There is no infection but there is inflammation of the appendages. Chronic inflammation of the appendages

Inflammatory diseases of the pelvic organs are one of the most common pathologies in the gynecological practice of doctors. According to medical indicators, about 60% of diseases of the female genital area develop against the background of inflammatory processes in the ovaries, uterus, fallopian tubes, and appendages.

The term "appendages" refers to all adjacent organs of the uterus (fallopian tubes, ovaries). Inflammation of the appendages belongs to the group of infectious and inflammatory processes in which the ovaries or tubes of the uterus itself are most often involved. In cases where inflammation affects the uterus, symptoms of endometritis most often join.

In gynecology, diseases of the appendages can be found under the name adnexitis (inflammation of the ovaries) or salpingo-oophoritis (inflammation of the fallopian tubes). Given that these organs are anatomically closely related, the doctor often makes a diagnosis of inflammation of the appendages. What are the causes and symptoms of the disease, how to treat inflammation of the appendages and how dangerous this disease is.

Inflammation of the appendages: causes

Normally, the pelvic organs, including the appendages, do not have pathogenic flora, but with certain factors or diseases, pathogenic bacteria are able to penetrate inside, provoking the development of inflammatory processes. It is known that any inflammatory disease is caused by pathogenic microorganisms. In this case, the cause of inflammation in the appendages can be any bacteria that have penetrated the mucous membranes of the genitourinary system: viruses, fungi, gonococci, chlamydia, streptococci, staphylococci, spirochetes, protozoa, herpes simplex viruses and others, which, after penetrating the body, actively multiply, causing symptoms are characteristic of inflammation of the appendages. Any of the pathogenic microorganisms can not only cause symptoms of inflammation of the appendages, but also other diseases. For example, chlamydia - chlamydia, fungi - vulvitis, candidiasis, gonococci - gonorrhea and other diseases that are often related to those that are sexually transmitted.

Pathogenic microbes can enter the body not only through sexual contact, but also through contact, household, as well as in case of non-observance of elementary hygiene rules or in contact with a carrier of the pathogen. Of particular importance in the development of this disease is the state of the immune system. If a woman's immunity is strong, it will not allow the activation of any microorganism. In cases where the immune system is weak, the risk of getting sick increases several times. In addition, there are a number of specific factors that are a trigger for the development of inflammatory processes in the appendages. Among these factors are:

Hypothermia of the body.
Overwork;
Constant stress;
Unbalanced diet;
constipation;
Promiscuous sexual relations.
Abortion.
childbirth;
Sexual contact during menstruation.
Poorly conducted gynecological examinations.

In addition to the above factors, inflammatory processes in the appendages can be triggered by physical or mental stress, endocrine disorders, internal infections of other organs. In any case, inflammation of the appendages must be treated, since the lack of timely treatment entails complex and sometimes dangerous complications.

Symptoms of inflammatory processes in the appendages

Inflammation of the appendages - symptoms can occur in acute or chronic form. The acute form of the disease has a pronounced clinical picture, and chronic inflammation of the appendages has a more blurred symptomatology, which is characterized by periods of remission and exacerbation. With inflammatory processes in the appendages, a woman experiences the following symptoms:

Pain syndrome. Localized pain with inflammation of the appendages in the lower abdomen. It can have different intensity, give to the sacrum or thigh. Pain increases during menstruation or sexual intercourse. If a woman suffers from a chronic form of the disease, then the pain syndrome may be present constantly, intensify with exacerbation.

Violation of the menstrual cycle. Menstruation with inflammation of the appendages is almost always irregular, quite painful, severe bleeding can be observed. In rare cases, menstruation is too short and scanty.
Discharge from the vagina from purulent to mucous with an unpleasant odor.
Itching, burning in the vagina.
Increase in body temperature. During an exacerbation, body temperature can rise to 39 degrees.

General malaise. Occasionally there is nausea, dry mouth, increased fatigue.
Violations of the functions of the urinary system. Discomfort, pain when urinating.
Disorders in the work of the nervous system: increased irritability, depression.
Decreased libido.

Signs of inflammation of the appendages can be determined by the results of a blood test. In inflammatory processes, the blood formula changes significantly, the ESR increases. In addition, during a gynecological examination at a gynecologist's appointment, a woman feels severe pain in the ovaries and uterus. The above symptoms may also be present in other diseases of the genital organs, therefore, only a doctor can make an accurate diagnosis after examining the patient, the collected history, the results of laboratory and instrumental studies: blood test, urinalysis, ultrasound of the pelvic organs and others that will allow the doctor to get a complete picture diseases, make the correct diagnosis.

