What is Chronic Pelvic Inflammatory Disease (PID)

From: Jean Long (creative@enter.net)
Tue Nov 27 11:53:04 2001


What is Chronic Pelvic Inflammatory Disease (PID)

Chronic infection and inflammation of the internal genital organs is known as chronic pelvic inflammatory disease (PID).

An inflammatory process that results from other pelvic diseases; although it may result from gonorrhea, chlamydia it ALSO can be caused by ovarian cystic disease, or post-partum infections.

http://www.medhelp.org/glossary/new/gls_3273.htm

While the infection is usually mild in terms of symptoms, it produces chronic inflammation of the pelvic organs with scarring, adhesions, and tubal blockage. The damaged organs also become vulnerable to infection by other bacteria, so that chronic PID often involves multiple bacteria. Even with effective antibiotic treatment, long term resolution of chronic PID is difficult to achieve because the damaged tissues are easily reinfected. In some cases, the scarred tissue contains tiny collections of pus which are inaccessible to antibiotics and cause a recurrent exacerbation of disease.

Typically, chronic PID results in the formation of adhesions, frequently massive, between pelvic organs, including the uterus, fallopian tubes, ovaries, bowel and pelvic side walls. The ovaries are frequently encased in scar and tend to develop cysts. The tubes are typically blocked at their terminal end (hydrosalpinx) and tend to be enlarged, with thick and inflamed walls. Because of bowel involvement in pelvic adhesions, bowel symptoms such as abdominal cramps and constipation are frequent. Pelvic pain of variable pattern and severity is common including severe generalized or localized pain which is crampy or constant. There is a tendency for heavy periods or intermenstrual irregular bleeding. Infertility is the rule with chronic PID. Intermittently, the chronic infection is complicated by acute episodes of disease characterized by fever and severe pain.

Chronic PID, especially when accompanied by severe chronic pain or by recurrent episodes of acute pain and fever is a debilitating condition. Commonly this condition is treated by surgical removal of both ovaries and fallopian tubes, with or without hysterectomy, especially if future pregnancy is not an issue. Occasionally the uterine cervix becomes scarred and narrowed; this may result in recurrent pyometra (pus accumulation inside the uterus) which may be treated by means of cervical dilation and antibiotics. But if childbearing is not an issue, the most common approach to chronic PID is surgical removal of the uterus, ovaries and fallopian tubes. In my experience, the great majority of patients with chronic pelvic inflammatory disease can be successfully treated without a hysterectomy. First, the patient is treated with a long course (6-8 weeks) of antibiotics and anti-inflammatory steroids (prednisone). The prednisone helps resolve the inflammatory process and increase the efficiency of the antibiotics in reaching pockets of infection within scarred tissues. Next, surgery is performed. Using meticulous microsurgical technique all adhesions are removed, the fallopian tubes are repaired and their patency is re-established. However, not infrequently, one tube (or less frequently both tubes) is destroyed beyond repair and must be sacrificed to ensure complete eradication of the chronic infection. Following such treatment, most patients are free of pain and many go on to a successful pregnancy.

How does a woman get PID? There are several ways women can get PID. The most common way is to have sex with a person who has gonorrhea or chlamydia. These diseases are carried in the semen and other body fluids of infected people. During sexual contact, the germs spread to the woman's cervix. The germs can also infect the glands at the opening of the vagina, the urethra (passageway for urine) or the anus. When the cervix is infected with gonorrhea or chlamydia, normal vaginal bacteria can spread through the cervix and into the uterus, fallopian tubes, ovaries and abdomen.

Sometimes women get PID without being exposed to gonorrhea or chlamydia. Doctors aren't sure why this happens, but sometimes normal bacteria in the vagina spread into the uterus, fallopian tubes and abdomen, causing PID.

PID can also occur after certain surgical procedures on the female organs. PID can occur after the insertion of an intrauterine device (IUD), but this isn't common. PID may occur after an abortion or after procedures that take a sample from the inside of the womb, such as a dilatation and curettage (D & C). Sometimes PID can occur after the cervix is treated because of an abnormal Pap smear.

OVARIAN CYSTIC DISEASE - http://www.medhelp.org/glossary/new/gls_3192.htm A painful condition associated with the recurrent formation of large ovarian cysts. Distention of the ovarian capsule causes pain and rupture of a larger cyst can, in rare instances, cause internal bleeding. Treatment often includes hormone manipulation (birth control pills).

INFECTIONS - The successful invasion, establishment and growth of micro-organisms in the tissues of the host. JEAN

"OLD" IS WHEN..... Your sweetie says, "Let's go upstairs and make love," and you answer, "Pick one, I can't do both!"


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