Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease, commonly called PID, is an infection of the female reproductive organs(uterus,fallopian tubules ovaries &cervix). PID is one of the most serious complications of a sexually transmitted disease in women: It can lead to irreversible damage to the uterus, ovaries, fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.

Causes

Pelvic inflammatory disease (PID) occurs when bacteria move from the vagina or cervix into the uterus, fallopian tubes, ovaries, cervix
Most cases of PID are due to the bacteria that cause chlamydia and gonorrhea. These are sexually transmitted infections (STIs). The most common way a woman develops PID is by having unprotected sex with someone who has a sexually transmitted infection.

However, bacteria may also enter the body during some surgical or office procedures, such as:

 	Childbirth
 	Endometrial biopsy
 	Insertion of an intrauterine device (IUD)
 	Miscarriage
 	Therapeutic or elective abortion

Symptoms

Signs and symptoms of pelvic inflammatory disease may include:

 	Pain in your lower abdomen and pelvis
 	Heavy vaginal discharge with an unpleasant odor
 	Irregular menstrual bleeding
 	Pain during intercourse
 	Low back pain
 	Fever, fatigue, diarrhea or vomiting
 	Painful or difficult urination

PID may cause only minor signs and symptoms or none at all. Asymptomatic PID is especially common when the infection is due to chlamydia.

Other symptoms that may occur with PID:

 	Bleeding after intercourse
 	Chills
 	Fatigue
 	Frequent or painful urination
 	Increased menstrual cramping
 	Irregular menstrual bleeding or spotting
 	Lack of appetite
 	Nausea, with or without vomiting
 	No menstruation
 	Painful sexual intercourse

Diagnosis

 	Pelvic ultrasound. This test uses sound waves to create images of your reproductive organs.
 	Endometrial biopsy. During this procedure, a small piece of your uterine lining (endometrium) is removed and tested.
 	Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.

Pelvic Inflammatory Disease (PID) - Causes, Symptoms & Diagnosis Of It!

Pelvic or abdominal pain is a pain that occurs below a woman's belly button. The pain can usually occur due to their periods or menstruation. Pelvic pain can be acute or chronic and varies from woman to woman. Acute means that you are having this pain for the first time. Chronic means that pain has been a problem for a long time may be more than six months. Pelvic pain is more common in women than in men.

Causes of Chronic Female Pelvic Pain:
The commonly known causes of pelvic pain are a urinary disorder, such as bladder or kidney problems, a bowel problem or a problem with the reproductive system which includes the uterus, Fallopian tubes and ovaries. Scar tissue in the pelvic area after an infection or surgery can also lead to such pain. At times physical or sexual abuse is also attributed to such a pain.

How to diagnose chronic female pelvic pain:
You should always see a doctor if you are not sure of what is causing the pain. The doctor will ask questions regarding your periods, urine and bowel movements and about general symptoms such as fever, nausea and vomiting.

Next, the doctor will examine your abdomen and may examine you internally if necessary. The doctor may ask you to have a urine test done which can be tested for infection. If you have symptoms of vaginal discharge or other related symptoms the doctor may take some vaginal swabs. A pregnancy test may be advised. The doctor may ask you to undergo a routine ultrasound scan to diagnose problems such as ovarian cysts.
If the first tests don't find a cause, you may have other tests that show pictures of the organs in your belly. These may include Transvaginal ultrasound, MRI, CT scan of the pelvis.
You may also have to undergo a minor surgery called laparoscopy which is basically a surgical diagnostic procedure which is used to examine the organs inside the abdomen.

Treatment:
You will be treated for the particular problem that causes pelvic pain. Some common treatments include:

Prescribing birth control pills or hormone treatment for problems related to your periods
You might have to undergo a surgery to remove a growth, cyst, or tumor
Medicine to treat the problem, such as an antibiotic for infection or medicine for irritable bowel syndrome
You can try some home remedies as well-
Try nonprescription medicine, such as ibuprofen
Apply heat on the lower abdomen or the area where you feel the pain
Lie down and elevate your legs by placing a pillow under your knees to reduce the back pain
You can go in for some relaxation techniques, such as meditation, yoga and some breathing exercises as well.

How To Cure Pain In Pelvic & Abdominal Area?

Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

Pelvic inflammatory disease (PID) refers to the infection that occurs in the female reproductive organs. It happens when sexually transmitted bacteria infect the uterus, ovaries or fallopian tubes on spreading from the vagina. Generally, the cervix plays the role of preventing the bacteria from entering the vagina and infecting the reproductive organs. But when the cervix becomes exposed to an STD, it loses its power to put a stop to the spread of these microorganisms to the reproductive organs.

What causes this condition?
STDs like gonorrhea and chlamydia have been found to be responsible for about 90% of PID cases.

Some of the other causes include
- Abortion
- Childbirth
- Pelvic procedures

The condition is only detected later in life when you face difficulty in getting pregnant or have chronic pelvic pain complaints. If you experience symptoms like vomiting, high fever, pain in the lower abdomen and instances of fainting, you should immediately seek a doctor.

What puts you at risk for PID?
Certain factors may put you at a higher risk for PID and these are:

- Instances of sexually transmitted diseases like Chlamydia (an STD that can occur from anal, oral or vaginal sex) and gonorrhea (a condition that causes discharge from the vagina or urethra) can make you prone to developing PID.

