Pelvic inflammatory disease (formerly inflammation of the appendages) is a female condition which, due to its non-specific symptoms, may be far more common than official statistics indicate. The correct treatment of the disease is, in turn, extremely important, as its omission increases the risk of complications, which include peritonitis and infertility. So what complaints are grounds for suspecting pelvic inflammatory disease and should prompt a visit to the doctor?
Table of contents:
- Pelvic organ inflammation: causes
- Pelvic inflammatory disease: symptoms
- Pelvic organ inflammation: diagnosis
- Pelvic organ inflammation: possible complications
- Inflammation of the organs of the lower pelvis: treatment
- Inflammation of the organs of the lower pelvis: prevention
Pelvic inflammatory disease(PID for short) is mainly a disease of young women - it is most common in patients in their second decade of life who are sexually active. It is estimated that about 1.5 % of women develop PID each year, but in practice, experts warn that the incidence of pelvic inflammatory disease (PID) may be much higher - the disease has very non-specific symptoms and for this reason some patients may not be properly diagnosed.
Pelvic inflammatory disease: causes
Pelvic inflammatory disease occurs when micro-organisms in the vagina or cervix enter other parts of the female reproductive system, such as the uterus or fallopian tubes. In the past, the gonorrhoea bacillus was responsible for a large proportion of cases, but nowadays it is also caused by many other bacterial species, such as Escherichia coli, Chlamydia tracheomatis and streptococcus, among others.
Numerous risk factors for pelvic inflammatory disease are known, the most important being:
- a large number of sexual partners,
- a history of some sexually transmitted diseases,
- iUD implantation,
- in vitro fertilisation,
- abortion,
- engaging in unprotected sex.
It is worth mentioning here that a history of pelvic inflammatory disease itself increases the risk of recurrence in the future.
Pelvic inflammatory disease: symptoms
Possible complaints in the course of this entity include:
- lower abdominal pain (typically aggravated by pressure and after sexual contact),
- discharge with a particularly unpleasant odour,
- abnormal bleeding (e.g. intermenstrual bleeding or bleeding occurring after intercourse; increased menstrual flow is also possible),
- dyspareunia (pain occurring during sexual intercourse).
Pelvic inflammatory disease: diagnosis
There is not really one specific test that can be performed to make a confident diagnosis of pelvic inflammatory disease. If the condition is suspected, it is important to carry out a gynaecological examination, which can identify, for example, pressure tenderness in the lower abdomen or tenderness of the cervix when trying to move it. In the diagnosis of pelvic inflammatory disease, laboratory tests may be ordered - possible abnormalities in the course of the disease include increased values for inflammatory markers (such as ESR and CRP) or leukocytosis, i.e. an increased number of white blood cells in the blood.
Swabs from the genital tract are used, which later serve as material for bacteriological tests, and ultrasound examination (Medical US) is also helpful in making the diagnosis. In situations where there is considerable doubt about the diagnosis, invasive diagnostic tests such as exploratory laparoscopy may be used.
As the symptoms of pelvic organ inflammation are non-specific, differential diagnosis is necessary before making a diagnosis of this entity. In the differential diagnosis of PID, the main considerations are appendicitis, ovarian torsion, ectopic pregnancy and endometriosis and cholecystitis.
Pelvic organ inflammation, photo: panthermedia
Pelvic organ inflammation: possible complications
The symptoms of pelvic inflammatory disease alone can be very distressing for patients, but it is worth adding here that the disease can have very dangerous consequences. One possible complication is an ovarian-ovarian abscess, the rupture of which may even result in sepsis. Patients suffering from pelvic inf lammatory disease have an increased risk of ectopic pregnancy, but also peritonitis or even infertility. Looking at the problems mentioned above, it is clear that treatment of pelvic inflammatory disease is absolutely necessary - the sooner it is started, the lower the risk of the patient developing complications of this disease.
Pelvic inflammatory disease: treatment
As pelvic inflammatory disease is caused by bacteria, antibiotic therapy is used to treat this condition. Various drugs are sometimes used, such as ceftriaxone, doxycycline or clindamycin. Then, if the patient is in relatively good condition, she can be treated at home with oral antibiotics. However, there are situations in which the patient's condition is severe or she is unresponsive to oral antibiotics, in which case hospitalisation and treatment based on the administration of intravenous antibiotics may become necessary.
Pelvic inflammatory disease: prevention
Treatment of pelvic inflammatory disease is not always easy and it is therefore beneficial to take measures to reduce the risk of the disease. Patients are advised to avoid risky sexual contact, i.e. unprotected sex and frequent change of partners. Proper hygiene of the intimate area is advisable, but vaginal irrigation should be avoided, as it adversely affects the beneficial bacterial flora of the vagina and may therefore ultimately increase the risk of various infections. It is also important for patients to visit their gynaecologist regularly and not to delay going to see a specialist if they develop any new, worrying symptoms.