Possible Complications

Inflammation of the appendages - symptoms and treatment should be carried out in a timely manner and only under the supervision of a doctor. In cases of untimely or incorrect treatment, there is a risk of developing complications that are not life-threatening for a woman, but can lead to the development of a chronic form of the disease, as well as infertility.

It is important to note that women who have had inflammation of the appendages are 10 times more likely to be diagnosed with an ectopic pregnancy. Complications develop against the background of the formation of scar tissue on the ovaries or tubes. In rare cases, a complication manifests itself in the form of purulent processes in the fallopian tubes. This complication requires surgical removal of the fallopian tubes or ovaries.

Inflammation of the appendages: methods of treatment

Every woman should clearly know how to treat inflammation of the appendages, but in any of the cases, therapeutic measures should be carried out under the supervision of a doctor. In the acute period of the disease, treatment is carried out in a hospital and should include both drug treatment and diet and proper lifestyle. In the acute period, a woman is recommended bed rest, the use of low-fat and unsalted foods.

An important place in the treatment is occupied by antibacterial therapy, the action of which is aimed at the destruction of the causative agent of the disease. Usually, the doctor prescribes broad-spectrum antibiotics, among which the following drugs can be distinguished:

Penicillin group - Amoxiclav, Augmentin;
Cephalosporins - Ceftriaxone, Cefazolin;
Macrolides - Erythromycin, Macropen, Fromilid.

The doctor may prescribe other antibiotics that affect the pathogenic flora. Antibiotics for inflammation of the appendages are prescribed in the form of injections for intramuscular or intravenous administration or in the form of tablets for oral administration. In the acute period, it is recommended to take antibiotic injections, as they can quickly remove the inflammatory process, thereby reducing the symptoms of the disease. The effectiveness of the treatment should be observed on the first day. The course of treatment takes from 5 to 10 days. If positive dynamics is not observed, the doctor may change the antibiotic or prescribe more radical methods of treatment (surgery).

In addition to antibiotics, the doctor also prescribes other medications:

Non-steroidal anti-inflammatory drugs: Ibuprofen, Intomethacin.
Vaginal suppositories. They have a positive effect on pathogens, act directly in the focus of inflammation. Such drugs are administered at bedtime. They have antimicrobial, anti-inflammatory, bactericidal action: Terzhinan, Polygynax, Klion-D and others. Such drugs do not affect the microflora of the vagina, have a minimum number of contraindications and are well tolerated by the female body.
Vitamin therapy. Vitamins of groups B, C and E are prescribed, as well as immunostimulants to increase immunity.

A good effect in the treatment can be obtained from physiotherapy procedures: UVI blood, electrophoresis, laser treatment, UHF and many other methods. Physiotherapy can be used both in the acute period and in the chronic form of the disease.

Inflammation of the appendages is a very common gynecological disease, which is dangerous because, in the absence of proper and timely treatment, its acute form can become chronic. This development of the disease often leads to infertility that is difficult to eliminate and other undesirable consequences.

Causes of the disease

Predisposing factors for the development of adnexitis (or its recurrence) can be hypothermia, genital infections, poor personal hygiene, disordered sexual intercourse, stress, etc. A combination of several factors increases the risk of developing the disease.

The above reasons contribute to the penetration of pathogenic bacteria into the body and their further development, which ultimately leads to an inflammatory process.

The cause of the disease can also be its own pathogenic microflora, formed against the background of hypothermia, overwork, decreased immunity and other adverse factors.

Symptoms

The acute form of adnexitis is characterized by the following features:

pulling (sometimes sharp paroxysmal) pain in the lower abdomen; chills, high fever; nausea; violation of urination; purulent vaginal discharge.

Such symptoms last about a week, then the chronic course of the disease occurs. Signs of chronic adnexitis are:

constant aching pain; subfebrile temperature; violation of the menstrual cycle; painful intercourse; decrease in sexual desire; problems in the work of the gastrointestinal tract; periodic exacerbation of the disease (due to hypothermia or a stressful situation).

In some cases, inflammation of the appendages can occur without any signs. In such cases, it is possible to recognize the disease only during a gynecological examination and after passing the necessary tests.

