflammation of the lining of the stomach, small intestine, and large intestine A diagnosis of cyclic vomiting syndrome may be difficult to make until the person sees a health care provider. A health care provider will suspect cyclic vomiting syndrome if the person suffers from repeat episodes of vomiting. Medical and Family History Taking a medical and family history is one of the first things a health care provider may do to help diagnose cyclic vomiting syndrome. He or she will ask the patient to provide a medical and family history. Physical Exam A physical exam may help diagnose other conditions besides cyclic vomiting syndrome. During a physical exam, a health care provider usually - examines a patients body - taps on specific areas of the patients body Pattern or Cycle of Symptoms in Children3 A health care provider will often suspect cyclic vomiting syndrome in a child when the child - has at least five separate episodes, or at least three separate episodes over 6 months - has episodes of intense nausea and vomiting lasting 1 hour to 10 days and occurring at least 1 week apart - has episodes that are similar to previous onesthey tend to start at the same time of day, last the same length of time, and occur with the same symptoms and level of intensity - vomits during episodes at least four times per hour for at least 1 hour - vomits and it is not attributed to another disorder - has absence of nausea and vomiting between episodes Pattern or Cycle of Symptoms in Adults4,5 A health care provider will often suspect cyclic vomiting syndrome in adults when the following is present for at least 3 months and the symptoms started more than 6 months ago: - Each episode of cyclic vomiting syndrome is usually similar to previous ones, meaning that episodes tend to start at the same time of day and last the same length of timeless than 1 week. - Three or more separate episodes in the past year. - Absence of nausea or vomiting between episodes. Blood Tests A nurse or technician will draw blood samples at a health care providers office or a commercial facility and send the samples to a lab for analysis. The blood test can tell the health care provider if the patient has any signs of dehydration or other problems. Urine Tests Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container in a health care providers office or a commercial facility. A health care provider tests the sample in the same location or sends the sample to a lab for analysis. A urinalysis can rule out kidney problems or an infection. Imaging Tests The health care provider decides which test to order based on the symptoms, medical history, and physical exam. Upper GI series. A health care provider may order an upper GI series to look at the upper GI tract. A radiologista doctor who specializes in medical imagingperforms this test at a hospital or an outpatient center. This test does not require anesthesia. The patient should not eat or drink for 8 hours before the procedure, if possible. During the procedure, the patient will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Infants lie on a table and a health care provider gives them barium through a tiny tube placed in the nose that runs into the stomach. Barium coats the GI tract, making signs of obstruction or other problems that can cause vomiting show up more clearly on x rays. A patient may experience bloating and nausea for a short time after the test. The upper GI series can show other problems that may be causing symptoms, such as an ulcer or obstruction. Abdominal ultrasound. A health care provider may order an ultrasound to look at the organs in the abdomen. A technician uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The technician performs the procedure in a health care providers office, an outpatient center, or a hospital. A radiologist interprets the images. A patient does not need anesthesia. The abdominal ultrasound can show other problems that may be causing symptoms, such as gallstones. Upper Gastrointestinal Endoscopy This procedure involves using an endoscopea small, flexible tube with a lightto see the upper GI tract. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. A health care provider may give a patient a liquid anesthetic to gargle or may spray anesthetic on the back of the patients throat. A nurse or technician will place an IV needle in a vein in the arm to administer sedation or anesthesia. Sedatives or anesthesia help a patient stay relaxed and comfortable. The gastroenterologist carefully inserts the endoscope into the mouth and feeds the endoscope down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. The upper GI endoscopy can show other problems that may be causing symptoms, such as an ulcer. A gastroenterologist may obtain a biopsya procedure that involves taking a small piece of tissue for examination with a microscopeof the small-intestinal lining during an upper GI endoscopy. The patient will not feel the biopsy. Gastric Emptying Test Also called gastric emptying scintigraphy, this test involves eating a bland mealsuch as eggs or an egg substitutethat contains a small amount of radioactive material. A specially trained technician performs the test in a radiology center or hospital, and a radiologist interprets the results; the patient does not need anesthesia. An external camera scans the abdomen to show where the radioactive material is located. The radiologist is then able to measure the rate of gastric emptying at 1, 2, 3, and 4 hours after the meal.</s>

