What is bedwetting?

Bedwetting, or nocturnal enuresis, is a condition that causes your child to urinate in his bed while he sleeps. The condition occurs in children who are 5 years or older. Your child may wet his bed at least 2 times each week. He may never have had a dry night. He may have dry nights for at least 6 months and then begin to wet the bed again. 

What causes bedwetting? 

•      The exact cause of your child's bedwetting may not be known. Any of the following can cause bedwetting: 

•      A small bladder

•      Bladder tightening before the bladder is full, causing leakage

•      Large amounts of urine made while your child sleeps

•      Deep sleep that keeps your child from waking to the feeling of a full bladder

What increases my child's risk for bedwetting? 

•      Drinking a lot of liquid before bed

•      A medical condition such as constipation or a urinary tract infection (UTI) 

•      Family history of bedwetting

•      Attention deficit hyperactivity disorder (ADHD)

•      Increased stress such as moving to a new home or the birth of a new sibling

How is bedwetting diagnosed? 

Your child's healthcare provider will ask when your child started to wet the bed and how often it happens. He will check your child's abdomen, spine, and genitals. Your child's healthcare provider will ask if your child wets himself during the day. Your child may need any of the following: 

•      A urine test may show infection or dehydration

•      A blood test may show organ function and sugar levels

What is fatty liver disease?

Fatty liver disease is when you have too much fat in your liver. It is common in the United States -about 1 in 10 people have fatty liver. A more serious form of fatty liver disease is called ''NASH,'' which stands for ''Non-alcoholic steatohepatitis'' and causes damage to the liver.

How can I tell if I have fatty liver disease?

You will not feel any symptoms of fatty liver disease. Your doctor may do blood tests to check your liver. You may also get an ultrasound of your liver to see how much fat there is. Rarely, a biopsy is done to look at a very small piece of your liver.

Why do I have fatty liver disease?

How can I make my fatty liver disease better?

There are no medicines to cure fatty liver disease. You can lower the fat in your liver when you:

•     Lose weight, with a goal of losing 2 pounds a week

•     Exercise daily

•     Take medicines as directed by your doctor, especially if you have high blood sugar or high cholesterol

•     Do not drink alcohol 

What causes diaper rash? 

Diaper rash can occur at any age but is most common between 12 and 24 months. Diaper rash may be caused by any of the following:

•      Irritated skin from urine and bowel movement

•      Not changing his diapers often enough

•      Skin sensitivity or allergy to chemicals in soaps, lotions, or fabric softeners

•      Hot or humid weather

•      Bacteria or yeast

•      Eczema

What are the signs and symptoms of diaper rash? 

The rash may be located on the skin surface, in the skin folds, or both. Your child may have any of the following:

•      Red and shiny skin

•      Raw and tender skin

•      Raised bumps or scales

•      Red spots

How is diaper rash treated?

•      Change your child's diaper often. Change your child's diaper right away if it is wet or soiled from a bowel movement. Check his diaper every hour during the day, and at least once during the night

•      Clean your child's diaper area with plain, warm water. Use a squirt bottle, wet cotton balls, or a moist, soft cloth to clean your child's diaper area. Allow the skin to air dry, or gently pat it dry with a clean cloth. Do not use baby wipes or soap during diaper changes. This may cause the rash area to burn or sting. Make sure your child's diaper area is completely dry before you put on a new diaper

•      Leave your child's diaper area open to air as much as possible. Take off your child's diaper when you are at home. Place a large towel or waterproof pad underneath your child while he plays or naps. The exposure to air can help heal the rash

•      Do not rub the diaper rash. This could make your child's skin worse

•      Protect your child's skin with cream or ointment. Make sure his diaper area is clean and dry before you apply cream or ointment. Petroleum jelly or zinc oxide will help heal his rash

•      Use extra-absorbent disposable diapers. These pull moisture away from your child's skin so it will not be as irritated. If your child wears cloth diapers, use a stay-dry liner to help pull moisture away from the skin

What if my child wears cloth diapers?

Presoak all diapers that have bowel movement on them. Wash diapers in hot water and dye-free or perfume-free laundry soap. Rinse them at least 2 times to get rid of extra laundry soap. Do not use fabric softener or dryer sheets. Try not to use plastic pants. If you must use plastic pants, attach them loosely around the diaper. This will help air flow in and out of the diaper and keep your child's skin drier.

When should I contact my child's healthcare provider?

•      Your child has increased redness, crusting, pus, or large blisters

•      Your child's rash gets worse or does not get better in 2 or 3 days

•      You have questions or concerns about your child's condition or care

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. 

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes^® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.  

What is a vulvovaginal candidiasis?

Vulvovaginal candidiasis, or yeast infection, is a common vaginal infection. Vulvovaginal candidiasis is caused by a fungus, or commonly referred to as yeast. Yeast is normally found in your vagina. Too much or some specific types of yeast can cause an infection.

