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### Human:\nmy new omeprazole prescription (40 mg twice daily) is working but must i always take it on an empty stomach?\n\n### Assistant: omeprazole 40 mg twice daily is a high dose and is not recommended over a long period of time. it is a safe and effective medication used within the recommended prescribing guidelines. the medication is intended to decrease the release of stomach acid. therefore it is the most effective if taken 30 minutes prior to having a meal. this medication has 24-hour coverage. therefore it should not be taken prior to every meal. it is intended to be taken on an empty stomach. if you take it with food the stomach will release acid to digest the food. the acid can decrease the absorption of the medication and decrease the effectiveness. therefore i would not recommend taking the medication with food or a meal. it is important to take the dose 30 minutes prior to a meal or first thing in the morning.

### Human:\nwill a tooth extraction get rid of bad breath?\n\n### Assistant: most bad breath is caused by an infected tooth inflamed gums or a stomach problem. so the answer is maybe. if the tooth is being extracted for an infection the bad breath may go away. if not you may need to look further.

### Human:\ncan lactose intolerance cause weight gain? if all my food rushes through could my body be overdoing calorie retention? . if all the food i eat constantly rushes through could my body be overcompensating and desperately trying to get calories out of food because it usually 'rushes' out? . i've timed my body before and high-lactose items last 15 minutes (until desperate release). this sounds like the gi may have to be in high gear just to try to absorb food. if it's in this gear when i don't have lactose i feel it may be a reason for weigh gain or retention.\n\n### Assistant: although its an interesting theory it's not supported by science. lactose intolerance does not cause weight gain. excess weight occurs when you eat more calories than your body burns. in fact people with more serious gastrointestinal problems like ulcerative colitis or crohns have food rush through them and they tend to be underweight and sometimes malnourished. the body does not seem to overcompensate.

### Human:\nwhat are the types of echocardiograms?\n\n### Assistant: there are several types of echocardiograms and your doctor will help determine which is best for you. transthoracic echocardiogram: this is the standard echocardiogram. it is a painless test similar to x-ray but without the radiation. the procedure uses the same technology used to evaluate a baby's health before birth. a hand-held device called a transducer is placed on the chest and transmits high frequency sound waves (ultrasound). these sound waves bounce off the heart structures producing images and sounds that can be used by the doctor to detect heart damage and disease. transesophageal echocardiogram (tee): this test requires that the transducer be inserted down the throat into the esophagus (the swallowing tube that connects the mouth to the stomach). because the esophagus is located close to the heart clear images of the heart structures can be obtained without the interference of the lungs and chest. stress echocardiogram: this is an echocardiogram that is performed while the person exercises on a treadmill or stationary bicycle. this test can be used to visualize the motion of the heart's walls and pumping action when the heart is stressed. it may reveal a lack of blood flow that isn't always apparent on other heart tests. the echocardiogram is performed just prior and just after the exercise. dobutamine stress echocardiogram: this is another form of stress echocardiogram. however instead of exercising to stress the heart the stress is obtained by giving a drug that stimulates the heart and makes it "think" it is exercising. the test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary bike. it is also used to determine how well your heart tolerates activity and your likelihood of having coronary artery disease (blocked arteries) as well as evaluating the effectiveness of your cardiac treatment plan. intravascular ultrasound: this is a form of echocardiography performed during cardiac catheterization. during this procedure the transducer is threaded into the heart blood vessels via a catheter in the groin. it is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels.

### Human:\nwhat are the risk factors for pelvic organ prolapse?\n\n### Assistant: the most consistently cited risk factors are: increasing age being overweight and increased number of vaginal deliveries. number of deliveries by c-section does not increase prolapse risk. other associated factors can include irritable bowel syndrome constipation and overall poor health. african-american women are less likely to have symptomatic pelvic prolapse. one small study even found that having a history of stretch marks doubled one's risk for prolapse. "stretch marks " you might be thinking "why would that be? " the bones of the female pelvis do a great job protecting lower abdominal contents but they do not provide support. the pelvic organs are supported by the muscles in the pelvic floor and the ligaments which can attach from the organs to the bones. it has been theorized that pelvic muscle and ligament strength may be linked to strength of collagen. collagen along with fibrillin is decreased in women with stretch marks.

### Human:\nwhat can be absorbed by the stomach? . what percentages of various normally consumed foods and liquids can be absorbed into the body through the stomach. while i understand that the intestines absorb most of the nutrients we consume i was lead to believe that a potion of some foods and beverages were absorbed into the body through the stomach.\n\n### Assistant: the stomach does not absorb nutrients but it does play a role enhancing absorption of certain nutrients in the small intestine. for example the stomach secretes intrinsic factor which binds to b12 for absorption in the small intestine. stomach acid turns iron into a form that is better absorbed in the small intestine. and people who have part of their stomach removed may be at risk for osteoporosis because the stomach empties faster which can decrease the amount of calcium being absorbed and utilized by the body. anyone who has surgery to remove part of the stomach should see a dietitian to be sure they are not at risk for nutrition deficiencies.

### Human:\nwhat is an iron infusion? . an iron infusion is simply a liquid dose of iron given in the veins.\n\n### Assistant: an iron infusion is simply a liquid dose of iron given in the veins. iron is an essential mineral that we get from eating foods such as meat eggs and leafy greens. iron is needed to make hemoglobin the oxygen-carrying substance in red blood cells. many people especially women having regular menstrual periods have low iron levels (iron deficiency). if iron remains low for weeks or months the body makes fewer red blood cells and a low blood count (iron-deficiency anemia) can result. for the overwhelming majority of people with iron deficiency taking iron pills every day replaces the missing iron and low blood counts return to normal. in a few people iron pills aren’t sufficient to keep up with iron losses. this can occur when there is ongoing bleeding or the intestines can’t absorb the swallowed iron. in other people oral iron may cause a bad reaction. people in these special situations may need to receive an iron infusion to replace the missing iron. an iron infusion is most often given at a doctor’s office or hospital. a nurse places an iv and a bag of fluid containing dissolved iron drains into the person’s veins. some conditions or situations that may require an iron infusion include: • people with inflammatory bowel disease with severe iron deficiency • people with end-stage renal disease on dialysis • people with cancer and anemia • people taking erythropoietin or similar drugs to stimulate red blood cell production iron infusions are generally safe but severe reactions to the drug preparation do occasionally occur. these can cause shortness of breath itching spasms or (rarely) a life-threatening allergic reaction called anaphylaxis. how many times do you have to iron infusion to not feel tired?

### Human:\nis probiotics in all yogurts? . i'm just wondering since yogurts have "live active cultures". and there's a new market for "probiotic" items. do all yogurts have these "probiotics" in them?\n\n### Assistant: probiotics are live microorganisms that preliminary research suggests might have a useful effect on your health. your body’s digestive system already contains hundreds of different types of bacteria beneficial and necessary for the digestion process. probiotics are specific bacteria that are thought to help regulate the digestive system by managing certain gastrointestinal conditions like diarrhea constipation or inflammatory bowel disease. not all yogurts contain probiotics however. to ensure that the specific brand of yogurt that you’re looking to purchase contains probiotics make sure that the label says that it contains “live active cultures”. you can also read the ingredient list to determine which bacteria specifically since different types of bacteria are thought to promote different health benefits. for example the probiotic bacterium specifically promoted by dannon activia yogurt is bifidus regularis which among other claims is suggested to help alleviate constipation to keep you regular. it’s important to keep in mind that in order to continually see any of these suggested health benefits that you would need to regularly consume these products. yogurt with or without probiotics can provide many great health benefits. check out this webmd article for more information: <link>.

### Human:\ncan i mix vicodin with fioricet?\n\n### Assistant: let's look at the ingredients of each of these medications separately. vicodin contains hydrocodone and acetaminophen. fioricet contains acetaminophen butalbital and caffeine. i would be cautious in using both products in order to prevent overdosing of acetaminophen. this medication while safe as an over-the-counter medication can cause damage to the liver at extreme doses. if you need to take both medications consult your local pharmacist to discuss the correct dose for you.

### Human:\nwhat's the difference between the fat-burning mode and the cardio mode on the machines at the gym?\n\n### Assistant: there are problems with the fat burning option on the cardio machines and it really ought to be eliminated. the idea behind the fat-burning option is this: because fat is denser than carbohydrate it requires more oxygen to burn. so to maximize the percentage of fat you burn compared to carbohydrate the fat-burning mode would have you work out at a pace at which your body can deliver lots of oxygen to your muscles. that generally means a slow pace to keep you from getting breathless. the problem is that when you exercise at a slower speed you burn fewer total calories -- from both carbohydrate and fat -- because you simply don't do as much work. further the way to get aerobically fit is to get your heart rate into the training range (usually 60% to 85% of your maximum heart rate) which is hard to do at slower speeds. and fitness is ultimately what you're after whether your goals are better health burning calories or improving heart and lung capacity. the bottom line is that the fat-burning mode probably won't be intense enough to maximize total calorie- or fat-burning or to help you increase or maintain optimum fitness levels. use the cardio mode to maximize your exercise benefits. using the fat burning mode on exercise machines at the gym actually isn’t the best way to burn fat. the key concepts to understand here are the percentage of calories that come from fat and total calories. the fat burning mode is typically set at lower exercise intensity where more calories burned come from fat. not as many calories burned during higher exercise intensity will come from fat. the point to understand though is that while more of the calories that you burn will come from fat at a lower exercise intensity you have the potential to burn more calories per session doing higher exercise intensity. the percentage of calories burned from fat will be lower during the higher exercise intensity but you will be burning more calories overall including the amount of calories from fat. also higher exercise intensity leads to a greater boost in metabolism even after you’re done exercising which burns additional calories. it’s best to do exercise that you’re comfortable with and that meets your level of training/conditioning. in general however increasing the time spent on exercise and increasing exercise intensity will provide a greater potential to burn more calories and lose weight.

### Human:\nhow long can i take a multi vitamin and it remain effective?\n\n### Assistant: while it's impossible to say exactly how long a multivitamin is effective understanding how different vitamins are absorbed and stored in the body can give you some idea. generally water soluble vitamins (b vitamins and vitamin c) aren't stored in the body. instead they are absorbed based on need with the remaining excesses being excreted in the urine. this is why it's important to get these vitamins on a regular basis. on the other hand fat soluble vitamins (a d e and k) need fat present to be absorbed and are stored in the body for later use (fat tissue and liver). so basically some of the vitamins are excreted daily while others are stored. for more on the difference between fat and water soluble vitamins see this webmd article <link>

### Human:\nis thrush contagious?\n\n### Assistant: no thrush is not contagious in the way a cold or the flu is. thrush is caused by a fungus (more specifically a yeast) called candida. candida is a commensal organism meaning that under healthy conditions it lives harmlessly in our bodies. we all have candida living on our skin and in our intestines and healthy women carry candida in their vaginas. when the body’s defenses are in balance candida is not noticeable or bothersome. however certain conditions can give candida the opportunity to grow excessively: a low-functioning immune system. use of topical or oral corticosteroids such as prednisone (often for asthma or autoimmune conditions). damage to the mucous membranes (the skin lining the mouth vagina and gi tract). antibiotic use. in these situations candida can grow on the skin or in the lining of the mouth gi tract or vagina. the fungus creates a white patch or plaque across the mucous membranes. in the mouth visible candida infection is called thrush. in the vagina it’s a yeast infection. in people with weakened immune systems candida can grow almost anywhere in the body. because candida is normally present in all our bodies someone with thrush can’t exactly pass it to someone else -- that person already has candida. to develop thrush a yeast infection or another candida infection that person may have one or more of the above risk factors or conditions.

