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The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Intestinal Pseudo-obstruction ?	A health care provider will treat intestinal pseudo-obstruction with nutritional support, medications, and, in some cases, decompression. Rarely, a person will need surgery. If an illness, a medication, or both cause intestinal pseudo-obstruction, a health care provider will treat the underlying illness, stop the medication, or do both. Nutritional Support People with intestinal pseudo-obstruction often need nutritional support to prevent malnutrition and weight loss. Enteral nutrition provides liquid food through a feeding tube inserted through the nose into the stomach or placed directly into the stomach or small intestine. A health care provider inserts the feeding tube, sometimes using x ray or endoscopy for guidance, and teaches the person how to care for the tube after returning home. Enteral nutrition is sufficient for most people with intestinal pseudo-obstruction. In a severe case, a person may need IV feeding, also called parenteral nutrition, which provides liquid food through a tube placed in a vein. Enteral nutrition is possible because the intestinal lining is normal in most people with intestinal pseudo-obstruction. Enteral nutrition is preferred over parenteral nutrition because it has a much lower risk of complications. Medications A health care provider prescribes medications to treat the different symptoms and complications of intestinal pseudo-obstruction, such as - antibiotics to treat bacterial infections - pain medication, which should be used sparingly, if at all, because most pain medications delay intestinal transit - medication to make intestinal muscles contract - antinausea medications - antidiarrheal medications - laxatives Decompression A person with acute colonic pseudo-obstruction and a greatly enlarged colon who does not respond to medications may need a procedure, called decompression, to remove gas from the colon. A gastroenterologist can perform the procedure in a hospital or an outpatient center. The gastroenterologist may choose to decompress the colon by using colonoscopy. During colonoscopy, the gastroenterologist inserts a flexible tube into the colon through the anus. A health care provider gives the person a light sedative, and possibly pain medication, to relax. If the person requires long-term decompression, the gastroenterologist also can decompress the colon through a surgical opening in the cecum. In this case, the health care provider gives the person local anesthesia. Surgery In severe cases of intestinal pseudo-obstruction, a person may need surgery to remove part of the intestine. However, surgery should be performed rarely, if at all, because intestinal pseudo-obstruction is a generalized disorder that typically affects the entire intestine. Removing part of the intestine cannot cure the disease. A surgeona doctor who specializes in surgerywill perform the surgery at a hospital; a person will need general anesthesia. A few highly specialized treatment centers offer small intestine transplantation. A health care provider may recommend small intestine transplantation when all other treatments have failed.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Intestinal Pseudo-obstruction ?	Researchers have not found that eating, diet, and nutrition play a role in causing or preventing intestinal pseudo-obstruction. Following special diets usually does not help improve the disorder. However, eating frequent, small meals with pureed foods or liquids may ease digestion. Vitamin and trace mineral supplements may help a person who is malnourished.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Intestinal Pseudo-obstruction ?	- Intestinal pseudo-obstruction is a rare condition with symptoms that resemble those caused by a blockage, or obstruction, of the intestines, also called the bowel. However, when a health care provider examines the intestines, no blockage exists. Instead, the symptoms are due to nerve or muscle problems that affect the movement of food, fluid, and air through the intestines. - Intestinal pseudo-obstruction symptoms may include abdominal swelling or bloating, also called distension; abdominal pain; nausea; vomiting; constipation; and diarrhea. Over time, the condition can cause malnutrition, bacterial overgrowth in the intestines, and weight loss. - To diagnose intestinal pseudo-obstruction, a health care provider may suggest the person consult a gastroenterologista doctor who specializes in digestive diseases. A health care provider will perform a physical exam; take a complete medical history, imaging studies, and a biopsy; and perform blood tests. A health care provider may order other tests to confirm the diagnosis. - A health care provider will treat intestinal pseudo-obstruction with nutritional support, medications, and, in some cases, decompression. Rarely, a person will need surgery. If an illness, a medication, or both cause intestinal pseudo-obstruction, a health care provider will treat the underlying illness, stop the medication, or do both. A health care provider may recommend small intestine transplantation when all other treatments have failed.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What is (are) Graves' Disease ?	Graves disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States. Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. The Thyroid The thyroid is a 2-inch-long, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid makes two thyroid hormones, triiodothyronine (T3 ) and thyroxine (T4 ). T3 is made from T4 and is the more active hormone, directly affecting the tissues. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Hyperthyroidism causes many of the bodys functions to speed up. Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production. Autoimmune Disorder Graves disease is an autoimmune disorder. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the bodys own cells and organs. With Graves disease, the immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI)sometimes called TSH receptor antibodythat attaches to thyroid cells. TSI mimics TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the TSI antibody instead blocks thyroid hormone production, leading to conflicting symptoms that may make correct diagnosis more difficult.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What are the symptoms of Graves' Disease ?	People with Graves disease may have common symptoms of hyperthyroidism such as - nervousness or irritability - fatigue or muscle weakness - heat intolerance - trouble sleeping - hand tremors - rapid and irregular heartbeat - frequent bowel movements or diarrhea - weight loss - goiter, which is an enlarged thyroid that may cause the neck to look swollen and can interfere with normal breathing and swallowing A small number of people with Graves disease also experience thickening and reddening of the skin on their shins. This usually painless problem is called pretibial myxedema or Graves dermopathy. In addition, the eyes of people with Graves disease may appear enlarged because their eyelids are retractedseem pulled back into the eye socketsand their eyes bulge out from the eye sockets. This condition is called Graves ophthalmopathy (GO).
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What is (are) Graves' Disease ?	Graves ophthalmopathy is a condition associated with Graves disease that occurs when cells from the immune system attack the muscles and other tissues around the eyes. The result is inflammation and a buildup of tissue and fat behind the eye socket, causing the eyeballs to bulge out. Rarely, inflammation is severe enough to compress the optic nerve that leads to the eye, causing vision loss. Other GO symptoms are - dry, gritty, and irritated eyes - puffy eyelids - double vision - light sensitivity - pressure or pain in the eyes - trouble moving the eyes About 25 to 30 percent of people with Graves disease develop mild GO, and 2 to 5 percent develop severe GO.1 This eye condition usually lasts 1 to 2 years and often improves on its own. GO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop and may even occur in people whose thyroid function is normal. Smoking makes GO worse. 1Yeung SJ, Habra MA, Chiu AC. Graves disease. emedicine website. emedicine.medscape.com/article/120619-overview. Updated 2010. Accessed December 10, 2011.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	How to diagnose Graves' Disease ?	Health care providers can sometimes diagnose Graves disease based only on a physical examination and a medical history. Blood tests and other diagnostic tests, such as the following, then confirm the diagnosis. TSH test. The ultrasensitive TSH test is usually the first test performed. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available. T3 and T4 test. Another blood test used to diagnose Graves disease measures T3 and T4 levels. In making a diagnosis, health care providers look for below-normal levels of TSH, normal to elevated levels of T4, and elevated levels of T3. Because the combination of low TSH and high T3 and T4 can occur with other thyroid problems, health care providers may order other tests to finalize the diagnosis. The following two tests use small, safe doses of radioactive iodine because the thyroid uses iodine to make thyroid hormone. Radioactive iodine uptake test. This test measures the amount of iodine the thyroid collects from the bloodstream. High levels of iodine uptake can indicate Graves disease. Thyroid scan. This scan shows how and where iodine is distributed in the thyroid. With Graves disease the entire thyroid is involved, so the iodine shows up throughout the gland. Other causes of hyperthyroidism such as nodulessmall lumps in the glandshow a different pattern of iodine distribution. TSI test. Health care providers may also recommend the TSI test, although this test usually isnt necessary to diagnose Graves disease. This test, also called a TSH antibody test, measures the level of TSI in the blood. Most people with Graves disease have this antibody, but people whose hyperthyroidism is caused by other conditions do not. More information about testing for thyroid problems is provided in the NIDDK health topic, Thyroid Tests.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What are the treatments for Graves' Disease ?	People with Graves disease have three treatment options: radioiodine therapy, medications, and thyroid surgery. Radioiodine therapy is the most common treatment for Graves disease in the United States. Graves disease is often diagnosed and treated by an endocrinologista doctor who specializes in the bodys hormone- secreting glands. Radioiodine Therapy In radioiodine therapy, patients take radioactive iodine-131 by mouth. Because the thyroid gland collects iodine to make thyroid hormone, it will collect the radioactive iodine from the bloodstream in the same way. Iodine-131stronger than the radioactive iodine used in diagnostic testsgradually destroys the cells that make up the thyroid gland but does not affect other body tissues. Many health care providers use a large enough dose of iodine-131 to shut down the thyroid completely, but some prefer smaller doses to try to bring hormone production into the normal range. More than one round of radioiodine therapy may be needed. Results take time and people undergoing this treatment may not notice improvement in symptoms for several weeks or months. People with GO should talk with a health care provider about any risks associated with radioactive iodine treatments. Several studies suggest radioiodine therapy can worsen GO in some people. Other treatments, such as prescription steroids, may prevent this complication. Although iodine-131 is not known to cause birth defects or infertility, radioiodine therapy is not used in pregnant women or women who are breastfeeding. Radioactive iodine can be harmful to the fetus thyroid and can be passed from mother to child in breast milk. Experts recommend that women wait a year after treatment before becoming pregnant. Almost everyone who receives radioactive iodine treatment eventually develops hypothyroidism, which occurs when the thyroid does not make enough thyroid hormone. People with hypothyroidism must take synthetic thyroid hormone, a medication that replaces their natural thyroid hormone. Medications Beta blockers. Health care providers may prescribe a medication called a beta blocker to reduce many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. But beta blockers do not stop thyroid hormone production. Anti-thyroid medications. Health care providers sometimes prescribe anti-thyroid medications as the only treatment for Graves disease. Anti-thyroid medications interfere with thyroid hormone production but dont usually have permanent results. Use of these medications requires frequent monitoring by a health care provider. More often, anti-thyroid medications are used to pretreat patients before surgery or radioiodine therapy, or they are used as supplemental treatment after radioiodine therapy. Anti-thyroid medications can cause side effects in some people, including - allergic reactions such as rashes and itching - a decrease in the number of white blood cells in the body, which can lower a persons resistance to infection - liver failure, in rare cases In the United States, health care providers prescribe the anti-thyroid medication methimazole (Tapazole, Northyx) for most types of hyperthyroidism. Anti-thyroid medications and pregnancy. Because pregnant and breastfeeding women cannot receive radioiodine therapy, they are usually treated with an anti-thyroid medication instead. However, experts agree that women in their first trimester of pregnancy should probably not take methimazole due to the rare occurrence of damage to the fetus. Another anti-thyroid medication, propylthiouracil (PTU), is available for women in this stage of pregnancy or for women who are allergic to or intolerant of methimazole and have no other treatment options. Health care providers may prescribe PTU for the first trimester of pregnancy and switch to methimazole for the second and third trimesters. Some women are able to stop taking anti-thyroid medications in the last 4 to 8 weeks of pregnancy due to the remission of hyperthyroidism that occurs during pregnancy. However, these women should continue to be monitored for recurrence of thyroid problems following delivery. Studies have shown that mothers taking anti-thyroid medications may safely breastfeed. However, they should take only moderate doses, less than 1020 milligrams daily, of the anti-thyroid medication methimazole. Doses should be divided and taken after feedings, and the infants should be monitored for side effects.2 Women requiring higher doses of the anti-thyroid medication to control hyperthyroidism should not breastfeed. 2Ogunyemi DA. Autoimmune thyroid disease and pregnancy. emedicine website. emedicine.medscape.com/article/261913-overview. Updated March 12, 2012. Accessed April 10, 2012. Stop your anti-thyroid medication and call your health care provider right away if you develop any of the following while taking anti-thyroid medications: - fatigue - weakness - vague abdominal pain - loss of appetite - skin rash or itching - easy bruising - yellowing of the skin or whites of the eyes, called jaundice - persistent sore throat - fever Thyroid Surgery Surgery is the least-used option for treating Graves disease. Sometimes surgery may be used to treat - pregnant women who cannot tolerate anti-thyroid medications - people suspected of having thyroid cancer, though Graves disease does not cause cancer - people for whom other forms of treatment are not successful Before surgery, the health care provider may prescribe anti-thyroid medications to temporarily bring a patients thyroid hormone levels into the normal range. This presurgical treatment prevents a condition called thyroid storma sudden, severe worsening of symptomsthat can occur when hyperthyroid patients have general anesthesia. When surgery is used, many health care providers recommend the entire thyroid be removed to eliminate the chance that hyperthyroidism will return. If the entire thyroid is removed, lifelong thyroid hormone medication is necessary. Although uncommon, certain problems can occur in thyroid surgery. The parathyroid glands can be damaged because they are located very close to the thyroid. These glands help control calcium and phosphorous levels in the body. Damage to the laryngeal nerve, also located close to the thyroid, can lead to voice changes or breathing problems. But when surgery is performed by an experienced surgeon, less than 1 percent of patients have permanent complications.1 People who need help finding a surgeon can contact one of the organizations listed under For More Information. Eye Care The eye problems associated with Graves disease may not improve following thyroid treatment, so the two problems are often treated separately. Eye drops can relieve dry, gritty, irritated eyesthe most common of the milder symptoms. If pain and swelling occur, health care providers may prescribe a steroid such as prednisone. Other medications that suppress the immune response may also provide relief. Special lenses for glasses can help with light sensitivity and double vision. People with eye symptoms may be advised to sleep with their head elevated to reduce eyelid swelling. If the eyelids do not fully close, taping them shut at night can help prevent dry eyes. In more severe cases, external radiation may be applied to the eyes to reduce inflammation. Like other types of radiation treatment, the benefits are not immediate; most people feel relief from symptoms 1 to 2 months after treatment. Surgery may be used to improve bulging of the eyes and correct the vision changes caused by pressure on the optic nerve. A procedure called orbital decompression makes the eye socket bigger and gives the eye room to sink back to a more normal position. Eyelid surgery can return retracted eyelids to their normal position.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What are the treatments for Graves' Disease ?	Treatment for Graves disease can sometimes affect pregnancy. After treatment with surgery or radioactive iodine, TSI antibodies can still be present in the blood, even when thyroid levels are normal. If a pregnant woman has received either of these treatments prior to becoming pregnant, the antibodies she produces may travel across the placenta to the babys bloodstream and stimulate the fetal thyroid. A pregnant woman who has been treated with surgery or radioactive iodine should inform her health care provider so her baby can be monitored for thyroid-related problems later in the pregnancy. Pregnant women may safely be treated with anti-thyroid medications. For more information about pregnancy and anti-thyroid medications, see Medications under the section titled How is Graves disease treated?More information about pregnancy and thyroid disease is provided in the NIDDK health topic, Pregnancy and Thyroid Disease.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What to do for Graves' Disease ?	Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition is provided by the National Agricultural Library available at www.nutrition.gov. Dietary Supplements Iodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet, available at www.nlm.nih.gov/medlineplus. Women need more iodine when they are pregnantabout 250 micrograms a daybecause the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met. To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health. 3 Zimmerman MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. American Journal of Clinical Nutrition. 2009;89(2):668S672S.