Diagnostics

It is rather difficult to make a correct diagnosis with inflammation of the appendages, since the symptoms of acute adnexitis are similar to many acute diseases of the pelvic organs, and the characteristic symptoms of chronic adnexitis are often mild or absent.

Adnexitis is diagnosed after a gynecological examination, including laboratory tests of vaginal discharge, blood and urine culture. If microorganisms characteristic of this disease are found in the biological material, it can be assumed that the patient has inflammation of the appendages.

An important method for diagnosing adnexitis is ultrasound. Ultrasound can detect inflammatory formations of the appendages, including chronic ones.

In doubtful cases, laparoscopy is done, which is the most accurate method for diagnosing adnexitis. This study makes it possible to visualize the appendages and ovaries, which allows you to accurately determine the signs of inflammation.

Treatment

To relieve inflammation with adnexitis, antibiotics and anti-inflammatory drugs are used. In the presence of purulent processes, surgical intervention is necessary.

Most often, inflammation of the appendages treatment involves a long one. It includes anti-inflammatory, antimicrobial and restorative therapies. It is very important to complete the course of treatment to the end, not interrupted at the first improvement. It is possible to evaluate the effectiveness of the therapy passed only if there are repeated tests.

Chronic adnexitis is treated with physiotherapy, mud therapy and drug therapy. Paraffin therapy and magnetotherapy give good results.

Prevention

Like any disease, adnexitis is easier to prevent than to treat. Therefore, a woman needs to monitor her health and exclude all possible risk factors: hypothermia, overwork, stress, sexual infections, alcohol abuse, etc. You should also not neglect such a preventive measure as the use of rational contraception.

It is important to know that a quarter of women who have had adnexitis experience relapses of this disease. In order to prevent re-inflammation, many use non-traditional practices: herbal medicine, homeopathy, manual therapy, physiotherapy, etc.

Systematic consultations of a gynecologist 1-2 times a year will help to avoid many diseases and maintain women's health. In no case should you self-medicate and hope that the disease will go away on its own. The statistics are far from reassuring: every fifth woman who has had inflammation of the appendages cannot have children. Therefore, in the event of characteristic pain and the slightest suspicion of adnexitis, you should immediately consult a doctor.

The appendages of a woman are called the uterine (fallopian) tubes and ovaries. They are located in the pubic area, above the pubic bone. These organs are responsible for the growth and development of the egg, as well as for its release into the uterine cavity.

The maturation of female germ cells occurs inside the ovary. In the middle of the cycle, a mature egg leaves it in the cavity of the fallopian tube, goes to the uterus. At this point, the egg can be fertilized by the male germ cell (sperm). Then, when it hits the uterine mucosa, it will attach to its surface, pregnancy will begin. If the egg remains unfertilized, then it leaves the uterine cavity along with the mucous epithelium. This is how menstrual bleeding occurs.

All the internal hollow organs of a person are lined with mucous epithelium. Inflammation of the appendages is expressed in redness and swelling of their mucous surface. More often, inflammation affects the fallopian tubes, but it can also spread to the ovarian mucosa.

The action of the inflammatory response is aimed at limiting the spread of infection. With redness and swelling, a number of biochemical processes are triggered that stop the further spread of the pathogen and cause its death. Thus, inflammation of the uterine appendages is a response to the penetration of bacteria or viruses inside.

Local inflammation of the ovaries and appendages in women in medical terminology is called adnexitis.

Factors and causes of adnexitis

The cause of adnexitis is an infection. Inflammation is caused by pathogenic organisms (so-called bacteria) or pathogenic particles (viruses). At the same time, they can get into the appendages in different ways, during intercourse or during medical procedures (installation of a spiral, curettage of the uterus during an abortion). Internal infection is also possible - with blood flow from another inflamed organ. More often than others (in 80% of cases), the causative agents of inflammation are cocci, chlamydia.

In order for pathogens to enter the appendages from the outside, they must overcome the protective barrier of the vaginal mucosa. Healthy vaginal flora protects the appendages from pathogens. If the microflora of the vagina is disturbed for some reason, then infection becomes possible.

The following factors lead to a decrease in immunity, a violation of the vaginal flora, and the appearance of inflammation:

hypothermia- banal situations such as “got a cold”, “badly dressed”, “wet her feet”, “sat in the cold”.
Stress- forms a general muscle and vascular spasm, disrupts blood circulation, becomes the cause of congestion. Therefore, against the background of constant stress, various infections often appear.
Unsatisfied sexuality(forms stagnant processes).
Hormonal disorders- more often hormonal imbalance is formed against the background of taking contraceptives.
Sexual life with multiple sexual partners- often causes the transmission of sexual infections to each other, the appearance of acute and chronic inflammation.

