August 2025

Diabetic ketoacidosis Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin. Insulin normally plays a key role in helping sugar (glucose)  a major source of energy for your muscles and other tissues enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you’re at risk of diabetes, learn the warning signs of diabetic ketoacidosis  and know when to seek emergency care. Symptoms Diabetic ketoacidosis Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: More-specific signs of diabetic ketoacidosis  which can be detected through home blood and urine testing kits include: When to see a doctor? If you feel ill or stressed or you’ve had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit.  Contact your doctor immediately if: Seek emergency care if: N.B – Remember, untreated diabetic ketoacidosis can be fatal. Causes Diabetic ketoacidosis Sugar is a main source of energy for the cells that make up your muscles and other tissues. Normally, insulin helps sugar enter your cells. Without enough insulin, your body can’t use sugar properly for energy.  This prompts the release of hormones that break down fat as fuel, which produces acids known as ketones. Excess ketones build up in the blood and eventually “spill over” into the urine. Diabetic ketoacidosis is usually triggered by: An illness.  An infection or other illness can cause your body to produce higher levels of certain hormones, such as adrenaline or cortisol. Unfortunately, these hormones counter the effect of insulin sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits. A problem with insulin therapy.  Missed insulin treatments or inadequate insulin therapy can leave you with too little insulin in your system, triggering diabetic ketoacidosis. Other possible triggers of diabetic ketoacidosis include: Risk factors The risk of diabetic ketoacidosis is highest if you: Complications Diabetic ketoacidosis is treated with fluids, electrolytes  such as sodium, potassium and chloride and insulin. Perhaps surprisingly, the most common complications of diabetic ketoacidosis are related to this lifesaving treatment. Possible complications of the treatments Treatment complications include: Low blood sugar (hypoglycemia).  Insulin allows sugar to enter your cells, causing your blood sugar level to drop. If your blood sugar level drops too quickly, you can develop low blood sugar. Low potassium (hypokalemia).   The fluids and insulin used to treat diabetic ketoacidosis can cause your potassium level to drop too low. A low potassium level can impair the activities of your heart, muscles and nerves. Swelling in the brain (cerebral edema).  Adjusting your blood sugar level too quickly can produce swelling in your brain. This complication appears to be more common in children, especially those with newly diagnosed diabetes. Left untreated, the risks are much greater  Diabetic ketoacidosis can lead to loss of consciousness and, eventually, it can be fatal. Prevention Diabetic ketoacidosis There’s much you can do to prevent diabetic ketoacidosis and other diabetes complications. Commit to managing your diabetes.  Make healthy eating and physical activity part of your daily routine. Take oral diabetes medications or insulin as directed. Monitor your blood sugar level.  You might need to check and record your blood sugar level at least three to four times a day — more often if you’re ill or under stress. Careful monitoring is the only way to make sure your blood sugar level remains within your target range. Adjust your insulin dosage as needed.  Talk to your doctor or diabetes educator about how to adjust your insulin dosage in relation to your blood sugar level, what you eat, how active you are, whether you’re ill and other factors. If your blood sugar level begins to rise, follow your diabetes treatment plan to return your blood sugar level to your target range. Check your ketone level.  When you’re ill or under stress, test your urine for excess ketones with an over-the-counter urine ketones test kit. If your ketone level is moderate or high, contact your doctor right away or seek emergency care. If you have low levels of ketones, you may need to take more insulin. Be prepared to act quickly.  If you suspect that you have diabetic ketoacidosis — your blood sugar level is high, and you have excess ketones in your urine — seek emergency care. Diabetes complications are scary.  But don’t let fear keep you from taking good care of yourself. Follow your diabetes treatment plan carefully, and ask your diabetes treatment team for help when you need it. Diagnosis Diabetic ketoacidosis If your doctor suspects diabetic ketoacidosis, he or she will do a physical exam and various blood tests. In some cases, additional tests may be needed to help determine what triggered the diabetic ketoacidosis. Blood tests Blood tests used in the diagnosis of diabetic ketoacidosis will measure: Blood sugar level.  If there isn’t enough insulin in your body to allow sugar to enter your cells, your blood sugar level will rise (hyperglycemia). As your body breaks down fat and protein for energy, your blood sugar level will continue to rise. Ketone level.  When your body breaks down fat and protein for energy, acids known as ketones enter your bloodstream. Blood acidity.  If you have excess ketones in your blood, your blood will become acidic (acidosis). This can alter the normal function of organs throughout your body. Additional tests Your doctor may order tests to identify underlying health problems that might have contributed to diabetic ketoacidosis and to check for complications. Tests might include: Treatment Diabetic ketoacidosis If you’re diagnosed with diabetic ketoacidosis, you might be treated in the emergency room or

Diabetes Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel. The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes  and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. Symptoms Diabetes Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the signs and symptoms of type 1 and type 2 diabetes are: Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it’s more common in people older than 40. When to see a doctor? If you suspect you or your child may have diabetes. If you notice any possible diabetes symptoms, contact your doctor. The earlier the condition is diagnosed, the sooner treatment can begin. If you’ve already been diagnosed with diabetes. After you receive your diagnosis, you’ll need close medical follow-up until your blood sugar levels stabilize. Causes Diabetes To understand diabetes, first you must understand how glucose is normally processed in the body. How insulin works Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas). The role of glucose Causes of type 1 diabetes The exact cause of type 1 diabetes is unknown. What is known is that your immune system which normally fights harmful bacteria or viruses attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream. Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what those factors are is still unclear. Weight is not believed to be a factor in type 1 diabetes. Causes of prediabetes and type 2 diabetes In prediabetes which can lead to type 2 diabetes and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it’s needed for energy, sugar builds up in your bloodstream. Exactly why this happens is uncertain, although it’s believed that genetic and environmental factors play a role in the development of type 2 diabetes too. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight. Causes of gestational diabetes During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin. Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can’t keep up. When this happens, too little glucose gets into your cells and too much stays in your blood, resulting in gestational diabetes. Risk factors  Risk factors for diabetes depend on the type of diabetes. Risk factors for type 1 diabetes Although the exact cause of type 1 diabetes is unknown, factors that may signal an increased risk include: Family history.  Your risk increases if a parent or sibling has type 1 diabetes. Environmental factors.  Circumstances such as exposure to a viral illness likely play some role in type 1 diabetes. The presence of damaging immune system cells (autoantibodies).  Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes autoantibodies. If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes. Geography.  Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes. Risk factors for prediabetes and type 2 diabetes Researchers don’t fully understand why some people develop prediabetes and type 2 diabetes and others don’t. It’s clear that certain factors increase the risk, however, including: Weight.  The more fatty tissue you have, the more resistant your cells become to insulin. Inactivity.  The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. Family history.  Your risk increases if a parent or sibling has type 2 diabetes. Race.  Although it’s unclear why, people of certain races including black people, Hispanics, American Indians and Asian-Americans are at higher risk. Age.  Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is also increasing among children, adolescents and younger adults. Gestational diabetes.  If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes later increases.  If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes. Polycystic ovary syndrome.  For women, having polycystic ovary syndrome a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes. High blood pressure.  Having blood pressure over 140/90 millimeters of mercury (mm Hg) is linked to an increased risk of type 2 diabetes. Abnormal cholesterol and triglyceride levels.  If you have low levels of high-density lipoprotein (HDL), or “good,” cholesterol, your risk of type 2 diabetes is

Diabetes insipidus Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you’ve had something to drink. It also leads you to produce large amounts of urine. While the terms “diabetes insipidus” and “diabetes mellitus” sound similar, they’re not related. Diabetes mellitus which can occur as type 1 or type 2  is the more common form of diabetes. There’s no cure for diabetes insipidus. But treatments can relieve your thirst and decrease your urine output. Symptoms Diabetes insipidus Signs and symptoms of diabetes insipidus include: An infant or young child with diabetes insipidus may have the following signs and symptoms: When to see a doctor? See your doctor immediately if you notice excessive urination and extreme thirst. Causes Diabetes insipidus Diabetes insipidus occurs when your body can’t properly balance the body’s fluid levels. When your fluid regulation system is working properly, your kidneys help maintain this balance. The kidneys remove fluids from your bloodstream. This fluid waste is temporarily stored in your bladder as urine, until you urinate. The body can also rid itself of excess fluids through sweating, breathing or diarrhea. A hormone called anti-diuretic hormone (ADH), or vasopressin, helps control how fast or slow fluids are excreted. ADH is made in a part of the brain called the hypothalamus and stored in the pituitary gland, a small gland found in the base of the brain. If you have diabetes insipidus, your body can’t properly balance fluid levels.  The cause varies depending on the type of diabetes insipidus you have: Central diabetes insipidus.  Damage to the pituitary gland or hypothalamus from surgery, a tumor, a head injury or an illness can cause central diabetes insipidus by affecting the usual production, storage and release of ADH. An inherited genetic disease can also cause this condition. Nephrogenic diabetes insipidus.  Nephrogenic diabetes insipidus occurs when there’s a defect in the kidney tubules the structures in your kidneys that cause water to be excreted or reabsorbed. This defect makes your kidneys unable to properly respond to ADH. The defect may be due to an inherited (genetic) disorder or a chronic kidney disorder.  Certain drugs, such as lithium or antiviral medications such as foscarnet (Foscavir), also can cause nephrogenic diabetes insipidus. Gestational diabetes insipidus.  Gestational diabetes insipidus is rare. It occurs only during pregnancy when an enzyme made by the placenta destroys ADH in the mother. Primary polydipsia.  Also known as dipsogenic diabetes insipidus, this condition can cause production of large amounts of diluted urine. The underlying cause is drinking an excessive amount of fluids. Primary polydipsia can be caused by damage to the thirst-regulating mechanism in the hypothalamus. The condition has also been linked to mental illness, such as schizophrenia. Sometimes, there’s no obvious cause of diabetes insipidus.  However, in some people, the disorder may be the result of an autoimmune reaction that causes the immune system to damage the cells that make vasopressin. Risk factors Nephrogenic diabetes insipidus that’s present at or shortly after birth usually has an inherited (genetic) cause that permanently changes the kidneys’ ability to concentrate the urine. Nephrogenic diabetes insipidus usually affects males, though women can pass the gene on to their children. Complications Diabetes insipidus Diabetes insipidus can cause an imbalance in electrolytes minerals in your blood, such as sodium and potassium, that maintain the fluid balance in your body. Symptoms of an electrolyte imbalance may include: Diagnosis Diabetes insipidus Some of the tests doctors use to diagnose diabetes insipidus include: Water deprivation test.  While being monitored by a doctor and health care team, you’ll be asked to stop drinking fluids for several hours. To prevent dehydration while fluids are restricted, ADH allows your kidneys to decrease the amount of fluid lost in the urine. While fluids are being withheld, your doctor will measure changes in your body weight, urine output, and the concentration of your urine and blood. Your doctor may also measure blood levels of ADH or give you synthetic ADH during this test. This will determine if your body is producing enough ADH and if your kidneys can respond as expected to ADH. Magnetic resonance imaging (MRI).  