### Human:\ncan sweetners react to stomach ulcers\n\n### Assistant: i am not aware of sweeteners (sugars or artificial sweeteners) causing problems for stomach ulcers. that being said too much alcohol can make them worse. the key is finding out the cause of the stomach ulcer and getting the proper treatment. here is more about how diet can help.

### Human:\nwhat are the possable causes of your body not being able to absorb iron after having your stomach and spleen removed?\n\n### Assistant: the removal of the stomach has the biggest impact on iron absorption. this is because the stomach secrets acid that lowers the ph of iron greatly improving its ability to be absorbed in the small intestine. the spleen plays various roles in the body including acting as a filter for blood recycling old red blood cells.

### Human:\ncan gas cause chest pain?\n\n### Assistant: yes. chest pain has many possible causes; some are harmless but some (like a heart attack) can be life-threatening. part of the problem is that the heart and other internal organs have a type of sensory nerve conduction where it is sometimes difficult to precisely pinpoint the exact origin of a painful sensation. pain due to something wrong in the heart lungs or belly can be vague or feel like something else. this is why chest pain can be such a difficult problem for those who have it as well as for their doctors. gas causes swelling in the intestines and a bloated feeling. when gas causes pain it’s usually in the abdomen (belly). however the pain may also be felt in the chest. if pain is due to gas it should go away within a short time. other causes of chest pain not due to the heart include problems with the esophagus gastroesophageal reflux disease (gerd) musculoskeletal (chest wall) pain problems in the lungs and many others. studies have shown that even doctors have a hard time identifying the cause of chest pain just through conversation or physical examination. laboratory tests a chest x-ray and an electrocardiogram are generally needed to know for sure that chest pain is nothing serious. no one wants to call 911 or sit in an emergency room to be treated for what turns out to be gas pain. however playing a waiting game when you are having chest pain can be a gamble with your health or maybe your life. if you’re having chest pain in almost all cases a doctor’s recommendation will be to seek medical attention. yes thanks i have been having a chest pain and thru my underarm since early this morning i am scared it could be a heart attack then again i have experienced this pain before but does not last as long as it has today. it gets worse when i lay down. could it be gas or should i go to the emergency room yes yes

### Human:\nwhat is bun-creatinine ratio?\n\n### Assistant: bun stands for blood urea nitrogen. creatinine is a natural product of muscle breakdown that occurs at a low level in the body. both bun and creatinine are filtered by the kidney and excreted in urine. for this reason bun and creatinine are used together to measure kidney function. if kidney function begins to decline bun and creatinine rise. a normal creatinine depends on muscle mass and age. in general a normal creatine is 0. 5 to 1. 2 milligrams per deciliter (mg/dl). a normal bun is 7 to 20 mg/dl. remember that different laboratories use different testing equipment and may have slightly different ranges for normal. a small temporary increase in either bun or creatinine can occur during illness or dehydration; the numbers usually return to normal during recovery. in cases of dehydration bun may increase in a higher proportion than the creatinine. a normal bun-to-creatinine ratio is between 10 to 1 and 20 to 1. (for example a bun of 14 and a creatinine of 1. 2 would be a ratio of 12. ) in cases of dehydration the bun-to-creatinine ratio may be higher than 20 to 1 as the kidney responds by making the urine more concentrated. other conditions that cause bun-to-creatinine ratio to rise are kidney disease kidney stones or bleeding in the intestines. low bun-to-creatinine can occur in pregnancy liver disease or a diet low in protein. the bun-to-creatinine ratio is not a precise or reliable test though. it may often be somewhat abnormal in healthy people. more important is the creatinine level itself; if it’s elevated the kidneys are not working properly and the reason should be sought out. i'm very concern about my kidney health since i'm getting older. my father and two of my brothers contracted kidney diisease in their 60's. all are deceased. recent ly i had bloodworkand my bun/creatinine ratio came back high (31) do i need to be concern? my doctor is well aware of my family history for this. thanks 1. 2 to 30 10 answer

### Human:\nwhen i eat spicy food within 15 minutes i get loose-motion. it is a real problem for me. please advice a solution. when i eat spicy food within 15 minutes i get loose-motion. also a growling sound comes from my stomach. it is a real problem for me. please advice a solution.\n\n### Assistant: it sounds like you have a sensitivity to spicy foods that is causing diarrhea (loose motion? ) after eating. although some people's gastrointestinal tract (gi) can't handle spicy foods without any side effects others are more sensitive. spicy foods can irritate the gi tract. if you want to avoid the loose bowels and stomach growling then it makes sense to avoid spicy food. if you really love spicy food you can cut back or manage your body's reaction. here are some tips on how to manage diarrhea. good luck!

### Human:\nin the morning before i leave for work should i eat before exercising & how long do i wait before i start exercising? . i want to excersise in the moring before i leave for work but i am unsure if i should eat before exercising and if i eat should i wait before i start exercising. .\n\n### Assistant: while it's a good thing to eat before exercise eating in the morning will depend upon how much exercise you are getting. if you are going for a 30 minute run first thing you may be able to skip it. but if you are working hard for over an hour you'll need some energy such as a carbohydrate-rich small banana toast or half of an energy bar. try different strategies to see what works best for you. does that fuel first thing give you more energy? or does it bother your stomach? with time and trial and error you'll figure it out. see this webmd article for more on what to eat before during and after exercise congrats on your commitment to exercise!

### Human:\nwhat am i allowed to eat before having a colonoscopy?\n\n### Assistant: nothing! at least not after midnight the night before. and don’t drink anything either. a few bites of food or sips of coffee before your colonoscopy may seem like no big deal. but you won’t be fooling your gastroenterologist. a little food goes a long way toward obscuring the view of your colon. that makes it harder to identify any polyps or potential tumors during a colonoscopy. it might seem almost unbearable to go hungry or face a medical procedure caffeine-free. but think how much more uncomfortable it will be to undergo a repeat colonoscopy because of your “poor prep. ” peanut butter

### Human:\nwhat is the importance of getting enough folic acid during pregnancy?\n\n### Assistant: folic acid or folate is important for overall health. but it is especially important for women during their childbearing years to help prevent neural tube birth defects such as spina bifida. folic acid is found in melons strawberries bananas citrus fruit and drinks beans legumes eggs liver and green leafy vegetables. you can also find it in breads cereals and other types of products that are fortified and enriched.

### Human:\nhow can you tell a child has strep?\n\n### Assistant: when your child has a sore throat it’s important to find out if it’s strep throat or not. ever wonder why? strep (officially called group a streptococcus) is a bacterial infection that needs to be treated with antibiotics. and all the other sore throats caused by the virus of the week just need time and tlc to resolve. why does strep need to be treated? while many people clear the throat infection on their own untreated strep can do some pretty serious damage in other body parts. untreated strep can infect the heart brain and joints. that’s called rheumatic fever. and it’s why we need to know if that sore throat is due to strep bacteria. doctors have always known that strep prefers to infect school-aged kids instead of babies toddlers or preschoolers. but a recent study in the journal pediatrics confirmed this. about 37% of school-aged children who see their docs for a sore throat will have a strep infection. but only 24% of children under five years of age have strep when they have a throat infection. bottom line: little kids usually get viral sore throats big kids are more likely to have strep. so how do docs know when it’s strep throat (besides doing a strep test of course). here are 10 things that make me think of strep: 1. 5 years of age or older? 2. sore throat without runny nose or cough? 3. sore throat with headache and/or stomachache? 4. sore throat and fine pinpoint sandpapery/rough feeling rash (called “scarlet fever”)? 5. sore throat and raised dots on the tongue (called “strawberry tongue”)? 6. sore throat and a persistent fever for more than a couple of days? 7. (for girls) sore throat and a really red vaginal area? 8. sore throat and really red skin around his/her anus? 9. strep going around your child’s school childcare or your house (late fall winter spring)? 10. a history of getting strep throat before? if you think your child has strep don’t panic. even if your child has had the illness for a few days antibiotics will do the trick to clear the infection and prevent rheumatic fever. just make an appointment to see your child’s doctor!

### Human:\ndoes stomach fat decrease insulin effectiveness\n\n### Assistant: fat around the belly is associated with insulin resistance and increased risk of diabetes. this may not happen for every person especially if they engage in healthy habits but this type of fat is considered a risk factor for certain health conditions like diabetes. for more on the subject see the truth about fat.

### Human:\ni want to know what i can eat while i have a stomach ulcer. my doctor has me taking prevacid for a 10 day trial to see if it will go away. she told me to change my diet but did not give me the specifics. all the sites i have looked at have all been contradicting of each other so i just want to know what i can eat so im not starving all day.\n\n### Assistant: it used to be recommended that people with ulcers consume a bland diet but there is no evidence to show this is effective. the key is to adopt a balanced nutrient-rich diet to help the ulcer heal and keep your body healthy. small frequent meals (4-6 times) tend to be better tolerated than fewer (2-3 times) big meals. avoid or limit alcohol as it can make symptoms worse and delay healing of the ulcer. avoid caffeine-containing food and beverages (coffee tea and chocolate) as they can increased stomach acid making symptoms worse. watch for foods that may cause discomfort such as spicy or greasy foods while your ulcer is healing. see this article for more on diet and ulcers.

### Human:\nthe two ferrous gluconate tablets i take daily upset my stomach. is there an alternative to get my iron?\n\n### Assistant: iron alone is harsh on the stomach. ferrous sulfate rather than gluconate is more commonly used and in an enteric coating to help decrease the tendencies of upset stomach. take the medication with food. you also can take it twice daily rather than two tablets at once. in addition the slow-absorption iron may aid in decreasing the upset stomach effects.

### Human:\nis it safe to take buspar and drink alcohol?\n\n### Assistant: caution should be the watchword here. any med taken with alcohol can be a problem because almost all meds have to go through the liver to be broken down and that's exactly where the alcohol goes too. so there's a fight in the liver for passage and because of this the med builds up in your system since it can't be broken down. the result is something like a massive dose of the med and this has consequences. it's never a good idea to drink alcohol when you're taking any type of psychotropic med. some of them can have extremely bad effects but not everyone is aware enough of this. the best advice is to avoid alcohol.

### Human:\nwhat is salmonella and how can i prevent getting it?\n\n### Assistant: salmonella (specifically salmonella enteritidis) is the most common form of bacterial food poisoning. within 12 hours to three days after an exposure people develop nasty diarrhea vomiting fever and stomach cramps. unlike the watery diarrhea one typically sees with a stomach virus salmonella usually causes diarrhea mixed with mucus and/or blood. and this infection lasts up to a week. . the good news is that most people fully recover without needing any special treatment or medication. some unlucky people can get dehydrated and end up being hospitalized. and a few very unlucky people can become seriously ill from this infection. that includes young infants people with weakened immune systems and the elderly. . so how do you avoid getting salmonella and other forms of food poisoning? make sure to thoroughly wash countertops sinks and cutting boards with soap and water when preparing foods with eggs raw meat or poultry. only prepare fully cooked eggs. make sure hamburger/ground beef is cooked completely until it is brown. yes pink makes a juicier burger but it also makes a germ-filled one. use pasteurized eggs in recipes that call for raw eggs (like caesar salad dressing). keep eggs meat and poultry properly refrigerated. keep all baby bottles pacifiers and breast pump supplies away from food preparation areas. keep pet iguanas or turtles out of the kitchen counter area. (you think i am joking… i had a patient get salmonella this way). make sure to wash hands thoroughly after handling. buy only pasteurized apple cider and other juice products. wash hands thoroughly after visiting a petting zoo. take-home tip: if you or a family member develops diarrhea that is bloody or mucousy it’s time to call your doctor.