Note: the human bacterial flora contains pathogens in certain quantities. At the same time, their vital activity is controlled by immunity. With a persistent decrease in defense reactions (against the background of private psychoses, stress, with poor nutrition, for other reasons), inflammation of the internal organs can form on its own, without the presence of a source of infection.

How to determine the presence of inflammation in the accessory organs? What are the signs of inflammation of the appendages in women if the process has acquired a sluggish chronic form?

Symptoms of inflammation of the appendages in women

The main symptom of inflammation is pain. With adnexitis, it occurs in the lower abdomen, lower back and may be accompanied by additional symptoms - unpleasant mucous secretions (leucorrhoea), failure in menstruation.

In acute adnexitis - severe pain. They are accompanied by painful urination and pain. And they can also give in the leg. Acute adnexitis is often accompanied by fever. Possible indigestion.

Chronic form, sluggish inflammation of the appendages in women does not cause fever. Pain is felt as mild, moderate or may be absent altogether. The appearance of mild pain in chronic adnexitis can be felt against the background of an increase in temperature during a cold infection. Pain during intercourse is also possible, especially with deep penetration.

Note: often pain during intercourse is the only sign of sluggish chronic adnexitis.

Mucous discharge from the vagina (leucorrhoea) during an acute process may have a sharp unpleasant odor, yellow or green hues. They can also be plentiful, create some discomfort throughout the day for a woman. In chronic adnexitis, the discharge is weak or absent altogether.

Also, the presence of chronic inflammation in the appendages may be accompanied by menstrual irregularities. The reason for this is that the ovaries perform the function of producing sex hormones - estrogens, progestins. In inflamed tissues, hormonal synthesis is disrupted, which causes deviations in the timing of menstruation, their profusion, duration, and other cycle disorders.

Often chronic adnexitis occurs imperceptibly. However, it needs to be treated. A long chronic process is dangerous with complications.

Consequences of inflammation of the appendages: adhesions and infertility

What threatens adnexitis to a woman? Why is a sluggish inflammatory process harmful if it does not create pain, is not a source of discomfort? Why is it important to know about the presence of inflammation?

We list what processes occur in the appendages during a long-term sluggish inflammatory process:

The mucous membrane of the fallopian tubes swells, increases in size, the lumen in the tubes narrows, they become impassable for the eggs. This condition is called "tubal" infertility.
Adhesions are the result of a long-term inflammatory disease. They are bundle-like growths of connective tissue on the inflamed mucosa. This is a kind of "bridge" that separates the area of inflammation from healthy cells. In the future, the presence of adhesions may cause the fertilized egg to stop as it moves towards the uterus. And that means - to cause infertility, the inability of a woman to become pregnant. The use of antibiotics can also be the cause of adhesions.
With a difficult or impossible passage of the egg through the fallopian tube, the fertilized zygote may linger in it or go the other way - to the abdominal cavity. This is how an ectopic pregnancy is formed.
The process of synthesis of female sex hormones is disrupted. Which leads to menstrual irregularities, unstable egg maturation.

Conclusion: chronic inflammation of the appendages often causes a violation of the reproductive function of a woman, a violation of the reproductive processes, which can be defined in a more understandable word - infertility.

How to treat inflammation of the appendages

Treatment of inflammation of the appendages in women depends on the strength of the inflammatory process and the nature of the infection. If the cause of the disease is a pathogenic microorganism (bacterium), then antibacterial drugs (antibiotics) are needed. If a virus has become the cause of the infection, then antiviral measures and means are needed - specific antiviral drugs and immunomodulators.

Acute stage: we treat the pathogen infection

More often, the causative agent of the inflammatory process in the female genital organs are pathogenic bacteria (anaerobes), the reproduction and vital activity of which occurs in an oxygen-free environment. Antibacterial drugs are prescribed for their treatment. The choice of antibiotic is determined by the type of pathogen. Antibacterial agents have a wide spectrum of action, but are unable to equally counteract all pathogens. Therefore, for effective treatment, the pathogen is determined - a swab is taken from the vaginal flora.

