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Pelvic Inflammatory Disease
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease is a general term which refers to the infection of female reproductive organs.
- The female reproductive system consists of the uterus, fallopian tubes and ovaries.
- Pelvic Inflammatory disease or PID is a serious consequence of sexually transmitted diseases (STD). Sexually active women in the age group of 15 to 25 years, especially who have multiple sexual partners are at a higher risk although the disease may occur in women with monogamous relationship.
- Increased risk of Infertility and ectopic pregnancy, especially tubal pregnancies are serious consequences of Pelvic Inflammatory disease.
Symptoms of Pelvic Inflammatory Disease
General: The most common symptoms of Pelvic Inflammatory disease include -
- Abdominal pain
- Vaginal discharge
Other symptoms include -
- Lack of appetite,
- Pain during sexual intercourse
- Bleeding after intercourse
- Irregular menstrual bleeding
- Low back pain
- Frequency of urination
- Painful urination
Sometimes, there may be no symptoms at all and the Pelvic Inflammatory Disease (PID) may be silent.
Cause of Pelvic Inflammatory Disease
The two commonest causes of sexually transmitted disease or STD are Neisseria Gonorrhoeae and Chlamydia Trachomatis.
- Infection with N. Gonorrheae gives rise to symptoms of vaginal discharge which is usually purulent.
- Infection with C. Trachomatis will mostly have mild symptoms or no symptoms at all.
- Both Gonorrhoea and Chlamydia are sexually transmitted disease ( STD). PID due to Chlamydia infection is more common among teenagers and younger women.
Risk Factors of Pelvic Inflammatory Disease
- Having multiple sexual partners and not using condoms while sexual intercourse puts a person at higher risk.
- People with a previous history of PID are at higher risk
- Women using IUCD for birth control
- Recent history of abortion or douche also increases the risk.
Treatment and Precautions of Pelvic Inflammatory Disease
Basic Treatment of PID:
- Treatment of PID is with appropriate antibiotics. Usually broad spectrum antibiotics are prescribed.
- Most commonly used antibiotics are Doxycycline, erythromycin, cephalosporins.
- If the cause of infection is STD then both the partners have to take treatment to avoid re-infection. The couple is advised to avoid sex during the course of treatment.
Advance Treatment of PID:
- If the patient condition is serious then one has to stay in the hospital and take intravenous (IV) antibiotics.
- If the person is having an IUCD for birth control, it has to be removed. If there is an abscess formation, then surgery is performed to drain the abscess.
Diagnosis of Pelvic Inflammatory Disease
Pelvic Inflammatory Disease is diagnosed by the combination of medical history, symptoms, physical examination, and lab test results. There is no single test which can detect PID.
- If the doctor is suspecting PID, then the doctor will take a complete medical history and will also do pelvic examination. It is important to rule out other diseases which may cause pelvic pain, such as appendicitis and endometriosis. If on examination there is tenderness or pain in pelvic region, or tenderness on movement of the cervix, then these signs are indicative of PID.
- Making a specific diagnosis of PID is difficult as the upper pelvic organs are difficult to reach for sampling. The doctor may also take samples directly from the cervix and examine the sample for causative organism that are causing infection.
- The doctor may take out fluid from a sac in the pelvis surrounding the ovaries called the cul de sac. This fluid can be examined for bacteria or culture can also be done. Diagnosis of PID may also be done using a laparoscope, but laparoscopy is expensive, and it is an invasive procedure that carries some risk for the patient.
Tests for Pelvic Inflammatory Disease
- Total and differential blood count
- Serum HCG (pregnancy test)
- Endocervical culture
- CRP (C-reactive protein)
- Test for confirming Gonorrhea and Chlamydia
- Culdocentesis also helps to differentiate hemoperitoneum from pelvic sepsis.
- Ultrasound - Vaginal and pelvic ultrasound help in diagnosing PID and also help to rule out ectopic pregnancy.
Conditions of Pelvic Inflammatory Disease
Things to Tell/Ask your Doctor:
- What is pelvic inflammatory disease (Pelvic Inflammatory Disease)?
- How does a woman get Pelvic Inflammatory Disease?
- How is Pelvic Inflammatory Disease (PID) treated?
- What are the risk factors for Pelvic Inflammatory Disease (PID)?
- Should my partner be treated if I have Pelvic Inflammatory Disease?
Related Conditions/Other Types:
- Bacterial vaginosis
- Tubo-ovarian abscess
Pelvic Inflammatory Disease in INDIAN CONTEXT
Overview with Indian Name (s):
In developing countries like India lack of proper hygiene during delivery and septic abortions done by untrained persons contribute to the higher incidence of PID. Infection of genital tracts with tuberculosis bacteria is common giving rise to genital tuberculosis.
In India common conditions are:
- Genital Tuberculosis
- Tuberculous Salpingitis
Incidence/Causes in India:
Due to poor hygiene during delivery and abortions done in unhygienic condition the incidence of PID is high in India. In India, genital tuberculosis is the common cause of PID. If a virgin girl presents PID, it is usually tubercular in origin.
- To prevent PID, the delivery should be done ideally in a hospital but if the delivery is being done at home, the environment should be clean and hygienic.
- Abortion must be done by trained and authorized persons to avoid the risk of septic abortion.
- Maintaining monogamous relationship
- Barrier methods like condom are helpful in preventing sexually transmitted disease
- Even female condoms (Femshield) are highly effective in preventing infection
Alternate Therapy for Pelvic Inflammatory Disease
- Ciprofloxacin and metronidazole are the antibiotics used to treat PID.
- Supplementing with friendly bacteria like acidophilus in combination is very useful during antibiotic therapy and even after the course of antibiotic is over.
- Supplements of Vitamin C are used in high doses along with plant derivatives like bioflavonoid to support the immune system. Additional supplement of zinc along with vitamin A or beta-carotene are also helpful in recovering the damage mucous membrane of reproductive tract of the woman.
Asparagus is perhaps best known as a female rejuvenative. The Indian name is Satvari. It has the ability to balance pH in the cervical area. It is also useful in pelvic inflammatory disease like endometriosis.
Some other herbs like Echinacea and Calendula are believed to have antibacterial properties and may augment the action of prescribed antibiotics.
Panchakarma is a yoga method. Basic objective of "Panchakarma" is to remove the accumulated toxin.
- Vamana (Kapha) - Medically induced vomiting
- Virechana (Pitta) - Medically induced purgation
- Vasthi (vata) - Enema with oil or decoction
- Nasya - Application of medicine through nostrils
- Raktamokshana - Bloodletting
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