A health care provider may refer patients to a gastroenterologist for treatment. People with cyclic vomiting syndrome should get plenty of rest and take medications to prevent a vomiting episode, stop an episode in progress, speed up recovery, or relieve associated symptoms. The health care team tailors treatment to the symptoms experienced during each of the four cyclic vomiting syndrome phases: - Prodrome phase treatment. The goal during the prodrome phase is to stop an episode before it progresses. Taking medication early in the phase can help stop an episode from moving to the vomiting phase or becoming severe; however, people do not always realize an episode is coming. For example, a person may wake up in the morning and begin vomiting. A health care provider may recommend the following medications for both children and adults: - ondansetron (Zofran) or lorazepam (Ativan) for nausea - ibuprofen for abdominal pain - ranitidine (Zantac), lansoprazole (Prevacid), or omeprazole (Prilosec, Zegerid) to control stomach acid production - sumatriptan (Imitrex)prescribed as a nasal spray, an injection, or a pill that dissolves under the tonguefor migraines - Vomiting phase treatment. Once vomiting begins, people should call or see a health care provider as soon as possible. Treatment usually requires the person to stay in bed and sleep in a dark, quiet room. A health care provider may recommend the following for both children and adults: - medication for pain, nausea, and reducing stomach acid and anxiety - anti-migraine medications such as sumatriptan to stop symptoms of a migraine or possibly stop an episode in progress - hospitalization for severe nausea and vomiting - IV fluids and medications to prevent dehydration and treat symptoms - IV nutrition if an episode continues for several days - Recovery phase treatment. During the recovery phase, drinking and eating will replace lost electrolytes. A person may need IV fluids for a period of time. Some people find their appetite returns to normal right away, while others start by drinking clear liquids and then moving slowly to other liquids and solid food. A health care provider may prescribe medications during the recovery phase and well phase to prevent future episodes. - Well phase treatment. During the well phase, a health care provider may use medications to treat people whose episodes are frequent and long lasting in an effort to prevent or ease future episodes. A person may need to take a medication daily for 1 to 2 months before evaluating whether it helps prevent episodes. A health care provider may prescribe the following medications for both children and adults during the well phase to prevent cyclic vomiting syndrome episodes, lessen their severity, and reduce their frequency: - amitriptyline (Elavil) - propranolol (Inderal) - cyproheptadine (Periactin)

What are the treatments for Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Cyclic Vomiting Syndrome ? [/INST] \n A health care provider may refer patients to a gastroenterologist for treatment. People with cyclic vomiting syndrome should get plenty of rest and take medications to prevent a vomiting episode, stop an episode in progress, speed up recovery, or relieve associated symptoms. The health care team tailors treatment to the symptoms experienced during each of the four cyclic vomiting syndrome phases: - Prodrome phase treatment. The goal during the prodrome phase is to stop an episode before it progresses. Taking medication early in the phase can help stop an episode from moving to the vomiting phase or becoming severe; however, people do not always realize an episode is coming. For example, a person may wake up in the morning and begin vomiting. A health care provider may recommend the following medications for both children and adults: - ondansetron (Zofran) or lorazepam (Ativan) for nausea - ibuprofen for abdominal pain - ranitidine (Zantac), lansoprazole (Prevacid), or omeprazole (Prilosec, Zegerid) to control stomach acid production - sumatriptan (Imitrex)prescribed as a nasal spray, an injection, or a pill that dissolves under the tonguefor migraines - Vomiting phase treatment. Once vomiting begins, people should call or see a health care provider as soon as possible. Treatment usually requires the person to stay in bed and sleep in a dark, quiet room. A health care provider may recommend the following for both children and adults: - medication for pain, nausea, and reducing stomach acid and anxiety - anti-migraine medications such as sumatriptan to stop symptoms of a migraine or possibly stop an episode in progress - hospitalization for severe nausea and vomiting - IV fluids and medications to prevent dehydration and treat symptoms - IV nutrition if an episode continues for several days - Recovery phase treatment. During the recovery phase, drinking and eating will replace lost electrolytes. A person may need IV fluids for a period of time. Some people find their appetite returns to normal right away, while others start by drinking clear liquids and then moving slowly to other liquids and solid food. A health care provider may prescribe medications during the recovery phase and well phase to prevent future episodes. - Well phase treatment. During the well phase, a health care provider may use medications to treat people whose episodes are frequent and long lasting in an effort to prevent or ease future episodes. A person may need to take a medication daily for 1 to 2 months before evaluating whether it helps prevent episodes. A health care provider may prescribe the following medications for both children and adults during the well phase to prevent cyclic vomiting syndrome episodes, lessen their severity, and reduce their frequency: - amitriptyline (Elavil) - propranolol (Inderal) - cyproheptadine (Periactin)</s>

A person should stay away from known triggers, especially during the well phase, as well as - get adequate sleep to prevent exhaustion - treat sinus problems or allergies - seek help on reducing stress and anxiety - avoid foods that trigger episodes or foods with additives A health care provider may refer people with cyclic vomiting syndrome and anxiety to a stress management specialist for relaxation therapy or other treatments. A health care provider may prescribe medications to prevent migraines for people with cyclic vomiting syndrome.