### Human:\nmy baby is 2 weeks old and i am breastfeeding exclusively. my flow is very low. how can i get my milk flow up again\n\n### Assistant: if your baby is gaining weight (usually by age two weeks they should be the same since they tend to lose a bit right after delivery or a bit higher than their birth weight) you may be making more milk than you realize. if your baby is pooping and peeing gaining weight chances are that you are producing enough. if your baby seems hungry after breast feeding on both sides and is not gaining weight contact a lactation consultant (often at the hospital where you may have delivered) or via your baby's pediatrician.

### Human:\nwhat is albumin?\n\n### Assistant: albumin is an important protein made by the liver and released continuously into the blood. one of albumin’s main functions is to bind with other substances in the blood to help them get where they need to go. for example albumin binds to thyroid hormone and certain drugs and nutrients allowing their stable transport through the blood to their destination. albumin molecules also act like tiny sponges inside blood vessels keeping fluid inside rather than allowing it to leak out. for this reason albumin may sometimes be given as an intravenous medicine to raise blood pressure in hospitalized people. albumin is often checked routinely by doctors in a liver function test panel. severe liver disease can cause low albumin levels as the liver loses its ability to make enough albumin. severe malnutrition also causes low albumin. however many illnesses can cause a temporary drop in albumin levels and most people with a slightly low albumin on a blood test do not have liver disease or any nutritional problem.

### Human:\nhow long does it take for your stomach to shrink when dieting\n\n### Assistant: there is no research to show that the stomach shrinks when dieting or following a low calorie diet. the only way to decrease the size of the stomach is through surgery which is certainly not for everyone. but by changing what and how you eat you can change your appetite. for example eating regular balanced meals at the table not letting yourself get over hungry fitting in regular exercise and getting adequate sleep can go a long way towards curbing your appetite. hunger is not a bad thing but something we all need to learn how to manage. good luck!

### Human:\nis there a coated naproxen medication to prevent stomach problems?\n\n### Assistant: all over-the-counter and prescription-strength naproxen have a shiny coating on the pill which means it has a slight enteric coating to prevent stomachache. in addition this medication should be taken with food to help buffer the effects on the stomach.

### Human:\nwhat is fluoroscopy?\n\n### Assistant: fluoroscopy is a continuous x-ray (think of it as an x-ray video). doctors use fluoroscopy to see inside the body in real-time during medical procedures. fluoroscopy machines vary in shape and size but they are usually quite large. as during a regular x-ray two plates are positioned in front and back of the person. the one in front is moveable and is positioned in front of the appropriate body area. during the procedure the doctor periodically activates the fluoroscopy machine and live x-ray images are displayed on a video screen. fluoroscopy delivers radiation to the body. the radiation risk from fluoroscopy is low. although fluoroscopy theoretically can increase the risk for cancer later in life the risk of not doing the appropriate procedure must be considered as well. the national cancer institute states that the benefits of properly performed fluoroscopy almost always outweigh the radiation risk to an individual.

### Human:\nare folate and l-methylfolate (lmf) helpful for treating depression?\n\n### Assistant: this is a vitamin-type product that seems to be turning the corner from a good idea to a reasonable almost proven treatment for depression. 1) folate is an essential nutrient in our diet. it can be found in spinach lentils liver asparagus beans and collard greens. some research studies have shown that folate tablets can help treat depression but these are small and poorly regulated studies. 2) your liver takes the folate you eat in your diet and converts it to a special form of brain folate called l-methylfolate (lmf). however your liver has the ability to only convert a little bit of regular folate into brain lmf at a time. therefore you can eat all the spinach in the world but still only get little bits of lmf into your brain at a time. 3) once in the brain lmf has the theoretical ability to provide nerves with the ability to make more neurotransmitters such as serotonin. this boost in serotonin allows antidepressants that work by manipulating serotonin to have a greater chance to work their antidepressant mechanisms. lmf tablets are available by prescription now as they are considered a medical food similar to prenatal vitamin classifications. 4) more stringent research studies that compare lmf to placebo sugar pills are being published and scrutinized and it appears that adding lmf products to antidepressants may improve depression symptoms. these studies are preliminary in nature but are clearly better regulated and supportive in that lmf may be safe and help in the treatment of depression. larger 400 patient studies are needed to prove definitive antidepressant effects but these current medium sized studies are promising.

### Human:\ndiagnosed with celiac disease but not given any care. what is my next step? . i was given a blood test and told by my family doctor that i had celiac disease and to stop eating gluten 2 years ago. i was never referred to a doctor who deals with my disease or given any other tests or scopes. being as its 2 years after the diagnosis should i try to consult a doctor for better care?\n\n### Assistant: you may have to undergo an endoscopy to biopsy your small intestine to confirm that you have celiac disease. typically a blood test may be done first since it can be an indicator and is less invasive but a biopsy is better at confirming a diagnosis. you may also want to attempt an elimination diet to determine any food allergies sensitivities or intolerances that you may have. this type of diet starts out very basic and restrictive but you will gradually start to reintroduce certain foods back into your diet one at a time and monitor your body’s response. if you have an allergy or sensitivity you may notice side effects when you reintroduce different foods. this isn’t meant to replace a proper diagnosis but it can help provide you with an association and causal relationship. another option might be to keep a food journal and write down your dietary intake each day. you may be able to better identify triggers and notice trends between symptoms and foods consumed by doing so. it may then be worthwhile for you to discuss treatment and management options with other health professionals like another doctor or a registered dietitian. i'm sorry you're coping with celiac disease which is an autoimmune condition that renders the body unable to process gluten (a component of wheat) and causes the body to attack its own small intestine when gluten is consumed. your doctor did the right thing in advising you to avoid foods that contain gluten. in fact this is the only treatment for celiac disease. however it sounds like you might have been offered more resources and support than you received. you might want to consult a medical provider who specializes in digestive disorders to have your diagnosis confirmed and receive more specific counseling. because celiac disease isn't just a digestive disorder but also causes damage to your small intestine it's important you understand how to manage this disease. a specialist may be able to offer you that type of thorough support. webmd also offers a great digestive disorders community. you might consider checking in there to find the celiac disease group and start chatting with others who share your condition. wishing you well!

### Human:\nmy granddaughter has to have a gluton free diet what can i feed her? . she has stomach pain alot and she has a cousin (her aunts child) that is allergic to gluten so they want to put her my granddaughter on a gluten free diet to see if this helps her. i need to know what i can and cant feed her and what i can substitute so she still gets nutrients she needs. with out it costing me an arm and a leg im on a rather small income but want to do whats best for her.\n\n### Assistant: gluten is a protein found in wheat and grain products. people on a gluten-free diet often avoid wheat rye and barley; though there is also debate on whether to avoid oats as well. a gluten-free diet allows for fresh fruits vegetables meat/poultry/fish and many dairy products. unprocessed beans and nuts are also acceptable as well as products made with rice corn and soy. if not buying fresh food it’s important to always read food labels to look for foods specifically labeled as gluten-free. for example foods like cereal bread and lunch meat may or may not contain gluten so the only way to know for sure is to check the packaging. the food industry can use gluten in many products that don't seem like they would contain gluten so it's important to always read the label first. having a family history of food allergies could mean that your granddaughter may have a genetic predisposition to having food allergies as well. it may be beneficial for her to try an elimination diet to identify any food allergies sensitivities or intolerances that she may have. the basic premise of this eating plan is to initially restrict eating to very basic foods and then to gradually reincorporate more foods. the person doing this can then better discern which foods trigger a negative response when added back into their diet. review this webmd article for more information on elimination diets and also consult with a doctor or registered dietitian before implementing drastic dietary changes. well she has celiacs disease (non life threatning disease) but she can not have wheat so feed her corn based products like ( some chex mix cerals corn tortillas some soups any thing that says gluten free on the label

### Human:\nam blood sugar 86 - ate water 4 hamburger patties 1/4 c almonds 1/4 c cashews 1/4 cup plain yogurt next am 99 how? . i have candida and have been monitoring my blood sugar to ensure it doesn't go too high and further my problems. i don't understand how i can go from blood sugar of 86 one morning to 99 the next when i had no more than 31 carbs all day. please help me understand where i'm making my mistake. . water = carb free. 4 hamburger patties = (<1 each). 1/4 cup cashews = 8 carbs. 1/4 cup almonds = 8 carbs. 2 tblsp plain yogurt = 11 carbs in a cup\n\n### Assistant: diet is not the only factor that increases blood sugar. if you don't have diabetes your blood sugar will be tightly controlled either by increasing insulin to combat high carb intake or utilizing stored forms from the liver and muscles to be put back into the blood stream. so even though you take in little carbohydrates your body will aim to keep levels within a normal range. when the diet remains low in carbohydrates and the stored sources run low the body then turns fat into glucose but this also produces ketones which can have unpleasant side effects. don't forget your brain needs glucose! according to the institute of medicine individuals need 130g of carbohydrate for the brain to run efficiently. i would check with your healthcare provider or registered dietitian for the appropriate diet for your condition. if you have diabetes it's best to see a diabetes educator to help with any changes in diet as medication is also likely to change.

### Human:\ndoes yogurt help with divertiulosis symptons? is there any otc meds to help improve mild case of diverticulitis?\n\n### Assistant: first it's important to point out the difference between diverticulosis and diverticulitis. diverticulosis is the formation of pouches or pockets in the colon wall. when these pouches get inflamed that is diverticulitis and it needs a doctor's attention. the typical diet recommended during inflammation (diverticulitis) is low fiber and gradually increasing fiber when things improve. but the research is not clear that high fiber diets are beneficial for preventing the disease. regardless of this ambiguity a healthy diet and lifestyle are important. see this article <link>. this has led researchers to look at changing the bacteria that resides in the gut as a way of helping people suffering with diverticulosis. there is some research that probiotics live microorganisms that are beneficial to health can delay the return of symptoms. so including foods with probiotics may be helpful such as kefir yogurt and yogurt drinks. ask your gastrointestinal doctor if he or she recommends a probiotic supplement. for more on probiotics see this article <link> good luck!

### Human:\nhow long can you go without a bowel movement? . doctors define constipation as having a bowel movement less than three times per week. that doesn’t mean constipation is necessarily dangerous just that it’s then labeled abnormal possibly needing treatment.\n\n### Assistant: doctors define constipation as having a bowel movement less than three times per week. that doesn’t mean constipation is necessarily dangerous just that it’s then labeled abnormal possibly needing treatment. for people who are generally healthy constipation is almost never a serious health risk. so it’s difficult to answer the question of “how long can you go ” because if you’re generally healthy you eventually will go with few if any adverse effects. people for whom constipation can have serious health effects include: • the elderly especially those with dementia; • people with damage to the nerves controlling defecation such as hirschsprung disease or spinal cord injuries. a general rule is if you’re healthy and you’re not experiencing abdominal pain a small delay between bowel movements should be of no concern. from a medical standpoint stimulating bowel movements for their own sake (such as with “colon cleansing” or excessive laxative use) can have risks. constipation can result from hard stools and/or slow movement of the colon. for most healthy people with constipation simple treatments work: • increased fiber intake • bulk-forming laxatives (citrucel fiberall metamucil serutan) • stimulant laxatives (alophen dulcolax ex-lax and senokot) • stool softeners (colace correctol soft gels diocto surfak) a few people will need prescription medicines to help get their bowels moving. if constipation isn’t causing symptoms though waiting for nature to take its course is the best option. 4 to 5 days

### Human:\nwhat is duodenitis?\n\n### Assistant: duodenitis is inflammation of the duodenum the first portion of the small intestine. the duodenum is a tube around a foot long. its near end connects to the stomach; the duodenum’s far end blends into the rest of the small intestine. duodenitis can only be diagnosed with a tissue biopsy which is performed using endoscopy (esophagogastroduodenoscopy). the duodenum can become inflamed (irritated swollen and occupied by white blood cells) for various reasons. the most common is infection by h. pylori a bacteria that lives in the stomach and/or duodenum. about half of americans over age 60 have been infected with h. pylori at some point in life. h. pylori stimulates increased acid production by the stomach and causes low-grade inflammation of the duodenum (duodenitis). symptoms can include pain in the middle of the belly or indigestion. in some cases the inflammation of duodenitis worsens to create a small sore (ulcer) in the duodenum’s wall. less commonly inflammatory conditions can cause duodenitis: crohn's disease ulcerative colitis whipple’s disease severe stress caused by surgery or a serious infection (sepsis) cases of duodenitis or duodenal ulcer caused by h. pylori can usually be cured with antibiotics and stomach acid-suppressing drugs.