On this page: Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up. Graves’ disease affects nearly 1 in 100 Americans.1 About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.1 Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you Untreated, Graves’ disease can cause serious health problems, including Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time. Symptoms of hyperthyroidism can vary from person to person and may include5 More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).6 GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms. Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless. Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus. With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone. Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI. Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease. Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern. Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding. Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors. Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen. Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus. While taking antithyroid drugs, call your doctor right away if you have any of the following symptoms Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid. Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems. Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines. When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels and will adjust your thyroid medicine dosage as needed. Most cases of GO are mild. The following tips may help you control mild symptoms. Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.6 Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov. Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with your health care professional about The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life. Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future. Researchers are studying many aspects of Graves’ disease, including new medicines for treating Graves’ disease and GO. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. You can view a filtered list of clinical studies on Graves’ disease that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study. [1] Akram S, Elfenbein DM, Chen H, Schneider DF, Sippel RS. Assessing American Thyroid Association guidelines for total thyroidectomy in Graves’ disease. Journal of Surgical Research. 2020;245:64–71. doi: 10.1016/j.jss.2019.07.029 [2] Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. European Thyroid Journal. 2018;7(4):167–186. doi: 10.1159/000490384 [3] Ferrari SM, Fallahi P, Ruffilli I, et al. The association of other autoimmune diseases in patients with Graves’ disease (with or without ophthalmopathy): review of the literature and report of a large series. Autoimmunity Reviews. 2019;18(3):287–292. doi: 10.1016/j.autrev.2018.10.001 [4] Rotondi M, Virili C, Pinto S, et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. Journal of Endocrinological Investigation. 2020;43(2):157–162. doi: 10.1007/s40618-019-01094-7 [5] Mathew P, Rawla P. Hyperthyroidism. In: StatPearls [Internet]. StatPearls Publishing. Updated November 21, 2020. Accessed July 14, 2021. www.ncbi.nlm.nih.gov/books/NBK537053 [6] Antonelli A, Fallahi P, Elia G, et al. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines), and therapy. Best Practice & Research Clinical Endocrinology & Metabolism. 2020;34(1):101388. doi: 10.1016/j.beem.2020.101388 This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital The NIDDK would like to thank: Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital	What to do for Graves' Disease ?	- Graves disease is the most common cause of hyperthyroidism in the United States. - In Graves disease, the immune system stimulates the thyroid gland to make too much thyroid hormone. - Common symptoms of hyperthyroidism include nervousness or irritability, fatigue or muscle weakness, heat intolerance, trouble sleeping, hand tremors, rapid and irregular heartbeat, frequent bowel movements or diarrhea, weight loss, and goiter. - People with Graves disease may also have bulging eyes, a condition called Graves ophthalmopathy (GO). - Graves disease is most often treated with radioiodine therapy, which gradually destroys the cells that make up the thyroid gland. Anti-thyroid medications and surgery to remove the thyroid are sometimes used. - The eye problems associated with Graves disease may require separate treatment. - A pregnant woman who has been treated with surgery or radioactive iodine prior to becoming pregnant should inform her health care provider so her baby can be monitored for thyroid-related problems later in the pregnancy.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Short Bowel Syndrome ?	Short bowel syndrome is a group of problems related to poor absorption of nutrients. Short bowel syndrome typically occurs in people who have - had at least half of their small intestine removed and sometimes all or part of their large intestine removed - significant damage of the small intestine - poor motility, or movement, inside the intestines Short bowel syndrome may be mild, moderate, or severe, depending on how well the small intestine is working. People with short bowel syndrome cannot absorb enough water, vitamins, minerals, protein, fat, calories, and other nutrients from food. What nutrients the small intestine has trouble absorbing depends on which section of the small intestine has been damaged or removed.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Short Bowel Syndrome ?	The small intestine is the tube-shaped organ between the stomach and large intestine. Most food digestion and nutrient absorption take place in the small intestine. The small intestine is about 20 feet long and includes the duodenum, jejunum, and ileum: duodenumthe first part of the small intestine, where iron and other minerals are absorbed jejunumthe middle section of the small intestine, where carbohydrates, proteins, fat, and most vitamins are absorbed ileumthe lower end of the small intestine, where bile acids and vitamin B12 are absorbed
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Short Bowel Syndrome ?	The large intestine is about 5 feet long in adults and absorbs water and any remaining nutrients from partially digested food passed from the small intestine. The large intestine then changes waste from liquid to a solid matter called stool.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes Short Bowel Syndrome ?	The main cause of short bowel syndrome is surgery to remove a portion of the small intestine. This surgery can treat intestinal diseases, injuries, or birth defects. Some children are born with an abnormally short small intestine or with part of their bowel missing, which can cause short bowel syndrome. In infants, short bowel syndrome most commonly occurs following surgery to treat necrotizing enterocolitis, a condition in which part of the tissue in the intestines is destroyed.1 Short bowel syndrome may also occur following surgery to treat conditions such as - cancer and damage to the intestines caused by cancer treatment - Crohn's disease, a disorder that causes inflammation, or swelling, and irritation of any part of the digestive tract - gastroschisis, which occurs when the intestines stick out of the body through one side of the umbilical cord - internal hernia, which occurs when the small intestine is displaced into pockets in the abdominal lining - intestinal atresia, which occurs when a part of the intestines doesn't form completely - intestinal injury from loss of blood flow due to a blocked blood vessel - intestinal injury from trauma - intussusception, in which one section of either the large or small intestine folds into itself, much like a collapsible telescope - meconium ileus, which occurs when the meconium, a newborn's first stool, is thicker and stickier than normal and blocks the ileum - midgut volvulus, which occurs when blood supply to the middle of the small intestine is completely cut off - omphalocele, which occurs when the intestines, liver, or other organs stick out through the navel, or belly button Even if a person does not have surgery, disease or injury can damage the small intestine.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How many people are affected by Short Bowel Syndrome ?	Short bowel syndrome is a rare condition. Each year, short bowel syndrome affects about three out of every million people.1
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Short Bowel Syndrome ?	The main symptom of short bowel syndrome is diarrhealoose, watery stools. Diarrhea can lead to dehydration, malnutrition, and weight loss. Dehydration means the body lacks enough fluid and electrolyteschemicals in salts, including sodium, potassium, and chlorideto work properly. Malnutrition is a condition that develops when the body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function. Loose stools contain more fluid and electrolytes than solid stools. These problems can be severe and can be life threatening without proper treatment. Other signs and symptoms may include - bloating - cramping - fatigue, or feeling tired - foul-smelling stool - heartburn - too much gas - vomiting - weakness People with short bowel syndrome are also more likely to develop food allergies and sensitivities, such as lactose intolerance. Lactose intolerance is a condition in which people have digestive symptomssuch as bloating, diarrhea, and gasafter eating or drinking milk or milk products. More information is provided in the NIDDK health topic, Lactose Intolerance.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the complications of Short Bowel Syndrome ?	The complications of short bowel syndrome may include - malnutrition - peptic ulcerssores on the lining of the stomach or duodenum caused by too much gastric acid - kidney stonessolid pieces of material that form in the kidneys - small intestinal bacterial overgrowtha condition in which abnormally large numbers of bacteria grow in the small intestine 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 and children are most likely to become dehydrated. Parents or caretakers should watch for the following signs and symptoms of dehydration: - 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: - organ damage - shockwhen low blood pressure prevents blood and oxygen from getting to organs - comaa sleeplike state in which a person is not conscious
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Short Bowel Syndrome ?	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 and children are most likely to become dehydrated. Parents or caretakers should watch for the following signs and symptoms of dehydration: - 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: - organ damage - shockwhen low blood pressure prevents blood and oxygen from getting to organs - comaa sleeplike state in which a person is not conscious
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Short Bowel Syndrome ?	A health care provider diagnoses short bowel syndrome based on - a medical and family history - a physical exam - blood tests - fecal fat tests - an x-ray of the small and large intestines - upper gastrointestinal (GI) series - computerized tomography (CT) scan Medical and Family History Taking a medical and family history may help a health care provider diagnose short bowel syndrome. He or she will ask the patient about symptoms and may request a history of past operations. Physical Exam A physical exam may help diagnose short bowel syndrome. During a physical exam, a health care provider usually - examines a patient's body, looking for muscle wasting or weight loss and signs of vitamin and mineral deficiencies - uses a stethoscope to listen to sounds in the abdomen - taps on specific areas of the patient's body Blood Tests A blood test involves drawing a patient's blood at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. Blood tests can show mineral and vitamin levels and measure complete blood count. Fecal Fat Tests A fecal fat test measures the body's ability to break down and absorb fat. For this test, a patient provides a stool sample at a health care provider's office. The patient may also use a take-home test kit. The patient collects stool in plastic wrap that he or she lays over the toilet seat and places a sample into a container. A patient can also use a special tissue provided by the health care provider's office to collect the sample and place the tissue into the container. For children wearing diapers, the parent or caretaker can line the diaper with plastic to collect the stool. The health care provider will send the sample to a lab for analysis. A fecal fat test can show how well the small intestine is working. X-ray An x-ray is a picture created by using radiation and recorded on film or on a computer. The amount of radiation used is small. An x-ray technician performs the x-ray at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images. An x-ray of the small intestine can show that the last segment of the large intestine is narrower than normal. Blocked stool causes the part of the intestine just before this narrow segment to stretch and bulge. Upper Gastrointestinal Series Upper GI series, also called a barium swallow, uses x rays and fluoroscopy to help diagnose problems of the upper GI tract. Fluoroscopy is a form of x ray that makes it possible to see the internal organs and their motion on a video monitor. An x-ray technician performs this test at a hospital or an outpatient center, and a radiologist interprets the images. 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 esophagus, stomach, and small intestine so the radiologist and a health care provider can see the shape of these organs 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. Upper GI series can show narrowing and widening of the small and large intestines. More information is provided in the NIDDK health topic, Upper GI Series. Computerized Tomography Scan Computerized tomography 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 a contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device that takes x-rays. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. CT scans can show bowel obstruction and changes in the intestines.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Short Bowel Syndrome ?	A health care provider will recommend treatment for short bowel syndrome based on a patient's nutritional needs. Treatment may include - nutritional support - medications - surgery - intestinal transplant Nutritional Support The main treatment for short bowel syndrome is nutritional support, which may include the following: - Oral rehydration. Adults should drink water, sports drinks, sodas without caffeine, and salty broths. Children should drink oral rehydration solutionsspecial drinks that contain salts and minerals to prevent dehydrationsuch as Pedialyte, Naturalyte, Infalyte, and CeraLyte, which are sold in most grocery stores and drugstores. - Parenteral nutrition. This treatment delivers fluids, electrolytes, and liquid vitamins and minerals into the bloodstream through an intravenous (IV) tubea tube placed into a vein. Health care providers give parenteral nutrition to people who cannot or should not get their nutrition or enough fluids through eating. - Enteral nutrition. This treatment delivers liquid food to the stomach or small intestine through a feeding tubea small, soft, plastic tube placed through the nose or mouth into the stomach. Gallstonessmall, pebblelike substances that develop in the gallbladderare a complication of enteral nutrition. More information is provided in the NIDDK health topic, Gallstones. - Vitamin and mineral supplements. A person may need to take vitamin and mineral supplements during or after parenteral or enteral nutrition. - Special diet. A health care provider can recommend a specific diet plan for the patient that may include - small, frequent feedings - avoiding foods that can cause diarrhea, such as foods high in sugar, protein, and fiber - avoiding high-fat foods Medications A health care provider may prescribe medications to treat short bowel syndrome, including - antibiotics to prevent bacterial overgrowth - H2 blockers to treat too much gastric acid secretion - proton pump inhibitors to treat too much gastric acid secretion - choleretic agents to improve bile flow and prevent liver disease - bile-salt binders to decrease diarrhea - anti-secretin agents to reduce gastric acid in the intestine - hypomotility agents to increase the time it takes food to travel through the intestines, leading to increased nutrient absorption - growth hormones to improve intestinal absorption - teduglutide to improve intestinal absorption Surgery The goal of surgery is to increase the small intestine's ability to absorb nutrients. Approximately half of the patients with short bowel syndrome need surgery.2 Surgery used to treat short bowel syndrome includes procedures that - prevent blockage and preserve the length of the small intestine - narrow any dilated segment of the small intestine - slow the time it takes for food to travel through the small intestine - lengthen the small intestine Long-term treatment and recovery, which for some may take years, depend in part on - what sections of the small intestine were removed - how much of the intestine is damaged - how well the muscles of the intestine work - how well the remaining small intestine adapts over time Intestinal Transplant An intestinal transplant is surgery to remove a diseased or an injured small intestine and replace it with a healthy small intestine from a person who has just died, called a donor. Sometimes a living donor can provide a segment of his or her small intestine. Transplant surgeonsdoctors who specialize in performing transplant surgeryperform the surgery on patients for whom other treatments have failed and who have lifethreatening complications from long-term parenteral nutrition. An intestinal-transplant team performs the surgery in a hospital. The patient will need anesthesia. Complications of intestinal transplantation include infections and rejection of the transplanted organ. A successful intestinal transplant can be a life-saving treatment for people with intestinal failure caused by short bowel syndrome. By 2008, transplant surgeons had performed almost 2,000 intestinal transplantations in the United Statesapproximately 75 percent of which were in patients younger than 18 years of age.3 A health care provider will tailor treatment to the severity of the patient's disease: - Treatment for mild short bowel syndrome involves eating small, frequent meals; drinking fluid; taking nutritional supplements; and using medications to treat diarrhea. - Treatment for moderate short bowel syndrome is similar to that for mild short bowel syndrome, with the addition of parenteral nutrition as needed. - Treatment for severe short bowel syndrome involves use of parenteral nutrition and oral rehydration solutions. Patients may receive enteral nutrition or continue normal eating, even though most of the nutrients are not absorbed. Both enteral nutrition and normal eating stimulate the remaining intestine to work better and may allow patients to discontinue parenteral nutrition. Some patients with severe short bowel syndrome require parenteral nutrition indefinitely or surgery.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to prevent Short Bowel Syndrome ?	People can ask their health care providers about surgical techniques that minimize scar tissue. Scientists have not yet found a way to prevent short bowel syndrome that is present at birth, as its cause is unknown.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Short Bowel Syndrome ?	Intestinal adaptation is a process that usually occurs in children after removal of a large portion of their small intestine. The remaining small intestine goes through a period of adaptation and grows to increase its ability to absorb nutrients. Intestinal adaptation can take up to 2 years to occur, and during this time a person may be heavily dependent on parenteral or enteral nutrition.1
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Short Bowel Syndrome ?	Researchers have not found that eating, diet, and nutrition play a role in causing or preventing short bowel syndrome.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Short Bowel Syndrome ?	- Short bowel syndrome is a group of problems related to poor absorption of nutrients. - People with short bowel syndrome cannot absorb enough water, vitamins, minerals, protein, fat, calories, and other nutrients from food. - The main symptom of short bowel syndrome is diarrhealoose, watery stools. Diarrhea can lead to dehydration, malnutrition, and weight loss. - A health care provider will recommend treatment for short bowel syndrome based on a patient's nutritional needs. Treatment may include - nutritional support - medications - surgery - intestinal transplant