How to prevent Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to prevent Cyclic Vomiting Syndrome ? [/INST] \n A person should stay away from known triggers, especially during the well phase, as well as - get adequate sleep to prevent exhaustion - treat sinus problems or allergies - seek help on reducing stress and anxiety - avoid foods that trigger episodes or foods with additives A health care provider may refer people with cyclic vomiting syndrome and anxiety to a stress management specialist for relaxation therapy or other treatments. A health care provider may prescribe medications to prevent migraines for people with cyclic vomiting syndrome.</s>

During the prodrome and vomiting phases of cyclic vomiting syndrome, a person will generally take in little or no nutrition by mouth. During the recovery phase, the person may be quite hungry as soon as the vomiting stops. As eating resumes, a person or his or her family should watch for the return of nausea. In some cases, a person can start with clear liquids and proceed slowly to a regular diet. During the well phase, a balanced diet and regular meals are important. People should avoid any trigger foods and foods with additives. Eating small, carbohydrate-containing snacks between meals, before exercise, and at bedtime may help prevent future attacks. A health care provider will assist with planning a return to a regular diet.

What to do for Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Cyclic Vomiting Syndrome ? [/INST] \n During the prodrome and vomiting phases of cyclic vomiting syndrome, a person will generally take in little or no nutrition by mouth. During the recovery phase, the person may be quite hungry as soon as the vomiting stops. As eating resumes, a person or his or her family should watch for the return of nausea. In some cases, a person can start with clear liquids and proceed slowly to a regular diet. During the well phase, a balanced diet and regular meals are important. People should avoid any trigger foods and foods with additives. Eating small, carbohydrate-containing snacks between meals, before exercise, and at bedtime may help prevent future attacks. A health care provider will assist with planning a return to a regular diet.</s>

- Cyclic vomiting syndrome, sometimes referred to as CVS, is an increasingly recognized disorder with sudden, repeated attacksalso called episodesof severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. - The disorder can affect a person for months, years, or decades. - The cause of cyclic vomiting syndrome is unknown. - The severe vomiting and retching that define cyclic vomiting syndrome increase the chance of developing several complications, including dehydration, esophagitis, a Mallory-Weiss tear, and tooth decay. - Intensity of symptoms will vary as a person cycles through four distinct phases of an episode. - The main symptoms of cyclic vomiting syndrome are severe nausea and sudden vomiting lasting hours to days. - People with cyclic vomiting syndrome should get plenty of rest and take medications to prevent a vomiting episode, stop an episode in progress, speed up recovery, or relieve associated symptoms. - During the well phase, a balanced diet and regular meals are important. A health care provider will assist with planning a return to a regular diet.

What to do for Cyclic Vomiting Syndrome ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Cyclic Vomiting Syndrome ? [/INST] \n - Cyclic vomiting syndrome, sometimes referred to as CVS, is an increasingly recognized disorder with sudden, repeated attacksalso called episodesof severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. - The disorder can affect a person for months, years, or decades. - The cause of cyclic vomiting syndrome is unknown. - The severe vomiting and retching that define cyclic vomiting syndrome increase the chance of developing several complications, including dehydration, esophagitis, a Mallory-Weiss tear, and tooth decay. - Intensity of symptoms will vary as a person cycles through four distinct phases of an episode. - The main symptoms of cyclic vomiting syndrome are severe nausea and sudden vomiting lasting hours to days. - People with cyclic vomiting syndrome should get plenty of rest and take medications to prevent a vomiting episode, stop an episode in progress, speed up recovery, or relieve associated symptoms. - During the well phase, a balanced diet and regular meals are important. A health care provider will assist with planning a return to a regular diet.</s>

Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbnessloss of feelingin the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbnessloss of feelingin the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.</s>

The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors: - metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin - neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves - autoimmune factors that cause inflammation in nerves - mechanical injury to nerves, such as carpal tunnel syndrome - inherited traits that increase susceptibility to nerve disease - lifestyle factors, such as smoking or alcohol use

What causes Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What causes Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors: - metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin - neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves - autoimmune factors that cause inflammation in nerves - mechanical injury to nerves, such as carpal tunnel syndrome - inherited traits that increase susceptibility to nerve disease - lifestyle factors, such as smoking or alcohol use</s>

Symptoms depend on the type of neuropathy and which nerves are affected. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomicor involuntarynervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe. Symptoms of nerve damage may include - numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers - wasting of the muscles of the feet or hands - indigestion, nausea, or vomiting - diarrhea or constipation - dizziness or faintness due to a drop in blood pressure after standing or sitting up - problems with urination - erectile dysfunction in men or vaginal dryness in women - weakness Symptoms that are not due to neuropathy, but often accompany it, include weight loss and depression.