What increases my risk for a yeast infection?

•      Pregnancy

•      Medicines, such as antibiotics, birth control pills, or steroid medicine

•      Medical conditions, such as diabetes

•      Contraceptive devices, such as diaphragms, sponges, and intrauterine devices

What are the signs and symptoms of a yeast infection?

•      Thick, white, cheese-like discharge from your vagina

•      Itching, swelling, and redness in your vagina

•      Burning when you urinate

How is a yeast infection diagnosed and treated?

•      Your healthcare provider will ask about your medical history and examine you. A sample of your vaginal discharge may show what germ is causing your infection

•      Medicines help treat the fungal infection and decrease inflammation. The medicine may be a pill, cream, ointment, or vaginal tablet or suppository. With treatment, the infection is usually gone within a week

Keep your vagina healthy:

•      Clean in and around your vagina with mild soap and warm water each day. Gently dry the area after washing. Do not use hot tubs. The heat and moisture from hot tubs can increase your risk for another yeast infection

•      Do not wear tight-fitting clothes or undergarments for long periods. Wear breathable cotton underwear. Tights and nylons worn for long periods of time might trap heat and moisture which promote yeast growth

•      Change your laundry soap or fabric softener if you think it is irritating your skin

•      Do not douche or use feminine hygiene sprays or bubble bath. Scented soaps, pads, tampons, or toilet paper may cause additional skin irritation

•      Ask your healthcare provider about birth control options if necessary. Condoms have latex and diaphragms have gel that kills sperm. Both of these may irritate your genital area

When should I contact my healthcare provider?

•      You have fever and chills

•      You develop abdominal or pelvic pain

•      Your discharge is bloody and it is not your monthly period

•      Your signs and symptoms get worse, even after treatment

•      You have questions or concerns about your condition or care

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.   

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes^® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics. 

What is plantar fasciitis?

Plantar fasciitis is swelling of the plantar fascia. The plantar fascia is a band of fibers that connect your heel bone to the front of your foot. It helps support the arch of your foot and absorbs shock. Plantar fasciitis is caused by small tears in the plantar fascia. Over time, the tears cause swelling and irritation.

What increases my risk for plantar fasciitis?

•      Obesity

•      High impact exercises such as running

•      Activities or sports that involve jumping, such as basketball

•      A sudden increase in the intensity of an activity

•      Flat feet, high arches, or feet that rotate inward when you walk or run

•      Tight calf muscles and tendons

•      Wearing shoes that do not support your feet, such as shoes that are worn out

•      Standing on hard surfaces for long periods of time

What are the signs and symptoms of plantar fasciitis? 

•      Pain on the bottom of your foot near your heel

•      Pain that is worse right after you get out of bed or after a long period of rest

•      Pain after activity

How is plantar fasciitis diagnosed?

Why do I have gas?

Everyone has gas. Burping and "passing gas” is normal. But because it is embarrassing, many people believe they pass gas too often or have too much gas. A person actually having too much gas is rare.

Most of the time, gas in the body is odorless. The odor of passed gas comes from sulfur made by bacteria in the large intestine. Sometimes gas causes bloating or pain. Not everyone has these symptoms. How much gas the body makes and how sensitive a person is to gas in the large intestine have an effect on how uncomfortable one feels.

What can I do about gas?

Changing what you eat and drink can help prevent or reduce gas. If you feel like you have too much gas, you might want to try these things.

1.     Cut down on foods that can cause gas.

The amount of gas caused by certain foods varies from person to person. The only way to know your own limits is to keep track of what you eat and how much gas is causes later. You may want to keep a food diary. Write down what you eat every day and any symptoms you may develop to help determine which foods cause you the most problems.

Foods That May Contribute to Gas Production 

•      Milk Products: Milk, ice cream, cheese

•      Vegetables: Cabbage, broccoli, Brussels sprouts,

•      cauliflower, cucumbers, sauerkraut, kohlrabi, asparagus

•      Root Vegetables: Potatoes, rutabaga, turnips, radishes, onions

•      Fruits: Prunes, apricots, apples, raisins, bananas

•      Cereals & Breads: Cereals, breads, pastries, and all foods containing wheat and wheat products. Check labels

•      Fatty Foods: Pan-fried or deep-fried foods, fatty meats, rich cream sauces and gravies, pastries, and any high-fat food. Check labels

•      Liquids: Carbonated beverages, fizzy medicine 

2.      Drink plenty of water and clear soup but not “fizzy” liquids. 

Try not to drink liquids that can cause gas, like soda and beer.

3.      Eat more slowly and chew your food more.

When you eat fast, you may swallow too much air and this can also cause gas.

This document is intended to provide health related information so that you may be better informed.It is not a substitute for your care team’s medical advice and should not be relied upon for treatment forspecific medical conditions.

