Pelvic inflammatory disease

PID or pelvic inflammatory disease refers to inflammation of the pelvic parts, i.e. reproductive parts. It is one of the most common problems for which women seek consultation worldwide. It is more common in women in their reproductive years due to multiple factors.

Sunday, December 05, 2010
Pain in the lower abdomen may be a result of pelvic infection (Photo.Internet)

PID or pelvic inflammatory disease refers to inflammation of the pelvic parts, i.e. reproductive parts.

It is one of the most common problems for which women seek consultation worldwide. It is more common in women in their reproductive years due to multiple factors.

Blood loss during menstruation is the first cause for infection and inflammation to occur in pelvic parts. The blood passed, provides a rich medium for bacteria and other germs to grow.  Poor pelvic hygiene observed during menstruation and nylon undergarments aggravate the problem.

Intercourse with an infected partner also introduces germs in the pelvic parts, leading to PID.

Any intervention done during delivery like episiotomy (cutting of part of vagina during first delivery to make way for baby) or forceps delivery can induce infection.  Even infection can occur during normal labor at times.

The more the number of pregnancies and deliveries, the greater is the susceptibility of the individual to have pelvic infection.

Women are more prone to urinary tract infections. Short length of the urethra (tube for passing out urine) facilitates germs to ascend easily. Because of the proximity of the urinary and pelvic parts, urinary infections can lead to pelvic infections.

Pain in the lower abdomen, lower back pain, vaginal discharge, vaginal itching, painful intercourse, pain during passing urine; all these symptoms indicate a pelvic infection. Colour and characteristics of the vaginal discharge can give a clue to the type of infection.

Usually Trichomonias (protozoal) infection will cause a profuse, dirty yellow colored, watery and foul smelling discharge. Fungal infections like candidiasis can cause thick white, curd like, odorless discharge.

In case of bacterial infections the discharge may be scant with mild odour. Long standing pelvic infections can give rise to sterility due to blocking of the fallopian tubes. Adhesions can form in and around pelvic parts due to chronic infection, which can cause miscarriages in subsequent pregnancies. It also increases the risk of having an ectopic pregnancy.

Apart from this, there may be backache, nausea, vomiting and or fever. A woman may be having one or more of these symptoms in any combination.  Severity of the symptoms depends on amount of infecting germs and resistance of the woman. Those with reduced immunity like diabetic or AIDS are much more prone to pelvic infections. Most of the times pelvic infections occurring, are chronic.

Common microorganisms implicated in PID are bacteria like Escheria coli, gonococci, Chlamydia, fungal infections, protozoal infections like Trichomoniasis.

Diagnosis is established by examining the vaginal discharge or taking a swab from wall of vagina or lower end of cervix. Treatment involves giving a suitable antimicrobial drug which will clear the infection.

In case of chronic inflammation of the uterine cervix, any ulcer or scar can be burnt by cautery.

Pelvic inflammatory disease seems like a simple infection, but in reality it gives much suffering to the affected woman. Therefore it is better prevented than treated.
Good hygiene maintained during menses is very useful in preventing pelvic infections. Drinking large amounts of water helps prevention of urinary tract and subsequent pelvic infections.

After passing urine, a woman should ideally wash the genital parts. This removes any contamination of the genital parts by infectious germs present in urine.
Similarly after intercourse, the genital parts should be washed immediately to avoid any infectivity. Unless desiring pregnancy, a lady should demand that her partner should use condoms while doing intercourse.  One should strictly avoid intercourse with any partner having genital itching, ulcer or discharge, as these are the potential donors of infectious germs causing PID.

Once somebody has PID, she should complete the entire prescribed course of medication, otherwise incompletely treated infections, tend to relapse again.

Men also suffer from PID though to a lesser extent. In men it is mostly a sexually acquired infection. Urethral discharge, painful urination, swelling and pain over affected parts occur in men also. Good hygiene of genital parts particularly in relation to sex helps prevention of PID in them also.

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