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Anemia of Inflammation and Chronic Disease ?	Anemia is a condition in which a person has a lower than normal number of red blood cells or the amount of hemoglobin in the red blood cells drops below normal, which prevents the bodys cells from getting enough oxygen. Hemoglobin is an iron-rich protein that gives blood its red color and lets red blood cells transport oxygen from the lungs to the bodys tissues. Therefore, low numbers of red blood cells or low levels of hemoglobin also cause low blood iron levels. People with anemia may feel tired because their blood does not supply enough oxygen to the bodys organs and tissues. If anemia becomes severe and prolonged, the lack of oxygen in the blood can lead to shortness of breath or exercise intolerancea condition in which a person becomes easily fatigued during or after physical activityand eventually can cause the heart and other organs to fail.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Anemia of Inflammation and Chronic Disease ?	Anemia of inflammation and chronic disease is a type of anemia that commonly occurs with chronic, or long term, illnesses or infections. Cancer and inflammatory disorders, in which abnormal activation of the immune system occurs, can also cause AI/ACD. AI/ACD is easily confused with iron-deficiency anemia because in both forms of anemia levels of iron circulating in the blood are low. Iron in the body is found both circulating in the blood and stored in body tissues. Circulating iron is necessary for red blood cell production. Low blood iron levels occur in iron-deficiency anemia because levels of the iron stored in the bodys tissues are depleted. In AI/ACD, however, iron stores are normal or high. Low blood iron levels occur in AI/ACD, despite normal iron stores, because inflammatory and chronic diseases interfere with the bodys ability to use stored iron and absorb iron from the diet. AI/ACD is the second most common form of anemia, after iron-deficiency anemia.1
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	Who is at risk for Anemia of Inflammation and Chronic Disease? ?	While AI/ACD can affect people at any age, older adults are especially at risk because they have the highest rates of chronic disease. AI/ACD is also common among hospitalized patients, particularly those with chronic illnesses. More than 130 million Americans live with at least one chronic illness.2 Addressing the causes of anemia in people with chronic disease can help improve their health and quality of life.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes Anemia of Inflammation and Chronic Disease ?	Anemia of inflammation and chronic disease is caused by red blood cells not functioning normally, so they cannot absorb and use iron efficiently. In addition, the body cannot respond normally to erythropoietin (EPO), a hormone made by the kidneys that stimulates bone marrow to produce red blood cells. Over time, this abnormal functioning causes a lower than normal number of red blood cells in the body. Some of the chronic diseases that lead to AI/ACD include infectious and inflammatory diseases, kidney disease, and cancer. Certain treatments for chronic diseases may also impair red blood cell production and contribute to AI/ACD. Infectious and inflammatory diseases. As part of the immune system response that occurs with infectious and inflammatory diseases, cells of the immune system release proteins called cytokines. Cytokines help heal the body and defend it against infection. However, they can also affect normal body functions. In AI/ACD, immune cytokines interfere with the bodys ability to absorb and use iron. Cytokines may also interfere with the production and normal activity of EPO. Infectious diseases that cause AI/ACD include - tuberculosis, an infection in the lungs - HIV/AIDS, an infection that destroys the immune system - endocarditis, an infection in the heart - osteomyelitis, a bone infection Sometimes, acute infectionsthose that develop quickly and may not last longcan also cause AI/ACD. Inflammatory diseases that can lead to AI/ACD include - rheumatoid arthritis, which causes pain, swelling, stiffness, and loss of function in the joints - lupus, which causes damage to various body tissues, such as the joints, skin, kidneys, heart, lungs, blood vessels, and brain - diabetes, in which levels of blood glucose, also called blood sugar, are above normal - heart failure, in which the heart cannot pump enough blood to meet the bodys needs - inflammatory bowel disease (IBD), diseases that cause inflammation and irritation in the intestines IBD, including Crohns disease, can also cause iron deficiency due to poor absorption of iron by the diseased intestine and bleeding from the gastrointestinal (GI) tract. Kidney disease. People with kidney disease can develop anemia for several different reasons. Diseased kidneys often fail to make enough EPO. In addition, kidney disease results in abnormal absorption and use of iron, which is typical of AI/ACD. Anemia worsens as kidney disease advances. Therefore, most people with kidney failure have anemia. Kidney failure is described as end-stage kidney disease, sometimes called ESRD, when treated with a kidney transplant or blood-filtering treatments called dialysis. People with kidney failure can also develop iron deficiency due to blood loss during hemodialysis, a type of dialysis that uses a special filter called a dialyzer to remove wastes from the blood. Low levels of iron and folic acidanother nutrient required for normal red blood cell productionmay also contribute to anemia in people with kidney disease. Cancer. AI/ACD can occur with certain types of cancer, including Hodgkins disease, non-Hodgkins lymphoma, and breast cancer. Like infectious and inflammatory diseases, these types of cancer cause inflammatory cytokines to be released in the body. Anemia can also be made worse by chemotherapy and radiation treatments that damage the bone marrow, and by the cancers invasion of bone marrow.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Anemia of Inflammation and Chronic Disease ?	Anemia of inflammation and chronic disease typically develops slowly and, because it is usually mild, may cause few or no symptoms. Symptoms of anemia may also be masked by the symptoms of the underlying disease. Sometimes, AI/ACD can cause or contribute to - fatigue - weakness - pale skin - a fast heartbeat - shortness of breath - exercise intolerance
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Anemia of Inflammation and Chronic Disease ?	To diagnose AI/ACD, a health care provider orders a blood test called a complete blood count (CBC). A blood test involves drawing a persons blood at a health care providers office or commercial facility and sending the sample to a lab for analysis. The CBC includes a measurement of a persons hematocrit, the percentage of the blood that consists of red blood cells. The CBC also measures the amount of hemoglobin in the blood and can show whether a person has a lower than normal number of red blood cells. In addition to measuring hematocrit and hemoglobin, the CBC includes two other measurements to show whether a person has enough iron: - The ferritin level indicates the amount of iron stored in the body. A ferritin score below 200 nanograms per liter is a sign that a person may have an iron deficiency. - The transferrin saturation (TSAT) is a score that indicates how much iron is available, or circulating, to make red blood cells. A TSAT score below 20 percent is another sign of iron deficiency.3 A CBC result that shows low iron levels in the blood yet normal measures of iron stores in the body is a hallmark of AI/ACD.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Anemia of Inflammation and Chronic Disease ?	Anemia of inflammation and chronic disease often is not treated separately from the condition with which it occurs. In general, health care providers focus on treating the underlying illness. If this treatment is successful, the anemia usually resolves. For example, antibiotics prescribed for infection and anti-inflammatory medications prescribed for rheumatoid arthritis or IBD can cause AI/ACD to disappear. However, AI/ACD is increasingly being viewed as a medical condition that merits direct treatment. For people with cancer or kidney disease who have low levels of EPO, a synthetic form of EPO may be prescribed. A health care provider usually injects EPO subcutaneouslyunder the skintwo or three times a week. A person may be taught how to inject the EPO at home. People on hemodialysis who cannot tolerate EPO shots may receive EPO intravenously during hemodialysis. If iron deficiency has a role in causing AI/ACD, a person may need iron supplements to raise hematocrit to a target level. Iron supplements can be taken by pill, subcutaneously, or intravenously during hemodialysis. People with kidney disease and AI/ACD may also be advised to take vitamin B12 and folic acid supplements. A person should talk with a health care provider before taking any supplements. More information is provided in the NIDDK health topic, Anemia in Kidney Disease and Dialysis.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Anemia of Inflammation and Chronic Disease ?	People with anemia caused by iron, vitamin B12, or folic acid deficiencies are usually advised to include sources of these nutrients in their diets. Dietary sources of iron include - beans - breakfast cereals - chicken - enriched bread - spinach - turkey Dietary sources of vitamin B12 include - beef liver - breakfast cereals - chicken - clams - fish - turkey Dietary sources of folic acid include - beans - breakfast cereals - chicken - enriched bread - rice - turkey
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Anemia of Inflammation and Chronic Disease ?	- Anemia is a condition in which a person has a lower than normal number of red blood cells or the amount of hemoglobin in the red blood cells drops below normal, which prevents the bodys cells from getting enough oxygen. - Anemia of inflammation and chronic disease (AI/ACD) is a type of anemia that commonly occurs with chronic illnesses, infections, cancer, or inflammatory disorders. - AI/ACD typically develops slowly and, because it is usually mild, may cause few or no symptoms. Sometimes, AI/ACD can cause or contribute to fatigue, weakness, pale skin, a fast heartbeat, shortness of breath, and exercise intolerance. - To diagnose AI/ACD, a health care provider orders a blood test called a complete blood count (CBC). - AI/ACD often is not treated separately from the condition with which it occurs. In general, health care providers focus on treating the underlying illness.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) What I need to know about Hirschsprung Disease ?	Hirschsprung* disease (HD) is a disease of the large intestine that causes severe constipation or intestinal obstruction. Constipation means stool moves through the intestines slower than usual. Bowel movements occur less often than normal and stools are difficult to pass. Some children with HD cant pass stool at all, which can result in the complete blockage of the intestines, a condition called intestinal obstruction. People with HD are born with it and are usually diagnosed when they are infants. Less severe cases are sometimes diagnosed when a child is older. An HD diagnosis in an adult is rare. *See Pronunciation Guide for tips on how to say the words in bold type.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) What I need to know about Hirschsprung Disease ?	The large intestine, which includes the colon and rectum, is the last part of the digestive tract. The large intestines main job is to absorb water and hold stool. The rectum connects the colon to the anus. Stool passes out of the body through the anus. At birth, the large intestine is about 2 feet long. An adults large intestine is about 5 feet long.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes What I need to know about Hirschsprung Disease ?	People with HD have constipation because they lack nerve cells in a part or all of the large intestine. The nerve cells signal muscles in the large intestine to push stool toward the anus. Without a signal to push stool along, stool will remain in the large intestine. How severe HD is depends on how much of the large intestine is affected. Short-segment HD means only the last part of the large intestine lacks nerve cells. Long-segment HD means most or all of the large intestine, and sometimes the last part of the small intestine, lacks nerve cells. In a person with HD, stool moves through the large intestine until it reaches the part lacking nerve cells. At that point, the stool moves slowly or stops, causing an intestinal obstruction.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes What I need to know about Hirschsprung Disease ?	Before birth, a childs nerve cells normally grow along the intestines in the direction of the anus. With HD, the nerve cells stop growing too soon. Why the nerve cells stop growing is unclear. Some HD is inherited, meaning it is passed from parent to child through genes. HD is not caused by anything a mother did while pregnant.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of What I need to know about Hirschsprung Disease ?	The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. Constipation in infants and children is common and usually comes and goes, but if your child has had ongoing constipation since birth, HD may be the problem. Symptoms in Newborns Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. Other symptoms include - green or brown vomit - explosive stools after a doctor inserts a finger into the rectum - swelling of the belly, also known as the abdomen - lots of gas - bloody diarrhea Symptoms in Toddlers and Older Children Symptoms of HD in toddlers and older children include - not being able to pass stools without laxatives or enemas. A laxative is medicine that loosens stool and increases bowel movements. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle. - swelling of the abdomen. - lots of gas. - bloody diarrhea. - slow growth or development. - lack of energy because of a shortage of red blood cells, called anemia.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose What I need to know about Hirschsprung Disease ?	HD is diagnosed based on symptoms and test results. A doctor will perform a physical exam and ask questions about your childs bowel movements. HD is much less likely if parents can identify a time when their childs bowel habits were normal. If HD is suspected, the doctor will do one or more tests. X rays An x ray is a black-and-white picture of the inside of the body. To make the large intestine show up better, the doctor may fill it with barium liquid. Barium liquid is inserted into the large intestine through the anus. If HD is the problem, the last segment of the large intestine will look narrower than normal. Just before this narrow segment, the intestine will look bulged. The bulging is caused by blocked stool stretching the intestine. Manometry During manometry, the doctor inflates a small balloon inside the rectum. Normally, the rectal muscles will relax. If the muscles dont relax, HD may be the problem. This test is most often done in older children and adults. Biopsy Biopsy is the most accurate test for HD. The doctor removes a tiny piece of the large intestine and looks at it with a microscope. If nerve cells are missing, HD is the problem.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for What I need to know about Hirschsprung Disease ?	Pull-through Procedure HD is treated with surgery called a pull-through procedure. A surgeon removes the segment of the large intestine lacking nerve cells and connects the healthy segment to the anus. The pull-through procedure is usually done soon after diagnosis. Ostomy surgery An ostomy allows stool to leave the body through an opening in the abdomen. Although most children with HD do not need an ostomy, a child who has been very sick from HD may need an ostomy to get better before the pull-through procedure. For ostomy surgery, the surgeon first takes out the diseased segment of the large intestine. The end of the healthy intestine is moved to an opening in the abdomen where a stoma is created. A stoma is created by rolling the intestines end back on itself, like a shirt cuff, and stitching it to the abdominal wall. An ostomy pouch is attached to the stoma and worn outside the body to collect stool. The pouch will need to be emptied several times each day. If the surgeon removes the entire large intestine and connects the small intestine to the stoma, the surgery is called an ileostomy. If the surgeon leaves part of the large intestine and connects it to the stoma, the surgery is called a colostomy. Later, during the pull-through procedure, the surgeon removes the stoma and closes the abdomen with stitches.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for What I need to know about Hirschsprung Disease ?	- Hirschsprung disease (HD) is a disease of the large intestine that causes severe constipation or intestinal obstruction. People with HD are born with it. - The large intestine, which includes the colon and rectum, is the last part of the digestive tract. - The cause of HD is unclear. HD is not caused by anything a mother did while pregnant. - The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. - Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. - HD is diagnosed based on symptoms and test results. - HD is treated with surgery called a pull-through procedure. - A child who has been very sick from HD may need an ostomy to get better before the pull-through procedure. - Most children pass stool normally after the pull-through procedure. - People with HD can suffer from an infection of the intestines, called enterocolitis, before or after surgery. - If you have a child with HD, your chance of having more children with HD is greater.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) What I need to know about Diverticular Disease ?	Diverticular* disease affects the colon. The colon is part of the large intestine that removes waste from your body. Diverticular disease is made up of two conditions: diverticulosis and diverticulitis. Diverticulosis occurs when pouches, called diverticula, form in the colon. These pouches bulge out like weak spots in a tire. Diverticulitis occurs if the pouches become inflamed. *See the Pronunciation Guide for tips on how to say the words in bold type.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes What I need to know about Diverticular Disease ?	Doctors are not sure what causes diverticular disease. Many think a diet low in fiber is the main cause. Fiber is a part of food that your body cannot digest. It is found in many fruits and vegetables. Fiber stays in the colon and absorbs water, which makes bowel movements easier to pass. Diets low in fiber may cause constipation, which occurs when stools are hard and difficult to pass. Constipation causes your muscles to strain when you pass stool. Straining may cause diverticula to form in the colon. If stool or bacteria get caught in the pouches, diverticulitis can occur.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of What I need to know about Diverticular Disease ?	The symptoms for diverticulosis and diverticulitis are different. Diverticulosis. Many people don't have symptoms, but some people have cramping, bloating, and constipation. Some people also have bleeding, inflammation, and fistulas. If you are bleeding, bright red blood will pass through your rectum. The rectum is the end of the colon that connects to the anus. The rectum and anus are part of the gastrointestinal tract, which is the passage that food goes through. Rectal bleeding is usually painless, but it can be dangerous. You should see a doctor right away. Diverticulitis. People with diverticulitis can have many symptoms. Often pain is felt in the lower part of the abdomen. If you have diverticulitis, you may have fevers, feel sick to your stomach, vomit, or have a change in your bowel habits.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	Who is at risk for What I need to know about Diverticular Disease? ?	Many people get diverticular disease. Starting at age 40, the chance of getting it increases about every 10 years. About half of people between the ages of 60 and 80 have diverticular disease. Almost everyone over 80 has it.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for What I need to know about Diverticular Disease ?	Treatment for diverticular disease depends on how serious the problem is and whether you are suffering from diverticulosis or diverticulitis. Most people get better by changing their diet. If you have rectal bleeding, you need to go to the hospital so a doctor can find the part of your colon that is bleeding. The doctor may use a special drug that makes the bleeding stop. The doctor may also decide to operate and remove the part of the colon that is bleeding.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for What I need to know about Diverticular Disease ?	Eating high-fiber foods can help relieve symptoms. Sometimes mild pain medications also help.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for What I need to know about Diverticular Disease ?	A doctor may prescribe antibiotics and recommend following a liquid diet. Most people get better with this treatment. Some people may need surgery and other treatments. - Surgery. Serious problems from diverticulitis are treated with surgery. Surgeons can clean the abdomen after infections and remove bleeding pouches and fistulas. - Colon resection. If you get diverticulitis many times, your doctor might suggest taking out the part of the colon with diverticula. The healthy sections can be joined together. With the diverticula gone, you may avoid other infections. - Emergency surgery. If you have severe problems, you may need emergency surgery to clear the infection and remove part of the colon. Later, a second surgery rejoins the healthy sections of the colon. The colon is separated for a brief time between surgeries, because rejoining the colon during the first surgery is not always safe. A temporary colostomy is needed between the two surgeries. A colostomy is an opening made on the abdomen where a plastic bag is connected to collect stool after food is digested. The surgeon makes the opening, called a stoma, and connects it to the end of the colon.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) What I need to know about Diverticular Disease ?	