© 2017 The General Hospital Corporation.

Primary Care Office lnSite

developed by the MGH Laboratory of Computer Science and Division of General Internal Medicine

What is cellulitis? 

Cellulitis is a skin infection caused by bacteria. Cellulitis usually appears on the legs and feet, arms and hands, or face.

What increases my risk for cellulitis?

•      An injury that breaks the skin, such as a bite, scratch, or cut

•      Sores or injuries exposed to hot tub water or water in ponds, streams, or oceans

•      Shared belongings, such as towels or exercise equipment

•      Drugs that are injected

•      A weak immune system or diabetes

•      Lymphedema, chronic venous insufficiency, peripheral vascular disease, or deep vein thrombosis

What are the signs and symptoms of cellulitis?

•      A red, warm, swollen area on your skin

•      Pain when the area is touched

•      Bumps or blisters (abscess) that may drain pus

•      Bumpy, raised skin that feels like an orange peel

How is cellulitis diagnosed? 

Your healthcare provider may know you have cellulitis by looking at and feeling your skin. Tell him or her how long you have had symptoms, and if anything helps decrease your symptoms. Tell your healthcare provider if you have ever had a cellulitis infection. He or she may not know which kind of bacteria caused your cellulitis. You may need any of the following tests:

•      Blood tests may show which kind of bacteria is causing your infection. Blood tests may also show if the infection is in your blood

•      A sample of tissue or fluid from your infected skin may show what is causing your infection. The sample may also show if your infection is caused by another kind of skin disorder

What does the liver do?

Your liver is a large organ inside your body. It is also one of the most important. The liver performs many functions, including changing food into energy and cleaning alcohol and other toxins from the blood. Your liver also makes bile, a yellowish-green liquid that helps with digestion.

What is a liver function test?

A liver function test (LFT) is used to detect, evaluate and monitor liver disease or damage. There are several tests (sometimes called a liver panel) that may be run at the same time on one blood sample. These include tests that measure liver inflammation.

The test is simple and practically painless. A small amount of blood is drawn, usually from a vein inside the elbow.

When are liver tests ordered?

Many patients with early or mild to moderate liver disease have few if any symptoms. In some cases, liver disease is first detected through routine blood testing. Specific liver tests may be ordered when a person has been or may have been exposed to a hepatitis virus; has a family history of liver disease; has excessive alcohol intake; or is taking a drug that can cause liver damage.

Liver tests may also be ordered when symptoms suspicious of a liver condition are noticed. These include: jaundice (yellow-colored skin and eyes), dark urine, or light-colored bowel movements; nausea, vomiting and/or diarrhea; loss of appetite; vomiting of blood; bloody or black bowel movements; swelling or pain in the belly; unusual weight change; or fatigue or loss of stamina.

What will happen if my liver function test results are abnormal?

It  is not unusual for the results of a liver function test to come out abnormal. If this happens in your case, your doctor will probably order another test. Often, the second test shows a normal result and there is no need for further testing. If your doctor is still concerned, he or she may ask for an imaging test such as an ultrasound to find out more about the condition of your liver.

What can I do to prevent the development of fatty liver disease, a common cause of liver inflammation?

There are important things you can do to help prevent fatty liver disease. They include: 

•      Weight loss and exercise. If you are overweight or obese, a diet and exercise program can help prevent the accumulation of fat in your liver. Your doctor can give you information about a healthy weight-loss diet and starting an exercise program

•      Blood sugar control. A healthy diet and exercise can help prevent diabetes from developing. If you have diabetes, it is very important to manage your blood sugar level with diet, medications or insulin. Some diabetes medications can actually help prevent the accumulation of fat in your liver

•      Avoid alcohol. Alcohol can cause liver damage. If you drink alcohol, limit your intake to no more than 1 drink a day for women and no more than 2 drinks a day for men. A drink is a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 11/2 ounce shot of liquor

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team’s medical advice and should not be relied upon for treatment for specific medical conditions.

© 2017 The General Hospital Corporation.

Primary Care Office lnSite

developed by the MGH Laboratory of Computer Science and Division of General Internal Medicine

What do I need to know about acute neck pain? 

Acute neck pain starts suddenly, increases quickly, and goes away in a few days. The pain may come and go, or be worse with certain movements. The pain may be only in your neck, or it may move to your arms, back, or shoulders. You may also have pain that starts in another body area and moves to your neck.

What causes or increases my risk for acute neck pain?

Acute neck pain is often caused by a muscle strain or ligament sprain. Any of the following may cause acute neck pain:

• Inflammation of discs in your neck

• A condition that affects neck to arm nerves, such as thoracic outlet syndrome or brachial neuritis

• A trauma or injury to your neck, such as being hit from behind in a car (whiplash) or sleeping in a bad position

• Shingles, or an infection such as meningitis