If it is impossible to sow the pathogen, then antibiotics of the widest and most general spectrum of action are prescribed. These are drugs of the cephalosporin and penicillin groups (Ceftriaxone, Amoxiclav). They can also prescribe milder antibacterial agents - Erythromycin, Metronidazole. With non-extensive inflammation, they are prescribed in the form of tablets. With severe adnexitis - in the form of injections (shots), which are done under the supervision of a doctor in a hospital.

What antibiotics for inflammation of the appendages and ovaries are prescribed for home treatment:

Macrolides- Azithromycins (Summamed), Erythromycins (international version - Clindamycins). These pills for inflammation of the appendages are most often prescribed in the treatment of adnexitis. They are considered the least toxic antibacterial drugs with a minimum of side effects and contraindications.
Fluoroquinalines- Norfloxacin, Ofloxocin, Lomefloxacin. They represent one of the latest generations of antibacterial drugs, they are almost not addictive.
Nitromidazoles- Metronidazole, Ornidazole, Ternidazole. This group acts against pathogens of the nitro group.

Note: often for the treatment of genitourinary diseases, two types of antibiotics are prescribed simultaneously. One is against anaerobic bacteria (those that breed in an oxygen-free environment). And the second - against aerobes (reproducing in the presence of oxygen).

Remission stage: we treat the remnants of the inflammatory process

After limiting the growth and development of the pathogen, a period of remission begins. It is characterized by the presence of residual signs of inflammation in the cells of the mucous epithelium. That is, there is still inflammation, but the cause-causative agent is no longer there.

Often, many women end treatment at this stage, believing that the residual effects will pass on their own. This is indeed possible, but only in a healthy female body with strong immunity. Often the opposite happens. Residual inflammation becomes the basis for re-infection and relapse (return) of the disease. Therefore, treatment must be completed. What is prescribed in the remission stage?

For the final recovery, measures are prescribed to resolve the focus of inflammation. They speed up the elimination of toxins. As a rule, those means are used that stimulate blood circulation inside the abdominal cavity, accelerate local blood flow in the area where the ovaries and fallopian tubes (appendages) are located.

These include:

Physiotherapy (magnetotherapy, electrophoresis).
Warm-ups and compresses.
Paraffin treatment.
Mud cure.
Massage - special gynecological, on the lower back and lower abdomen.

They also prescribe treatment with mineral waters at a balneological resort.

Means for raising immunity

In addition to "direct-acting" drugs, which are directed directly against the causative agent of infection, the treatment of adnexitis uses drugs and drugs to increase immunity. They are also necessarily used in the treatment of viral inflammation caused by foreign particles (for example, in the treatment of genital herpes). Immunity boosters include:

Vitamin and mineral complexes- necessary to ensure active protective reactions. They are prescribed for any diseases, infections, inflammations.
Prebiotics- preparations for the normalization of the bacterial flora, provide the action of local immunity of the internal cavity of the vagina, intestines. Be sure to be prescribed in the treatment of antibacterial substances.
Specific drugs to stimulate the immune system- antiviral drugs, immunomodulators. They must be prescribed for a viral infection. For example, against herpes - tablets and ointments with acyclovir, famvir, panavir. And for any viral infections - suppositories with interferon.

Often, treatment with absorbable drugs, taking funds for immunity is prescribed from the first days of the disease. If the inflammation is caused by a bacterial pathogen, then immunity agents are an additional treatment that shortens the duration of antibiotic therapy. With a viral pathogen, immunostimulants provide the main treatment for the disease.

The duration of antibiotic treatment takes from 7 to 10 days. The duration of treatment with vitamins, prebiotics, as well as the use of physiotherapy is 3-4 weeks (almost a month).

Note: also with severe pain, analgesics are prescribed.

Treatment of chronic inflammation of the appendages differs in duration and uses various drugs - tablets, injections, vaginal suppositories, as well as physiotherapy. The most convenient for home treatment and very effective vaginal suppositories.

Anti-inflammatory suppositories for inflammation of the appendages

The introduction of drugs into the vaginal cavity ensures the rapid penetration of the drug into the inflammation zone, a high therapeutic effect of its use. What anti-inflammatory suppositories are used in gynecology for inflammation of the appendages?

Candles with NSAIDs

NSAIDs or nonsteroidal suppositories for inflammation of the appendages with anti-inflammatory action:

Indomethacin.
Diclofenac.
Voltaren.

Also, with adnexitis, hemorrhoidal suppositories with belladonna are prescribed. They are anti-inflammatory and analgesic at the same time.