- Douching on a regular basis can increase your risk of PID as it disrupts the equilibrium of good and bad bacteria in your vagina, and may hide the symptoms of the condition as well.

- Even a previous history of PID can increase your chances of having another episode of PID.

- Compared to older women, teenagers who are sexually active are more prone to developing PID.

- Having multiple sexual partners can also put you at a greater risk for PID and STDs.

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Could you be at a risk of pelvic inflammatory disease (PID)?

Most women get accustomed to and know the pattern of their menstrual cramps. So, when something out of this pattern happens, they know it is not normal. There are various reasons for pelvic pains not associated with menses. The following are some common causes and it is always advisable to seek medical help, which will help in right diagnosis, early intervention and reduced complications.

1. Ectopic pregnancy: If a fertilized egg has planted itself outside of the uterus or the womb, it is referred to as ectopic pregnancy. The fallopian tube is the most common place for ectopic pregnancies. There is associated pelvic pain, which is unilateral, sharp, and gradually worsens. There would also be associated bleeding which is darker than the regular bleeding. This again should be confirmed on an ultrasound and then the ectopic pregnancy removed.

2. Endometriosis: The inner thick layer of the uterus could be infected leading to severe pelvic pain, especially in women who are in their 30s, who are not able to conceive. This is often ignored, considering it as normal and it continues to progress and could even result in infertility.

3. Pelvic inflammatory disease (PID): Infections like gonorrhea or chlamydia travel up from the genital tract and reach the uterus. Infection along the entire reproductive tract can lead to severe pain. In most cases, if identified early, a course of antibiotics is all that is required to control this infection. Left untreated, it can even cause infertility.

4. Ovarian cysts: Another common cause of pelvic pain, they are quite often asymptomatic, except for occasional pelvic pain. They also disappear with no medical intervention. Sometimes, however, it may get infected or rupture and can cause severe pain. This can is an indication for medical intervention. Ultrasound may be required for diagnosis and treatment may include surgical removal.

5. Uterine fibroids: The fibroids are noncancerous growths, which can grow to a considerable size and fall short of blood supply. This may cause them to burst, which can be very painful.

6. Miscarriage: Most miscarriages occur before 13 weeks of pregnancy and the usual accompanying symptoms of bleeding are severe pelvic cramps. If you are pregnant and notice bleeding with pelvic pain, it is advisable to immediately visit a doctor. Diagnosis may require an ultrasound to confirm the miscarriage. If medications are not sufficient to remove the remnants, then a dilation and curettage may be required.

7. Non-gynecological causes: Appendicitis, urinary tract infections, hernia, lower spinal problems, irritable bowel syndrome can also cause pelvic pain. The cause should be identified and managed accordingly.

Unfortunately, most women continue to experience and suffer with chronic pelvic pain without a cause identified. A thorough internal examination can help identify the problem and treat the issue.

How to Deal with Pelvic Pain other than Menstrual Cramps

In medical terms, the pelvic floor refers to a group of muscles in the pelvic area. These muscles provide support to the organs in the pelvic region, including the bladder, uterus (women), prostate (men), and rectum.

What is pelvic floor dysfunction?
This is a medical condition that is used to refer to a situation when you are unable to control the functioning of the pelvic floor. It means you fail to control the bowel movement. People suffering from pelvic floor dysfunction use these muscles to contract rather than to relax. It is for this reason that they cannot have a bowel movement. They often have an incomplete one.

What causes pelvic floor dysfunction?
In most of the cases, the exact reason behind this dysfunction is unknown. It is often believed that this condition is caused due to traumatic injuries to the pelvic area. This can happen after an accident and due to complications aroused after vaginal childbirth.

What are the symptoms?
There are several symptoms that are linked to this medical condition. You must visit your doctor if you come across the following signs:

The feel of having several bowel movements within a short period of time.
If you feel that you cannot complete a bowel movement.
When there is constipation pain linked with bowel movements.
A frequent urge to urinate.
Painful urination.
Pain in lower back.
Continuous pain in pelvic region, genitals, or rectum.
Pain during intercourse in women
How is pelvic floor dysfunction diagnosed?
It may be diagnosed through a physical examination by the doctor. You will ask several questions to know the case history and find out the cause. You may also be asked to take pelvic muscle control test by placing surface electrodes on the perineum or sacrum. A small device called a perineometer is also used for the same.

What are the best ways for treating pelvic floor dysfunction?
It can be treated without surgery. There are several techniques. Some of these are as follows:

Biofeedback: It is done with the help of a physical therapist.He uses special sensors to watch and monitor the muscles.
Medication: A low-dose muscle relaxant is prescribed to treat the same.
Relaxation techniques: Your therapist may ask you to take up techniques for relaxation such as warm baths, yoga, and exercises.
Surgery: If your physician finds out that the dysfunction is caused by a rectal prolapse or rectocele, he or she will take up surgery.
Pelvic Floor Dysfunction results in Urinary Dysfunction. Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:

Stress Incontinence   when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
Urge Incontinence   when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
Overflow Incontinence (chronic urinary retention)   when you're unable to fully empty your bladder, which causes frequent leaking
Total Incontinence   when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
It's also possible to have a mixture of both stress and urge urinary incontinence.

Pelvic Organ Prolapse

Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough.


Pelvic Floor Dysfunction - What is the Best Way to Treat it?

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