### Human:\nmy cancer is in remission. how do i deal with the fear of reoccurrence?\n\n### Assistant: one of the most difficult challenges in coping with cancer is dealing with the fears of recurrence. in the jargon of cancer we talk of “remission ” which can be partial (cancer goes partly away) or complete (no evidence of cancer can be found). examples of partial remission include stage iv cancers (metastatic to different regions of the body) that reduce in size as detected by tests such as cat pet or bone scans; complete remission may be obtained at surgery (for early stages of breast colon prostate lung etc. ) which is often followed by some type of chemotherapy or hormonal therapy to prevent a cancer relapse or recurrence. so whether a person is living with an active cancer or has been told they are “cancer- free ” the possibility of the cancer returning or reactivating is very real. it takes work to deal with the fears of recurrence. the first step in doing so is to acknowledge the reality of the situation — not to bury it mentally and ignore it. but it is not helpful to focus on it again and again; it is important to “live for today ” as i have recently blogged about. there are many other helpful coping strategies and helpful individuals experienced in this field. finally i would encourage all cancer patients and their loved ones to attend a support group led by an experienced professional such as an oncology social worker or family therapist. rather than inciting more fear bonding with other survivors can be a great comfort. individual counseling should also be sought out especially for those who have private concerns that they would not like to share with others. most cancer centers have counselors available free of charge; there are also other organizations that have support groups and counseling such as cancercare or gilda’s club. i have had cancer twice in 5 years and i now in remission with my second cancer. how i deal with it is to take one day at a time and hope for the best. try to do exercising everyday and try to eat healthy and hopefully that will help. it's really hard. you will have your good days and bad days. try to keep busy. another thing is to look on the bright side such as your family friends. they're there for you and if that don't help try to seek some help through the cancercare. gov. they have been good for me. there is a lot of information etc that is very helpfull. you might even want to join a group session.

### Human:\ndoes anal sex worsen symptoms of diverticulitis?\n\n### Assistant: not really. diverticuli tend to form in the large intestine not the anal or cecum area. anal sex does have its inherent risks but it should not adversely effect a diverticula located higher in the large intestine.

### Human:\nwhat is electrical cardioversion?\n\n### Assistant: if drugs are not able to control a persistent irregular heart rhythm (such as atrial fibrillation) cardioversion may be required. after administration of a short-acting anesthesia an electrical shock is delivered to your chest wall that synchronizes the heart and allows the normal rhythm to restart.

### Human:\nmy mom has stomach cancer and it is bad what do i do and look for win it is her time to go home\n\n### Assistant: i am very sorry to hear that your mother is so sick. from your question it sounds like she is still in the hospital. before she is sent home ask her if you can talk to the doctor who is taking care of her. you will need her permission for the doctors and nurses to talk to you about her illness. this is to protect her privacy. have a list of questions ready to ask the doctor. depending on your mom’s health you might want answers to some of the following questions. • is there any special diet that she will be on? if so can you talk to a dietitian? • will you need any special equipment at home to help take care of your mom? (like a bedside commode or hospital bed) • will homecare nurses be coming out to help her? • will she be in any pain and if so what can you do to help her? • will she be having any further treatments? • what can you and your mom expect over the next several days or weeks? when should you call the doctor? • is she on any new medication? if so how does she take it and are there any side effects? • would hospice care be appropriate at this time? • are there any support groups for cancer patients and their families in the area? hopefully you will get all the answers that you both need. your mother is very lucky to have someone like you to be her advocate.

### Human:\ncan taking clarithromycin 500 mg make my ulcer pain worse?\n\n### Assistant: just like many antibiotics clarithromycin can cause upset stomach nausea vomiting and diarrhea. however there isn’t any contraindication regarding a history of ulcers when taking this medication. if you are taking any ulcer medications it would be important to check with your pharmacist to make sure there aren’t any drug interactions that would decrease the effectiveness of your ulcer medication which would cause flare-ups. the medication can be taken with or without food. if the upset stomach is present try taking it with food to see if it subsides. if at any point it worsens you should consult your health-care provider to see if another medication is better for you.

### Human:\nwhat foods contain vitamin k?\n\n### Assistant: the following foods are sources of vitamin k: - green leafy vegetables including spinach kale collards romaine and green leaf lettuce - vegetables like brussels sprouts asparagus cabbage broccoli and cauliflower - oils like soybean canola and olive oil - foods of animal origin like fish liver meat and eggs (in smaller amounts)

### Human:\ni'd like to know what the best combination of supplements are for a vegan including enzymes amino acids and vitamins. i've been looking into collagen (to improve bone density skin and hair) spirulina (for protein and immune function) maca powder(hormonal function and fertility) omega3 6 9 and digestive enzymes (to help with bloating and stomach problems). i also take a multi vitamin. i am overwhelmed with the wealth of information and would like advice on the best combination as i don't want to take too many supplements when i don't fully understand how they might effect each other. thanks in advance.\n\n### Assistant: i'm not familiar with the supplements you are taking. you can look here for more info. my guess is there isn't a lot of evidence to support them. i can help you from a nutrition standpoint though. if you are a vegan and eat a balanced diet you still need to watch out for the following nutrients: calcium: this article will help you figure out if you are getting enough. plant foods and fortified milk alternatives can get you there but you need to be diligent. you can always supplement if you fall short. iron: beans and grains contain iron but they aren't absorbed as well as animal foods. this article can help you ensure you get enough. vitamin b12: plant foods do not contain vitamin b12 so you will can include fortified foods or take a supplement. vitamin d: this vitamin is not in plant foods unless its fortified. you will likely need to supplement. i recommend getting your levels checked at annual physical to determine how much you need. omega 3s dha and epa: plant foods do not contain these important fats -- there are vegan supplements you can look into. if you are still confused consider seeing a registered dietitian. he/she can help you figure out what supplements you need and what you can just get from food good luck!

### Human:\nim on cumdine = so i cant eat any dark leafy veggies -what other foods cant i eat? . i need a guide= to what i can eat and cant eat- on cumidine? '. . can i eat peanuts? . can i eat potatoes? . if i eat veggies? how much each day or do i alternate= with a salad. . i eat a handful since i do not know if a cup a day- is just vegetable or includes green salad- a cupful?\n\n### Assistant: the good news is that most people do not have to drastically change their diet when they start on the blood-thinner warfarin (coumadin). but you do have to pay close attention to what you are eating. the goal is to keep the level of vitamin k about the same from day to day. you can do this by knowing which foods have a lot of vitamin k and not making any big changes in how much of them you are eating each day. foods that have a lot of vitamin k include most of the green leafy vegetables like spinach kale lettuce cabbage swiss chard endive and seaweed. greens such as turnip collard and mustard are all high in vitamin k as well. other vegetables that contain a lot of vitamin k are cauliflower broccoli and asparagus. liver is also high in vitamin k. other things to watch out for include green tea canola oil and soybean oil. peanuts and potatoes do not have a large amount of vitamin k. but watch out for cashews and pine nuts. they have a bit more vitamin k so eat them sparingly. so what does all this mean? if you have always had a salad for lunch then it is probably fine to keep eating one every day as long as it is ok with your doctor. if you want broccoli or asparagus with your dinner for a change then it would be best to skip the salad that day. and remember to keep your portions small. liver has a lot of cholesterol so i would recommend skipping that altogether. if your doctor has recommended a multivitamin make sure you take it every day. they usually have vitamin k in them as well so you want to be consistent. talk to your doctor before making any changes in your diet. do not take any over-the-counter medicines or supplements without checking with your doctor first. some of them may interfere with your medicine. also be sure to get all blood tests done on time. don’t be overwhelmed! it may seem like a lot to do at first but it will become second nature before you know it.

### Human:\ni have little yellow-green bits coming up out of the back of my throat. is this food that is lodged in my esophagus?\n\n### Assistant: it sounds like an ent or gastroenterology issue. gastric reflux can be very damaging to the esophagus as well as the teeth. oral rinses may help but it sounds like a medical problem. start with your internist.

### Human:\ncure for gastroparesis. i was diagnosed with gastroparesis 4 years ago. i modified my diet to low fiber and took domperidone and nexium. for about 18 months after the diet change i still had occasional symptoms. however for the last 2 years i have not had symptoms and have reduced my rx intake by half. i have slowly introduced regular food back into my diet and still have not incurred any symptoms. is it possible to recover from this?\n\n### Assistant: i think it depends on the cause of gastroparesis. if it was due to uncontrolled diabetes and you are now have better control it can go into remission. so without knowing the cause i can't say for sure. i would work closely with your healthcare provider and a dietitian that specializes in gastrointestinal diseases. for more info see what is gastroparesis?

### Human:\nwhat is the cause of halitosis and what can be used to cure it?\n\n### Assistant: halitosis or “bad breath” has a number of causes. food odors gum disease tooth decay stomach problems sinus problems and even certain diseases can all cause halitosis. the cures vary. to knock out any possible dental causes i always advise my patients to have a good cleaning and examination followed by a review of your at-home oral hygiene regimen. your dentist can help you figure out the exact cause and treatment. mouthwash can help and some specialized rinses may also offer other benefits. for example antibacterial rinses kill plaque-causing bacteria that can cause gingivitis a mild form of gum disease.

### Human:\ninfant runny bowel movements. my 2 month old son has had very runny bowel movements since birth. we have checked with his doctor changed his formula and still have had no changes. his bm's most often happen before he has even finished a. 5-6 oz. bottle. he also grunts a lot as if constipated. wehave gotten no answers from out dr and are very concerned.\n\n### Assistant: two important things to note here are growth and hydration. if your child is growing steadily as shown on his growth chart and is having plenty of wet diapers than that is a good sign. diarrhea that results in dehydration or slowed growth is problematic. you also might want to try a formula with probiotics (good bacteria for the gut) to see if that helps. if you are still concerned ask to be referred to a pediatric gastroenterologist. they can perform some tests and have the appropriate experience to troubleshoot potential solutions or let you know everything is fine. trust your instincts and get the help you need!

### Human:\nhow can i get enough choline in my diet if i don't eat eggs or liver?\n\n### Assistant: choline is a nutrient important for brain development so it is vital during pregnancy. while eggs are one of the most concentrated sources other food sources of choline include salmon wheat germ and vegetables such as broccoli and spinach.