Eat a high-fiber diet to help prevent problems. Talk to your doctor about using fiber products like Benefiber, Citrucel, or Metamucil. Daily use can help you get the fiber you need if you do not get it through your diet. Ask your doctor about which food choices are right for you. Eating foods high in fiber is simple and can help reduce diverticular disease symptoms and problems. Try eating more of the following: - Fruit. Raw apples, peaches, pears, and tangerines. - Vegetables. Fresh broccoli, squash, carrots, and brussels sprouts. - Starchy vegetables. Potatoes, baked beans, kidney beans, and lima beans. - Grains. Whole-wheat bread, brown rice, bran flake cereal, and oatmeal. Talk with your doctor about making diet changes. Learn what to eat and how to put more of these high-fiber foods in your diet.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for What I need to know about Diverticular Disease ?	- Diverticular disease is more common in people as they grow older. - A low-fiber diet is the most likely cause of the disease. - Most people are treated with a high-fiber diet and pain medication. - Add whole grain foods, high-fiber fruits, and vegetables to your diet. - Contact a doctor if you notice symptoms such as fever, chills, nausea, vomiting, abdominal pain, rectal bleeding, or change in bowel habits.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for What I need to know about Living with Kidney Failure ?	Kidney failure means your kidneys no longer work well enough to do their job. You need treatment to replace the work your damaged kidneys have stopped doing. The treatments for kidney failure are - hemodialysis - peritoneal dialysis - a kidney transplant Your kidneys filter wastes and extra fluid from your blood to keep you healthy. The wastes and extra fluid become urine that is stored in your bladder until you urinate. When your kidneys fail, dialysis can take over a small part of the work your damaged kidneys can no longer do. You can make treatments work better by - sticking to your treatment schedule - taking all medicines your doctor prescribes - following a special diet that keeps wastes from building up in your blood - being active most days of the week Hemodialysis Hemodialysis is a treatment for kidney failure. Hemodialysis uses a machine to filter your blood outside your body. First, a dialysis nurse places two needles into your arm. A pump on the hemodialysis machine draws your blood through one of the needles into a tube. The tube takes the blood to a filter, called a dialyzer. Inside the dialyzer, your blood flows through thin fibers that are like straws. The wastes and extra fluid leave the blood through tiny holes in the fibers. Then, a different tube carries the filtered blood back to your body through the second needle. More information is provided in the NIDDK health topics, Treatment Methods for Kidney Failure: Hemodialysis and Home Hemodialysis. Peritoneal Dialysis catheter Treatment Methods for Kidney Failure: Peritoneal Dialysis Kidney Transplant A kidney transplant places a healthy kidney from another person into your body. The kidney may come from someone who has just died. Your doctor will place your name on a waiting list for a kidney. A family member or friend might be able to give you a kidney. Then you dont have to wait. The new kidney takes over filtering your blood. The damaged kidneys usually stay where they are. The new kidney is placed in the front lower abdomen, on one side of the bladder. Your body normally attacks anything that shouldnt be there, such as bacteria. Your body will think the new kidney shouldnt be there. You will take medicines called immunosuppressants to keep your body from attacking the new kidney. More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Transplantation. *See the Pronunciation Guide for tips on how to say the the words in bold type.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for What I need to know about Living with Kidney Failure ?	Learning about different treatments for kidney failure will help you choose the one that best fits your lifestyle. Talk with your doctor and people on hemodialysis or peritoneal dialysis to learn about the pros and cons of each treatment. Ask your doctor about the transplant waiting list and about medicines required after a transplant. Talk with people who have had kidney transplants and ask how it has changed their lives. If you plan to keep working, think about which treatment can help make that easier. If spending time with family and friends means a lot to you, learn about which treatment may give you the most free time. Find out which treatment will give you the best chance to be healthy and live longer. Talking with your doctor ahead of time about your options can help you take control of your care. Understanding the treatment you choose and getting used to the idea that you will be receiving this treatment takes time. If you choose one type of dialysis treatment and find it is not a good fit for your life, talk with your doctor about selecting another type of dialysis treatment that better meets your needs. While kidney failure can make your life harder, treatments can help improve your life.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for What I need to know about Living with Kidney Failure ?	Eating the right foods can help you feel better when you are on dialysis or have a kidney transplant. Staying healthy with kidney failure requires watching how much of these elements are included in your diet: - Protein is in many foods you eat. Protein is in foods from animals and plants. Most diets include both types of protein. Protein provides the building blocks that maintain and repair muscles, organs, and other parts of the body. Too much protein can cause waste to build up in your blood, making your kidneys work harder. However, if you are on hemodialysis or peritoneal dialysis, you need lots of protein to replace the protein that dialysis removes. - Phosphorus is a mineral that keeps your bones healthy. Phosphorus also keeps blood vessels and muscles working. This mineral is found naturally in foods rich in protein, such as meat, poultry, fish, nuts, beans, and dairy products. Phosphorus is also added to many processed foods. You need phosphorus to turn food into energy; however, too much can cause your bones to weaken. - Water is in drinks and in foods such as fruits, vegetables, ice cream, gelatin, soup, and popsicles. Your body needs water; however, too much can cause fluid to build up in your body and make your heart work harder. - Sodium is a part of salt. You can find sodium in many canned, packaged, and fast foods and in seasonings and meats. You need sodium to help control the amount of fluid in your body; however, too much can cause high blood pressure. - Potassium is a mineral that helps your nerves and muscles work the right way. Potassium is found in fruits and vegetables such as oranges, bananas, tomatoes, and potatoes. You need potassium for healthy nerves and brain cells; however, too much can make your heartbeat irregular. - Calories are found in all foods and are especially high in oils and sugary foods. You need calories for energy; however, too many can cause weight gain and high blood sugar. Talk with your clinics renal dietitian to find a meal plan that works for you. Each treatment requires a different diet. If you are on hemodialysis, you have to stay away from foods such as potatoes and oranges because they have lots of potassium. If you are on peritoneal dialysis, eating potassium is fine. Instead, you may need to watch your calories. Your food needs will also depend on your weight and activity level. Changing your diet may be hard at first. Eating the right foods will help you feel better. You will have more strength and energy. Having more energy will help you live a fuller, healthier life. More information is provided in the NIDDK health topic, Eat Right to Feel Right on Hemodialysis.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for What I need to know about Living with Kidney Failure ?	- Kidney failure means your kidneys no longer work well enough to do their job. - Learning about treatments for kidney failure will help you choose the one that best fits your lifestyle. - Many people with kidney failure continue to work. - Physical activity is an important part of staying healthy when you have kidney failure. - You can help prevent relatives from having kidney failure by talking with them about their risk. - Eating the right foods can help you feel better when you are on dialysis or have a kidney transplant.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Primary Biliary Cirrhosis ?	Primary biliary cirrhosis is a chronic, or long lasting, disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear. The bile ducts carry a fluid called bile from the liver to the gallbladder, where it is stored. When food enters the stomach after a meal, the gallbladder contracts, and the bile ducts carry bile to the duodenum, the first part of the small intestine, for use in digestion. The liver makes bile, which is made up of bile acids, cholesterol, fats, and fluids. Bile helps the body absorb fats, cholesterol, and fat-soluble vitamins. Bile also carries cholesterol, toxins, and waste products to the intestines, where the body removes them. When chronic inflammation, or swelling, damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue. This damage to the liver tissue can lead to cirrhosis, a condition in which the liver slowly deteriorates and is unable to function normally. In cirrhosis, scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver. The liver is the bodys largest internal organ. The liver is called the bodys metabolic factory because of the important role it plays in metabolismthe way cells change food into energy after food is digested and absorbed into the blood. The liver has many functions, including - taking up, storing, and processing nutrients from foodincluding fat, sugar, and proteinand delivering them to the rest of the body when needed - making new proteins, such as clotting factors and immune factors - producing bile - removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete, and the liver creates scar tissue. Scarring of the liver may lead to cirrhosis. The buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail. Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively replace damaged cells. Primary biliary cirrhosis usually occurs between the ages of 30 and 65 and affects women more often than men.1
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes Primary Biliary Cirrhosis ?	The causes of primary biliary cirrhosis are unknown. Most research suggests it is an autoimmune disease. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. An autoimmune disease is a disorder in which the bodys immune system attacks the bodys own cells and organs. In primary biliary cirrhosis, the immune system attacks the small bile ducts in the liver. Genetics, or inherited genes, can make a person more likely to develop primary biliary cirrhosis. Primary biliary cirrhosis is more common in people who have a parent or siblingparticularly an identical twinwith the disease. In people who are genetically more likely to develop primary biliary cirrhosis, environmental factors may trigger or worsen the disease, including - exposure to toxic chemicals - smoking - infections Genetics can also make some people more likely to develop other autoimmune diseases, such as - autoimmune hepatitis, a disease in which the bodys immune system attacks liver cells - Sjgrens syndrome, a condition in which the immune system attacks the glands that produce tears and saliva - autoimmune thyroid dysfunctions, conditions in which the immune system attacks the thyroid gland
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Primary Biliary Cirrhosis ?	The first and most common symptoms of primary biliary cirrhosis are - fatigue, or feeling tired - itching skin, and darkened skin in itching areas due to scratching - dry eyes and mouth Some people may have jaundice, a condition that causes the skin and whites of the eyes to turn yellow. Health care providers diagnose up to 60 percent of people with primary biliary cirrhosis before symptoms begin.2 Routine blood tests showing abnormal liver enzyme levels may lead a health care provider to suspect that a person without symptoms has primary biliary cirrhosis.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the complications of Primary Biliary Cirrhosis ?	Most complications of primary biliary cirrhosis are related to cirrhosis and start after primary biliary cirrhosis progresses to cirrhosis. In some cases, portal hypertension and esophageal varices may develop before cirrhosis. Portal hypertension. The portal vein carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver. In cirrhosis, scar tissue partially blocks the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension. Portal hypertension is a common complication of cirrhosis. This condition may lead to other complications, such as - edemaswelling due to a buildup of fluidin the feet, ankles, or legs, and ascitesa buildup of fluid in the abdomen - enlarged blood vessels, called varices, in the esophagus, stomach, or both - an enlarged spleen, called splenomegaly - mental confusion due to a buildup of toxins that are ordinarily removed by the liver, a condition called hepatic encephalopathy Edema and ascites. Liver failure causes fluid buildup that results in edema and ascites. Ascites can lead to spontaneous bacterial peritonitis, a serious infection that requires immediate medical attention. Varices. Portal hypertension may cause enlarged blood vessels in the esophagus, stomach, or both. These enlarged blood vessels, called esophageal or gastric varices, cause the vessel walls to become thin and blood pressure to increase, making the blood vessels more likely to burst. If they burst, serious bleeding can occur in the esophagus or upper stomach, requiring immediate medical attention. Splenomegaly. Portal hypertension may cause the spleen to enlarge and retain white blood cells and platelets, reducing the numbers of these cells and platelets in the blood. A low platelet count may be the first evidence that a person has developed cirrhosis. Hepatic encephalopathy. A failing liver cannot remove toxins from the blood, so they eventually accumulate in the brain. The buildup of toxins in the brain is called hepatic encephalopathy. This condition can decrease mental function and cause stupor and even coma. Stupor is an unconscious, sleeplike state from which a person can only be aroused briefly by a strong stimulus, such as a sharp pain. Coma is an unconscious, sleeplike state from which a person cannot be aroused. Signs of decreased mental function include - confusion - personality changes - memory loss - trouble concentrating - a change in sleep habits Metabolic bone diseases. Some people with cirrhosis develop a metabolic bone disease, which is a disorder of bone strength usually caused by abnormalities of vitamin D, bone mass, bone structure, or minerals, such as calcium and phosphorous. Osteopenia is a condition in which the bones become less dense, making them weaker. When bone loss becomes more severe, the condition is referred to as osteoporosis. People with these conditions are more likely to develop bone fractures. Gallstones and bile duct stones. If cirrhosis prevents bile from flowing freely to and from the gallbladder, the bile hardens into gallstones. Symptoms of gallstones include abdominal pain and recurrent bacterial cholangitisirritated or infected bile ducts. Stones may also form in and block the bile ducts, causing pain, jaundice, and bacterial cholangitis. Steatorrhea. Steatorrhea is a condition in which the body cannot absorb fat, causing a buildup of fat in the stool and loose, greasy, and foul-smelling bowel movements. Steatorrhea may be caused by impairment of bile delivery to the small intestine or by the pancreas not producing enough digestive enzymes. Liver cancer. Liver cancer is common in people with cirrhosis. Liver cancer has a high mortality rate. Current treatments are limited and only fully successful if a health care provider detects the cancer early, before the tumor is too large. For this reason, health care providers should check people with cirrhosis for signs of liver cancer every 6 to 12 months. Health care providers use blood tests, ultrasound, or both to check for signs of liver cancer.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Primary Biliary Cirrhosis ?	A health care provider may use the following tests to diagnose primary biliary cirrhosis: - a medical and family history - a physical exam - blood tests - imaging tests - a liver biopsy A health care provider usually bases a diagnosis of primary biliary cirrhosis on two out of three of the following criteria: - a blood test showing elevated liver enzymes - a blood test showing the presence of anti-mitochondrial antibodies (AMA) - a liver biopsy showing signs of the disease Health care providers may order additional tests to rule out other causes of symptoms. Health care providers diagnose the majority of people with primary biliary cirrhosis early in the course of the disease. 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 primary biliary cirrhosis. He or she will ask a patient to provide a medical and family history. Physical exam. A physical exam may help diagnose primary biliary cirrhosis. During a physical exam, a health care provider usually - examines a patients body - uses a stethoscope to listen to sounds in the abdomen - taps on specific areas of the patients body The health care provider will perform a physical exam to look for signs of the disease. For example, the liver may feel hard or ascites may cause the abdomen to enlarge. Blood test. A blood test involves drawing blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. The blood test can show elevated levels of liver enzymes, such as alkaline phosphatase. A routine blood test may show high levels of the liver enzyme alkaline phosphatase in people who have primary biliary cirrhosis and are not yet showing symptoms. The health care provider will perform an AMA blood test to help confirm the diagnosis. A blood test will detect the presence of AMA in 90 to 95 percent of people with primary biliary cirrhosis.3 Imaging tests. A health care provider may use the following imaging tests to examine the bile ducts. These tests can distinguish between primary biliary cirrhosis and other conditions that affect the bile ducts. - Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care providers office, an outpatient center, or a hospital, and a radiologista doctor who specializes in medical imaging interprets the images. A patient does not need anesthesia. In addition to showing problems with the bile ducts, the images can show signs of advanced cirrhosis or complications. - Magnetic resonance cholangiopancreatography uses magnetic resonance imaging (MRI) to examine the bile ducts. MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. A specially trained technician performs magnetic resonance cholangiopancreatography in an outpatient center or a hospital, and a radiologist interprets the images. A patient does not need anesthesia, though a health care provider may use light sedation for patients with a fear of confined spaces. With most MRI machines, the patient lies 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. - Endoscopic retrograde cholangiopancreatography uses an x ray to look at the bile ducts. A gastroenterologista doctor who specializes in digestive diseasesperforms the test at a hospital or an outpatient center. After lightly sedating the patient, the gastroenterologist inserts an endoscopea small, flexible tube with a light and a camera on the endthrough the mouth into the duodenum and bile ducts. The endoscope is connected to a computer and video monitor. The gastroenterologist injects a special dye, called contrast medium, through the tube into the bile ducts, which makes the ducts show up on the monitor. This test is more invasive than other imaging tests, and health care providers do not routinely need the test to make the diagnosis of primary biliary cirrhosis. A health care provider uses the test selectively when he or she is concerned that the blockage of the bile ducts has another cause, such as a gallstone or a narrowing of the large bile ducts due to inflammation or cancer. Patients may have pain, nausea, or vomiting after the test or may develop bacterial cholangitis or pancreatitisinflammation of the pancreas. Liver biopsy. A liver biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to stop taking certain medications temporarily before the liver biopsy. The health care provider may ask the patient to fast for 8 hours before the procedure. During the procedure, the patient lies on a table, right hand resting above the head. The health care provider applies a local anesthetic to the area where he or she will insert the biopsy needle. If needed, a health care provider will also give sedatives and pain medication. The health care provider uses a needle to take a small piece of liver tissue. He or she may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home. A health care provider performs a liver biopsy at a hospital or an outpatient center. The health care provider sends the liver sample to a pathology lab, where the pathologista doctor who specializes in diagnosing diseaseslooks at the tissue with a microscope and sends a report to the patients health care provider. A liver biopsy can confirm the diagnosis of primary biliary cirrhosis; however, a person does not always need this test. A health care provider will perform a biopsy if the AMA blood test is negative and the person shows other signs of primary biliary cirrhosis. Sometimes a health care provider finds a cause of liver damage other than primary biliary cirrhosis during biopsy.