An MRI can look for abnormalities in or near the pituitary gland. This test is noninvasive. It uses a powerful magnetic field and radio waves to construct detailed pictures of brain tissues. Genetic screening.  If others in your family have had problems with excess urination, your doctor may suggest genetic screening. Treatment Diabetes insipidus Treatment options for the most common types of diabetes insipidus include: Central diabetes insipidus.  If you have mild diabetes insipidus, you may only need to increase your water intake. If the condition is caused by an abnormality in the pituitary gland or hypothalamus (such as a tumor), your doctor will first treat the abnormality. Typically, this form is treated with a man-made hormone called desmopressin (DDAVP, Minirin, others). This medication replaces the missing anti-diuretic hormone (ADH) and decreases urination. You can take desmopressin as a nasal spray, as oral tablets or by injection. Most people still make some ADH, though the amount can vary day to day. So, the amount of desmopressin you need also may vary. Taking more desmopressin than you need can cause water retention and potentially serious low-sodium levels in the blood. Other medications may also be prescribed, such as indomethacin (Indocin, Tivorbex) and chlorpropamide. These drugs can make ADH more available in the body. Nephrogenic diabetes insipidus.  Since the kidneys don’t properly respond to ADH in this form of diabetes insipidus, desmopressin won’t help. Instead, your doctor may prescribe a low-salt diet to help reduce the amount of urine your kidneys make. You’ll also need to drink enough water to avoid dehydration. Treatment with the drug hydrochlorothiazide (Microzide) may improve your symptoms.  Although hydrochlorothiazide is a type of drug that usually increases urine output (diuretic), in some people it can reduce urine output for people with nephrogenic diabetes insipidus. If your symptoms are due to

Dermatitis Dermatitis is a general term that describes a skin irritation. Dermatitis is a common condition that has many causes and occurs in many forms. It usually involves itchy, dry skin or a rash on swollen, reddened skin. Or it may cause the skin to blister, ooze, crust or flake off. Examples of this condition are atopic dermatitis (eczema), dandruff and contact dermatitis. Dermatitis isn’t contagious, but it can make you feel uncomfortable and self-conscious. Moisturizing regularly helps control the symptoms. Treatment may also include medicated ointments, creams and shampoos. Causes of Dermatitis Causes of the most common types of dermatitis include: Atopic dermatitis (eczema).  This type is likely related to dry skin, a gene variation, an immune system dysfunction, a skin infection, exposure to food, airborne, or contact allergens, or a combination of these. Contact dermatitis.  This type results from contact with something that irritates your skin or causes an allergic reaction. Irritants or allergens include poison ivy, perfumes, jewelry containing nickel, cleaning products, and the preservatives in many creams and lotions. Seborrheic dermatitis.  This type is caused by a yeast (fungus) that is in the oil secretion on the skin. Risk factors of Dermatitis Common risk factors for dermatitis include: Age.  Dermatitis can occur at any age, but atopic dermatitis (eczema) usually begins in infancy. Allergies and asthma.  People who have a personal or family history of eczema, allergies, hay fever or asthma are more likely to develop atopic dermatitis. Occupation.  Jobs that put you in contact with certain metals, solvents or cleaning supplies increase your risk of contact dermatitis. Being a health care worker is linked to hand eczema. Health conditions.  Health conditions that put you at increased risk of seborrheic dermatitis include congestive heart failure, Parkinson’s disease and HIV/AIDS. Symptoms of Dermatitis Each type of dermatitis may look a little different and tends to occur on different parts of your body. Signs and symptoms of different types of dermatitis include: Atopic dermatitis (eczema).  Usually beginning in infancy, this red, itchy rash usually occurs where the skin flexes inside the elbows, behind the knees and in front of the neck. The rash may leak fluid when scratched and crust over. People with atopic dermatitis may experience improvement and then seasonal flare-ups. Contact dermatitis.   This red, itchy stinging rash occurs where your skin has come into contact with substances that irritate the skin or cause an allergic reaction. You may develop blisters. Seborrheic dermatitis.  This condition causes scaly patches, red skin and stubborn dandruff. It usually affects oily areas of the body, such as the face, upper chest and back. Seborrheic dermatitis can be a long-term condition with periods of improvement and then seasonal flare-ups. In infants, this condition is called cradle cap. Follicular eczema.  With this type, the affected skin thickens and develops bumps in hair follicles. This condition is common in African Americans and in people with dark-brown skin. When to see a doctor See your doctor if: Complications of Dermatitis Scratching the itchy rash associated with dermatitis can cause open sores, which may become infected. These skin infections can spread and may very rarely become life-threatening. Prevention Wear protective clothing if you are doing a task that involves irritants or caustic chemicals. Avoid dry skin by adopting these habits when bathing: Take shorter baths and showers.  Limit your baths and showers to 5 to 10 minutes. Use warm, rather than hot, water. Bath oil also may be helpful. Use a gentle, nonsoap cleanser.  Choose unscented nonsoap cleansers. Some soaps can dry your skin. Dry yourself gently.  After bathing, gently pat your skin dry with a soft towel. Moisturize your skin.  While your skin is still damp, seal in moisture with an oil, cream or lotion. Try different products to find one that works for you. Ideally, the best one for you will be safe, effective, affordable and unscented. Two small studies showed that applying a protective moisturizer to the skin of infants at high risk of atopic dermatitis reduced the incidence of the condition by up to 50 percent. Diagnosis of Dermatitis Your doctor will likely talk with you about your symptoms and examine your skin. You may need to have a small piece of skin removed (biopsied) for study in a lab, which helps rule out other conditions. Patch testing Your doctor may recommend patch testing on your skin. In this test, small amounts of different substances are applied to your skin and then covered. The doctor looks at your skin during visits over the next few days to look for signs of a reaction. Patch testing can help diagnose specific types of allergies causing your dermatitis. Treatment The treatment for dermatitis varies, depending on the cause and your symptoms. In addition to the lifestyle and home remedies recommendations below, dermatitis treatment includes one or more of the following: Lifestyle and home remedies These self-care habits can help you manage dermatitis and feel better: Moisturize your skin.  