### Human:\nis there any diet that can help improve or reverse hypothyroidism?\n\n### Assistant: the main treatment for hypothyroid is thyroid hormone pills. excessive intake of certain foods may decrease thyroid function including cruciferous vegetables (broccoli cauliflower kale) asparagus peaches peanuts peas soybeans spinach strawberries and radishes. being consistent with fiber intake instead of consuming a lot at one sitting can help as too much can reduce the absorption of thyroid medication. lastly it is recommended not to take thyroid medication on an empty stomach and not the same time as other supplements especially calcium and iron. i take synthroid and it specifically states to take on an empty stomach at lease 1 hour before breakfast. i am confused with your response about taking with food. the instructions for taking synthroid specifically state to take on an empty stomach and to take at the same time each day. i have been doing research myself concerning this matter since i am hypo and frustrated with the excessive lbs. whole wheat bread fish and eggs are helpful with this condition. i find that eating more vegetables helps to give me energy. parfaits seem to give me a boost. let me mention that these are things i am training my body to adapt to help the metabolism with this condition. exercising is a great option but let's be realistic some of us work crazy hours come home to children pets significant others school so that can be a bit complicated. my ideas aren't much but i hope you find what works best for you. corazondel anything with whole wheat in it is the worse thing you can eat because of the gluten it kills the thyroid. the best is completely gluten free. there are so many websites about this.

### Human:\ngastic bypass help. can you shrink your stomach back after stretching it out? . ive had gastric bypass a few years ago. i've done extremely well with it. but this year i've struggled a lot with excerise and eating healthy. some things were out of my control and some things were in my control as far as staying on track. . my concern is i have gained almost 30 lbs back in the last 18months. if my stomach stretched out do to this weight gain csn it be reshrunk? . my goal is to get back on track asap. what can i do to make my stomach shrink back down.\n\n### Assistant: it is difficult to stretch out your stomach after gastric bypass. it may happen somewhat with constant overeating over a long period of time but i wouldn't worry about it now. you still have your tool of a smaller stomach but you need more than just that. the most important thing is to seek help and support from you doctor and support staff such as the dietitian. the hardest part is dealing with life's ups and downs after you have lost weight. learning new coping skills positive ways to deal with stress and ways to keep your diet on track is key. support is what you need so you can be ready the next time you struggle.

### Human:\ni’ve been diagnosed with h. pylori but i’m allergic to the antibiotics. what about other treatments such as mastic gum?\n\n### Assistant: helicobacter pylori (h. pylori) is a bacterium that causes inflammation and ulcers in the stomach. about 80% of patients with h. pylori are asymptomatic meaning they do not feel any pain or symptoms. treatment is very important. we must eradicate the bacteria and allow the ulcer to heal. typically treatment is a combination of two antibiotics and 1-2 stomach medications. there are several different effective combinations for treating h. pylori. depending on what your antibiotic allergy is we can find an alternative antibiotic that will safely and effectively eradicate the infection. work with your pharmacist for alternatives. the mastic gum is not going to be as effective in eliminating the bacteria. .

### Human:\ni'm taking vicodin for pain and clindamycin for infection after a tooth extraction. can i add zantac 150 or tums?\n\n### Assistant: both vicodin and clindamycin have side effects like upset stomach nausea and vomiting but not heartburn. these medications currently do not have any known drug interactions with zantac 150 (ranitidine) or tums. he should be fine taking all these products together. however watch his symptoms. if symptoms worsen you may want to seek medical advice to make sure he doesn’t have another condition.

### Human:\nmy doctor said i cant marry someone with my same blood type after i took a blood test why is this?\n\n### Assistant: hello i have no idea why you would be told this informaiton. certainly people don't check blood types before they fall in love! the only blood type related problem that affects couples is related to the "rh" factor. if the father of a child in a couple is rh positive and the mother is rh negative the mother can develop antibodies to the baby duing the pregnancy. this is treated by giving any rh negative mother an injection of medication called rhogam once during the pregnancy (at about 28 weeks) and again within 72 hours of delivery. laurie anderson rnp

### Human:\ndoes resveratrol really work?\n\n### Assistant: resveratrol which is a compound found largely in the skins of red grapes has gained a lot of media attention and has been touted as having many beneficial health effects. resveratrol is a component of ko-jo-kon an oriental medicine used to treat diseases of the blood vessels heart and liver. it came to scientific attention during the mid-90s as a possible explanation for the “french paradox” — the low incidence of heart disease among the french people who eat a relatively high-fat diet. since then it has been touted by manufacturers and examined by scientific researchers as an antioxidant anti-cancer agent and phytoestrogen. it has also been advertised online as “the french paradox in a bottle. ” if you do a literature search and look at well-accepted peer review journals there is very little published to support any of these effects of resveratrol. new work produced by both amgen and pfizer has cast doubt on the manner in which the health supplement is said to work. prominent researchers supposed that it worked by activating a certain gene sirt1. this activation is thought to produce the benefits of a caloric restriction diet even among those with high fat and high caloric intake. in 2009 in chemical biology and drug design amgen scientists published experimental results that indicate resveratrol does not in fact activate sirt1. pfizer scientists in the journal of biological chemistry in 2010 offered similar results showing that resveratrol (and related substances such as srt1720) do not active sirt1 and did not reduce blood sugar in mice fed a high-fat diet. thus it suggests that resveratrol doesn’t work at all (though it’s not possible to translate mice studies into human studies). despite what is promoted on many national television shows on health none of the claims has been demonstrated in any valid human study. while present in other plants such as eucalyptus spruce and lily and in other foods such as mulberries and peanuts resveratrol’s most abundant natural sources are vitis vinifera labrusca and muscadine grapes which are used to make wines. it occurs in the vines roots seeds and stalks but its highest concentration is in the skin. the resveratrol content of wine is related to the length of time the grape skins are present during the fermentation process. thus the concentration is significantly higher in red wine than in white wine because the skins are removed earlier during white-wine production lessening the amount that is extracted. grape juice which is not a fermented beverage is not a significant source of resveratrol. since wine is the most notable dietary source it is the object of much speculation and research. resveratrol is also available from supplement pills and liquids in which it is sometimes combined with vitamins and/or other ingredients. it is also an ingredient in topical skin creams. the supplements are generally labeled as containing from 20 to 500 mg per tablet or capsule. however the purity of these products is unknown. and because dietary supplements are loosely regulated it should not be assumed that the labeled dosage is accurate.

### Human:\ni have bad breath. how do i cure it? will a tongue scraper work?\n\n### Assistant: bad breath or halitosis can have many causes including poor oral hygiene smoking alcohol stomach problems dry mouth sinusitis diabetes tooth abscess gum infections etc. with so many potential causes it is hard to say that a tongue scraper will help. the bottom line is that you need a diagnosis for the cause of the halitosis before deciding on a treatment.

### Human:\nis it harmful to drink alcoholic beverages while taking prednisone?\n\n### Assistant: currently there are no drug-drug interactions between alcoholic beverages and prednisone. however new drug interactions may be discovered. so it is important to check with your health care professional especially the pharmacist to make sure it is still ok to take this combination together. prednisone and alcohol even when ingested separately can have the potential to cause irritation to the gastrointestinal system leading to an increased risk for stomach ulcers or gastrointestinal bleeding. know more here <link>

### Human:\nis it possible for one's stomach to expand to an enormous size after years of binging? i have never felt full. i was diagnosed with celiac disease in 2013 at the age of 30 but was showing symptoms when i was 10. i have always eaten large amounts (at least 4 times normal serving sizes) and never gained weight. after diagnosis i gained 100 lbs. and i can't manage my weight. i try to eat until i feel satisfied but i never am satisfied. i never feel full if i overeat.\n\n### Assistant: the size of your stomach shouldn't be a factor in not feeling full. if you were used to eating large amounts of food due to your disease your body likely got used to that. now that (i assume) the celiac is under control. you are still eating the same way but your body is now absorbing the food. weight gain can also change hunger hormones increasing appetite further. i suggest getting help from a dietitian who specializes in eating issues. there are lots of tricks to helping feeling full including choosing filling food and being mindful while eating. you can find a dietitian in your area by going to eatright. org more reading. 9 surprising facts about your stomach satiety: the secret sauce to weight control

### Human:\ni have started a low-sugar and low-wheat diet and i keep going to the toilet more than normal. is my diet the reason?\n\n### Assistant: the question is how else has your eating changed? if your low sugar and no wheat diet also includes more fruits and vegetables and other sources of fiber like beans then you have your reason (fiber makes food go through the intestine faster). i don't think just removing sugar and wheat would cause you to go to the bathroom more but its likely due to any other changes you are making. if you feel the changes are a problem see your healthcare provider.

### Human:\ni don't eat meat that often but my skin smells terrible. what can i do?\n\n### Assistant: most body odor is caused by an accumulation of bacteria on the surface of the skin. in general this problem can usually be improved with the use of natural cleansers while bathing. there are also certain medical conditions -- diabetes liver disease and infections for instance -- that may contribute to body odor. a balanced diet is critical to your well-being. imbalances in your nutritional intake may lead to an accumulation of unfriendly bacteria within your digestive system.

### Human:\nhow is thrush diagnosed?\n\n### Assistant: your dentist can diagnose thrush by examining your mouth. he or she looks for the distinctive white lesions on your mouth tongue or cheeks. lightly brushing the lesions away reveals a reddened tender area that may bleed slightly. a microscopic examination of tissue from a lesion can confirm the diagnosis. thrush that extends into your esophagus may require other tests to make the diagnosis. such tests might include taking a throat culture (swabbing the back of your throat with sterile cotton and studying the microorganisms under a microscope) performing an endoscopy of your esophagus stomach and small intestine (examining the lining of these body areas with a lighted camera mounted on the tip of a tube passed through these areas) or taking x-rays of your esophagus.

### Human:\nhow do the new recommendations for pap smears benefit patients?\n\n### Assistant: the primary benefit for reduced pap smear screening would be less over treatment -- especially in younger patients. in the 1980s i can remember young women being sent for laser destruction of cervical tissue for what we now consider to be mild dysplasia or cin 1. some of the more aggressive treatments can remove a significant amount of cervical tissue. if the removal of cervical tissue is extensive (removal of tissue can range from a few millimeters to slightly less than an inch) it can undermine the ability of the cervix to remain closed until full-term delivery. fortunately studies were done that demonstrated young women with a healthy immune system were able to clear many mild cervical cell changes on their own. this was true in about 60% of mild cases. more frequent pap smears in this group for one to two years after diagnosis would identify the small group that did not spontaneously clear.

### Human:\ndo i have ibs? 3 bowel movements a day. i'm a 20 year old male and lately i have been having about 3 small(not too small but smaller) bowel movements daily usually after each meal. . i eat a lot of fiber 35-40 grams per day and usually drink a lot of water. is this normal for my high fiber/lots of water diet or is this progression a sign of me possibly developing ibs or colitis? . for the record this bowel movement increase does coincide with a rise in my fiber intake prior to the rise i usually had a bowel movement daily.\n\n### Assistant: only a doctor can diagnose you with ibs or another related gastrointestinal disorder. but from what you have shared it seems your increase in bowel movements is due to your increase in fiber. especially if you are not feeling abdominal pain or bloating and your bowels are not hard or really loose. for more on the symptoms of ibs see this webmd article. if your daily bowel movements are due to increasing your fiber as i suspect your bowels will likely evolve to less frequent as your body adapts. if you feel something is wrong though don't hesitate to see your healthcare provider. best of luck to you!

### Human:\nis it best to exercise first and then eat a full meal or eat a full meal first?\n\n### Assistant: there's no "best" way to do it. generally if you get hungry during or after exercise or you feel your energy is running low during the workout then have a snack 30 minutes before the workout. carbs and protein like in an energy bar are good. if you feel okay during the workout not eating then it's okay. some people can eat a full meal before working out but for the most part too much food in the gut will make you feel uncomfortable during the workout. again if you run low on energy without food during exercise then have something to eat. it’s often recommended to not have a full meal at least two hours before exercise though three to four hours is better. the reason for this is called blood shunting. to put it in simple terms blood shunting is a process where your body diverts more blood to certain areas that need it. we have a set amount of blood in our body but the amount that certain areas of your body receive can change at different times. the theory is that not eating close to when you exercise will allow for more blood to be delivered to your muscles instead of being partially diverted towards digestion. this will allow your body to work more efficiently during exercise to help you get the most out of it. you can eat something small right before exercise but be sure to not eat too much. if you’re exercising in the morning try to have something like a glass of juice a piece of fruit or a slice of toast before exercising so that you have some energy and aren’t exercising on a completely empty stomach. also there is the possibility that eating a heavy meal before exercise may cause you to feel uncomfortable while doing exercise or it may lead to cramps. check out this article for more formation.

