Pelvic Inflammatory Disease

　　1. Early sexual activity: With the openness of sex education, now urban women have sexual life at the age of fifteen or sixteen, but because of the lack of knowledge of sexual health care, their resistance to pathogens is relatively poor; therefore, early sexual activity is more likely to cause infection and pelvic inflammatory disease.

　　2. Infection after gynecological surgery: During procedures such as induced abortion, sterilization or removal of sterilization devices, fallopian tube hydrotubation, hysterosalpingography, removal of endometrial polyps, or submucosal uterine fibroidectomy, if sterilization is not strict or there is a chronic inflammatory disease in the original reproductive system, it may cause postoperative infection. Some patients also do not pay attention to personal hygiene after surgery, or do not follow medical advice after surgery, and resume sexual life too early, which can also cause bacteria to ascend and infect, leading to pelvic inflammatory disease.

　　3. Infection after childbirth or post-abortion: Patients are physically weak after childbirth or abortion, the cervix has not been well closed after expansion, and at this time, bacteria existing in the vagina and cervix may cause ascending infection in the pelvis.

　　4. Poor hygiene during menstruation: During menstruation, the endometrium is shed, the uterine cavity is open with blood sinusoids, and there are blood clots present, which are good conditions for bacterial growth. If hygiene is not paid attention to during menstruation, using unqualified sanitary napkins or toilet paper, or having sexual intercourse, it will provide bacteria with an opportunity for retrograde infection, leading to the occurrence of pelvic inflammatory disease.

　　5. The spread of inflammation to adjacent organs: The most common is the occurrence of appendicitis and peritonitis, as they are adjacent to the female internal reproductive organs, inflammation can spread directly, causing pelvic inflammatory disease in women. When suffering from chronic cervicitis, inflammation can also spread through the lymphatic circulation, causing pelvic connective tissue inflammation.

1. Acute pelvic inflammatory disease can cause acute endometritis, acute myometritis, acute salpingitis, hydrosalpinx, ovarian-tubal abscess, acute pelvic adnexitis, acute pelvic peritonitis, sepsis, and septicemia.

2. Hydrosalpinx: Chronic salpingitis is more common on both sides, with the fallopian tube showing mild or moderate enlargement, and the fimbria may be partially or completely closed, adhering to surrounding tissues. If the fimbria and isthmus of the fallopian tube are adhered and closed due to inflammation, serous exudate accumulates to form hydrosalpinx; sometimes, as the pus in the hydrosalpinx is gradually absorbed, serous fluid continues to渗出 from the tube wall, filling the lumen, and can also form hydrosalpinx.　　

3. Ovarian-tubal cysts: When salpingitis affects the ovary, the fallopian tube and ovary may form inflammatory masses due to mutual adhesions, or the fimbria of the fallopian tube and the ovary may adhere and communicate, with fluid leakage forming ovarian-tubal cysts.　　

4. Chronic abdominal pain: After pelvic inflammatory disease, chronic abdominal pain may occur in up to 18%. The pain is often periodic and mainly related to adhesions of the fallopian tubes, ovaries, and surrounding tissues.

5. Ectopic pregnancy: Chronic pelvic inflammatory disease often leads to ectopic pregnancy due to untimely treatment. Over time, it can cause adhesions of the inner mucosa of the fallopian tubes, resulting in narrowing or closure of the tube lumen, and blocking the movement of ova, sperm, or fertilized ova, leading to ectopic pregnancy.

6. Infertility: Inflammation in any part of the pelvic cavity, including the peritoneum, around the uterus, fallopian tubes, and ovaries can cause infertility in women. Especially when acute inflammation is not treated thoroughly, it may develop into chronic inflammation, or infertility may occur due to the slow onset of chronic pelvic inflammatory disease and untimely treatment.