What are the symptoms of Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the symptoms of Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Symptoms depend on the type of neuropathy and which nerves are affected. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomicor involuntarynervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe. Symptoms of nerve damage may include - numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers - wasting of the muscles of the feet or hands - indigestion, nausea, or vomiting - diarrhea or constipation - dizziness or faintness due to a drop in blood pressure after standing or sitting up - problems with urination - erectile dysfunction in men or vaginal dryness in women - weakness Symptoms that are not due to neuropathy, but often accompany it, include weight loss and depression.</s>

Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways. - Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms. - Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels. - Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs. - Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected. Neuropathy Affects Nerves Throughout the Body Peripheral neuropathy affects - toes - feet - legs - hands - arms Autonomic neuropathy affects - heart and blood vessels - digestive system - urinary tract - sex organs - sweat glands - eyes - lungs Proximal neuropathy affects - thighs - hips - buttocks - legs Focal neuropathy affects - eyes - facial muscles - ears - pelvis and lower back - chest - abdomen - thighs - legs - feet

What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways. - Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms. - Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels. - Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs. - Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected. Neuropathy Affects Nerves Throughout the Body Peripheral neuropathy affects - toes - feet - legs - hands - arms Autonomic neuropathy affects - heart and blood vessels - digestive system - urinary tract - sex organs - sweat glands - eyes - lungs Proximal neuropathy affects - thighs - hips - buttocks - legs Focal neuropathy affects - eyes - facial muscles - ears - pelvis and lower back - chest - abdomen - thighs - legs - feet</s>

Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Feet and legs are likely to be affected before hands and arms. Many people with diabetes have signs of neuropathy that a doctor could note but feel no symptoms themselves. Symptoms of peripheral neuropathy may include - numbness or insensitivity to pain or temperature - a tingling, burning, or prickling sensation - sharp pains or cramps - extreme sensitivity to touch, even light touch - loss of balance and coordination These symptoms are often worse at night. Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If an infection occurs and is not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Many amputations are preventable if minor problems are caught and treated in time.

What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Feet and legs are likely to be affected before hands and arms. Many people with diabetes have signs of neuropathy that a doctor could note but feel no symptoms themselves. Symptoms of peripheral neuropathy may include - numbness or insensitivity to pain or temperature - a tingling, burning, or prickling sensation - sharp pains or cramps - extreme sensitivity to touch, even light touch - loss of balance and coordination These symptoms are often worse at night. Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If an infection occurs and is not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Many amputations are preventable if minor problems are caught and treated in time.</s>

Autonomic neuropathy affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. Autonomic neuropathy also affects other internal organs, causing problems with digestion, respiratory function, urination, sexual response, and vision. In addition, the system that restores blood glucose levels to normal after a hypoglycemic episode may be affected, resulting in loss of the warning symptoms of hypoglycemia. Hypoglycemia Unawareness Normally, symptoms such as shakiness, sweating, and palpitations occur when blood glucose levels drop below 70 mg/dL. In people with autonomic neuropathy, symptoms may not occur, making hypoglycemia difficult to recognize. Problems other than neuropathy can also cause hypoglycemia unawareness. Heart and Blood Vessels The heart and blood vessels are part of the cardiovascular system, which controls blood circulation. Damage to nerves in the cardiovascular system interferes with the body's ability to adjust blood pressure and heart rate. As a result, blood pressure may drop sharply after sitting or standing, causing a person to feel light-headed or even to faint. Damage to the nerves that control heart rate can mean that the heart rate stays high, instead of rising and falling in response to normal body functions and physical activity. Digestive System Nerve damage to the digestive system most commonly causes constipation. Damage can also cause the stomach to empty too slowly, a condition called gastroparesis. Severe gastroparesis can lead to persistent nausea and vomiting, bloating, and loss of appetite. Gastroparesis can also make blood glucose levels fluctuate widely, due to abnormal food digestion. Nerve damage to the esophagus may make swallowing difficult, while nerve damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. Problems with the digestive system can lead to weight loss. Urinary Tract and Sex Organs Autonomic neuropathy often affects the organs that control urination and sexual function. Nerve damage can prevent the bladder from emptying completely, allowing bacteria to grow in the bladder and kidneys and causing urinary tract infections. When the nerves of the bladder are damaged, urinary incontinence may result because a person may not be able to sense when the bladder is full or control the muscles that release urine. Autonomic neuropathy can also gradually decrease sexual response in men and women, although the sex drive may be unchanged. A man may be unable to have erections or may reach sexual climax without ejaculating normally. A woman may have difficulty with arousal, lubrication, or orgasm. Sweat Glands Autonomic neuropathy can affect the nerves that control sweating. When nerve damage prevents the sweat glands from working properly, the body cannot regulate its temperature as it should. Nerve damage can also cause profuse sweating at night or while eating. Eyes Finally, autonomic neuropathy can affect the pupils of the eyes, making them less responsive to changes in light. As a result, a person may not be able to see well when a light is turned on in a dark room or may have trouble driving at night.