### Human:\nwhat is the critical difference between a sterol and a stanol?\n\n### Assistant: we hear in the news and in commercials that plant sterols are good for us and lower cholesterol levels. we are even fortifying certain foods and some baby aspirin with these phytosterols. yet these phytosterols may be more atherogenic (have the ability to initiate or accelerate atherogenesis — formation of fat deposits on the inner lining of blood vessels) than cholesterol in certain groups of people. stanols on the other hand are good for everyone and do lower cholesterol levels. let’s start with some definitions: * cholesterol is a sterol. a sterol is a steroid with an alcohol group attached to it. * stanols are saturated or reduced sterols that are similar to cholesterol but have a methyl or an ethyl group attached to them. this difference minimizes stanol absorption in the intestines. * cholestanol is a stanol. cholesterol can be broken down by the liver into cholestanol and thus is a by-product of cholesterol metabolism. if sterols or stanols are esterified (combined with fatty acids) then they can be incorporated into margarine. we consume many sterols from plant sources (sitosterol campesterol and stigmasterol) shellfish (desmosterol and fucosterol) and animal sources (cholesterol). all of these sterols with the exception of cholesterol are collectively referred to as noncholesterol sterols. collectively these sterols can be called phytosterols. sitosterol represents about 80% of all noncholesterol sterols in the diet and is the most well known noncholesterol sterol in the diet. when fats (triglycerides) enter the intestine in our food they are broken down into their basic building blocks. the main breakdown products are called fatty acids. these fatty acids and sterols from dietary sources are packaged into what is called a micelle. these micelles “ferry” these fatty acids and sterols to the intestinal lining (epithelium). they are then absorbed by passive diffusion into the intestinal cells. passive diffusion is a biological principle that substances flow through a semi-permeable tissue from an area of higher concentration to an area of lesser concentration. there is no pump required to get them out of the intestine and ultimately into the bloodstream. most humans absorb about 50% of sterols in the intestines. however there are some people who are what is termed” hyperabsorbers” (they absorb 60-80%) and some are “hypoabsorbers” (they absorb less than 50%). noncholesterol sterols are not esterified as humans do not have the enzymes necessary for that. when these unesterified sterols get into an arterial wall they are more atherogenic than cholesterol (an esterified sterol). this means they have a greater artery clogging potential than does cholesterol. if one lacks these transporters (homozygote) all sterols are absorbed and none are pumped back out: this is a very rare homozygous condition leading to the disease called sitosterolemia or phytosterolemia. it is associated with severe atherosclerosis as noncholesterol sterols (which cannot be esterified) are more atherogenic than cholesterol. heterozygotes people who have some transporter function eliminate some but not all of these phytosterols. stanols do not require these transporters to get back into these intestines. this is the reason that they are safe and effective to reduce cholesterol. stanols are commercially available in the supermarket in a product called benecol. in summary noncholesterol sterols serve no physiologic function in man. all sterols are atherogenic if they accumulate in the arterial wall. stanols are saturated sterols. they are not absorbed and can be used therapeutically to reduce cholesterol absorption from the intestine.

### Human:\nis all vitamin d the same?\n\n### Assistant: vitamin d from sunlight foods and even vitamin supplements is not biologically active. it has to undergo two processes the first occurring in the liver which converts vitamin d to the 25(oh)d form also known as calcidiol or vitamin d². the kidney then makes the most active form 1 25(oh)²d also known as calcitriol or vitamin d³. if you check your bottle of vitamins or calcium + vitamin d supplements you can see which type you have been taking. currently the preferred supplement form may be vitamin d³ as it increases the amount of active vitamin d while increasing the time vitamin d is active in the blood and tissues.

### Human:\nwhat is a fistula?\n\n### Assistant: a fistula is an abnormal connection that develops between two body parts. fistulas most often form as part of the healing process in an area of inflammation injury or previous surgery. there are many different types of fistulas: enterocutaneous fistula (between the intestine and the skin usually developing after abdominal surgery) rectovaginal fistula (between the rectum and the vagina) tracheoesophageal fistula (between the trachea and the esophagus) umbilical fistula (between the navel and the intestine) arteriovenous fistula (between an artery and a vein). some fistulas may heal and go away on their own. fistulas that do not heal generally require surgical repair.

### Human:\nwhat is a reasonable price to pay for a dental overnight mouth guard? my dentist is saying $550 which seems expensive.\n\n### Assistant: it all depends on whether the night guard is custom made or not. the fabrication process involves the taking of impressions a lab fabrication fee a delivery visit with adjustments and most likely a follow up visit or two. so i recommend asking the dentist to explain exactly what is involved in the process.

### Human:\nwhat blood sugar levels are considered normal and what levels are diabetic?\n\n### Assistant: at present the diagnosis of diabetes or prediabetes is based in an arbitrary cut-off point for a normal blood sugar level. a normal sugar level is currently considered to be less than 100 mg/dl when fasting and less than 140 mg/dl two hours after eating. but in most healthy people sugar levels are even lower. during the day blood glucose levels tend to be at their lowest just before meals. for most people without diabetes blood sugar levels before meals hover around 70 to 80 mg/dl. in some 60 is normal; in others 90. again anything less than 100 mg/dl while fasting is considered normal by today's standards. what's a low sugar level? it varies widely too. many people's sugar levels won't ever fall below 60 mg/dl even with prolonged fasting. when you diet or fast the liver keeps sugar levels normal by turning fat and muscle into sugar. a few people's sugar levels may fall somewhat lower. without taking diabetes medicine though or having uncommon medical problems it's difficult to drop sugar levels to an unsafe point. to diagnose diabetes your doctor may do a fasting blood glucose test. fasting blood glucose values: low – less than 70mg/dl normal - between 70 to 99mg/dl pre-diabetic – between 100 – 125mg/dl diabetic – greater than 126mg/dl non-fasting blood glucose values: low – less than 70mg/dl normal - between 70 to 139mg/dl pre-diabetic – between 140 – 199mg/dl diabetic – greater than 200mg/dl the standard diagnosis of diabetes is made when at least two separate blood tests show that your blood sugar is elevated. 80 to 120 normal. fasting : under 120 is normal over 120 is high two hrs after food testing: under 150 is normal over 150 is high. 80 to 100

### Human:\nwhat is the max dosage of zyrtec? . i am a 6'2" 280 lb male can i take 20 mg total of zyrtec at once i read somewhere the max dosage is 20mg?\n\n### Assistant: cetirizine (zyrtec) is an antihistamine that is used for allergies. it is available over the counter. the maximum recommended dose of zyrtec is 10mg per day. studies have been done in people with chronic hives comparing the 10 mg to the 20 mg dose of zyrtec and no advantage was seen with the higher dose. the recommended dose of zyrtec is not based on weight and height. whenever you take a higher than recommended dose of a medication you increase your risk of side effects. although zyrtec is available over the counter that doesn’t mean it is harmless. zyrtec can cause sleepiness and this effect is increased when zyrtec is combined with alcohol or other drugs that cause sedation. zyrtec use has also been associated with liver damage in rare individuals. play it safe and stick with the recommended dose. talk with your doctor about using zyrtec and whether the benefits of increasing the dose outweigh the risks. i am a conservative medical provider so i rarely if ever push the recommended dosages on zyrtec or any drug. these things are carefully studied during the clinical trials so taking two may not be considered toxic or dangerous for a short period of time (even for a big guy) but this dose is not recommended. like many drugs this one is excreted by your kidneys so why push the limit? <link> if this or any drug is not controlling allergy symptoms it may be better to try something else. there are many ways to treat allergies than exceeding recommended dosages. talk to your medical provider but i bet he or she will not endorse your double dosage.

### Human:\nwhat is the difference between famotidine and omeprazole?\n\n### Assistant: famotidine (pepcid products) is in a drug class called h2 blockers. omeprazole (prilosec) belongs to the proton pump inhibitors. these medications work two different ways to decrease acid production and flare-ups with stomach issues. both medications can be found over-the-counter. famotidine is typically taken 1 to 2 times daily while omeprazole is taken once daily (may be dosed differently than recommended in over-the-counter packaging label by prescriber). it is also important to keep in mind that since they are two different medications the side effect profile will be different.

### Human:\nwhat foods are good sources of vitamin d?\n\n### Assistant: a majority of dietary vitamin d comes from fortified items like milk but is also found naturally in foods including fatty fish (salmon mackerel and herring) and some animal foods. to give you an idea of how much is typical foods and how that relates to nutritional needs the institute of medicine recommends 600iu vitamin d for people age 1 to 70. below are the amounts listed for various foods according to the 2010 dietary guidelines for americans: -8oz of low-fat milk (83-122iu) - 1 cup fortified orange juice (118iu) - 3 ounces of salmon (184iu) - 3 ounces of tuna (168iu) - 3 oz of pork (153-337iu) - 3 oz beef liver (149iu) - 1 egg (78iu)

### Human:\nthe last few months my anus has been itchy before i go to bed. i am usually busy in the day so i am wondering if i am itchy all during the day but only notice it at night (when i'm almost always laying stomach down while using the computer). i also had mysterious itchy red dots on my legs 3 years ago and i usually still have one or two on my thigh at any given time. could unseen ones on my anus be the cause of the itch? or is my anus just itchy because i almost never scratch (a fear of pinworms makes me almost never scratch)?\n\n### Assistant: pinworms are always a possibility and you can certainly have a pinworm test to see if this is the underlying problem. pinworms can be spread to adults by children especially those with less-than-optimum handwashing habits. itching can be caused by improper hygiene allergic reactions to soaps improper rinsing during a shower allergic reaction to perfumed toilet tissue laundry detergents and dryer softener sheets. skin tags tiny fissures or even small hemorrhoid can cause itching. any skin condition especially a fungal skin condition can cause itching. if your problem continues you will need to see a medical professional. while having someone look at your bottom may seem embarrassing it is not considered a problem for clinicians. they do it all of the time. why suffer? get some help if you cannot solve this issue yourself.

### Human:\ni have large brown patches on my forehead and cheeks like liver spots. it's not skin cancer. what do you recommend?\n\n### Assistant: you may be suffering from melasma a skin condition characterized by hyperpigmentation of the cheeks and forehead. some melasma sufferers will exhibit refractory hyperpigmentation after topical regimens. you may want to consider further evaluation with a physician who is experienced in laser treatments for refractory melasma specifically for your skin type. go go a dermatologist and have the areas "frozen. " it will remove them completely.

