DEFINITION

Pelvic Inflammatory Disease is a term used to describe a number of infections that affect the upper reproductive tract of a female. Organs affected may include the uterus, ovaries and fallopian tubes. The infection may also involve the surrounding pelvic tissues. The infected areas become inflamed and swollen.

DESCRIPTION

Pelvic Inflammatory Disease is generally the result of micro-organisms transmitted during sexual intercourse, miscarriage, abortion, or any medical procedure that opens the cervix or abdomen. The most common causes of infections are Chlamydia (see the topic Chlamydia) and Gonorrhoea (see the Gonorrhoea topic). Bacteria normally found in the vagina and cervix may also be involved.

Women who are under 25 years of age seem to be most prone to this disease. Pelvic Inflammatory Disease generally does not occur before puberty, during pregnancy or after menopause.

RISK FACTORS - More than one sexual partner. - Past history of Pelvic Inflammatory Disease. Approximately 20 to 25% of women with Pelvic Inflammatory Disease will have a recurrence. - Use of IUD for contraception. - Presence of bacterial vaginosis or other sexually transmitted disease. - Never having given birth to a child. - Recent medical procedure involving cervical penetration (e.g. IUD insertion). - Loss of virginity at an early age. - Previous sexually transmitted disease. - Douching several times each month.

POSSIBLE COMPLICATIONS - Pelvic Inflammatory Disease may spread to other parts of the body, causing potentially fatal complications. - Scarring and damage from infection may cause infertility or increase the risk of an ectopic pregnancy (when a fertilised egg grows outside of the uterus). Pelvic Inflammatory Disease is one of the most common causes of infertility. - The accumulation of pus may occur in severe cases. This may require hospitalisation.. - Chronic pelvic pain may result from the distortion of the pelvic organs due to scar tissue. Surgery may be required.

PREVENTION

- Have sex only when in a monogamous relationship. - Use a barrier method of contraception such as a condom, a diaphragm and spermicide. - Visit your Doctor as soon as there are any symptoms of infection. - Try to limit the number of sexual partners. - Abstinence.

SIGNS AND SYMPTOMS

Possible symptoms and signs may include: - Lower abdominal pain. - fever - adults. - Vaginal discharge. - Abnormal uterine bleeding. - Painful urination. - Nausea and vomiting. - Painful sexual intercourse. - Back pain. - Fatigue.

Some women may not have any symptoms.

TREATMENT OPTIONS

As with all conditions your Doctor should be consulted to diagnose and treat this condition. Your Doctor may perform a pelvic examination and may recommend further tests. The usual treatment is a prescription for an antibiotics plus a follow-up visit to ensure that the treatment is working. In more severe cases, hospitalisation and intravenous antibiotics may be required. If the infection does not respond to antibiotics, surgery may be necessary. Sexual partners should be examined and treated (if necessary). Women generally should avoid sexual intercourse until all signs are resolved.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice. 1) Take all medication as instructed. 2) Consider using aspirin, paracetamol or ibuprofen for pain relief. 3) Follow the Diet Hints 4) Keep as healthy as possible. If you need help to quit smoking, ask your Pharmacist for suggestions. 5) Limit alcohol consumption. This will allow the liver to function at its best as a blood filter for the body. 6) Have adequate rest to improve the immune system and help the body fight infection. 7) If the diet is inadequate consider some food supplements. Beta carotene and echinacea have both been used to help the body ward off infection. In all cases the patient must stay on any prescribed medicine.

Aspirin should not be given to children under 16 years of age unless specified by a Doctor.

DIET HINTS

- Diet should consist of fresh raw fruit and vegetables, especially green leafy vegetables, citrus fruits and avocados. - All foods that place a strain on the natural immune system of the body should be avoided, e.g. sugar, alcohol, processed and allergic foods.

VITAMINS/MINERALS/HERBS

- Vitamin C is important to help support the immune system. - Vitamin A and beta carotene may be beneficial in the healing of mucous membrane. - Zinc is also important during an infection. - Acidophilus supplements are recommended while taking antibiotics.