Pelvic Inflammatory Disease

When there is inflammation in the fallopian tubes, ovaries and/or the uterus, this is called the Pelvic Inflammatory Disease (PID). Scarring and integration of tissues (sticking together) in the region, called adhesion also leads to infections. The disease can be caused by bacteria, virus or fungus, though the bacterial form is more prevalent. 

The other terms that define this generic name for the illness are (1) salpingitus –fallopian tube inflammation (2) cervicitis (cervix inflammation 93) peritonitis (abdominal lining membrane inflammation) and (4) endometritis (uterus lining inflammation).
 
Prevalence
 
An alarming number of women (more than 1,000,000) are afflicted by this disease in the US every month! A good percentage of these women are either first time mothers or young women in their teens.  Unfortunately, 13/100 among these women become infertile. In fact, PID is quite a significant cause for infertility.
 
Causes 
 
The disease may be caused due to
  • A sexually transmitted infection from sexually transmitted diseases like trachomatis or gonorrhea (caused by Chlamydia trachomatis and Neisseria gonorrhoeae respectively)
  • A problem that develops after childbirth or miscarriage
  • An infection due to complications arising from using an Intra-Uterine-Contraceptive-Device (IUCD)
  • A lymphatic disorder
  • A complication arising after an abortion. 
Symptoms
 
Symptoms for this disease can be mild or acute. They are
  • Pain in the lower abdomen
  • Fever
  • Back pain
  • Irregular discharge during periods
  • Abnormal discharge from vagina
  • Other unexplained kinds of discharge
  • Pain during intercourse
  • Pain during urination
  • Uterine bleeding
  • Discomfort in the cervical region
  • Nausea and vomiting
The doctor should be visited promptly if the woman experiences
  • Heavy vaginal bleeding
  • Unexplained fever (above 101 degrees F)
  • Nausea and vomiting
  • Vaginal discharge that is abnormal which has unpleasant odor
  • Persistent pain in the lower abdominal region
Treatment
 
Prompt treatment for PID is advised as any delay may lead to other severe health issues like thickening of the fallopian tubes, inflammation of the inner lining of the uterus and so on.  
 
Treatment for PID is based on the cause of the illness. As a general practice, antibiotics are prescribed. If antibiotics are not effective, patients are advised to consult the health care giver for further treatment. Sometimes the patient may be hospitalized in order to give her medication (either to swallow or intravenously) that will improve the potency and efficiency of the antibiotics prescribed.
 
Psychotherapy is also a part of PID treatment in order to help women become aware of (1) the potential causes for which the disease may recur and (2) the steps to prevent such a recurrence.
 
For some women with severe symptoms of PID, surgery is able to alleviate most symptoms. Surgery is also performed to remove or drain abscess (tubo-ovarian abscess).
 
Medications prescribed to treat PID include
  • Cefoxitin and doxycycline
  • Sulbactum, ampicillin and doxycycline
  • Ceftriaxone and doxycycline
  • Cefotetan and doxycycline
  • Clindamycin and gentamicin
Prevention
 
  • Being aware of the illness and abstain from practices that may increase the risk of its occurrence
  • Periodic check ups at the gynecologist to detect the earliest signs of the illness
  • Abstinence from sex or having protected intercourse
  • Prompt consultation with doctor when even a mild symptom of the disease is experienced



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