Routinely applying a moisturizer with high oil content can help your skin. Use nonprescription anti-inflammation and anti-itch products.  Over-the-counter (OTC) hydrocortisone cream can temporarily relieve redness and itching. Oral antihistamines, such as diphenhydramine, may help reduce itching. Apply a cool wet cloth.  This helps soothe your skin. Take a comfortably warm bath.  Sprinkle your bath water with baking soda or colloidal oatmeal — a finely ground oatmeal that’s made for the bathtub. Soak for 5 to 10 minutes, pat dry and apply unscented moisturizer while your skin is still damp. A lotion of 12 percent ammonium lactate or 10 percent alpha-hydroxy acid helps with flaky, dry skin. Use medicated shampoos.  For dandruff, use OTC shampoos containing selenium sulfide, zinc pyrithione, coal tar or ketoconazole. Take a dilute bleach bath.  This may help people with severe atopic dermatitis by decreasing the bacteria on the skin. For a dilute bleach bath, add 1/2 cup (about 118 milliliters) of household bleach, not concentrated bleach, to a 40-gallon (about 151-liter) bathtub filled with warm water. Measures are for a

Cystic fibrosis Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s. Causes cystic fibrosis In cystic fibrosis, a defect (mutation) in a gene changes a protein that regulates the movement of salt in and out of cells. The result is thick, sticky mucus in the respiratory, digestive and reproductive systems, as well as increased salt in sweat. Many different defects can occur in the gene. The type of gene mutation is associated with the severity of the condition. Children need to inherit one copy of the gene from each parent in order to have the disease. If children inherit only one copy, they won’t develop cystic fibrosis. However, they will be carriers and possibly pass the gene to their own children. Symptoms cystic fibrosis Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. Respiratory signs and symptoms The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: Digestive signs and symptoms The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren’t able to completely absorb the nutrients in the food you eat. The result is often: Frequent straining while passing stool can cause part of the rectum  the end of the large intestine to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis.  Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. When to see a doctor? If you or your child has symptoms of cystic fibrosis or if someone in your family has cystic fibrosis talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. Risk factors Family history.  Because cystic fibrosis is an inherited disorder, it runs in families. Race.  Although cystic fibrosis occurs in all races, it is most common in white people of Northern European ancestry. Respiratory system complications Damaged airways (bronchiectasis).  Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways. This makes it harder to move air in and out of the lungs and clear mucus from the airways (bronchial tubes). Chronic infections.  Thick mucus in the lungs and sinuses provides an ideal breeding ground for bacteria and fungi. People with cystic fibrosis may often have sinus infections, bronchitis or pneumonia. Growths in the nose (nasal polyps).  Because the lining inside the nose is inflamed and swollen, it can develop soft, fleshy growths (polyps). Coughing up blood (hemoptysis).  Over time, cystic fibrosis can cause thinning of the airway walls. As a result, teenagers and adults with cystic fibrosis may cough up blood. Pneumothorax.  This condition, in which air collects in the space that separates the lungs from the chest wall, also is more common in older people with cystic fibrosis. Pneumothorax can cause chest pain and breathlessness. Respiratory failure.  Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. Acute exacerbations.  People with cystic fibrosis may experience worsening of their respiratory symptoms, such as coughing and shortness of breath, for several days to weeks. This is called an acute exacerbation and requires treatment in the hospital. Digestive system complications Nutritional deficiencies.  Thick mucus can block the tubes that carry digestive enzymes from your pancreas to your intestines. Without these enzymes, your body can’t absorb protein, fats or fat-soluble vitamins. Diabetes.  The pancreas produces insulin, which your body needs to use sugar. Cystic fibrosis increases the risk of diabetes. Around 30 percent of people with cystic fibrosis develop diabetes by age 30. Blocked bile duct.  The tube that carries bile from your liver and gallbladder to your small intestine may become blocked and inflamed, leading to liver problems and sometimes gallstones. Intestinal obstruction.  Intestinal obstruction can happen to people with cystic fibrosis at all ages. Children and adults with cystic fibrosis are more likely than are infants to develop intussusception, a condition in which a section of the intestines folds in on itself like an accordion. Distal intestinal obstruction syndrome (DIOS).  DIOS is partial or complete obstruction where the small intestine meets the large intestine. Reproductive system complications N.B – Almost all men with cystic fibrosis are infertile because the tube

Cholera Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhea and dehydration. Left untreated, cholera can be fatal in a matter of hours, even in previously healthy people. Modern sewage and water treatment have virtually eliminated cholera in industrialized countries. The last major outbreak in Zimbabwe occurred in 2008 – 2009 . A resurgence outbreak began in 2024 to 2025 .But cholera is still present in Africa, Southeast Asia and Haiti. The risk of cholera epidemic is highest when poverty, war or natural disasters force people to live in crowded conditions without adequate sanitation. Cholera is easily treated. Death results from severe dehydration that can be prevented with a simple and inexpensive rehydration solution. Symptoms of Cholera Most people exposed to the cholera bacterium (Vibrio cholerae) don’t become ill and never know they’ve been infected. Yet because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others through contaminated water. Most symptomatic cases of cholera cause mild or moderate diarrhea that’s often hard to distinguish from diarrhea caused by other problems. Only about 1 in 10 infected people develops more-serious signs and symptoms of cholera, usually within a few days of infection. Symptoms of cholera infection may include: Diarrhea.  Cholera-related diarrhea comes on suddenly and may quickly cause dangerous fluid loss — as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool). Nausea and vomiting.  Occurring especially in the early stages of cholera, vomiting may persist for hours at a time. Dehydration.  Dehydration can develop within hours after the onset of cholera symptoms. Depending on how many body fluids have been lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration. Signs and symptoms of cholera dehydration include :  Dehydration may lead to a rapid loss of minerals in your blood (electrolytes) that maintain the balance of fluids in your body. This is called an electrolyte imbalance. Electrolyte imbalance An electrolyte imbalance can lead to serious signs and symptoms such as: Muscle cramps.  These result from the rapid loss of salts such as sodium, chloride and potassium. Shock.  This is one of the most serious complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. If untreated, severe hypovolemic shock can cause death in a matter of minutes. Signs and symptoms of cholera in children In general, children with cholera have the same signs and symptoms adults do, but they are particularly susceptible to low blood sugar (hypoglycemia) due to fluid loss, which may cause: When to see a doctor? The risk of cholera is slight in industrialized nations, and even in endemic areas you’re not likely to become infected if you follow food safety recommendations. Still, sporadic cases of cholera occur throughout the world. If you develop severe diarrhea after visiting an area with active cholera, see your doctor. If you have diarrhea, especially severe diarrhea, and think you may have been exposed to cholera, seek treatment right away. Severe dehydration is a medical emergency that requires immediate care regardless of the cause. Causes of Cholera A bacterium called Vibrio cholerae causes cholera infection.  However, the deadly effects of the disease are the result of a potent toxin called CTX that the bacterium produce in the small intestine. CTX binds to the intestinal walls, where it interferes with the normal flow of sodium and chloride. This causes the body to secrete enormous amounts of water, leading to diarrhea and a rapid loss of fluids and salts (electrolytes). Contaminated water supplies are the main source of cholera infection, although raw shellfish, uncooked fruits and vegetables, and other foods also can harbor V. cholerae. Cholera bacteria have two distinct life cycles  one in the environment and one in humans. Cholera bacteria in the environment Cholera bacteria occur naturally in coastal waters, where they attach to tiny crustaceans called copepods. The cholera bacteria travel with their hosts, spreading worldwide as the crustaceans follow their food source  certain types of algae and plankton that grow explosively when water temperatures rise. Algae growth is further fueled by the urea found in sewage and in agricultural runoff. Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still pass the bacteria in their stool. When human feces contaminate food and water supplies, both can serve as ideal breeding grounds for the cholera bacteria. Because more than a million cholera bacteria  approximately the amount you’d find in a glass of contaminated water are needed to cause illness, cholera usually isn’t transmitted through casual person-to-person contact. The most common sources of cholera infection are standing water and certain types of food, including seafood, raw fruits and vegetables, and grains. Surface or well water.  Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk of cholera. Seafood.  Eating raw or undercooked seafood, especially shellfish, that originates from certain locations can expose you to cholera bacteria. Most recent cases of cholera occurring in the Budiriro ,Harare. Raw fruits and vegetables.  Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where cholera is endemic. In developing nations, uncomposted manure fertilizers or irrigation water containing raw sewage can contaminate produce in the field. Grains.  In regions where cholera is widespread, grains such as rice and millet that are contaminated after cooking and allowed to remain at room temperature for several hours become a medium for the growth of cholera bacteria. Risk factors of Cholera Everyone is susceptible to cholera, with the exception of infants who derive immunity from nursing mothers who have previously had

Chlamydia trachomatis Chlamydia trachomatis is a common sexually transmitted infection (STI) caused by bacteria. You may not know you have chlamydia because many people never develop the signs or symptoms, such as genital pain and discharge from the vagina or penis. Chlamydia trachomatis affects both men and women and occurs in all age groups, though it’s most prevalent among young women. Chlamydia isn’t difficult to treat once you know you have it. If left untreated, however, it can lead to more-serious health problems. Causes Chlamydia trachomatis Chlamydia trachomatis is caused by Chlamydia trachomatis bacterium and is most commonly spread through vaginal, oral and anal sex. It’s also possible for a mother to spread chlamydia to her child during delivery, causing pneumonia or a serious eye infection in her newborn. Symptoms Chlamydia trachomatis Early-stage Chlamydia trachomatis infections often cause few or no signs and symptoms. When signs or symptoms occur, they usually start one to two weeks after exposure to chlamydia. Even when signs and symptoms occur, they’re often mild and passing, making them easy to overlook. Signs and symptoms of chlamydia trachomatis infection may include: N.B – Chlamydia trachomatis can also infect the rectum. While these infections often cause no signs or symptoms, you may experience rectal pain, discharge or bleeding. It’s also possible to acquire chlamydial eye infections (conjunctivitis) through contact with infected secretions. When to see a doctor? See your doctor if you have a discharge from your vagina, penis or rectum, or if you have pain during urination. Also, see your doctor if your sexual partner reveals that he or she has chlamydia. Your doctor will likely prescribe an antibiotic even if you have no symptoms. Risk factors Factors that increase your risk of chlamydia trachomatis include: Complications Associated with Chlamydia trachomatis Chlamydia trachomatis can be associated with: Other sexually transmitted infections.  People who have chlamydia trachomatis are at higher risk of also having other STIs ” including gonorrhea and HIV, the virus that causes AIDS. Pelvic inflammatory disease (PID).  PID is an infection of the uterus and fallopian tubes that causes pelvic pain and fever. Severe infections may require hospitalization for intravenous antibiotics. PID can damage the fallopian tubes, ovaries and uterus, including the cervix. Infection near the testicles (epididymitis).  A chlamydia infection can inflame the coiled tube located beside each testicle (epididymis). The infection may result in fever, scrotal pain and swelling. Prostate gland infection.  The chlamydia organism can spread to a man’s prostate gland. Prostatitis may result in pain during or after sex, fever and chills, painful urination, and lower back pain . Infections in newborns.  The chlamydia infection can pass from the vaginal canal to your child during delivery, causing pneumonia or a serious eye infection. Infertility.  Chlamydia infections ” even those that produce no signs or symptoms ” can cause scarring and obstruction in the fallopian tubes, which may make women infertile. Reactive arthritis.  People who have chlamydia trachomatis are at higher risk of developing reactive arthritis, also known as Reiter’s syndrome. This condition typically affects the joints, eyes and urethra ” the tube that carries urine from your bladder to outside of your body. Prevention of Chlamydia trachomatis The surest way to prevent a chlamydia trachomatis infection is to abstain from sexual activities. Short of that, you can: Use condoms.  Use a male latex condom or a female polyurethane condom during each sexual contact. Condoms used properly during every sexual encounter reduce but don’t eliminate the risk of infection. Limit your number of sex partners. Having multiple sex partners puts you at a high risk of contracting chlamydia and other sexually transmitted infections. Get regular screenings.  If you’re sexually active, particularly if you have multiple partners, talk with your doctor about how often you should be screened for chlamydia and other sexually transmitted infections. Avoid douching.  Douching isn’t recommended because it decreases the number of good bacteria present in the vagina, which may increase the risk of infection. Diagnosis of Chlamydia trachomatis Because of the chance of other health problems if you contract chlamydia trachomatis, ask your doctor how often you should have chlamydia screening tests if you’re at risk. The Centers for Disease Control and Prevention recommends chlamydia screening for: Sexually active women age 25 or younger.  The rate of chlamydia infection is highest in this group, so a yearly screening test is recommended. Even if you’ve been tested in the past year, get tested when you have a new sex partner. Pregnant women.  You should be tested for chlamydia during your first prenatal exam. If you have a high risk of infection — from changing sex partners or from your regular partner’s possible infection — get tested again later in your pregnancy. Women and men at high risk.  Consider frequent chlamydia screening if you have multiple sex partners, if you don’t always use a condom during sex or if you’re a man who has sex with men. Other markers of high risk are current infection with another sexually transmitted infection and possible exposure to an STI through an infected partner. Screening and diagnosis of chlamydia is relatively simple. Tests include: A urine test.  A sample of your urine analyzed in the laboratory may indicate the presence of this infection. A swab.  For women, your doctor takes a swab of the discharge from your cervix for culture or antigen testing for chlamydia. This can be done during a routine Pap test. Some women prefer to swab their vaginas themselves, which has been shown to be as diagnostic as doctor-obtained swabs. For men, your doctor inserts a slim swab into the end of your penis to get a sample from the urethra. In some cases, your doctor may swab the anus. If you’ve been treated for an initial chlamydia infection, you should be retested in about three months. Treatment of Chlamydia trachomatis Chlamydia trachomatis is treated with antibiotics. You may receive a one-time dose, or you may need to take the medication daily or multiple times a day for five

Chest pain Chest pain appears in many forms, ranging from a sharp stab to a dull ache. Sometimes chest pain feels crushing or burning. In certain cases, the pain travels up the neck, into the jaw, and then radiates to the back or down one or both arms. Many different problems can cause chest pain. The most life-threatening causes involve the heart or lungs. Because chest pain can indicate a serious problem, it’s important to seek immediate medical help. Symptoms Chest pain Chest pain can cause many different sensations depending on what’s triggering the symptom. Often, the cause has nothing to do with your heart though there’s no easy way to tell without seeing a doctor. Heart-related chest pain Although chest pain is often associated with heart disease, many people with heart disease say they experience a vague discomfort that isn’t necessarily identified as pain. In general, chest discomfort related to a heart attack or another heart problem may be described by or associated with one or more of the following: Other types of chest pain It can be difficult to distinguish heart-related chest pain from other types of chest pain. However, chest pain that is less likely due to a heart problem is more often associated with: When to see a doctor? If you have new or unexplained chest pain or suspect you’re having a heart attack, call for emergency medical help immediately. Causes Chest pain Chest pain has many possible causes, all of which need medical attention. Heart-related causes Examples of heart-related causes of chest pain include: Heart attack.  A heart attack results from blocked blood flow, often from a blood clot, to your heart muscle. Angina.  Angina is the term for chest pain caused by poor blood flow to the heart. This is often caused by the buildup of thick plaques on the inner walls of the arteries that carry blood to your heart. These plaques narrow the arteries and restrict the heart’s blood supply, particularly during exertion. Aortic dissection.  This life-threatening condition involves the main artery leading from your heart (aorta). If the inner layers of this blood vessel separate, blood is forced between the layers and can cause the aorta to rupture. Pericarditis.  This is the inflammation of the sac surrounding your heart. It usually causes sharp pain that gets worse when you breathe in or when you lie down. Digestive causes Chest pain can be caused by disorders of the digestive system, including: Heartburn.  This painful, burning sensation behind your breastbone occurs when stomach acid washes up from your stomach into the tube that connects your throat to your stomach (esophagus). Swallowing disorders.  Disorders of the esophagus can make swallowing difficult and even painful. Gallbladder or pancreas problems.  Gallstones or inflammation of your gallbladder or pancreas can cause abdominal pain that radiates to your chest. Muscle and bone causes Some types of chest pain are associated with injuries and other problems affecting the structures that make up the chest wall, including: Costochondritis.  In this condition, the cartilage of your rib cage, particularly the cartilage that joins your ribs to your breastbone, becomes inflamed and painful. Sore muscles.  Chronic pain syndromes, such as fibromyalgia, can produce persistent muscle-related chest pain. Injured ribs.  A bruised or broken rib can cause chest pain. Lung-related causes Many lung disorders can cause chest pain, including: Pulmonary embolism.  This occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue. Pleurisy.  If the membrane that covers your lungs becomes inflamed, it can cause chest pain that worsens when you inhale or cough. Collapsed lung.  The chest pain associated with a collapsed lung typically begins suddenly and can last for hours, and is generally associated with shortness of breath. A collapsed lung occurs when air leaks into the space between the lung and the ribs. Pulmonary hypertension.  This condition occurs when you have high blood pressure in the arteries carrying blood to the lungs, which can produce chest pain. Other causes of Chest pain Chest pain can also be caused by: Panic attack.  If you have periods of intense fear accompanied by chest pain, a rapid heartbeat, rapid breathing, profuse sweating, shortness of breath, nausea, dizziness and a fear of dying, you may be experiencing a panic attack. Shingles.  Caused by a reactivation of the chickenpox virus, shingles can produce pain and a band of blisters from your back around to your chest wall. Diagnosis of Chest pain Chest pain doesn’t always signal a heart attack. But that’s what emergency room doctors will test for first because it’s potentially the most immediate threat to your life. They may also check for lifethreatening lung conditions  such as a collapsed lung or a clot in your lung. Immediate tests Some of the first tests your doctor may order include: Electrocardiogram (ECG).  This test records the electrical activity of your heart through electrodes attached to your skin. Because injured heart muscle doesn’t conduct electrical impulses normally, the ECG may show that you have had or are having a heart attack. Blood tests.  Your doctor may order blood tests to check for increased levels of certain proteins or enzymes normally found in heart muscle. Damage to heart cells from a heart attack may allow these proteins or enzymes to leak, over a period of hours, into your blood. Chest X-ray.  An X-ray of your chest allows doctors to check the condition of your lungs and the size and shape of your heart and major blood vessels. A chest X-ray can also reveal lung problems such as pneumonia or a collapsed lung. Computerized tomography (CT scan).  CT scans can spot a blood clot in your lung (pulmonary embolism) or make sure you’re not having aortic dissection. Follow-up testing Depending upon the results from these initial tests, you may need follow-up testing, which may include: Echocardiogram.  An echocardiogram uses sound waves to produce a video image of your heart in motion. A small device may be passed down your

Colon cancer Colon cancer is a type of cancer that begins in the large intestine (colon). The colon is the final part of the digestive tract. Colon cancer typically affects older adults, though it can happen at any age. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time some of these polyps can become colon cancers. Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying and removing polyps before they turn into cancer. If colon cancer develops, many treatments are available to help control it, including surgery, radiation therapy and drug treatments, such as chemotherapy, targeted therapy and immunotherapy. Colon cancer is sometimes called colorectal cancer, which is a term that combines colon cancer and rectal cancer, which begins in the rectum. Symptoms Colon cancer Signs and symptoms of colon cancer include : Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the cancer’s size and location in your large intestine. When to see a doctor If you notice any persistent symptoms that worry you, make an appointment with your doctor. Talk with your doctor about when to begin colon cancer screening. Guidelines generally recommend that colon cancer screenings begin around 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease. Causes Colon cancer Doctors aren’t certain what causes most colon cancers. In general, colon cancer begins when healthy cells in the colon develop changes (mutations) in their DNA. A cell’s DNA contains a set of instructions that tell a cell what to do. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But when a cell’s DNA is damaged and becomes cancerous, cells continue to divide even when new cells aren’t needed. As the cells accumulate, they form a tumor. With time, the cancer cells can grow to invade and destroy normal tissue nearby. And cancerous cells can travel to other parts of the body to form deposits there (metastasis). Risk factors Factors that may increase your risk of colon cancer include: Older age.  Colon cancer can be diagnosed at any age, but a majority of people with colon cancer are older than 50. The rates of colon cancer in people younger than 50 have been increasing, but doctors aren’t sure why. African race African have a greater risk of colon cancer than do people of other races. A personal history of colorectal cancer or polyps.  If you’ve already had colon cancer or noncancerous colon polyps, you have a greater risk of colon cancer in the future. Inflammatory intestinal conditions.  Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer. Inherited syndromes that increase colon cancer risk.  Some gene mutations passed through generations of your family can increase your risk of colon cancer significantly. Only a small percentage of colon cancers are linked to inherited genes. The most common inherited syndromes that increase colon cancer risk are familial adenomatous polyposis (FAP) and Lynch syndrome, which is also known as hereditary nonpolyposis colorectal cancer (HNPCC).\ Family history of colon cancer.  You’re more likely to develop colon cancer if you have a blood relative who has had the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. Low-fiber, high-fat diet.  Colon cancer and rectal cancer may be associated with a typical Western diet, which is low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meat. A sedentary lifestyle.  People who are inactive are more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer. Diabetes.  People with diabetes or insulin resistance have an increased risk of colon cancer. Obesity.  People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight. Smoking.  People who smoke may have an increased risk of colon cancer. Alcohol.  Heavy use of alcohol increases your risk of colon cancer. Radiation therapy for cancer.  