　　Pelvic inflammatory disease is mainly divided into acute and chronic, with the following symptoms:

　　1. Symptoms of acute pelvic inflammatory disease: The characteristics are acute onset and severe condition, with symptoms such as lower abdominal pain, fever, chills, headache, and loss of appetite. It may be accompanied by fatigue, lumbar pain, and menstrual disorders. Severe cases may present with high fever, chills, headache, and loss of appetite. If peritonitis is present, symptoms such as nausea, vomiting, and abdominal distension may occur. If abscesses form, anterior abscesses may cause symptoms of bladder irritation, such as frequent urination, urgency, and dysuria. Posterior abscesses may cause symptoms of rectal irritation, such as tenesmus, anal坠胀, diarrhea, and difficulty defecating. In cases of sepsis, there may be other sites of abscesses.

　　2. Symptoms of chronic pelvic inflammatory disease:坠胀, pain in the lower abdomen, and soreness in the lumbosacral region, sometimes accompanied by discomfort in the anal area. These symptoms often worsen after fatigue, sexual intercourse, and before and during menstruation. This is due to scar adhesions formed by chronic inflammation and pelvic congestion.

　　3. Lower abdominal坠痛: Due to pelvic inflammation and adhesions, there may be varying degrees of lower abdominal坠痛, which worsens during menstruation. General symptoms: If it is an active stage, there may be general symptoms of tuberculosis, such as fever, night sweats, fatigue, loss of appetite, weight loss, and sometimes only fever during menstruation. Irregular menstruation: In the early stage, due to endometrial congestion and ulcers, there may be excessive menstrual bleeding. Most patients seek medical attention when the disease has been present for a long time, and the endometrium has been damaged to varying degrees, manifesting as oligomenorrhea or amenorrhea.

　　4. Infertility: Due to the destruction and adhesion of the fallopian tube mucosa, the lumen is often blocked; or due to adhesion around the fallopian tube, the lumen may still be partially patent. However, the cilia of the mucosa are destroyed, the fallopian tube becomes rigid, peristalsis is restricted, and its transport function is lost, making it impossible to conceive. Therefore, the vast majority of patients are infertile. In primary infertility patients, genitourinary tuberculosis is often one of the main causes.

　　5. In addition, the condition of tuberculous pelvic inflammatory disease can show general symptoms of tuberculosis during the active stage, such as fever, night sweats, fatigue, loss of appetite, weight loss, and sometimes fever during menstruation.

　　1. Pay attention to personal and sexual hygiene, strictly avoid sexual activity during menstruation, keep the external genitalia and vagina clean, actively treat gynecological inflammatory diseases such as vaginitis, cervicitis, appendicitis, etc., and prevent infection after artificial abortion and delivery.

　　2. Abstain from sexual activity to avoid exacerbation of symptoms. Wash the external genitalia with clean water every night, use separate basins for each person, and do not use hands to scoop the vagina, nor use hot water, soap, etc. to wash the external genitalia; also, change underwear frequently and do not wear tight or synthetic fabric underwear.

　　3. Eat light and healthy foods, and the diet should mainly consist of light foods. Eat nutritious foods such as eggs, tofu, red beans, spinach, etc. Avoid eating raw, cold, and spicy foods.

　　4. Avoid sexual intercourse during menstruation, as sexual activity during menstruation is taboo to prevent infection. The menstrual pad should be kept clean and hygienic, and it is best to use disposable sanitary napkins.

　　5. Drink plenty of water, as pelvic inflammatory disease can easily cause fever, so it is important to drink plenty of water to reduce body temperature.

　　6. Avoid unnecessary gynecological examinations, and try to avoid unnecessary gynecological examinations to prevent the spread of infection and inflammation.

　　7. Pay attention to vaginal discharge, and pay attention to the amount, quality, color, and smell of vaginal discharge every day. Excessive vaginal discharge, yellowish color, thick consistency, and foul smell indicate inflammation and infection; if the amount decreases and the taste tends to be normal, it indicates that there is no inflammation.

