Dialysis

When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.

There are two main types of dialysis. Both types filter your blood to rid your body of harmful wastes, extra salt, and water.:

• Hemodialysis uses a machine. It is sometimes called an artificial kidney. You usually go to a special clinic for treatments several times a week.
• Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diarrhea

What is diarrhea?

Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own.

Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go.

The most common causes of diarrhea include:

• Bacteria from contaminated food or water
• Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children.
• Parasites, which are tiny organisms found in contaminated food or water
• Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium
• Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance.
• Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease
• Problems with how the colon functions, such as irritable bowel syndrome

Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly.

Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary.

People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year.

People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water.

Other possible symptoms of diarrhea include:

• Cramps or pain in the abdomen
• An urgent need to use the bathroom
• Loss of bowel control

If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools.

Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems.

Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have:

• Signs of dehydration
• Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours.
• Severe pain in your abdomen or rectum (for adults)
• A fever of 102 degrees or higher
• Stools containing blood or pus
• Stools that are black and tarry

If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants.

To find the cause of diarrhea, your health care provider may:

• Do a physical exam
• Ask about any medicines you are taking
• Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection
• Ask you to stop eating certain foods to see whether your diarrhea goes away

If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease.

Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection.

Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food.

Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.

Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses.

You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries:

• Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth
• If you do use tap water, boil it or use iodine tablets
• Make sure that the cooked food you eat is fully cooked and served hot
• Avoid unwashed or unpeeled raw fruits and vegetables

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Digestive Diseases

When you eat, your body breaks food down to a form it can use to build and nourish cells and provide energy. This process is called digestion.

Your digestive system is a series of hollow organs joined in a long, twisting tube. It runs from your mouth to your anus and includes your esophagus, stomach, and small and large intestines. Your liver, gallbladder and pancreas are also involved. They produce juices to help digestion.

There are many types of digestive disorders. The symptoms vary widely depending on the problem. In general, you should see your doctor if you have:

• Blood in your stool
• Changes in bowel habits
• Severe abdominal pain
• Unintentional weight loss
• Heartburn not relieved by antacids

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Disabilities

What are disabilities?

A disability is any condition of your body or mind that makes it more difficult for you to do one or more major life activities and interact with the world around you.

There are many types of disabilities, such as those that can affect your:

• Vision
• Hearing
• Movement
• Thinking
• Remembering
• Learning
• Communicating
• Development
• Mental health
• Social relationships

More than 1 in 4 adults in the United States have some type of disability. Even though they all have disabilities, they can have a wide range of needs. For example, even people who have same type of disability can be affected in very different ways. Also, some disabilities are "visible" (easy to see), for example when someone is in a wheelchair. But other disabilities are "invisible" (hidden or not easy to see), such as problems with hearing, thinking, or learning.

Disabilities can have different causes. Some disabilities are present at birth, while others may happen later in life.

Causes of disabilities that are present at birth can include:

• Disorders in single genes, such as Duchenne muscular dystrophy
• Disorders of chromosomes, such as Down syndrome
• Exposures (before birth) to infections or substances, such as drugs, alcohol, or cigarettes

Causes of disabilities that happen later in life can include:

• Injuries, such as spinal cord injuries, traumatic brain injuries (TBIs), and back injuries
• Chronic (long-lasting) diseases, such as diabetes, heart disease, kidney disease, COPD, and arthritis
• Cancer
• Mental health problems
• Stroke
• Alzheimer's disease and other causes of dementia

Having a disability does not mean a person cannot be healthy. In fact, many people with disabilities report that their health as good or better. But they may have or be at risk of health problems related to their disability, called "secondary conditions." These conditions may include:

• Bowel or bladder problems
• Chronic pain
• Diabetes
• Fatigue
• Heart disease
• Injuries
• Mental health problems, including depression and substance use disorders
• Overweight and obesity
• Pressure sores or ulcers

Many of these conditions can be prevented, and there are treatments for them. It's also important for people with disabilities to get health care that meets their needs as a whole person, not just as a person with a disability.

Just like for people who don't have a disability, having a healthy lifestyle is important for people who do have a disability. A healthy lifestyle includes:

• Getting regular physical activity
• Eating healthy foods in healthy portions
• Limiting sun exposure and using sunscreen to prevent skin cancer
• Not smoking, and if needed, getting help to quit smoking
• Using medicines wisely
• Not drinking alcohol or drinking in moderation
• Getting help for any substance use or mental health problems
• Staying in touch with family and friends

Managing a disability can sometimes be challenging. There are resources that can help:

• Assistive devices and mobility aids can make daily tasks easier.
• Schools can develop plans around the specific needs of a child with a disability. The goal of the plans is to give the child an opportunity to perform at the same level as other children their age.
• Support networks, such as disability organizations, can help you learn more about resources for you and your family. Support groups can help you connect with other people who have the same disability. They can provide emotional and social support. They are also a place where people can share tips about how to deal with day-to-day challenges.
• Government programs may provide benefits, job training, employment resources, and protection against discrimination.