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Primary Biliary Cirrhosis ?	Treatment for primary biliary cirrhosis depends on how early a health care provider diagnoses the disease and whether complications are present. In the early stages of primary biliary cirrhosis, treatment can slow the progression of liver damage to cirrhosis. In the early stages of cirrhosis, the goals of treatment are to slow the progression of tissue scarring in the liver and prevent complications. As cirrhosis progresses, a person may need additional treatments and hospitalization to manage complications. Medications Health care providers prescribe ursodiol (Actigall, Urso) to treat primary biliary cirrhosis. Ursodiol is a nontoxic bile acid that people can take orally. Ursodiol replaces the bile acids that are normally produced by the liver, which are more toxic and can harm the liver. Treatment with ursodiol can reduce levels of bilirubin and liver enzymes in the blood. Early treatment with this medication reduces the likelihood of needing a liver transplant and improves survival.3 Early treatment provides the most benefit; however, ursodiol treatment late in the course of the disease can still slow the progression of liver damage. While ursodiol treatment improves the outcome of primary biliary cirrhosis, it does not cure the disease. Researchers are studying the effects of several other medications on the progression of primary biliary cirrhosis. To date, none has shown the positive effects of ursodiol. Avoiding Alcohol and Other Substances People with cirrhosis should not drink any alcohol or take any illegal substances, as both will cause more liver damage. People with cirrhosis should avoid complementary and alternative medications, such as herbs. People with cirrhosis should be careful about starting new medications and should consult a health care provider before taking prescription medications, over-the-counter medications, or vitamins. Many vitamins and prescription and over-the-counter medications can affect liver function. Treatment of Symptoms and Complications Health care providers treat symptoms and complications as follows: Itching. Antihistamines may help with mild itching. However, antihistamines often cause drowsiness, and a person should take antihistamines just before bedtime to help with nighttime itching. A health care provider will treat more problematic itching with cholestyramine (Locholest, Questran), which reduces cholesterol in the blood. Experts believe high levels of cholesterol let substances that cause itching build up in tissues. Dry eyes and mouth. Health care providers usually treat dry eyes and mouth with artificial tears and saliva substitutes, respectively. These products are available without a prescription. A health care provider may treat people whose symptoms do not improve with pilocarpine (Salagen) or cevimeline (Evoxac). People who have difficulty with dry eyes should see an ophthalmologista doctor who diagnoses and treats all eye diseases and eye disordersregularly. People with dry mouth should have regular dental exams. Portal hypertension. A health care provider may prescribe a beta-blocker or nitrate to treat portal hypertension. Beta-blockers lower blood pressure by helping the heart beat slower and with less force, and nitrates relax and widen blood vessels to let more blood flow to the heart and reduce the hearts workload. Varices. Beta-blockers can lower the pressure in varices and reduce the likelihood of bleeding. Bleeding in the stomach or esophagus requires an immediate upper endoscopy. This procedure involves using an endoscope to look for varices. The health care provider may use the endoscope to perform a band ligation, a procedure that involves placing a special rubber band around the varices that causes the tissue to die and fall off. A gastroenterologist performs the procedure at a hospital or an outpatient center. People who have had varices in the past may need to take medication to prevent future episodes. Edema and ascites. Health care providers prescribe diureticsmedications that remove fluid from the bodyto treat edema and ascites. A health care provider may remove large amounts of ascitic fluid from the abdomen and check for spontaneous bacterial peritonitis. A health care provider may prescribe bacteria-fighting medications called antibiotics to prevent infection. He or she may prescribe oral antibiotics; however, severe infection with ascites requires intravenous (IV) antibiotics. Hepatic encephalopathy. A health care provider will treat hepatic encephalopathy by cleansing the bowel with lactulose, a laxative given orally or as an enemaa liquid put into the rectum. A health care provider may also add antibiotics to the treatment. Hepatic encephalopathy may improve as other complications of cirrhosis are controlled. Osteoporosis. A health care provider may prescribe bisphosphonate medications to improve bone density. Gallstones and bile duct stones. A health care provider may use surgery to remove gallstones. He or she may use endoscopic retrograde cholangiopancreatography, which uses balloons and basketlike devices, to retrieve the bile duct stones. Liver cancer. A health care provider may recommend screening tests every 6 to 12 months to check for signs of liver cancer. Screening tests can find cancer before the person has symptoms of the disease. Cancer treatment is usually more effective when the health care provider finds the disease early. Health care providers use blood tests, ultrasound, or both to screen for liver cancer in people with cirrhosis. He or she may treat cancer with a combination of surgery, radiation, and chemotherapy.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Primary Biliary Cirrhosis ?	A healthy diet is important in all stages of cirrhosis because malnutrition is common in people with this disease. Malnutrition is a condition that occurs when the body does not get enough nutrients. Cirrhosis may lead to malnutrition because it can cause - people to eat less because of symptoms such as loss of appetite - changes in metabolism - reduced absorption of vitamins and minerals Health care providers can recommend a meal plan that is well balanced and provides enough calories and protein. If ascites develops, a health care provider or dietitian may recommend a sodium-restricted diet. To improve nutrition, the health care provider may prescribe a liquid supplement. A person may take the liquid by mouth or through a nasogastric tubea tiny tube inserted through the nose and throat that reaches into the stomach. A person with cirrhosis should not eat raw shellfish, which can contain a bacterium that causes serious infection. Cirrhosis affects the immune system, making people with cirrhosis more likely than healthy people to develop an infection after eating shellfish that contain this bacterium. A health care provider may recommend calcium and vitamin D supplements to help prevent osteoporosis.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Primary Biliary Cirrhosis ?	- Primary biliary cirrhosis is a chronic disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear. - When chronic inflammation damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue. This damage to the liver tissue can lead to cirrhosis. - The causes of primary biliary cirrhosis are unknown. Most research suggests it is an autoimmune disease. - Primary biliary cirrhosis is more common in people who have a parent or siblingparticularly an identical twinwith the disease. - The first and most common symptoms of primary biliary cirrhosis are fatigue, itching, and dry eyes and mouth. Some people may have jaundice, a condition that causes the skin and whites of the eyes to turn yellow. Health care providers diagnose up to 60 percent of people with primary biliary cirrhosis before symptoms begin. - Most complications of primary biliary cirrhosis are related to cirrhosis and start after primary biliary cirrhosis progresses to cirrhosis. - A health care provider may use the following tests to diagnose primary biliary cirrhosis: - a medical and family history - a physical exam - blood tests - imaging tests - a liver biopsy - Health care providers prescribe ursodiol (Actigall, Urso) to treat primary biliary cirrhosis. Early treatment with this medication reduces the likelihood of needing a liver transplant and improves survival. - A health care provider may consider a liver transplant when cirrhosis leads to liver failure or treatment for complications is ineffective.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Ectopic Kidney ?	An ectopic kidney is a birth defect in which a kidney is located below, above, or on the opposite side of its usual position. About one in 900 people has an ectopic kidney.1
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Ectopic Kidney ?	The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine a person produces each day. The urine flows to the bladder through tubes called ureters where it is stored until being released through urination.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes Ectopic Kidney ?	During fetal development, a babys kidneys first appear as buds inside the pelvisthe bowl-shaped bone that supports the spine and holds up the digestive, urinary, and reproductive organsnear the bladder. As the kidneys develop, they move gradually toward their usual position in the back near the rib cage. Sometimes, one of the kidneys remains in the pelvis or stops moving before it reaches its usual position. In other cases, the kidney moves higher than the usual position. Rarely does a child have two ectopic kidneys. Most kidneys move toward the rib cage, but one may cross over so that both kidneys are on the same side of the body. When a crossover occurs, the two kidneys often grow together and become fused. Factors that may lead to an ectopic kidney include - poor development of a kidney bud - a defect in the kidney tissue responsible for prompting the kidney to move to its usual position - genetic abnormalities - the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Ectopic Kidney ?	An ectopic kidney may not cause any symptoms and may function normally, even though it is not in its usual position. Many people have an ectopic kidney and do not discover it until they have tests done for other reasons. Sometimes, a health care provider may discover an ectopic kidney after feeling a lump in the abdomen during an examination. In other cases, an ectopic kidney may cause abdominal pain or urinary problems.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the complications of Ectopic Kidney ?	Possible complications of an ectopic kidney include problems with urine drainage from that kidney. Sometimes, urine can even flow backwards from the bladder to the kidney, a problem called vesicoureteral reflux (VUR). More information about VUR is provided in the NIDDK health topic, Vesicoureteral Reflux. Abnormal urine flow and the placement of the ectopic kidney can lead to various problems: - Infection. Normally, urine flow washes out bacteria and keeps them from growing in the kidneys and urinary tract. When a kidney is out of the usual position, urine may get trapped in the ureter or in the kidney itself. Urine that remains in the urinary tract gives bacteria the chance to grow and spread. Symptoms of a urinary tract infection include frequent or painful urination, back or abdominal pain, fever, chills, and cloudy or foul-smelling urine. - Stones. Urinary stones form from substances found in the urine, such as calcium and oxalate. When urine remains in the urinary tract for too long, the risk that these substances will have time to form stones is increased. Symptoms of urinary stones include extreme pain in the back, side, or pelvis; blood in the urine; fever or chills; vomiting; and a burning feeling during urination. - Kidney damage. If urine backs up all the way to the kidney, damage to the kidney can occur. As a result, the kidney cant filter wastes and extra water from the blood. One ectopic kidney, even when it has no function, will not cause kidney failure. The other kidney can usually perform the functions of two healthy kidneys. Total kidney failure happens only in rare cases when both kidneys are damaged. - Trauma. If the ectopic kidney is in the lower abdomen or pelvis, it may be susceptible to injury from blunt trauma. People with an ectopic kidney who want to participate in body contact sports may want to wear protective gear.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Ectopic Kidney ?	A health care provider may use one or more of the following imaging tests to diagnose an ectopic kidney: - Ultrasound. An ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show the location of the kidneys. - Intravenous pyelogram (IVP). An IVP is an x ray of the urinary tract. A special dye, called contrast medium, is injected into a vein in the persons arm, travels through the body to the kidneys, and makes urine visible on the x ray. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician, and the images are interpreted by a radiologist; anesthesia is not needed. An IVP can show a blockage in the urinary tract. In children, ultrasounds are usually done instead of IVPs. - Voiding cystourethrogram (VCUG). A VCUG is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The bladder and urethra are filled with contrast medium to make the structures clearly visible on the x-ray images. The x-ray machine captures images of the contrast medium while the bladder is full and when the person urinates. The procedure is performed in a health care providers office, outpatient center, or hospital by an x-ray technician supervised by a radiologist, who then interprets the images. Anesthesia is not needed, but sedation may be used for some people. The test can show abnormalities of the inside of the urethra and bladder and whether urine is backing up toward the kidneys during urination. - Radionuclide scan. A radionuclide scan is an imaging technique that relies on the detection of small amounts of radiation after injection of radioactive chemicals. Because the dose of the radioactive chemicals is small, the risk of causing damage to cells is low. Special cameras and computers are used to create images of the radioactive chemicals as they pass through the kidneys. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. This test can show the location of an ectopic kidney and whether the ureters are blocked. - Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include the injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines are designed to allow the person to lie in a more open space. The procedure is performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed though light sedation may be used for people with a fear of confined spaces. MRIs can show the location of the kidneys. In addition to imaging tests, blood tests may be done to determine how well the kidneys are working. These tests are almost always normal in people with an ectopic kidney, even if it is badly damaged, because the other kidney usually has completely normal function.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Ectopic Kidney ?	No treatment for an ectopic kidney is needed if urinary function is normal and no blockage of the urinary tract is present. If tests show an obstruction, surgery may be needed to correct the position of the kidney to allow for better drainage of urine. Reflux can be corrected by surgery to alter the ureter or injection of a gellike liquid into the bladder wall near the opening of the ureter. If extensive kidney damage has occurred, surgery may be needed to remove the kidney. As long as the other kidney is working properly, losing one kidney should have no adverse health effects. More information is provided in the NIDDK health topic, Solitary Kidney. With the right testing and treatment, if needed, an ectopic kidney should cause no serious long-term health problems.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Ectopic Kidney ?	Eating, diet, and nutrition have not been shown to play a role in causing or preventing an ectopic kidney.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Ectopic Kidney ?	- An ectopic kidney is a birth defect in which a kidney is located below, above, or on the opposite side of its usual position. - Factors that may lead to an ectopic kidney include - poor development of a kidney bud - a defect in the kidney tissue responsible for prompting the kidney to move to its usual position - genetic abnormalities - the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects - An ectopic kidney may not cause any symptoms and may function normally, even though it is not in its usual position. - Possible complications of an ectopic kidney include problems with urine drainage from that kidney. Abnormal urine flow and the placement of the ectopic kidney can lead to various problems such as infection, stones, kidney damage, and injury from trauma. - No treatment for an ectopic kidney is needed if urinary function is normal and no blockage of the urinary tract is present. Surgery or other treatment may be needed if there is an obstruction, reflux, or extensive damage to the kidney.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Proteinuria ?	Proteinuriaalso called albuminuria or urine albuminis a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body. As blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys' filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged. Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease. If CKD progresses, it can lead to end-stage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular blood-cleansing treatments called dialysis.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	Who is at risk for Proteinuria? ?	People with diabetes, hypertension, or certain family backgrounds are at risk for proteinuria. In the United States, diabetes is the leading cause of ESRD.1 In both type 1 and type 2 diabetes, albumin in the urine is one of the first signs of deteriorating kidney function. As kidney function declines, the amount of albumin in the urine increases. Another risk factor for developing proteinuria is hypertension, or high blood pressure. Proteinuria in a person with high blood pressure is an indicator of declining kidney function. If the hypertension is not controlled, the person can progress to full kidney failure. African Americans are more likely than Caucasians to have high blood pressure and to develop kidney problems from it, even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertension-related kidney failure.2 Other groups at risk for proteinuria are American Indians, Hispanics/Latinos, Pacific Islander Americans, older adults, and overweight people. These at-risk groups and people who have a family history of kidney disease should have their urine tested regularly.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Proteinuria ?	Proteinuria has no signs or symptoms in the early stages. Large amounts of protein in the urine may cause it to look foamy in the toilet. Also, because protein has left the body, the blood can no longer soak up enough fluid, so swelling in the hands, feet, abdomen, or face may occur. This swelling is called edema. These are signs of large protein loss and indicate that kidney disease has progressed. Laboratory testing is the only way to find out whether protein is in a persons urine before extensive kidney damage occurs. Several health organizations recommend regular urine checks for people at risk for CKD. A 1996 study sponsored by the National Institutes of Health determined that proteinuria is the best predictor of progressive kidney failure in people with type 2 diabetes. The American Diabetes Association recommends regular urine testing for proteinuria for people with type 1 or type 2 diabetes. The National Kidney Foundation recommends that routine checkups include testing for excess protein in the urine, especially for people in high-risk groups.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Proteinuria ?	Until recently, an accurate protein measurement required a 24-hour urine collection. In a 24-hour collection, the patient urinates into a container, which is kept refrigerated between trips to the bathroom. The patient is instructed to begin collecting urine after the first trip to the bathroom in the morning. Every drop of urine for the rest of the day is to be collected in the container. The next morning, the patient adds the first urination after waking and the collection is complete. In recent years, researchers have found that a single urine sample can provide the needed information. In the newer technique, the amount of albumin in the urine sample is compared with the amount of creatinine, a waste product of normal muscle breakdown. The measurement is called a urine albumin-to-creatinine ratio (UACR). A urine sample containing more than 30 milligrams of albumin for each gram of creatinine (30 mg/g) is a warning that there may be a problem. If the laboratory test exceeds 30 mg/g, another UACR test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, the person has persistent proteinuria, a sign of declining kidney function, and should have additional tests to evaluate kidney function.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Proteinuria ?	Tests that measure the amount of creatinine in the blood will show whether a persons kidneys are removing wastes efficiently. Having too much creatinine in the blood is a sign that a person has kidney damage. The doctor can use the creatinine measurement to estimate how efficiently the kidneys are filtering the blood. This calculation is called the estimated glomerular filtration rate, or eGFR. CKD is present when the eGFR is less than 60 milliliters per minute (mL/min).