### Human:\nwhy i am craving only for sweet food? . since i stopped contraception pills i couldn't stop eating sweet food. i gained 6kg within 2 weeks. and then i decided to stop. so for 2months now i haven't touched any sweet chocolate fizzy drink or bakery. instead i eat dried fruits peanuts yogurts fruits porridge. i cant eat salty. even though i eat only healthy im always eating! i feel this constant sweet food craving! (i haven't lost weight even though im doing sports everyday not eating in the evenings. i've been taking chromme for 1month).\n\n### Assistant: there may be a few reasons why you are cravings sweet foods. one thought is that your blood sugar may be low and your body is trying to tell you that you need to eat something in order to bring your blood sugar levels back to normal. low blood sugar could come about by not eating enough food throughout the day or by not making appropriate food choices. it could also be from a lack of energy or exhaustion especially from lack of sleep where your body will begin to look for other sources of energy. sugar can be metabolized and converted to energy very quickly so it’s an obvious choice. the cravings may come as a response from being very restrictive with your diet. it can be hard to sustain an eating plan where you are constantly depriving yourself of things that you want to indulge in. instead consider moderation and portion control as healthy alternatives. lastly there are also psychological reasons for craving sweets as well. for example when you are stressed you may sometimes seek comfort in food wanting something that tastes really good. eating sweets can trigger a reward mechanism in your brain by releasing serotonin which helps to boost your mood and help you to feel better. there are a variety of reasons for sweet cravings both physical and psychological. it could be that now that you are off the pill your cycles are back to normal and you are experiencing more cravings related to fluctuations in hormones. it also could be your restriction of sweet items is causing you to be even more drawn to them. you first want to look at your diet. is it balanced with all the food groups? are you getting enough dietary fat for satisfaction? what are your absolute favorite sweets? have you tried incorporating items like dark chocolate or smaller portions of other sweet foods you like? there is emerging research that mindful eating can decrease food cravings in people with eating problems. that means eating meals at the table eating slowly enjoying food and leaving judgment out of your thoughts about food. that means no more "i was bad so i might as well throw caution to the wind" or "i shouldn't eat that because it is bad for me. " it's all about listening to your body and trusting yourself around food. a registered dietitian can help you find out why you are craving sweets (go to eatright. org to find one in your area). for more on mindful eating see this post on webmd's real life nutrition. <link> good luck! hi and thanks so much for your question. there's a good chance that you have an issue with being hooked on or addicted to sugar. take a moment and complete this easy 2 min quiz devised by experts from yale university <link> in your situation what you're doing is actually something we call "eating around the addiction". you did well to eliminate refined and processed sugar from your dietary intake. however you didn't replace it with rewarding and tasty enough sweetness from natural sources and thus you're still in crave mode. you want the sweet but can't eat it so you eat around it by continuously munching on other foods. one problem with that in addition to packing on pounds is that you may start getting hooked on the dried fruits and nuts as well. the foods people become most hooked on are called the hyperpalatables--- sugary/fatty/salty food combos. it's never tuna on a bed of greens that we get hooked on. it's the super rewarding hyperpalatables most of which are refined and processed foods. in my book the hunger fix i note that you need a strategy of detox and recovery in which you substitute the refined sweets with natural sweets as well as add other foods that naturally boost the brain's dopamine the reward brain chemical that gives you pleasure and satisfaction. in addition log onto the webmd food and fitness planner and you'll also see a wealth of naturally sweet and tasty foods you can now incorporate into your dietary regimen to stop the cravings. another thing i note is that you're not taking in much protein. a secret way to stop cravings is to combine lean protein with fiber--- carrots and hummus peanut butter with apple slices yogurt with blueberries low fat cheese with an apple. works like a charm. good luck and let us know how you're doing dr. peeke i was struggling with sugar for quite a while. i did a little research for my personal dietary needs. i am basically a carbo addict. if you want to call it that. what i did find was really helpful. south beach diet book really helped me understand about what foods can do to your body chemistry. the processed foods manufactured these days are even more highly processed than in the recent past. these higher processed foods make you crave more and more of them. there are lots of hidden sugars in foods which also make you crave more of them. the trick i found was to 1. eat the type of foods that help you prevent the cravings like protein and foods on the low glyciemic index. foods that have lots of nutrition give your body what it needs and you begin to crave less of the junk. 2. take a look at your eating habits and modify them. me for example love to eat at night. it may not be the best thing but i seem to sleep better with some food in my stomach. that said i have switched out the junk or carbs. replace ice cream with greek yogurt. relpace high fat chips with cruncy celery and peanut butter or cream cheese. instead of a sandwich with bread make a turkey roll up. 3. exercise helps to regulate your sugar levels so i work at getting some exercise which also helps my mood levels in case the mood ties into eating for more comfort. 4. and lastly when the sugar craving gets the best of you have something like chocolate chips. put 10 or so into a tiny prep bowl. i bring them in my office for that afternoon pick me up. i am always suprised when i don't even eat them all. hope that helps a little! just a thought. i was craving sweets too for a long while. i also felt very tired most of the time. when i went to my doctor i found out i was diabetic. my body craved sweets because it thought it was needed in my diet. am only saying this because no one else mentioned it here and it would be smart to go get tests. you probably are not diabetic but why not get tests to find out if you have deficiencies etc? couldn't hurt to check.

### Human:\nare there any over-the-counter energy pills?\n\n### Assistant: there are caffeine pills that you can find over-the-counter to aid with energy. products such as nodoz alert vivarin and stay awake contain 200 milligrams of caffeine and are used for energy and treatment of some migraines and headaches. common side effects include nausea stomach upset insomnia restlessness nervousness tremor headache and lightheadedness. large amounts of caffeine may cause frequent urination flushing muscle twitch or irritability. use with caution! too much caffeine is not healthy and can become addictive. withdrawal can make it difficult to back off so tapering down the dose may be necessary. prior to use you should discuss the risks and benefits of using caffeine supplements with your pharmacist or health-care professional. other products consist of herbal remedies. use caution since there isn’t a standard or enough research behind these products to promote their use (not fda approved). what over the counter energy pills to offset present rx pills

### Human:\nwith gastroparesis: is liquid food like jevity good? already follow jackson siegelbaum diet for gastroparesis.\n\n### Assistant: jevity is typically used as a tube feeding but other oral supplements like ensure or glucerna (if you are diabetic) can be used. the jackson siegelbaum diet has three steps the first being liquids. there may be times you go back to liquids when symptoms worsen. liquids and low fiber foods tend to be tolerated the best for people with gastroparesis. oral supplements also make sense when weight and nutrition is a concern due to inability to eat regular meals. if you are concerned about your nutrition you can always see a dietitian -- you can find one at eatright. org. for more on diet for gastroparasis see this webmd article. good luck!

### Human:\nwhat is the cure for dry skin?\n\n### Assistant: dry skin can be attributed to a variety of skin disorders such as eczema rosacea or psoriasis. medical problems such as thyroid disease kidney disease liver disease and certain connective tissue diseases may also contribute to dry skin. your first approach is to exclude any potential medical causes with your physician. if your dry skin is not related to an underlying medical cause then your skin regimen needs to include moisturizers that contain health-rebuilding compounds such as vitamin a c e peptides or hyaluronic acid.

### Human:\nwhat is familial hypercholesterolemia?\n\n### Assistant: familial hypercholesterolemia (fh) is a group of genetic disorders that result in severe elevations of blood cholesterol levels. despite being of one the most common serious genetic disorders few people know about fh unless their life is affected in some way. the prevalence of fh is 1 in 300 to 500 in many populations. there are over 620 000 fh patients currently living in the united states. many of these people are unaware that their risk of premature coronary heart disease is elevated about 20-fold in patients that have not been treated. there are two different types of fh patients. the most serious type is called the homozygous form. this means that the genetic defect was inherited from both parents. homozygous fh type occurs in 1 out of every 1 000 000 individuals and is associated with the rapid and premature development of coronary heart disease in childhood or adolescence. many of these patients never live to see their second or third decade of life. the heterozygous form of fh means that that the genetic defect was inherited from one parent and is much more common. in certain populations such as french canadians the prevalence may be as high as 1 in 100. fh is a treatable disease. in addition to diet and lifestyle modification medications are an essential tool in management. some patients may require ldl apheresis which is a method of removing the bad cholesterol from the blood. some patients with the homozygote form have required liver transplantation to treat the disease.

### Human:\ncan fasting detox or cleanse your body?\n\n### Assistant: there is absolutely no scientific evidence showing that fasting will detox or cleanse your body. however you can do harm by not stimulating your colon with fiber to help maintain normal motility and thus regularity. and of course your gi system thrives on healthy nutrients continuously flowing through the lining of the gut.

### Human:\nwhat kinds of the otc products are best for getting rid of liver spots?\n\n### Assistant: brown spots on the hands and face have been called liver spots. but there is no connection whatsoever between these spots and the liver. these brown areas of pigmentation are actually due to sun exposure and skin aging. hydroquinone is a bleaching molecule that can help lighten the spots. however it is only available in only 2% strength over the counter. if this kind of product does not work for you see your physician to obtain a prescription for a 4% hydroquinone treatment which may work faster and more effectively. lastly laser treatments may ultimately be the best way to resolve these brown spots.

### Human:\nis it normal to constantly become hungry yet become full from eating very little? what does this sound like? . ever since i started strength training my appetite is out of control. i have to eat something almost every hour to avoid that feeling of starvation in my stomach. and yet when i choose to eat it takes very little to satisfy my appetite. i've never felt so confused about hunger in my life. what can i do so that i can feel full for more than an hour at a time and not have to worry about eating over a half dozen times a day? in the same vein how can i still feel hungry after a few bites?\n\n### Assistant: i'm not sure how you ate or exercised before strength training but now that you have made a change and are more hungry it's time to put more thought into your meals. you want to eat 3 balanced meals every day that contain 3-5 food groups at each meal (whole grain lean protein fruit vegetable dairy and healthy fat). if you are hungry in between meals have a snack with 2-3 food groups (e. g. apple with peanut butter yogurt with nuts cheese stick with whole grain crackers). so if you are used to having some cereal in the morning that may no longer be enough to keep you going. adding a lean protein source and more filling carbs like oatmeal along with chopped fruit and nuts will stick with you longer. protein (eggs lean meat nuts/seeds soy fish cheese) and fiber-rich foods (frutis veggies whole grains and beans) are the most filling and will keep hunger away longer. for more on what to eat before during and after exercise see this article. if you find that after taking a couple of bites of food you feel really full see your healthcare provider to make sure there is nothing else going on.

### Human:\nwhat are potential side effects of taking an antibiotic?\n\n### Assistant: adverse drug events can range from minor stomach ailments like nausea and vomiting to more serious consequences that may be life-threatening and require hospitalization. in children antibiotics are the most common cause of emergency department visits for adverse drug events. using antibiotics responsibly is the best way to avoid an adverse drug event.

### Human:\nis coffee good for your liver?\n\n### Assistant: did you know that drinking coffee is healthy for the liver! studies show that people who drank a few cups a day were less likely to scar their livers and less likely to get liver cancer. the same protective effect was not seen with tea or decaffeinated coffee.

### Human:\nis it safe to have another baby after i delivered three by c-section?\n\n### Assistant: you can certainly consider having another infant. however all the information in our literature would tell you not to consider having an attempt at a vaginal birth. you are at too high a risk to consider this. i think of myself as very progressive and will always consider a vbac for patients but not someone like you. the issue for you becomes the more c/s you have the higher the risk of possible placental abnormalities. if the placenta lies over the cervix (called a placenta previa) with the number of c/s you have had there could be a significant problem that could occur (called a placenta accreta). you should always discuss with your health care provider your concerns.