　　1. Ultrasound examination: There are exudates or inflammatory masses in the pelvis;

　　2. Gynecological examination: If the vagina is congested, swollen, and has a large amount of purulent, smelly discharge, and there is purulent discharge seen at the cervical os, it indicates that there is acute inflammation of the cervical canal mucosa or uterine cavity;

　　3. Vaginal, cervical, or urethral secretion smears; pathogen culture; cul-de-sac puncture;

　　4. Medical history and diagnostic examination: Doctors often ask about the patient's recent life, to see if there is a history of gynecological or obstetric surgery, including delivery, cesarean section, induced abortion, and placement or removal of intrauterine devices.

　　1. For pelvic inflammatory disease, attention should be paid to the symptoms of five hearts and hot flashes, and lumbar pain is often due to kidney Yin deficiency. The diet for pelvic inflammatory disease should include meat and egg products with emotional blood, and the diet should be nourishing and strengthening.

　　2. Patients should consume a diet rich in protein and vitamins, including lean meat, pork liver, tofu, chicken, fruits, and vegetables.

　　3. It is advisable to consume lean meat, chicken, eggs, crucian carp, turtle, cabbage, asparagus, celery, spinach, cucumber, winter melon, mushrooms, tofu, seaweed, purple seaweed, and fruits, among others.

　　4. For pain, eat horseshoe crabs, red crabs, lobsters, clam, sea cucumber, tiger fish, beetroot, mung beans, radish, chicken blood.

　　5. Eat more fresh cooked vegetables and fruits, more mushrooms, sunflower seeds, asparagus, tomatoes, carrots, etc.

　　6. Avoid spicy and stimulating foods and drinks such as chili, Sichuan pepper, green onions, garlic, and white wine.

　　7. Avoid cold and raw foods such as cold drinks and fruits.

　　8. Avoid sweet and rich foods: Foods that are too sweet and rich, such as candies, cream cakes, eight-treasure rice, glutinous rice cakes, lard, and fatty pork, sheep fat, and egg yolks, these foods have the effect of promoting dampness, which may reduce the therapeutic effect and make the disease difficult to treat.

　　9. It is not advisable to eat greasy, cold, sticky foods such as fatty meat, crabs, snails, preserved meat, etc.

　　10. It is strictly forbidden to eat spicy and stimulating foods such as cigarettes, alcohol, strong tea, etc.

　　1. Surgical Treatment: The surgical treatment of pelvic inflammatory disease is generally the main treatment method for pelvic inflammatory disease. If there is pelvic inflammatory disease, it is best to undergo surgical treatment. Surgery can be performed for masses such as hydrosalpinx or ovarian cysts, and for small infected foci that repeatedly cause inflammatory attacks, surgical treatment is also recommended.

　　Surgery is based on the principle of complete cure to avoid the recurrence of lesions, and unilateral salpingectomy or total hysterectomy with bilateral salpingectomy can be performed. The ovarian function should be preserved as much as possible for young women.

　　2. Physical Therapy: There are many instruments for treating female chronic pelvic inflammatory disease at present, and the effects produced by different physical therapy instruments are also different. Generally, during the process of irradiating the lower abdomen of women, the spectrum therapy can promote blood circulation and at the same time reduce pelvic congestion; the pelvic therapy instrument can not only help women achieve the effect of physical therapy but also help the absorption of drugs. It mainly promotes local blood circulation in the pelvis, improves tissue nutrition, enhances metabolism, and is conducive to the absorption and regression of inflammation.

　　3. Western Medicine Treatment: The main treatment for chronic pelvic inflammatory disease is the use of antibiotics and drugs to dissolve adhesions, which is conducive to the decomposition of adhesions and the absorption of inflammation. Acute pelvic inflammatory disease can be treated with penicillin, erythromycin, gentamicin, lincomycin, and clindamycin by intravenous infusion or intramuscular injection.