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Proteinuria ?	- Proteinuria is a condition in which urine contains a detectable amount of protein. - Proteinuria is a sign of chronic kidney disease (CKD). - Groups at risk for proteinuria include African Americans, American Indians, Hispanics/Latinos, Pacific Islander Americans, older people, overweight people, people with diabetes or hypertension, and people who have a family history of kidney disease. - Proteinuria may have no signs or symptoms. Laboratory testing is the only way to find out whether protein is in a person's urine. - Several health organizations recommend regular checks for proteinuria so kidney disease can be detected and treated before it progresses. - A person with diabetes, hypertension, or both should work to control blood glucose and blood pressure.
In this section: Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. Watch a video about diabetes and kidney disease. Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood. You should get tested every year for kidney disease if you The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys. To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level. Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant. Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy Learn more about these tips to manage diabetes. Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure. If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. [1] Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2019. Atlanta, GA: US Department of Health and Human Services. Centers for Disease Control and Prevention; 2019. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute	How to diagnose Kidney Disease of Diabetes ?	People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are eGFR and urine albumin. - eGFR. eGFR stands for estimated glomerular filtration rate. Each kidney contains about 1 million tiny filters made up of blood vessels. These filters are called glomeruli. Kidney function can be checked by estimating how much blood the glomeruli filter in a minute. The calculation of eGFR is based on the amount of creatinine, a waste product, found in a blood sample. As the level of creatinine goes up, the eGFR goes down. Kidney disease is present when eGFR is less than 60 milliliters per minute. The American Diabetes Association (ADA) and the National Institutes of Health (NIH) recommend that eGFR be calculated from serum creatinine at least once a year in all people with diabetes. - Urine albumin. Urine albumin is measured by comparing the amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amounts of creatinine but almost no albumin. Even a small increase in the ratio of albumin to creatinine is a sign of kidney damage. Kidney disease is present when urine contains more than 30 milligrams of albumin per gram of creatinine, with or without decreased eGFR. The ADA and the NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have had type 1 diabetes for 5 years or more. If kidney disease is detected, it should be addressed as part of a comprehensive approach to the treatment of diabetes.
In this section: Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. Watch a video about diabetes and kidney disease. Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood. You should get tested every year for kidney disease if you The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys. To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level. Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant. Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy Learn more about these tips to manage diabetes. Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure. If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. [1] Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2019. Atlanta, GA: US Department of Health and Human Services. Centers for Disease Control and Prevention; 2019. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute	How to diagnose Kidney Disease of Diabetes ?	People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are eGFR and urine albumin. - eGFR. eGFR stands for estimated glomerular filtration rate. Each kidney contains about 1 million tiny filters made up of blood vessels. These filters are called glomeruli. Kidney function can be checked by estimating how much blood the glomeruli filter in a minute. The calculation of eGFR is based on the amount of creatinine, a waste product, found in a blood sample. As the level of creatinine goes up, the eGFR goes down. Kidney disease is present when eGFR is less than 60 milliliters per minute. The American Diabetes Association (ADA) and the National Institutes of Health (NIH) recommend that eGFR be calculated from serum creatinine at least once a year in all people with diabetes. - Urine albumin. Urine albumin is measured by comparing the amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amounts of creatinine but almost no albumin. Even a small increase in the ratio of albumin to creatinine is a sign of kidney damage. Kidney disease is present when urine contains more than 30 milligrams of albumin per gram of creatinine, with or without decreased eGFR. The ADA and the NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have had type 1 diabetes for 5 years or more. If kidney disease is detected, it should be addressed as part of a comprehensive approach to the treatment of diabetes.
In this section: Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. Watch a video about diabetes and kidney disease. Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood. You should get tested every year for kidney disease if you The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys. To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level. Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant. Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy Learn more about these tips to manage diabetes. Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure. If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. [1] Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2019. Atlanta, GA: US Department of Health and Human Services. Centers for Disease Control and Prevention; 2019. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute	How to prevent Kidney Disease of Diabetes ?	Blood Pressure Medicines Scientists have made great progress in developing methods that slow the onset and progression of kidney disease in people with diabetes. Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more drugs to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic can also be useful. Beta blockers, calcium channel blockers, and other blood pressure drugs may also be needed. An example of an effective ACE inhibitor is lisinopril (Prinivil, Zestril), which doctors commonly prescribe for treating kidney disease of diabetes. The benefits of lisinopril extend beyond its ability to lower blood pressure: it may directly protect the kidneys' glomeruli. ACE inhibitors have lowered proteinuria and slowed deterioration even in people with diabetes who did not have high blood pressure. An example of an effective ARB is losartan (Cozaar), which has also been shown to protect kidney function and lower the risk of cardiovascular events. Patients with even mild hypertension or persistent microalbuminuria should consult a health care provider about the use of antihypertensive medicines. Moderate-protein Diets In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that people with kidney disease of diabetes consume the recommended dietary allowance for protein, but avoid high-protein diets. For people with greatly reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure. Anyone following a reduced-protein diet should work with a dietitian to ensure adequate nutrition. Intensive Management of Blood Glucose Antihypertensive drugs and low-protein diets can slow CKD. A third treatment, known as intensive management of blood glucose or glycemic control, has shown great promise for people with diabetes, especially for those in the early stages of CKD. The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body's cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes. Intensive management of blood glucose is a treatment regimen that aims to keep blood glucose levels close to normal. The regimen includes testing blood glucose frequently, administering insulin throughout the day on the basis of food intake and physical activity, following a diet and activity plan, and consulting a health care team regularly. Some people use an insulin pump to supply insulin throughout the day. A number of studies have pointed to the beneficial effects of intensive management of blood glucose. In the Diabetes Control and Complications Trial supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers found a 50 percent decrease in both development and progression of early diabetic kidney disease in participants who followed an intensive regimen for controlling blood glucose levels. The intensively managed patients had average blood glucose levels of 150 milligrams per deciliterabout 80 milligrams per deciliter lower than the levels observed in the conventionally managed patients. The United Kingdom Prospective Diabetes Study, conducted from 1976 to 1997, showed conclusively that, in people with improved blood glucose control, the risk of early kidney disease was reduced by a third. Additional studies conducted over the past decades have clearly established that any program resulting in sustained lowering of blood glucose levels will be beneficial to patients in the early stages of CKD.
In this section: Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. Watch a video about diabetes and kidney disease. Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood. You should get tested every year for kidney disease if you The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys. To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level. Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant. Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy Learn more about these tips to manage diabetes. Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure. If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. [1] Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2019. Atlanta, GA: US Department of Health and Human Services. Centers for Disease Control and Prevention; 2019. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute	How to prevent Kidney Disease of Diabetes ?	Blood Pressure Medicines Scientists have made great progress in developing methods that slow the onset and progression of kidney disease in people with diabetes. Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more drugs to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic can also be useful. Beta blockers, calcium channel blockers, and other blood pressure drugs may also be needed. An example of an effective ACE inhibitor is lisinopril (Prinivil, Zestril), which doctors commonly prescribe for treating kidney disease of diabetes. The benefits of lisinopril extend beyond its ability to lower blood pressure: it may directly protect the kidneys' glomeruli. ACE inhibitors have lowered proteinuria and slowed deterioration even in people with diabetes who did not have high blood pressure. An example of an effective ARB is losartan (Cozaar), which has also been shown to protect kidney function and lower the risk of cardiovascular events. Patients with even mild hypertension or persistent microalbuminuria should consult a health care provider about the use of antihypertensive medicines. Moderate-protein Diets In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that people with kidney disease of diabetes consume the recommended dietary allowance for protein, but avoid high-protein diets. For people with greatly reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure. Anyone following a reduced-protein diet should work with a dietitian to ensure adequate nutrition. Intensive Management of Blood Glucose Antihypertensive drugs and low-protein diets can slow CKD. A third treatment, known as intensive management of blood glucose or glycemic control, has shown great promise for people with diabetes, especially for those in the early stages of CKD. The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body's cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes. Intensive management of blood glucose is a treatment regimen that aims to keep blood glucose levels close to normal. The regimen includes testing blood glucose frequently, administering insulin throughout the day on the basis of food intake and physical activity, following a diet and activity plan, and consulting a health care team regularly. Some people use an insulin pump to supply insulin throughout the day. A number of studies have pointed to the beneficial effects of intensive management of blood glucose. In the Diabetes Control and Complications Trial supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers found a 50 percent decrease in both development and progression of early diabetic kidney disease in participants who followed an intensive regimen for controlling blood glucose levels. The intensively managed patients had average blood glucose levels of 150 milligrams per deciliterabout 80 milligrams per deciliter lower than the levels observed in the conventionally managed patients. The United Kingdom Prospective Diabetes Study, conducted from 1976 to 1997, showed conclusively that, in people with improved blood glucose control, the risk of early kidney disease was reduced by a third. Additional studies conducted over the past decades have clearly established that any program resulting in sustained lowering of blood glucose levels will be beneficial to patients in the early stages of CKD.
In this section: Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. Watch a video about diabetes and kidney disease. Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood. You should get tested every year for kidney disease if you The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys. To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level. Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant. Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy Learn more about these tips to manage diabetes. Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure. If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. [1] Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2019. Atlanta, GA: US Department of Health and Human Services. Centers for Disease Control and Prevention; 2019. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute	What to do for Kidney Disease of Diabetes ?	- Diabetes is the leading cause of chronic kidney disease (CKD) and kidney failure in the United States. - People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are estimated glomerular filtration rate (eGFR) and urine albumin. - Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. - In people with diabetes, excessive consumption of protein may be harmful. - Intensive management of blood glucose has shown great promise for people with diabetes, especially for those in the early stages of CKD.