### Human:\ni love oatmeal and i am a diabetic. is it good to eat in a regular basis? . the issue is that i read that some doctors say that oatmeal is alright but you must be careful with it as a major part of your diet but others say it is fine as long as it is not loaded up with all the "nice" things that make oatmeal so good like brown sugar and raisans which makes sense because of the high carbo content.\n\n### Assistant: most helpful answer the key for diabetes is keeping carbohydrate intake consistent throughout the day. oatmeal is a healthy carbohydrate-rich food that is beneficial for heart health and can fit in a healthy diet. you want to work with your healthcare provider on how many carbohydrates you need in a day. the american diabetes association recommends 45-60 grams of carbohydrate at a meal (3-4 carbohydrate servings). one half cup of oatmeal without added sugars contains about one carbohydrate serving (15 grams). if you add to tablespoons raisins that is another carbohydrate serving. the benefit of carbohydrate counting is you have flexibility about what you eat as long as you stay within your recommended carbohydrate intake. but choosing carbohydrates that are nutritous like oatmeal (and other whole grains) fruits and dairy is important for a healthy diet. if you need help see a diabetes educator for more assistance. for more information on carb counting see this article <link> i am a type 2diabetic and eat oats every morning. one of the first things i was taught was to add a good fat or protein to a carb breakfast. i eat 1/3rd cup of steel cut organic oats cooked in water 6 oz. of almond milk 1tsp cinnimon and 1 tbs. of almond butter. i also eat one cup of fruit but eat the fruit 1hr prior to the oats. this wait time allows the fruit to digest before the oats start to digest. i have been taught also to not eat a startch or grain carb together with a fruit as the stomach treats this combination by frementation during digestion. my blood sugars are norml eating this way. total carbs for this meal is around 66grams which is high but eating this way negates the high blood sugars!

### Human:\ncan i eat before a ct scan?\n\n### Assistant: it’s usually preferred that a person not eat for three or four hours before certain ct scans. there’s a small risk of nausea and vomiting during the scan which may be reduced if the stomach is empty. an empty stomach might also improve some of the images collected. check with your radiology center for specific instructions on how to prep for your ct scan.

### Human:\nhow do lasers work in dentistry?\n\n### Assistant: all lasers work by delivering energy in the form of light. when used for surgical and dental procedures the laser acts as a cutting instrument or a vaporizer of tissue that it comes in contact with. when used for "curing" a filling the laser helps to strengthen the bond between the filling and the tooth. when used in teeth whitening procedures the laser acts as a heat source and enhances the effect of tooth beaching agents.

### Human:\nare yeast infections contagious?\n\n### Assistant: no yeast infections are not contagious in the way a cold or the flu is. yeast infections are caused by a fungus (more specifically a yeast) called candida. candida is a commensal organism meaning that under healthy conditions it lives harmlessly in our bodies. we all have candida living on our skin and in our intestines and healthy women carry candida in their vaginas. when the body’s defenses are in balance candida is not noticeable or bothersome. however certain conditions can give candida the opportunity to grow excessively: a low-functioning immune system. use of topical or oral corticosteroids such as prednisone (often for asthma or autoimmune conditions). damage to the mucous membranes (the skin lining the mouth vagina and gi tract). antibiotic use. in these situations candida can grow on the skin or in the lining of the mouth gi tract or vagina. the fungus creates a white patch or plaque across the mucous membranes. in the mouth visible candida infection is called thrush. in the vagina it’s a yeast infection. in people with weakened immune systems candida can grow almost anywhere in the body. because candida is normally present in all our bodies someone with thrush can’t exactly pass it to someone else -- that person already has candida. to develop thrush a yeast infection or another candida infection that person may have one or more of the above risk factors or conditions.

### Human:\nwhat is the difference between prescription protonix 40 mg and ranitidine 150 mg an over-the-counter medicine?\n\n### Assistant: protonix and ranitidine can both be used to treat gi ulcers gerd maintenance therapy for ulcer prevention and heartburn. both of these medications block acid production by two different mechanisms. protonix is a proton pump inhibitor while ranitidine prevents gastric acid stimulation by blocking histamine release in the stomach. protonix is prescription strength while ranitidine is over-the-counter. this means that there could be a price difference depending on the co-pays with your health insurance. protonix does have a generic (pantoprazole) that is equally effective as the brand name. if you are thinking about switching without knowing the severity of your stomach condition is it hard to give information as to whether ranitidine can be supplemented for protonix. i recommend that you speak to your health-care provider about your options. these medications do work differently and the effectiveness can be different. if the symptoms have subsided keep in mind that the medication can be the controlling factor. therefore it may not be necessary to switch if your current treatment is working for you.

### Human:\nwould taking glutathione for cell boosting benefit me and where can i get it?\n\n### Assistant: glutathione (gsh) is a tripeptide meaning a large protein made up of several amino acids. it functions as an antioxidant protecting cells from free radicals and peroxides. raising one’s gsh levels through direct supplementation of glutathione is difficult. research suggests that glutathione taken orally is not well-absorbed by the gastrointestinal tract. if you feel that you need this to supplement your immune system speak to your health care provider first.

### Human:\ncan a b12 supplement taken with an antidepressant cause severe gas pains?\n\n### Assistant: it depends on the form of vitamin b12 you are taking. gastrointestinal side effects associated with parenteral cyanocobalamin or vitamin b12 given by injection have included dyspepsia nausea vomiting and mild transient diarrhea. these side effects are very mild or not present at all with oral vitamin b12. if you are experiencing severe gas pains that have not subsided within a few hours you should consult your health-care provider.

### Human:\nare there any drug interactions between pristiq levothyroxine and acai berries?\n\n### Assistant: the acai berry is a fruit that has more recently been marketed to have antioxidant properties. it has also been credited with other health benefits that have not yet been scientifically proven. false claims include the reversal of diabetes and other chronic illnesses enlarging the size of your genitals increasing men's sexual virility and increasing sexual desire in women. in addition there are no current studies supporting the berry’s supposed promotion of aiding in weight loss. i cannot tell you if there are any interactions with levothyroxine or pristiq. i can tell you that the two medications you are taking are safe to take together. pristiq does not have any food considerations when taken orally. it is recommended that levothyroxine be taken on an empty stomach 30 minutes to 1 hour prior to breakfast.

### Human:\ndoes it matter what time of day a person works out to promote the most weight loss? . i usually work out 30 min. before breakfast but wonder if i should do this before dinner since that is my largest meal to help rev up my metabolism to better promote weight loss. i don't see much weight loss now with my current regimen.\n\n### Assistant: there doesn’t seem to be a definitive answer in regards to what time of day will provide the most weight loss benefit from exercise. for you the best time of day is going to be whatever helps you in establishing a consistent routine. it helps to make exercise as convenient and enjoyable as possible for yourself so that it’s easier for you to stay on track. i would suggest experimenting with doing exercise at different times of day to see what works best for you. are you enough of a morning person to commit to waking up early? early morning exercise is great but it may not be good for you if you end up sleep deprived or if you’re prone to hitting the snooze button and end up skipping exercise sessions. is it possible to exercise during a lunch break for a mid-afternoon energy boost? what about after work or are you too tired from a long hard day of work and just want to relax? late-afternoon or early evening exercise works well for some but may be a challenge if you have other after-work obligations or commitments that might interfere. does exercising too late in the evening affect your sleep or cause you to have insomnia? ultimately the best time of day for you to exercise is going to be specific to what meets your needs and what works best with your schedule and lifestyle. the best thing to do is to find a time that helps to establish a consistent exercise routine. different people lives and schedules = different workout times. one thing i always make sure to do is exercise before i eat a meal. not after. sometimes i work out in the morning sometimes in the afternoon. this is largely based on my sleep/rest. as long as i get my own personal needs of eight hours of sleep a night i will get up and exercise early in the morning. my two big points here. are get enough rest and exercise if possible before eating meal or make sure to put something in your body after. i find the mornings before breakfast to be the best. here's what happens. you're exercising on an empty stomach so your blood has to pull energy from your fat reserves. then after exercising don't eat anything for at least 30 minutes. this allows your blood to stabilize to catch up to its normal state again from fat. this gives plenty of time to shower and otherwise get ready for work. then have a good breakfast. if you eat immediately after exercising your blood will replenish from that instead of your fat and you'll have less weight loss. and you've revved up your metabolizm to burn your breakfast instead of store it. i just wanted the answer to the question about the different time of day about a beneficial workout - could not seem to figure out where to get the answer - should it be this complicated? i myself walk for 30 minutes on my lunch hour before i eat my lunch. i used to when i was younger work out after work. i have heard that working out early morning is great i couldn't do it and before dinner now i'm too tired.

### Human:\nwhat is catheter ablation for the heart?\n\n### Assistant: during an ablation high-frequency electrical energy is delivered through a catheter to a small area of tissue inside the heart that causes the abnormal heart rhythm. this energy "disconnects" the pathway of the abnormal rhythm. ablation is used to treat most psvts atrial flutter atrial fibrillation and some atrial and ventricular tachycardias. ablation may be combined with other procedures to achieve optimal treatment.

### Human:\ndo i need a yearly pap. i'm 60 years old. post menopausal. i've had three children. i've had yearly pap smears all of my life up until age 55. all of them have been benign. do i need to continue having them? i am asexual.\n\n### Assistant: probably not an annual pap unless you have a family history of uterine or cervical cancer had some risky sexual exposure in the past and are not having any gynecological symptoms. remember that a pap smear is just a test. there are other important components on a pelvic examination that should not be skipped. a pap smear only reveals cervical or endocervical cells that may be cancerous. the pelvic examination can find other abnormalities in the uterus ovaries and pelvic area. like suspicious masses etc. hopefully you are getting a mammogram colonoscopy and other preventative tests needed at your age.

### Human:\ndoes dry mouth often go along with constipation?\n\n### Assistant: while dry mouth is not considered a symptom of constipation it could be related because inadequate fluid/water intake is often one of the causes of hard stools. if the body needs more water it will reabsorb it from the stool in the colon making it more hard and dry. for more on constipation signs and causes see this webmd article.

### Human:\nwhy does fiber makes me constipated? . i drink plenty of fluids and only started because i am over 50 and md suggested because of one internal hemorrhoid and one diverticulitis . i have always had the opposite. loose stools since a kid specially under stress lol. i have never had to use a laxative in my life. so whats the scoop? why since i have increased my fiber to more than 10 grams a day (additional) i have stools that wont move are are harder to pass? do i not need fiber and this is my bodies way of telling me?\n\n### Assistant: fiber is typically beneficial in alleviating constipation but too much without enough water can actually cause constipation. keep in mind that there are two types of fiber soluble and insoluble. soluble fiber slows digestion and helps you absorb nutrients from food where insoluble fiber adds bulk to your stool helping it to pass more quickly through the intestines. most plant foods contain some of each but insoluble fiber is more common in wheat bran whole grains cereals seeds and the skins of many fruits and vegetables. you may have added too much fiber too soon. it might be beneficial to temporarily decrease your fiber intake for now so that you can slowly and gradually reintroduce it back into your diet allowing your body time to adjust to it better. you’re correct in drinking plenty of fluids since water is necessary to help fiber move stool out of your body. if you eat too much fiber without enough water you can become constipated so it may be worthwhile to also drink more water even if you feel as though you’re getting enough. according to the academy of nutrition and dietetics women should aim for 25 grams of fiber per day and men should aim for 38 grams per day. after the age of 50 the recommendations for fiber drop to 21 grams per day for women and 30 grams per day for men. you and your doctor may discuss different needs based on your current health conditions. another idea may be to try to incorporate foods that might have a natural laxative effect such as prunes psyllium seed husk bran and methylcellulose to alleviate your constipation. some people just respond poorly to increases in fiber so it may be beneficial to discuss this further with your doctor. thanks for your answer doctor. i have stopped the fiber. it was metamucil. so it was psyillium. and now i am back to normal. i was also drinking double up on the water and my stomach doubled in size with the bloating. i may try to do just one of the wafers a day instead of the 4 i worked my way up to but then again since my pain stopped and my stools resumed to normal i do not understand the need. i also do eat fruit and vegetables already as well. i think i will listen to my body rather than the "you need to do this" type of advise we are getting over all. i can say in my case fiber is not the answer to life lol