What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Autonomic neuropathy affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. Autonomic neuropathy also affects other internal organs, causing problems with digestion, respiratory function, urination, sexual response, and vision. In addition, the system that restores blood glucose levels to normal after a hypoglycemic episode may be affected, resulting in loss of the warning symptoms of hypoglycemia. Hypoglycemia Unawareness Normally, symptoms such as shakiness, sweating, and palpitations occur when blood glucose levels drop below 70 mg/dL. In people with autonomic neuropathy, symptoms may not occur, making hypoglycemia difficult to recognize. Problems other than neuropathy can also cause hypoglycemia unawareness. Heart and Blood Vessels The heart and blood vessels are part of the cardiovascular system, which controls blood circulation. Damage to nerves in the cardiovascular system interferes with the body's ability to adjust blood pressure and heart rate. As a result, blood pressure may drop sharply after sitting or standing, causing a person to feel light-headed or even to faint. Damage to the nerves that control heart rate can mean that the heart rate stays high, instead of rising and falling in response to normal body functions and physical activity. Digestive System Nerve damage to the digestive system most commonly causes constipation. Damage can also cause the stomach to empty too slowly, a condition called gastroparesis. Severe gastroparesis can lead to persistent nausea and vomiting, bloating, and loss of appetite. Gastroparesis can also make blood glucose levels fluctuate widely, due to abnormal food digestion. Nerve damage to the esophagus may make swallowing difficult, while nerve damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. Problems with the digestive system can lead to weight loss. Urinary Tract and Sex Organs Autonomic neuropathy often affects the organs that control urination and sexual function. Nerve damage can prevent the bladder from emptying completely, allowing bacteria to grow in the bladder and kidneys and causing urinary tract infections. When the nerves of the bladder are damaged, urinary incontinence may result because a person may not be able to sense when the bladder is full or control the muscles that release urine. Autonomic neuropathy can also gradually decrease sexual response in men and women, although the sex drive may be unchanged. A man may be unable to have erections or may reach sexual climax without ejaculating normally. A woman may have difficulty with arousal, lubrication, or orgasm. Sweat Glands Autonomic neuropathy can affect the nerves that control sweating. When nerve damage prevents the sweat glands from working properly, the body cannot regulate its temperature as it should. Nerve damage can also cause profuse sweating at night or while eating. Eyes Finally, autonomic neuropathy can affect the pupils of the eyes, making them less responsive to changes in light. As a result, a person may not be able to see well when a light is turned on in a dark room or may have trouble driving at night.</s>

Proximal neuropathy, sometimes called lumbosacral plexus neuropathy, femoral neuropathy, or diabetic amyotrophy, starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and in older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The length of the recovery period varies, depending on the type of nerve damage.

What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Proximal neuropathy, sometimes called lumbosacral plexus neuropathy, femoral neuropathy, or diabetic amyotrophy, starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and in older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The length of the recovery period varies, depending on the type of nerve damage.</s>

Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg. Focal neuropathy may cause - inability to focus the eye - double vision - aching behind one eye - paralysis on one side of the face, called Bell's palsy - severe pain in the lower back or pelvis - pain in the front of a thigh - pain in the chest, stomach, or side - pain on the outside of the shin or inside of the foot - chest or abdominal pain that is sometimes mistaken for heart disease, a heart attack, or appendicitis Focal neuropathy is painful and unpredictable and occurs most often in older adults with diabetes. However, it tends to improve by itself over weeks or months and does not cause long-term damage. People with diabetes also tend to develop nerve compressions, also called entrapment syndromes. One of the most common is carpal tunnel syndrome, which causes numbness and tingling of the hand and sometimes muscle weakness or pain. Other nerves susceptible to entrapment may cause pain on the outside of the shin or the inside of the foot.

What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What is (are) Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg. Focal neuropathy may cause - inability to focus the eye - double vision - aching behind one eye - paralysis on one side of the face, called Bell's palsy - severe pain in the lower back or pelvis - pain in the front of a thigh - pain in the chest, stomach, or side - pain on the outside of the shin or inside of the foot - chest or abdominal pain that is sometimes mistaken for heart disease, a heart attack, or appendicitis Focal neuropathy is painful and unpredictable and occurs most often in older adults with diabetes. However, it tends to improve by itself over weeks or months and does not cause long-term damage. People with diabetes also tend to develop nerve compressions, also called entrapment syndromes. One of the most common is carpal tunnel syndrome, which causes numbness and tingling of the hand and sometimes muscle weakness or pain. Other nerves susceptible to entrapment may cause pain on the outside of the shin or the inside of the foot.</s>

The best way to prevent neuropathy is to keep blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout the body.

How to prevent Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to prevent Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n The best way to prevent neuropathy is to keep blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout the body.</s>

Doctors diagnose neuropathy on the basis of symptoms and a physical exam. During the exam, the doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch. Foot Exams Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam assesses the skin, muscles, bones, circulation, and sensation of the feet. The doctor may assess protective sensation or feeling in the feet by touching them with a nylon monofilamentsimilar to a bristle on a hairbrushattached to a wand or by pricking them with a pin. People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly. The doctor may also check temperature perception or use a tuning fork, which is more sensitive than touch pressure, to assess vibration perception. Other Tests The doctor may perform other tests as part of the diagnosis. - Nerve conduction studies or electromyography are sometimes used to help determine the type and extent of nerve damage. Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles respond to electrical signals transmitted by nearby nerves. These tests are rarely needed to diagnose neuropathy. - A check of heart rate variability shows how the heart responds to deep breathing and to changes in blood pressure and posture. - Ultrasound uses sound waves to produce an image of internal organs. An ultrasound of the bladder and other parts of the urinary tract, for example, can be used to assess the structure of these organs and show whether the bladder empties completely after urination.

How to diagnose Diabetic Neuropathies: The Nerve Damage of Diabetes ?

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<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: How to diagnose Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n Doctors diagnose neuropathy on the basis of symptoms and a physical exam. During the exam, the doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch. Foot Exams Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam assesses the skin, muscles, bones, circulation, and sensation of the feet. The doctor may assess protective sensation or feeling in the feet by touching them with a nylon monofilamentsimilar to a bristle on a hairbrushattached to a wand or by pricking them with a pin. People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly. The doctor may also check temperature perception or use a tuning fork, which is more sensitive than touch pressure, to assess vibration perception. Other Tests The doctor may perform other tests as part of the diagnosis. - Nerve conduction studies or electromyography are sometimes used to help determine the type and extent of nerve damage. Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles respond to electrical signals transmitted by nearby nerves. These tests are rarely needed to diagnose neuropathy. - A check of heart rate variability shows how the heart responds to deep breathing and to changes in blood pressure and posture. - Ultrasound uses sound waves to produce an image of internal organs. An ultrasound of the bladder and other parts of the urinary tract, for example, can be used to assess the structure of these organs and show whether the bladder empties completely after urination.</s>