In this section: Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. Watch a video about diabetes and kidney disease. Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood. You should get tested every year for kidney disease if you The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys. To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level. Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in –pril or –sartan. ACE inhibitors and ARBs are not safe for women who are pregnant. Healthy lifestyle habits can help you reach your blood glucose and blood pressure goals. Following the steps below will also help you keep your kidneys healthy Learn more about these tips to manage diabetes. Medicines may be an important part of your treatment plan. Your health care professional will prescribe medicine based on your specific needs. Medicine can help you meet your blood glucose and blood pressure goals. You may need to take more than one kind of medicine to control your blood pressure. Managing diabetes isn’t always easy. Feeling stressed, sad, or angry is common when you are living with diabetes. You may know what to do to stay healthy but may have trouble sticking with your plan over time. Long-term stress can raise your blood glucose and blood pressure, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Learn more about healthy ways to cope with stress. Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. However, most people with diabetes and kidney disease don’t end up with kidney failure. If your kidneys become damaged as a result of diabetes, learn how to manage kidney disease. [1] Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2019. Atlanta, GA: US Department of Health and Human Services. Centers for Disease Control and Prevention; 2019. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute The NIDDK would like to thank:Ian de Boer, MD, MS, Associate Professor, Division of Nephrology, University of Washington, Associate Director, Kidney Research Institute	What to do for Kidney Disease of Diabetes ?	- Diabetes is the leading cause of chronic kidney disease (CKD) and kidney failure in the United States. - People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are estimated glomerular filtration rate (eGFR) and urine albumin. - Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. - In people with diabetes, excessive consumption of protein may be harmful. - Intensive management of blood glucose has shown great promise for people with diabetes, especially for those in the early stages of CKD.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Urinary Incontinence in Men ?	Urinary incontinence is the loss of bladder control, resulting in the accidental leakage of urine from the body. For example, a man may feel a strong, sudden need, or urgency, to urinate just before losing a large amount of urine, called urgency incontinence. UI can be slightly bothersome or totally debilitating. For some men, the chance of embarrassment keeps them from enjoying many activities, including exercising, and causes emotional distress. When people are inactive, they increase their chances of developing other health problems, such as obesity and diabetes.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Urinary Incontinence in Men ?	The urinary tract is the bodys drainage system for removing urine, which is composed of wastes and extra fluid. In order for normal urination to occur, all parts in the urinary tract need to work together in the correct order. Kidneys. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. The kidneys work around the clock; a person does not control what they do. Ureters. Ureters are the thin tubes of muscleone on each side of the bladderthat carry urine from each of the kidneys to the bladder. Bladder. The bladder, located in the pelvis between the pelvic bones, is a hollow, muscular, balloon-shaped organ that expands as it fills with urine. Although a person does not control kidney function, a person does control when the bladder empties. Bladder emptying is known as urination. The bladder stores urine until the person finds an appropriate time and place to urinate. A normal bladder acts like a reservoir and can hold 1.5 to 2 cups of urine. How often a person needs to urinate depends on how quickly the kidneys produce the urine that fills the bladder. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. During urination, the bladder empties through the urethra, located at the bottom of the bladder. Three sets of muscles work together like a dam, keeping urine in the bladder between trips to the bathroom. The first set is the muscles of the urethra itself. The area where the urethra joins the bladder is the bladder neck. The bladder neck, composed of the second set of muscles known as the internal sphincter, helps urine stay in the bladder. The third set of muscles is the pelvic floor muscles, also referred to as the external sphincter, which surround and support the urethra. To urinate, the brain signals the muscular bladder wall to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Urinary Incontinence in Men ?	The prostate is a walnut-shaped gland that is part of the male reproductive system. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue. Located in front of the rectum and just below the bladder, the prostate surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What causes Urinary Incontinence in Men ?	Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex. A man may have factors that increase his chances of developing UI, including - birth defectsproblems with development of the urinary tract - a history of prostate cancersurgery or radiation treatment for prostate cancer can lead to temporary or permanent UI in men UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a mans life. Conditions or events that may increase a mans chance of developing UI include - benign prostatic hyperplasia (BPH)a condition in which the prostate is enlarged yet not cancerous. In men with BPH, the enlarged prostate presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty, leaving some urine in the bladder. The narrowing of the urethra and incomplete emptying of the bladder can lead to UI. - chronic coughinglong-lasting coughing increases pressure on the bladder and pelvic floor muscles. - neurological problemsmen with diseases or conditions that affect the brain and spine may have trouble controlling urination. - physical inactivitydecreased activity can increase a mans weight and contribute to muscle weakness. - obesityextra weight can put pressure on the bladder, causing a need to urinate before the bladder is full. - older agebladder muscles can weaken over time, leading to a decrease in the bladders capacity to store urine. More information is provided in the NIDDK health topics, Nerve Disease and Bladder Control and Prostate Enlargement: Benign Prostatic Hyperplasia.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Urinary Incontinence in Men ?	The types of UI in men include - urgency incontinence - stress incontinence - functional incontinence - overflow incontinence - transient incontinence Urgency Incontinence Urgency incontinence happens when a man urinates involuntarily after he has a strong desire, or urgency, to urinate. Involuntary bladder contractions are a common cause of urgency incontinence. Abnormal nerve signals might cause these bladder contractions. Triggers for men with urgency incontinence include drinking a small amount of water, touching water, hearing running water, or being in a cold environmenteven if for just a short whilesuch as reaching into the freezer at the grocery store. Anxiety or certain liquids, medications, or medical conditions can make urgency incontinence worse. The following conditions can damage the spinal cord, brain, bladder nerves, or sphincter nerves, or can cause involuntary bladder contractions leading to urgency incontinence: - Alzheimers diseasea disorder that affects the parts of the brain that control thought, memory, and language - injury to the brain or spinal cord that interrupts nerve signals to and from the bladder - multiple sclerosisa disease that damages the material that surrounds and protects nerve cells, which slows down or blocks messages between the brain and the body - Parkinsons diseasea disease in which the cells that make a chemical that controls muscle movement are damaged or destroyed - strokea condition in which a blocked or ruptured artery in the brain or neck cuts off blood flow to part of the brain and leads to weakness, paralysis, or problems with speech, vision, or brain function Urgency incontinence is a key sign of overactive bladder. Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without enough warning time to get to the toilet. More information is provided in the NIDDK health topic, Nerve Disease and Bladder Control. Stress Incontinence Stress incontinence results from movements that put pressure on the bladder and cause urine leakage, such as coughing, sneezing, laughing, or physical activity. In men, stress incontinence may also occur - after prostate surgery - after neurologic injury to the brain or spinal cord - after trauma, such as injury to the urinary tract - during older age Functional Incontinence Functional incontinence occurs when physical disability, external obstacles, or problems in thinking or communicating keep a person from reaching a place to urinate in time. For example, a man with Alzheimers disease may not plan ahead for a timely trip to a toilet. A man in a wheelchair may have difficulty getting to a toilet in time. Arthritispain and swelling of the jointscan make it hard for a man to walk to the restroom quickly or open his pants in time. Overflow Incontinence When the bladder doesnt empty properly, urine spills over, causing overflow incontinence. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Men with overflow incontinence may have to urinate often, yet they release only small amounts of urine or constantly dribble urine. Transient Incontinence Transient incontinence is UI that lasts a short time. Transient incontinence is usually a side effect of certain medications, drugs, or temporary conditions, such as - a urinary tract infection (UTI), which can irritate the bladder and cause strong urges to urinate - caffeine or alcohol consumption, which can cause rapid filling of the bladder - chronic coughing, which can put pressure on the bladder - constipationhard stool in the rectum can put pressure on the bladder - blood pressure medications that can cause increased urine production - short-term mental impairment that reduces a mans ability to care for himself - short-term restricted mobility
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How many people are affected by Urinary Incontinence in Men ?	Urinary incontinence occurs in 11 to 34 percent of older men. Two to 11 percent of older men report daily UI.1 Although more women than men develop UI, the chances of a man developing UI increase with age because he is more likely to develop prostate problems as he ages. Men are also less likely to speak with a health care professional about UI, so UI in men is probably far more common than statistics show. Having a discussion with a health care professional about UI is the first step to fixing this treatable problem.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to diagnose Urinary Incontinence in Men ?	Men should tell a health care professional, such as a family practice physician, a nurse, an internist, or a urologista doctor who specializes in urinary problemsthey have UI, even if they feel embarrassed. To diagnose UI, the health care professional will - take a medical history - conduct a physical exam - order diagnostic tests Medical History Taking a medical history can help a health care professional diagnose UI. He or she will ask the patient or caretaker to provide a medical history, a review of symptoms, a description of eating habits, and a list of prescription and over-the-counter medications the patient is taking. The health care professional will ask about current and past medical conditions. The health care professional also will ask about the mans pattern of urination and urine leakage. To prepare for the visit with the health care professional, a man may want to keep a bladder diary for several days beforehand. Information that a man should record in a bladder diary includes - the amount and type of liquid he drinks - how many times he urinates each day and how much urine is released - how often he has accidental leaks - whether he felt a strong urge to go before leaking - what he was doing when the leak occurred, for example, coughing or lifting - how long the symptoms have been occurring Use the Daily Bladder Diary to prepare for the appointment. The health care professional also may ask about other lower urinary tract symptoms that may indicate a prostate problem, such as - problems starting a urine stream - problems emptying the bladder completely - spraying urine - dribbling urine - weak stream - recurrent UTIs - painful urination Physical Exam A physical exam may help diagnose UI. The health care professional will perform a physical exam to look for signs of medical conditions that may cause UI. The health care professional may order further neurologic testing if necessary. Digital rectal exam. The health care professional also may perform a digital rectal exam. A digital rectal exam is a physical exam of the prostate and rectum. To perform the exam, the health care professional has the man bend over a table or lie on his side while holding his knees close to his chest. The health care professional slides a gloved, lubricated finger into the patients rectum and feels the part of the prostate that lies in front of the rectum. The digital rectal exam is used to check for stool or masses in the rectum and to assess whether the prostate is enlarged or tender, or has other abnormalities. The health care professional may perform a prostate massage during a digital rectal exam to collect a sample of prostate fluid that he or she can test for signs of infection. The health care professional may diagnose the type of UI based on the medical history and physical exam, or he or she may use the findings to determine if a man needs further diagnostic testing. Diagnostic Tests The health care professional may order one or more of the following diagnostic tests based on the results of the medical history and physical exam: - Urinalysis. Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container at home, at a health care professionals office, or at a commercial facility. A health care professional tests the sample during an office visit or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color to indicate signs of infection in urine. - Urine culture. A health care professional performs a urine culture by placing part of a urine sample in a tube or dish with a substance that encourages any bacteria present to grow. A man collects the urine sample in a special container in a health care professionals office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for culture. A health care professional can identify bacteria that multiply, usually in 1 to 3 days. A health care professional performs a urine culture to determine the best treatment when urinalysis indicates the man has a UTI. More information is provided in the NIDDK health topic, Urinary Tract Infections in Adults. - Blood test. A blood test involves drawing blood at a health care professionals office or a commercial facility and sending the sample to a lab for analysis. The blood test can show kidney function problems or a chemical imbalance in the body. The lab also will test the blood to assess the level of prostate-specific antigen, a protein produced by prostate cells that may be higher in men with prostate cancer. - Urodynamic testing. Urodynamic testing includes a variety of procedures that look at how well the bladder and urethra store and release urine. A health care professional performs urodynamic tests during an office visit or in an outpatient center or a hospital. Some urodynamic tests do not require anesthesia; others may require local anesthesia. Most urodynamic tests focus on the bladders ability to hold urine and empty steadily and completely; they may include the following: - uroflowmetry, which measures how rapidly the bladder releases urine - postvoid residual measurement, which evaluates how much urine remains in the bladder after urination - reduced urine flow or residual urine in the bladder, which often suggests urine blockage due to BPH More information is provided in the NIDDK health topic, Urodynamic Testing.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Urinary Incontinence in Men ?	Treatment depends on the type of UI. Urgency Incontinence As a first line of therapy for urgency incontinence, a health care professional may recommend the following techniques to treat a mans problem: - behavioral and lifestyle changes - bladder training - pelvic floor exercises - urgency suppression If those treatments are not successful, the following additional measures may help urgency incontinence: - medications - electrical nerve stimulation - bulking agents - surgery A health care professional may recommend other treatments for men with urgency incontinence caused by BPH. More information is provided in the NIDDK health topic, Prostate Enlargement: Benign Prostatic Hyperplasia. Behavioral and lifestyle changes. Men with urgency incontinence may be able to reduce leaks by making behavioral and lifestyle changes: - Eating, diet, and nutrition. Men with urgency incontinence can change the amount and type of liquid they drink. A man can try limiting bladder irritantsincluding caffeinated drinks such as tea or coffee and carbonated beveragesto decrease leaks. Men also should limit alcoholic drinks, which can increase urine production. A health care professional can help a man determine how much he should drink based on his health, how active he is, and where he lives. To decrease nighttime trips to the restroom, men may want to stop drinking liquids several hours before bed. - Engaging in physical activity. Although a man may be reluctant to engage in physical activity when he has urgency incontinence, regular exercise is important for good overall health and for preventing and treating UI. - Losing weight. Men who are overweight should talk with a health care professional about strategies for losing weight, which can help improve UI. - Preventing constipation. Gastrointestinal (GI) problems, especially constipation, can make urinary tract health worse and can lead to UI. The opposite is also true: Urinary problems, such as UI, can make GI problems worse. More information about how to prevent constipation through diet and physical activity is provided in the NIDDK health topic, Constipation. To Help Prevent Bladder Problems, Stop Smoking People who smoke should stop. Quitting smoking at any age promotes bladder health and overall health. Smoking increases a persons chance of developing stress incontinence, as it increases coughing. Some people say smoking worsens their bladder irritation. Smoking causes most cases of bladder cancer. People who smoke for many years have a higher risk of bladder cancer than nonsmokers or those who smoke for a short time.2 People who smoke should ask for help so they do not have to try quitting alone. Call 1-800-QUITNOW (1-800-784-8669) for more information. Bladder training. Bladder training is changing urination habits to decrease incidents of UI. The health care professional may suggest a man use the restroom at regular timed intervals, called timed voiding, based on the mans bladder diary. A man can gradually lengthen the time between trips to the restroom to help stretch the bladder so it can hold more urine. Pelvic floor muscle exercises. Pelvic floor muscle, or Kegel, exercises involve strengthening pelvic floor muscles. Strong pelvic floor muscles hold in urine more effectively than weak muscles. A man does not need special equipment for Kegel exercises. The exercises involve tightening and relaxing the muscles that control urine flow. Pelvic floor exercises should not be performed during urination. A health care professional can help a man learn proper technique. More information is provided in the NIDDK health topic, Kegel Exercise Tips. Men also may learn how to perform Kegel exercises properly by using biofeedback. Biofeedback uses special sensors to measure bodily functions, such as muscle contractions that control urination. A video monitor displays the measurements as graphs, and sounds indicate when the man is using the correct muscles. The health care professional uses the information to help the man change abnormal function of the pelvic floor muscles. At home, the man practices to improve muscle function. The man can perform the exercises while lying down, sitting at a desk, or standing up. Success with pelvic floor exercises depends on the cause of UI, its severity, and the mans ability to perform the exercises. Urgency suppression. By using certain techniques, a man can suppress the urge to urinate, called urgency suppression. Urgency suppression is a way for a man to train his bladder to maintain control so he does not have to panic about finding a restroom. Some men use distraction techniques to take their mind off the urge to urinate. Other men find taking long, relaxing breaths and being still can help. Doing pelvic floor exercises also can help suppress the urge to urinate. Medications. Health care professionals may prescribe medications that relax the bladder, decrease bladder spasms, or treat prostate enlargement to treat urgency incontinence in men. - Antimuscarinics. Antimuscarinics can help relax bladder muscles and prevent bladder spasms. These medications include oxybutynin (Oxytrol), tolterodine (Detrol), darifenacin (Enablex), trospium (Sanctura), fesoterodine (Toviaz), and solifenacin (VESIcare). They are available in pill, liquid, and patch form. - Tricyclic antidepressants. Tricyclic antidepressants such as imipramine (Tofranil) can calm nerve signals, decreasing spasms in bladder muscles. - Alpha-blockers. Terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral), and silodosin (Rapaflo) are used to treat problems caused by prostate enlargement and bladder outlet obstruction. These medications relax the smooth muscle of the prostate and bladder neck, which lets urine flow normally and prevents abnormal bladder contractions that can lead to urgency incontinence. - 5-alpha reductase inhibitors. Finasteride (Proscar) and dutasteride (Avodart) block the production of the male hormone dihydrotestosterone, which accumulates in the prostate and may cause prostate growth. These medications may help to relieve urgency incontinence problems by shrinking an enlarged prostate. - Beta-3 agonists. Mirabegron (Myrbetriq) is a beta-3 agonist a person takes by mouth to help prevent symptoms of urgency incontinence. Mirabegron suppresses involuntary bladder contractions. - Botox. A health care professional may use onabotulinumtoxinA (Botox), also called botulinum toxin type A, to treat UI in men with neurological conditions such as spinal cord injury or multiple sclerosis. Injecting Botox into the bladder relaxes the bladder, increasing storage capacity and decreasing UI. A health care professional performs the procedure during an office visit. A man receives local anesthesia. The health care professional uses a cystoscope to guide the needle for injecting the Botox. Botox is effective for up to 10 months.3 Electrical nerve stimulation. If behavioral and lifestyle changes and medications do not improve symptoms, a urologist may suggest electrical nerve stimulation as an option to prevent UI, urinary frequencyurination more often than normaland other symptoms. Electrical nerve stimulation involves altering bladder reflexes using pulses of electricity. The two most common types of electrical nerve stimulation are percutaneous tibial nerve stimulation and sacral nerve stimulation.4 - Percutaneous tibial nerve stimulation uses electrical stimulation of the tibial nerve, which is located in the ankle, on a weekly basis. The patient receives local anesthesia for the procedure. In an outpatient center, a urologist inserts a battery-operated stimulator beneath the skin near the tibial nerve. Electrical stimulation of the tibial nerve prevents bladder activity by interfering with the pathway between the bladder and the spinal cord or brain. Although researchers consider percutaneous tibial nerve stimulation safe, they continue to study the exact ways that it prevents symptoms and how long the treatment can last. - Sacral nerve stimulation involves implanting a battery-operated stimulator beneath the skin in the lower back near the sacral nerve. The procedure takes place in an outpatient center using local anesthesia. Based on the patients feedback, the health care professional can adjust the amount of stimulation so it works best for that individual. The electrical pulses enter the body for minutes to hours, two or more times a day, either through wires placed on the lower back or just above the pubic areabetween the navel and the pubic hair. Sacral nerve stimulation may increase blood flow to the bladder, strengthen pelvic muscles that help control the bladder, and trigger the release of natural substances that block pain. The patient can turn the stimulator on or off at any time. A patient may consider getting an implanted device that delivers regular impulses to the bladder. A urologist places a wire next to the tailbone and attaches it to a permanent stimulator under the skin. Bulking agents. A urologist injects bulking agents, such as collagen and carbon spheres, near the urinary sphincter to treat incontinence. The bulking agent makes the tissues thicker and helps close the bladder opening. Before the procedure, the health care professional may perform a skin test to make sure the man doesnt have an allergic reaction to the bulking agent. A urologist performs the procedure during an office visit. The man receives local anesthesia. The urologist uses a cystoscopea tubelike instrument used to look inside the urethra and bladderto guide the needle for injection of the bulking agent. Over time, the body may slowly eliminate certain bulking agents, so a man may need to have injections again. Surgery. As a last resort, surgery to treat urgency incontinence in men includes the artificial urinary sphincter (AUS) and the male sling. A health care professional performs the surgery in a hospital with regional or general anesthesia. Most men can leave the hospital the same day, although some may need to stay overnight. - AUS. An AUS is an implanted device that keeps the urethra closed until the man is ready to urinate. The device has three parts: a cuff that fits around the urethra, a small balloon reservoir placed in the abdomen, and a pump placed in the scrotumthe sac that holds the testicles. The cuff contains a liquid that makes it fit tightly around the urethra to prevent urine from leaking. When it is time to urinate, the man squeezes the pump with his fingers to deflate the cuff. The liquid moves to the balloon reservoir and lets urine flow through the urethra. When the bladder is empty, the cuff automatically refills in the next 2 to 5 minutes to keep the urethra tightly closed. - Male sling. A health care professional performs a sling procedure, also called urethral compression procedure, to add support to the urethra, which can sometimes better control urination. Through an incision in the tissue between the scrotum and the rectum, also called the perineum, the health care professional uses a piece of human tissue or mesh to compress the urethra against the pubic bone. The surgeon secures the ends of the tissue or mesh around the pelvic bones. The lifting and compression of the urethra sometimes provides better control over urination. Stress Incontinence Men who have stress incontinence can use the same techniques for treating urgency incontinence. Functional Incontinence Men with functional incontinence may wear protective undergarments if they worry about reaching a restroom in time. These products include adult diapers or pads and are available from drugstores, grocery stores, and medical supply stores. Men who have functional incontinence should talk to a health care professional about its cause and how to prevent or treat functional incontinence. Overflow Incontinence A health care professional treats overflow incontinence caused by a blockage in the urinary tract with surgery to remove the obstruction. Men with overflow incontinence that is not caused by a blockage may need to use a catheter to empty the bladder. A catheter is a thin, flexible tube that is inserted through the urethra into the bladder to drain urine. A health care professional can teach a man how to use a catheter. A man may need to use a catheter once in a while, a few times a day, or all the time. Catheters that are used continuously drain urine from the bladder into a bag that is attached to the mans thigh with a strap. Men using a continuous catheter should watch for symptoms of an infection. Transient Incontinence A health care professional treats transient incontinence by addressing the underlying cause. For example, if a medication is causing increased urine production leading to UI, a health care professional may try lowering the dose or prescribing a different medication. A health care professional may prescribe bacteria-fighting medications called antibiotics to treat UTIs.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	How to prevent Urinary Incontinence in Men ?	People who smoke should stop. Quitting smoking at any age promotes bladder health and overall health. Smoking increases a persons chance of developing stress incontinence, as it increases coughing. Some people say smoking worsens their bladder irritation. Smoking causes most cases of bladder cancer. People who smoke for many years have a higher risk of bladder cancer than nonsmokers or those who smoke for a short time.2 People who smoke should ask for help so they do not have to try quitting alone. Call 1-800-QUITNOW (1-800-784-8669) for more information.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Urinary Incontinence in Men ?	- Urinary incontinence (UI) is the loss of bladder control, resulting in the accidental leakage of urine from the body. - The urinary tract is the bodys drainage system for removing urine, which is composed of wastes and extra fluid. - Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. - To urinate, the brain signals the muscular bladder wall to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra. - UI results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. - Urgency incontinence happens when a man urinates involuntarily after he has a strong desire, or urgency, to urinate. - Stress incontinence results from movements that put pressure on the bladder and cause urine leakage, such as coughing, sneezing, laughing, or physical activity. - Functional incontinence occurs when physical disability, external obstacles, or problems in thinking or communicating keep a person from reaching a place to urinate in time. - When the bladder doesnt empty properly, urine spills over, causing overflow incontinence. Weak bladder muscles or a blocked urethra can cause this type of incontinence. - Transient incontinence is UI that lasts a short time. Transient incontinence is usually a side effect of certain medications, drugs, or temporary conditions. - UI occurs in 11 to 34 percent of older men. - Men should tell a health care professional, such as a family practice physician, a nurse, an internist, or a urologist, they have UI, even if they feel embarrassed. - Treatment depends on the type of UI. Some types of treatment include behavioral and lifestyle changes, bladder training, pelvic floor exercises, and urgency suppression. - People who smoke should stop. Quitting smoking at any age promotes bladder health and overall health.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Prevent diabetes problems: Keep your nervous system healthy ?	Your nervous system carries signals between your brain and other parts of your body through your spinal cord. Nerves are bundles of special tissues that transmit these signals. The signals share information between your brain and body about how things feel. The signals also send information between your brain and body to control automatic body functions, such as breathing and digestion, and to move your body parts. The nerves in your spinal cord branch out to all of your organs and body parts. All your nerves together make up your nervous system. Your nervous system is composed of the - central nervous systemyour brain and spinal cord - cranial* nervesnerves that connect your brain to your head, neck, and face - peripheral nervous systemnerves that connect your spinal cord to your entire body, including your organs and your arms, hands, legs, and feet *See the Pronunciation Guide for tips on how to say the the words in bold type.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the symptoms of Prevent diabetes problems: Keep your nervous system healthy ?	Nerve damage symptoms depend on which nerves have damage. Some people have no symptoms or mild symptoms. Other people have painful and long-lasting symptoms. As most nerve damage develops over many years, a person may not notice mild cases for a long time. In some people, the onset of pain may be sudden and severe.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What is (are) Prevent diabetes problems: Keep your nervous system healthy ?	Peripheral Neuropathy Peripheral neuropathy is the most common type of diabetic neuropathy, and it affects the sensory nerves of your feet, legs, hands, and arms. These areas of your body may feel - numb - weak - cold - burning or tingling, like pins and needles You may feel extreme pain in these areas of your body, even when they are touched lightly. You also may feel pain in your legs and feet when walking. These feelings are often worse at night and can make it hard to sleep. Most of the time, you will have these feelings on both sides of your body, such as in both feet; however, they can occur just on one side. You might have other problems, such as - swollen feet - loss of balance - loss of muscle tone in your hands and feet - a deformity or shape change in your toes and feet - calluses or open sores on your feet Autonomic Neuropathy Autonomic neuropathy can affect your - digestive system - sex organs - bladder - sweat glands - eyes - heart rate and blood pressure - ability to sense low blood glucose Digestive system. Damage to nerves in your stomach, intestines, and other parts of your digestive system may - make it hard to swallow both solid food and liquids - cause stomach pain, nausea, vomiting, constipation, or diarrhea - make it hard to keep your blood glucose under control Your doctor or dietitian may advise you to eat smaller, more frequent meals; avoid fatty foods; and eat less fiber. Sex organs. Damage to nerves in the sex organs may - prevent a mans penis from getting firm when he wants to have sex, called erectile dysfunction or impotence. Many men who have had diabetes for several years have impotence. - prevent a womans vagina from getting wet when she wants to have sex. A woman might also have less feeling around her vagina. Bladder. Damage to nerves in your bladder may make it hard to know when you need to urinate and when your bladder is empty. This damage can cause you to hold urine for too long, which can lead to bladder infections. You also might leak drops of urine. Sweat glands. Damage to nerves in your sweat glands may prevent them from working properly. Nerve damage can cause you to sweat a lot at night or while eating. Eyes. Damage to nerves in your pupils, the parts of your eyes that react to changes in light and darkness, may make them slow to respond to these changes. You may have trouble seeing the lights of other cars when driving at night. Your eyes may take longer to adjust when you enter a dark room. Heart rate and blood pressure. Damage to nerves that control your heart rate and blood pressure may make these nerves respond more slowly to changes in position, stress, physical activity, sleep, and breathing patterns. You might feel dizzy or pass out when you go from lying down to standing up or when you do physical activity. You also might have shortness of breath or swelling in your feet. Ability to sense low blood glucose. Autonomic nerves also let you know when your blood glucose is low. Damage to these nerves can prevent you from feeling the symptoms of low blood glucose, also called hypoglycemia. This kind of nerve damage is more likely to happen if you have had diabetes for a long time or if your blood glucose has often been too low. Low blood glucose can make you - hungry - dizzy or shaky - confused - pale - sweat more - weak - anxious or cranky - have headaches - have a fast heartbeat Severe hypoglycemia can cause you to pass out. If that happens, youll need help bringing your blood glucose level back to normal. Your health care team can teach your family members and friends how to give you an injection of glucagon, a hormone that raises blood glucose levels quickly. If glucagon is not available, someone should call 911 to get you to the nearest emergency room for treatment. Consider wearing a diabetes medical alert identification bracelet or necklace. If you have hypoglycemia and are not able to communicate, the emergency team will know you have diabetes and get you the proper treatment. You can find these bracelets or necklaces at your pharmacy or on the Internet. You can also ask your doctor for information on available products. Other Neuropathies Other types of neuropathies from diabetes can cause - damage to the joint and bones of your foot, called Charcots foot, in which you cannot sense pain or the position of your foot - carpal tunnel syndrome, in which a nerve in your forearm is compressed at your wrist, causing numbness, swelling, and pain in your fingers - paralysis on one side of your face, called Bells palsy - double vision or not being able to focus your eyes - aching behind one eye
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What are the treatments for Prevent diabetes problems: Keep your nervous system healthy ?	The treatment for nerve damage from diabetes is based on your symptoms. No treatment can reverse nerve damage; however, it can help you feel better. Your doctor might suggest taking low doses of medicines that both treat other health problems and help the pain of neuropathy. Some of these medicines include - antidepressants - anticonvulsants, or anti-seizure medicines Other treatment options include - creams or patches on your skin for burning pain - over-the-counter pain medicines - acupuncture, a form of pain treatment that uses needles inserted into your body at certain pressure points - physical therapy, which helps with muscle weakness and loss of balance - relaxation exercises, such as yoga - special shoes to fit softly around sore feet or feet that have changed shape Your doctor also can prescribe medicines to help with problems caused by nerve damage in other areas of your body, such as poor digestion, dizziness, sexual problems, and lack of bladder control. Stopping smoking and drinking alcoholic beverages also may help with symptoms.
The page you are looking for cannot be found. If you typed in the URL directly, please verify that you've entered it correctly. Try using the search box below, returning to the home page, or viewing the site map. If the problem continues, please contact us.	What to do for Prevent diabetes problems: Keep your nervous system healthy ?	You can keep your nervous system healthy by taking these steps: - Eat healthy meals and follow the meal plan that you and your doctor or dietitian have worked out. - If you drink alcoholic beverages, limit your intake to no more than one drink per day for women and two drinks per day for men. Drinking too many alcoholic beverages can make nerve damage worse. More information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes.
Cirrhosis is a condition in which your liver is scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents your liver from working normally. As cirrhosis gets worse, your liver begins to fail. Cirrhosis has many signs and symptoms, such as fatigue and severe itchy skin. They may not appear until the liver is badly damaged. Causes include alcoholic liver disease, nonalcoholic fatty liver disease, chronic hepatitis C, and chronic hepatitis B. Doctors diagnose cirrhosis based on your medical history, a physical exam, and the results of tests. Tests include blood tests such as liver function tests and tests for viral infections, imaging tests, and liver biopsy. Doctors do not have specific treatments that can cure cirrhosis. However, they can treat many of the diseases that cause cirrhosis. Treating the underlying causes of cirrhosis may keep your cirrhosis from getting worse and may help prevent liver failure. If you have cirrhosis, you should eat a healthy, well-balanced diet. Talk with your doctor, a dietitian, or nutritionist about healthy eating. Avoid foods and drinks that can damage your liver, such as shellfish and alcohol. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. See more about liver diseases research at NIDDK. The digestive system is made up of the gastrointestinal (GI) tract-also called the digestive tract-and the liver, pancreas, and the gallbladder. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank Jasmohan S. Bajaj, M.D., Virginia Commonwealth University School of Medicine The NIDDK would like to thank Jasmohan S. Bajaj, M.D., Virginia Commonwealth University School of Medicine	What is (are) Cirrhosis ?	Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally due to chronic, or long lasting, injury. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. The liver is the bodys largest internal organ. The liver is called the bodys metabolic factory because of the important role it plays in metabolismthe way cells change food into energy after food is digested and absorbed into the blood. The liver has many functions, including - taking up, storing, and processing nutrients from foodincluding fat, sugar, and proteinand delivering them to the rest of the body when needed - making new proteins, such as clotting factors and immune factors - producing bile, which helps the body absorb fats, cholesterol, and fat-soluble vitamins - removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete, and the liver creates scar tissue. Scarring of the liver, also called fibrosis, may lead to cirrhosis. The buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail. Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively replace damaged cells. Cirrhosis is the 12th leading cause of death in the United States, accounting for nearly 32,000 deaths each year. More men die of cirrhosis than women.1

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