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Jan 17, 2008

Pelvic Inflammatory Disease( PID)

Pelvic Inflammatory Disease (PID)
© Dr Vandana Patni 2008

Pelvic Inflammatory disease is a disease of young women who are sexually active and in child born age. Pelvic inflammatory disease is Inflammation of woman's upper genital tract or reproductive organs (cervix, uterus, fallopian tubes,ovaries and surrounding tissues), main victims are fallopian tubes and ovaries. Bacterial infection is most common cause of PID.

Read Homeopathic medicines for PID here.

How Nature Protect Reproductive Organs:

There are many natural barriers which prevent entry of bacteria from cervix to upward.


1.In Virgin girls intact Hymen prevents ascending infections.
2.Acidity of Vagina inhibits the bacterial growth.
3. Cervical canal has relatively small lumen and it is filled with a plug of alkaline mucus.
4.There are fimbrias in uterus and cervical canal which constantly move downwards
and so they discourage the spread of non-motile organisms further upward.

But this natural protective mechanism breaks during menstruation(periods), after abortion and delivery. During these events cervical canals dilates, fimbrial layer of uterus and cervical canal damages . Vaginal pH increases ( means vagina become more basic) and give favorable environment to germinal growth.

Manipulation like curettage for evacuation in abortion and manual removal of placenta give chance to entry of bacteria.
Intrauterine contraceptive device (inserting Copper T and other devices) may also be a source of infection.

Causes of PID

A- Multiple sex partner and frequent change of sex partner


B- Anemia- Which reduces the immune capacity to fight infections

C- In developing and poor countries most of the deliveries are conducted at home by untrained personals in aseptic environment. Criminal abortions are continue.

Infections Which causes PID

More than 40 type of organisms causes PID but most common infections are Chlamydia and Gonorrhea, both these organisms are transmitted sexually . More than 50% cases are infected by these 2 type of organisms.


What Happen in PID

Bacteria infects the fallopian tubes and cause inflammation. When this happens, normal tissue can become scarred and block the normal passage of an egg(block fallopian tube-either partial or full blockage). Fallopian tubes may damage.You may become infertile (unable to become pregnant). But if your tubes are partially blocked, an egg may implant outside the uterus and cause a dangerous condition called an ectopic pregnancy.In this way the worst outcome of PID could be Infertility in women.


PID has two main complications

1. Infertility (unable to become pregnant)

2. Ectopic Pregnancy( Implantation of Fetus outside the uterus) it may be a dangerous condition.
An ectopic pregnancy can cause internal bleeding leading to death.

Outlook of PID

1. According to US studies --Following a single episode of PID, 8% of women were infertile; after 2 episodes, 19.5% of women were infertile; and after 3 or more episodes, 40% of women were infertile.Tubal damage and scarring can result in infertility. PID is the most common cause of infertility in women.
2. Ectopic pregnancy is 6 times more common in women who have had PID at least once.
3.Chronic pelvic pain is present in up to 18% of women with PID.
4.Ovarian abscesses can occur after an episode of PID.Chronic infection may cause TOA. A TOA(tubo-ovarian mass) is a collection of bacteria, pus, and fluid that occurs in the fallopian tube. It is most often seen in teens. A TOA is also more likely to occur in teens or adult women who use intrauterine devices (IUDs) as birth control.
5.In Developing countries like India Criminal abortions are common. Many deliveries are conducted at home by untrained professionals which causes Pelvic Inflammatory Disease later on. It is estimated that 50 % pf al PID cases of developing countries are caused in this manner.

Symptoms of PID


1.Pain- Lower abdominal pain and Tenderness( pain on touch) which get worse before menstruation.
2. Back Pain
3. Heavy/foul smelling Vaginal Discharge
4.Abnormal Uterine Bleeding( Metrorrhagia)
5.Painful Sexual Intercourse (Dyspareunia)
6.Painful Urination

In Acute Condition

1.Fever

2. Nausea and Vomiting may coexist with PID.


Laboratory Tests


1. Complete Blood count.
2. Complete Urine test
3. Culture for gonorrhea and chlamydia
4. Test for other STD's and HIV.

Imaging

1.Pelvic Ultrasound

2.Laproscopy if indicated.

Treatment of PID


1. Bacterial samples are hard to collect from upper genital tract. So two type of Wide range Antibiotics can be used either orally or intravenously as indicated on intensity of symptoms.
2. Hospitalization may be necessary in severe cases or if PID occur during pregnancy(Although it is very rare).
3. Stop sexual activity until treatment is not completed. Sexual partner should also be treated to stop recurrence.

Complications Of PID


1.Infertility(unable to pregnant)
2.Ectopic pregnancy( Fertilized egg means embryo can implant outside the uterus it may be dangerous.)
3.Chronic PID -if acute infections not treated properly then chronic PID can develop.

Prevention Of PID


Follow few steps to remain healthy:-

1. Wipe from front to back after stool to prevent bacterial entery to vagina.
2.In case of vaginal itching,do not scratch ,just wash with water.
3.Frequent Vaginal douching may push bacteria to inside. So try to escape from frequent use of Vaginal douching.
4. Multiple sex partner is a potential risk of PID. Use barrier devices as latex condoms. Intrauterine Device (copper-T) does not prevent from Sexually transmitted diseases. Limit your sex partners and specially high risk partners.

Homeopathic Treatment


Either in Acute or in Chronic cases of PID homeopathy is equally indicated.

In Acute PID - severe pelvic pains, backaches, fever,vomiting, uterine bleeding can be permanently relieved without leaving any complications. In cases where woman is pregnant along with PID , of course homeopathy provide safe and effective alternative to conventional treatment.

Chronic cases equally treated successfully for pelvic pains and disturbed menstrual cycles.In cases of painful sexual intercourse homeopathy has provides good medication.

Homeopathy has more than 200 medicines for these different group of symptoms. Prescription of medicines vary from case to case on individual symptom group in particular case.Some common medicines for these conditions are-

Platina, Mercuris Sol, Belladona, Pulsatilla, Lachesis, Phosophorus, Sepia, Cantharis, Conium, Arsenic alb, Lycopodium etc. Medicines are prescribed on basis of similarity of patient's symptoms with medicine. Always consult to a Homeopath for correct medication.


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