Centers for Disease Control and Prevention

Diverticulosis and Diverticulitis

What is diverticulosis?

Diverticula are small pouches, or sacs, that bulge outward through weak spots in your colon. They mostly form in the lower part of the colon. Diverticulosis is a condition in which you have these pouches. Most people who have diverticulosis do not have symptoms or problems. But sometimes the pouches can cause symptoms or become inflamed.

Diverticulitis is the name for the condition you have when one or more of the pouches get inflamed. Diverticulitis may come on suddenly. It can sometimes cause serious health problems.

Diverticular disease is a condition that happens when the pouches cause:

• Chronic (long-term) symptoms
• Diverticular bleeding
• Diverticulitis or diverticulitis complications

Researchers aren't sure what causes diverticulosis and diverticulitis. They think certain factors may play a role in causing or increasing the risk for these conditions, including:

• Your genetics. Certain genes may make some people more likely to develop the conditions.
• Lifestyle factors such as:
  • Diets low in fiber and high in red meat
  • Lack of physical activity
  • Taking certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
  • Having obesity
  • Smoking

Researchers are also looking at other possible factors that may play a role in these conditions. Those factors include bacteria or stool (poop) getting caught in a pouch in your colon and changes in the microbiome in the intestines. Your microbiome is made up of the bacteria and other organisms in your intestines.

Diverticulosis is common, especially as people age. More than one-third of U.S. adults between the ages of 50 and 59 have diverticulosis. More than two-thirds who are over age 80 have it. Most of those people will not have symptoms or problems. But some of them will develop diverticulitis.

Diverticulosis usually doesn't cause symptoms. But some people can have chronic symptoms such as:

• Bloating
• Constipation or diarrhea
• Cramping or painin the lower abdomen (belly)

Diverticulitis may cause acute symptoms such as:

• Abdominal pain, most often in the lower left side of your abdomen
• Constipation or diarrhea
• Fevers and chills
• Nausea or vomiting

The pain caused by diverticulitis is usually severe and comes on suddenly. Less often, the pain may be mild and worsen over several days.

Some people with diverticulosis and diverticulitis may develop serious health problems (complications). Diverticular bleeding happens when a small blood vessel within the wall of a pouch bursts. The bleeding may be severe and sometimes even life-threatening.

People with diverticulitis can also develop serious problems such as:

• Abscess, a painful, swollen, pus-filled area caused by infection
• Fistula, an abnormal opening or passage between the colon and another part of the body, such as the bladder or vagina
• Intestinal obstruction, a partial or total blockage that keeps food, fluids, air, or stool from moving through your intestines
• Perforation, or a hole, in your colon
• Peritonitis, an infection of the lining of the abdominal cavity

Diverticulosis may be found when your health care provider is doing tests for another reason. Diverticulitis is usually found when you are having an acute attack.

To make a diagnosis, your provider will review your medical history, do a physical exam, and order tests. The tests may include:

• Blood tests
• Stool tests
• Imaging tests such as CT scan, ultrasound, or MRI
• Colonoscopy

If your diverticulosis is causing chronic symptoms, your provider may recommend:

• High-fiber foods or fiber supplements
• Antibiotics
• Medicines to reduce inflammation
• Probiotics

If you have diverticulitis without complications, your provider may recommend treatment at home. However, you probably need treatment in the hospital if you have severe diverticulitis, diverticulitis with complications, or a high risk for complications.

Treatments for diverticulitis may include:

• Antibiotics, except for very mild cases.
• A clear liquid diet for a short time to rest the colon. Your provider may suggest slowly adding solid foods to your diet as your symptoms improve.
• Medicines for pain. This is usually acetaminophen instead of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may increase the chance of diverticulitis complications.
• Antispasmodic medicines to relieve spasms.

If your diverticulitis doesn't improve with treatment or if it causes complications, you may need surgery to remove part of your colon.

Your provider may recommend lifestyle changes to prevent diverticulitis:

• Eating a diet high in fiber and low in red meat
• Being physically active on a regular basis
• Not smoking (and quitting smoking if you are a smoker)
• Reaching and maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases