Home :: Family Health :: Pelvic Inflammatory Disease

Pelvic Inflammatory Disease - Pelvic Inflammatory Disease symptom, treatment, causes

Pelvic Inflammatory Disease occurs due to the inflammation (usually infectious) of the pelvic reproductive organs: the uterus, fallopian tubes and ovaries in women and the prostate and seminal vesicles brgans that contribute liquid to semen and store sperm) in men. The commonest causes of pelvic inflammatory disease (PID) are sexually transmissible infections such as GONORRHOEA and CHLAMYDIA, though it may also occur following childbirth or abortion, surgical procedures on the reproductive organs or lower urinary tract, or appendicitis (especially when the appendix has ruptured). Because PID is a more common manifes-tation of the spread of sexually transmissible disease in women than in men, the term is usually reserved for women. PID may be acute or chronic.

Pelvic inflammatory disease is a general term for infection of the lining of the uterus, the fallopian tubes, or the ovaries. Normally, the cervix (opening to the womb) prevents bacteria in the vagina from spreading up into these organs. It is a common and serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. Up to 40% of women who get one of these infections and don't have it adequately treated will wind up with PID. PID can occur after a miscarriage, abortion, or any other procedure that opens the cervix or abdomen, allowing disease-causing germs easy entry to the reproductive organs. This can allow bacteria to travel up into the internal organs, making them inflamed and infected. If this occurs, the woman's fallopian tubes may be damaged, making it difficult for her to become pregnant. Each year more than 1 million women in the United States are diagnosed with PID. More than 100,000 women become infertile as a result of PID, while others experience complications during pregnancy. Prompt treatment of a sexually transmitted disease can help prevent PID.

Pelvic inflammatory disease (PID) is a spectrum of infections of the female genital tract that includes endometritis, salpingitis, tuboovarian abscess, and peritonitis. PID can affect the fallopian tubes (the tubes that carry eggs from the ovary to the uterus, or womb). It can also involve the tissues in and near the uterus and ovaries. PID occurs when disease-causing microorganisms in the lower genital tract rise through the opening in the cervix, which separates the uterus and the vagina (see "How PID infects the reproductive organs") Other potential risk factors include douching, which women should avoid. In some women, using an intrauterine device (IUD) to prevent pregnancy can also cause PID. Rarely, PID results from gynecological procedures or surgeries. Anaerobic bacteria, including those in the genera Peptococcus, Peptostreptococcus, and Bacteroides, appear to play an important role. The genital Mycoplasma and Ureaplasma organisms and the gut coliforms also have been isolated from the upper genital tract of women with PID.

Causes of Pelvic Inflammatory Disease

The common Causes of Pelvic Inflammatory Disease :

• The most common germ to cause PID in UK is Chlamydia trachomatis (in at least 50%). Gonorrhoea (Neisseria gonorrhoea) is also a fairly common cause. Both may occur together. Various other germs are sometimes involved, but in at least 20% of patients with PID no definite cause is found.
• A sexually transmitted disease (STD) organism is not recovered in a third of women with PID.
• Actinomyces species have been linked to some PID cases associated with intrauterine device (IUD) usage.
• In less-developed countries, PID may be due to a granulomatous salpingitis caused by Mycobacterium tuberculosis and Schistosoma species.

Symptom of Pelvic Inflammatory Disease

Acute Pelvic Inflammatory Disease causes severe lower abdominal pain, fever, malaise, and often a foul-smelling discharge from the vagina. There may be associated symptoms of inflammation of the urethra (the tube through which urine passes out of the bladder), such as pain when passing urine. The onset of chronic Pelvic Inflammatory Disease may be slow, with few or no symptoms until the inflammation is wide-spread, or there may be progressively worsening lower abdominal pain, back pain, pain with sex, bouts of fever, fatigue,heavier periods and perhaps bleeding between periods or after sex. In both acute and chronic Pelvic Inflammatory Disease, abscesses may form inside the pelvis. Occasionally the infection spreads from the fallopian tubes into the abdominal cavity, causing inflammation on the surface of the liver. This is called the Fitz-Hugh-Curtis syndrome, which causes upper abdominal pain - usually on the right side - that is often made worse by deep breathing or coughing; the pain is sometimes felt at the right shoulder-tip. Some common Symptoms of Pelvic Inflammatory Disease :

• Vaginal discharge with abnormal color, consistency or odor
• Back pain
• Abdominal pain
• Painful sexual intercourse
• Fever
• Chills
• Irregular menstrual bleeding or spotting
• Sexual intercourse, painful
• Low back pain
• Fatigue
• Lack of appetite
• Nausea, with or without vomiting

Diagnosis and Treament of Pelvic Inflammatory Disease

Pelvic Inflammatory Disease is diagnosed from the symptoms and signs, and from vaginal swabs taken to identify the bacteria responsible, Sometimes laparoscopy (examination via a viewing instrument of organs within the abdomen and pelvis) is needed to confirm the diagnosis and detect abscesses. Whether acute or chronic. PID can lead to scarring and ADHESIONS (scar tissue joining organs or other tissues that are normally separatel in the reproductive organs that may reduce fertility or increase the risk of ECTOPICPREGNANCY (pregnancy developing outside the uterus). Early diagnosis and vigorous treatment with appropriate antibiotics will reduce the risk of reproductive damage. If abscesses have formed in the pelvis, sur-gical drainage may be needed.

• The doctor is likely to prescribe antibiotics for at least two weeks. This will usually take the form of two different antibiotics at the same time, as the infection is often difficult to eradicate.
• Bed rest.
• Sexual abstinence .
• You will need extra rest and may need to take pain killers as well as the antibiotics. You should avoid sex until both you and your partner have been checked by the doctor and treated if necessary. Your doctor may want to refer you to a specialist for further advice.
• Sometimes intravenous (IV) treatment is required .