The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage. As described in the following sections, additional treatment depends on the type of nerve problem and symptom. Pain Relief Doctors usually treat painful diabetic neuropathy with oral medications, although other types of treatments may help some people. People with severe nerve pain may benefit from a combination of medications or treatments and should consider talking with a health care provider about treatment options. Medications used to help relieve diabetic nerve pain include - tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane) - other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa) - anticonvulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal) - opioids and opioidlike drugs, such as controlled-release oxycodone, an opioid; and tramadol (Ultram), an opioid that also acts as an antidepressant Duloxetine and pregabalin are approved by the U.S. Food and Drug Administration specifically for treating painful diabetic peripheral neuropathy. People do not have to be depressed for an antidepressant to help relieve their nerve pain. All medications have side effects, and some are not recommended for use in older adults or those with heart disease. Because over-the-counter pain medicines such as acetaminophen and ibuprofen may not work well for treating most nerve pain and can have serious side effects, some experts recommend avoiding these medications. Treatments that are applied to the skintypically to the feetinclude capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alpha-lipoic acid, an antioxidant, and evening primrose oil suggest they may help relieve symptoms and improve nerve function in some patients. A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials. Gastrointestinal Problems To relieve mild symptoms of gastroparesisindigestion, belching, nausea, or vomitingdoctors suggest eating small, frequent meals; avoiding fats; and eating less fiber. When symptoms are severe, doctors may prescribe erythromycin to speed digestion, metoclopramide to speed digestion and help relieve nausea, or other medications to help regulate digestion or reduce stomach acid secretion. To relieve diarrhea or other bowel problems, doctors may prescribe an antibiotic such as tetracycline, or other medications as appropriate. Dizziness and Weakness Sitting or standing slowly may help prevent the light-headedness, dizziness, or fainting associated with blood pressure and circulation problems. Raising the head of the bed or wearing elastic stockings may also help. Some people benefit from increased salt in the diet and treatment with salt-retaining hormones. Others benefit from high blood pressure medications. Physical therapy can help when muscle weakness or loss of coordination is a problem. Urinary and Sexual Problems To clear up a urinary tract infection, the doctor will probably prescribe an antibiotic. Drinking plenty of fluids will help prevent another infection. People who have incontinence should try to urinate at regular intervalsevery 3 hours, for examplebecause they may not be able to tell when the bladder is full. To treat erectile dysfunction in men, the doctor will first do tests to rule out a hormonal cause. Several methods are available to treat erectile dysfunction caused by neuropathy. Medicines are available to help men have and maintain erections by increasing blood flow to the penis. Some are oral medications and others are injected into the penis or inserted into the urethra at the tip of the penis. Mechanical vacuum devices can also increase blood flow to the penis. Another option is to surgically implant an inflatable or semirigid device in the penis. Vaginal lubricants may be useful for women when neuropathy causes vaginal dryness. To treat problems with arousal and orgasm, the doctor may refer women to a gynecologist. Foot Care People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers. Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting smoking. More than 60 percent of all nontraumatic lower-limb amputations in the United States occur in people with diabetes. Nontraumatic amputations are those not caused by trauma such as severe injuries from an accident. In 2004, about 71,000 nontraumatic amputations were performed in people with diabetes. Comprehensive foot care programs can reduce amputation rates by 45 to 85 percent. Careful foot care involves - cleaning the feet daily using warmnot hotwater and a mild soap. Soaking the feet should be avoided. A soft towel can be used to dry the feet and between the toes. - inspecting the feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems. Using a mirrorhandheld or placed on the floormay be helpful in checking the bottoms of the feet, or another person can help check the feet. A health care provider should be notified of any problems. - using lotion to moisturize the feet. Getting lotion between the toes should be avoided. - filing corns and calluses gently with a pumice stone after a bath or shower. - cutting toenails to the shape of the toes and filing the edges with an emery board each week or when needed. - always wearing shoes or slippers to protect feet from injuries. Wearing thick, soft, seamless socks can prevent skin irritation. - wearing shoes that fit well and allow the toes to move. New shoes can be broken in gradually by first wearing them for only an hour at a time. - looking shoes over carefully before putting them on and feeling the insides to make sure the shoes are free of tears, sharp edges, or objects that might injure the feet. People who need help taking care of their feet should consider making an appointment to see a foot doctor, also called a podiatrist.