Radiation therapy directed at the abdomen to treat previous cancers increases the risk of colon cancer. Prevention Colon cancer Screening colon cancer Doctors recommend that people with an average risk of colon cancer consider colon cancer screening around age 50. But people with an increased risk, such as those with a family history of colon cancer, should consider screening sooner. Several screening options exist each with its own benefits and drawbacks. Talk about your options with your doctor, and together you can decide which tests are appropriate for you. Lifestyle changes to reduce your risk of colon cancer You can take steps to reduce your risk of colon cancer by making changes in your everyday life. Take steps to : Eat a variety of fruits, vegetables and whole grains.  Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention. Choose a variety of fruits and vegetables so that you get an array of vitamins and nutrients. Drink alcohol in moderation, if at all.  If you choose to drink alcohol, limit the amount of alcohol you drink to no more than one drink a day for women and two for men. Stop smoking.  Talk to your doctor about ways to quit that may work for you. Exercise most days of the week.  Try to get at least 30 minutes of exercise on most days. If you’ve been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your doctor

Cirrhosis Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. Each time your liver is injured  whether by disease, excessive alcohol consumption or another cause  it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening. The liver damage done by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed. Symptoms Cirrhosis often has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include: Causes A wide range of diseases and conditions can damage the liver and lead to cirrhosis. Some of the causes include: Risk factors Drinking too much alcohol.  Excessive alcohol consumption is a risk factor for cirrhosis. Being overweight.  Being obese increases your risk of conditions that may lead to cirrhosis, such as nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Having viral hepatitis.  Not everyone with chronic hepatitis will develop cirrhosis, but it’s one of the world’s leading causes of liver disease. When to see a doctor? Make an appointment with your doctor if you have any of the signs or symptoms listed above. Complications Complications of cirrhosis can include: High blood pressure in the veins that supply the liver (portal hypertension).   Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood to the liver from the intestines and spleen. Swelling in the legs and abdomen.  The increased pressure in the portal vein can cause fluid to accumulate in the legs (edema) and in the abdomen (ascites). Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin. Enlargement of the spleen (splenomegaly).  Portal hypertension can also cause changes to and swelling of the spleen, and trapping of white blood cells and platelets. Decreased white blood cells and platelets in your blood can be the first sign of cirrhosis. Bleeding.  Portal hypertension can cause blood to be redirected to smaller veins. Strained by the extra pressure, these smaller veins can burst, causing serious bleeding. Portal hypertension may cause enlarged veins (varices) in the esophagus (esophageal varices) or the stomach (gastric varices) and lead to life-threatening bleeding. If the liver can’t make enough clotting factors, this also can contribute to continued bleeding. Infections.  If you have cirrhosis, your body may have difficulty fighting infections. Ascites can lead to bacterial peritonitis, a serious infection. Malnutrition.  Cirrhosis may make it more difficult for your body to process nutrients, leading to weakness and weight loss. Buildup of toxins in the brain (hepatic encephalopathy).  A liver damaged by cirrhosis isn’t able to clear toxins from the blood as well as a healthy liver can. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. With time, hepatic encephalopathy can progress to unresponsiveness or coma. Jaundice.  Jaundice occurs when the diseased liver doesn’t remove enough bilirubin, a blood waste product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of urine. Bone disease.  Some people with cirrhosis lose bone strength and are at greater risk of fractures. Increased risk of liver cancer.  A large proportion of people who develop liver cancer have pre-existing cirrhosis. Acute-on-chronic cirrhosis.  Some people end up experiencing multiorgan failure. Researchers now believe this is a distinct complication in some people who have cirrhosis, but they don’t fully understand its causes. Prevention Reduce your risk of cirrhosis by taking these steps to care for your liver: Do not drink alcohol if you have cirrhosis.  If you have liver disease, you should avoid alcohol. Eat a healthy diet.  Choose a plant-based diet that’s full of fruits and vegetables. Select whole grains and lean sources of protein. Reduce the amount of fatty and fried foods you eat. Maintain a healthy weight.  An excess amount of body fat can damage your liver. Talk to your doctor about a weight-loss plan if you are obese or overweight. Reduce your risk of hepatitis.  Sharing needles and having unprotected sex can increase your risk of hepatitis B and C. Ask your doctor about hepatitis vaccinations. If you’re concerned about your risk of liver cirrhosis, talk to your doctor about ways you can reduce your risk. Diagnosis People with early-stage cirrhosis of the liver usually don’t have symptoms. Often, cirrhosis is first detected through a routine blood test or checkup. To help confirm a diagnosis, a combination of laboratory and imaging tests is usually done. Tests Your doctor may order one or more tests that may suggest a problem with your liver, including: Laboratory tests.  Your doctor may order blood tests to check for signs of liver malfunction, such as excess bilirubin, as well as for certain enzymes that may indicate liver damage. To assess kidney function, your blood is checked for creatinine. You’ll be screened for the hepatitis viruses. Your international normalized ratio (INR) is also checked for your blood’s ability to clot. Based on the blood test results, your doctor may be able to diagnose the underlying cause of cirrhosis. He or she can also use blood tests to help identify how serious your cirrhosis is. Imaging tests.  Magnetic resonance elastography (MRE) may be recommended. This noninvasive advanced imaging test detects hardening or stiffening of the liver. Other imaging tests, such as MRI, CT and ultrasound, may also be done. Biopsy.  A tissue sample (biopsy) is not necessarily needed for diagnosis. However, your doctor may use it to identify the severity, extent and cause of liver damage. If you have cirrhosis, your doctor is likely to recommend regular diagnostic tests to monitor for signs of disease progression or complications, especially esophageal varices and liver cancer. Noninvasive