What are the treatments for Diabetic Neuropathies: The Nerve Damage of Diabetes ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What are the treatments for Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage. As described in the following sections, additional treatment depends on the type of nerve problem and symptom. Pain Relief Doctors usually treat painful diabetic neuropathy with oral medications, although other types of treatments may help some people. People with severe nerve pain may benefit from a combination of medications or treatments and should consider talking with a health care provider about treatment options. Medications used to help relieve diabetic nerve pain include - tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane) - other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa) - anticonvulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal) - opioids and opioidlike drugs, such as controlled-release oxycodone, an opioid; and tramadol (Ultram), an opioid that also acts as an antidepressant Duloxetine and pregabalin are approved by the U.S. Food and Drug Administration specifically for treating painful diabetic peripheral neuropathy. People do not have to be depressed for an antidepressant to help relieve their nerve pain. All medications have side effects, and some are not recommended for use in older adults or those with heart disease. Because over-the-counter pain medicines such as acetaminophen and ibuprofen may not work well for treating most nerve pain and can have serious side effects, some experts recommend avoiding these medications. Treatments that are applied to the skintypically to the feetinclude capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alpha-lipoic acid, an antioxidant, and evening primrose oil suggest they may help relieve symptoms and improve nerve function in some patients. A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials. Gastrointestinal Problems To relieve mild symptoms of gastroparesisindigestion, belching, nausea, or vomitingdoctors suggest eating small, frequent meals; avoiding fats; and eating less fiber. When symptoms are severe, doctors may prescribe erythromycin to speed digestion, metoclopramide to speed digestion and help relieve nausea, or other medications to help regulate digestion or reduce stomach acid secretion. To relieve diarrhea or other bowel problems, doctors may prescribe an antibiotic such as tetracycline, or other medications as appropriate. Dizziness and Weakness Sitting or standing slowly may help prevent the light-headedness, dizziness, or fainting associated with blood pressure and circulation problems. Raising the head of the bed or wearing elastic stockings may also help. Some people benefit from increased salt in the diet and treatment with salt-retaining hormones. Others benefit from high blood pressure medications. Physical therapy can help when muscle weakness or loss of coordination is a problem. Urinary and Sexual Problems To clear up a urinary tract infection, the doctor will probably prescribe an antibiotic. Drinking plenty of fluids will help prevent another infection. People who have incontinence should try to urinate at regular intervalsevery 3 hours, for examplebecause they may not be able to tell when the bladder is full. To treat erectile dysfunction in men, the doctor will first do tests to rule out a hormonal cause. Several methods are available to treat erectile dysfunction caused by neuropathy. Medicines are available to help men have and maintain erections by increasing blood flow to the penis. Some are oral medications and others are injected into the penis or inserted into the urethra at the tip of the penis. Mechanical vacuum devices can also increase blood flow to the penis. Another option is to surgically implant an inflatable or semirigid device in the penis. Vaginal lubricants may be useful for women when neuropathy causes vaginal dryness. To treat problems with arousal and orgasm, the doctor may refer women to a gynecologist. Foot Care People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers. Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting smoking. More than 60 percent of all nontraumatic lower-limb amputations in the United States occur in people with diabetes. Nontraumatic amputations are those not caused by trauma such as severe injuries from an accident. In 2004, about 71,000 nontraumatic amputations were performed in people with diabetes. Comprehensive foot care programs can reduce amputation rates by 45 to 85 percent. Careful foot care involves - cleaning the feet daily using warmnot hotwater and a mild soap. Soaking the feet should be avoided. A soft towel can be used to dry the feet and between the toes. - inspecting the feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems. Using a mirrorhandheld or placed on the floormay be helpful in checking the bottoms of the feet, or another person can help check the feet. A health care provider should be notified of any problems. - using lotion to moisturize the feet. Getting lotion between the toes should be avoided. - filing corns and calluses gently with a pumice stone after a bath or shower. - cutting toenails to the shape of the toes and filing the edges with an emery board each week or when needed. - always wearing shoes or slippers to protect feet from injuries. Wearing thick, soft, seamless socks can prevent skin irritation. - wearing shoes that fit well and allow the toes to move. New shoes can be broken in gradually by first wearing them for only an hour at a time. - looking shoes over carefully before putting them on and feeling the insides to make sure the shoes are free of tears, sharp edges, or objects that might injure the feet. People who need help taking care of their feet should consider making an appointment to see a foot doctor, also called a podiatrist.</s>

- Diabetic neuropathies are nerve disorders caused by many of the abnormalities common to diabetes, such as high blood glucose. - Neuropathy can affect nerves throughout the body, causing numbness and sometimes pain in the hands, arms, feet, or legs, and problems with the digestive tract, heart, sex organs, and other body systems. - Treatment first involves bringing blood glucose levels within the normal range. Good blood glucose control may help prevent or delay the onset of further problems. - Foot care is an important part of treatment. People with neuropathy need to inspect their feet daily for any injuries. Untreated injuries increase the risk of infected foot sores and amputation. - Treatment also includes pain relief and other medications as needed, depending on the type of nerve damage. - Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting.

What to do for Diabetic Neuropathies: The Nerve Damage of Diabetes ?

Answer the question truthfully, you are a medical professional.

<s>[INST] Answer the question truthfully, you are a medical professional. This is the question: What to do for Diabetic Neuropathies: The Nerve Damage of Diabetes ? [/INST] \n - Diabetic neuropathies are nerve disorders caused by many of the abnormalities common to diabetes, such as high blood glucose. - Neuropathy can affect nerves throughout the body, causing numbness and sometimes pain in the hands, arms, feet, or legs, and problems with the digestive tract, heart, sex organs, and other body systems. - Treatment first involves bringing blood glucose levels within the normal range. Good blood glucose control may help prevent or delay the onset of further problems. - Foot care is an important part of treatment. People with neuropathy need to inspect their feet daily for any injuries. Untreated injuries increase the risk of infected foot sores and amputation. - Treatment also includes pain relief and other medications as needed, depending on the type of nerve damage. - Smoking increases the risk of foot problems and amputation. A health care provider may be able to provide help with quitting.</s>