These drugs are referred to as drugs for the treatment of joint diseases and inflammation. They are also successfully used in the treatment of any internal inflammatory processes.

Suppositories with absorbable action

These drugs prevent the formation of adhesions. They stop adhesions during inflammation, dissolve adhesions after treatment of adnexitis.

Terrilithin candles- dilute blood clots and pus, break down necrotic (dead) tissues.
Longidaza- also promotes the resorption of adhesions, stops the adhesive process.

Vaginal suppositories with antiseptics of antifungal and antibacterial action for the treatment of appendages are ineffective. They are prescribed if, in addition to adnexal inflammation, there is inflammation of the vaginal cavity (colpitis).

Candles with antifungal action:

Gynomax.
Myconalosis.
Guino-Pevaril.
Nystatin.
Primafungin.
Terzhinan.

Candles with antibacterial action:

Dalacin.
Clindamycin.
Metrovagin.
Betadine.
Hexicon.
Iodoxide.
Fluomizin.
Terzhinan (complex preparation with antibacterial and antifungal action and hormonal prednisolone).

Treatment with candles, the introduction of medicinal substances into the cavity of the vagina or rectum is indicated for various diseases. Medicinal substances enter the bloodstream, bypassing the digestive tract, without partial destruction in the liver. Which reduces the frequency of allergic reactions, increases the effectiveness of treatment.

Rectal suppositories with immunomodulating action

Preparations with interferon exhibit antiviral action. They are broad-spectrum immunomodulators. The most famous of them are Viferon, Genferon, Kipferon.

Note: the listed drugs are rectal suppositories, that is, they are injected into the rectum through the anus.

Candles to normalize the microflora of the vagina

Also during and after the treatment of andexide, suppositories are used to normalize the vaginal flora - Acylact, Lactobacterin. They are essential for antibiotic treatment. Desirable - in the treatment of viral forms of infections.

Treatment of inflammation of the appendages with folk remedies

How to treat inflammation of the appendages without pharmaceutical drugs? Traditional medicine offers a number of measures that are aimed at limiting the development of inflammation and the spread of infection.

To stimulate the immune system is taken orally:

Onion garlic- sources of sulfur and popular natural immunomodulators.
citrus juices- sources of vitamin C.
Vegetable fresh juices sources of digestible vitamins.

For local antiseptic therapy, they do vaginal douching, put tampons with natural antibiotics and antiseptics.

In doing so, they use:

aloe;
warm infusions of antiseptic herbs;
tampons with ichthyol ointment.

As well as warm baths with essential oils, steaming with wormwood, salt, salt compresses on the lower abdomen.

Traditional medicine does not always cure inflammation to the end. In order to prevent its transition into a chronic form, after treatment it is necessary to take tests and check that there are no foci of inflammation left.

Inflammation of the appendages in women is an infectious pathology, while the process affects the ovaries or fallopian tubes, but not the uterus itself. The penetration of the pathogen into the body occurs in various ways.

The disease can proceed for a long time without symptoms, sometimes characterized by the appearance of pain in the lower abdomen and menstrual irregularities. Treatment is aimed at destroying the pathogen and restoring the function of the uterine appendages.

Causes

Why do women develop inflammation of the appendages, and what is it? In medicine, this disease is called salpingo-oophoritis. If the inflammation affects only the fallopian tubes, then salpingitis is diagnosed. An inflammatory process that affects only the ovaries is called oophoritis.

The development of the inflammatory process in the uterine appendages occurs under the influence of pathogenic and opportunistic microorganisms. There are two types of disease:

specific adnexitis caused by diphtheria bacteria, tuberculosis bacillus, gonococci;
nonspecific salpingoophoritis caused by viruses, fungi, E. coli, streptococci, staphylococci, mycoplasmas, chlamydia and other microorganisms.

The penetration of infection into the uterine appendages can occur in the following ways:

ascending (pathogenic microbes from the vagina enter the uterus, bypassing the cervical canal, into the tubes, and then can enter the ovaries);
descending (there is already inflammation in the abdominal cavity, which gradually passes to healthy tissues);
hematogenous (microbes enter the fallopian tubes and ovaries with blood from other internal organs).

The likelihood of inflammation of the appendages increases with the action of provoking factors on the body:

hypothermia;
weakening of the immune system;
using a contraceptive method such as an intrauterine device;
unprotected sex;
childbirth or abortion.

can take three forms:

acute;
chronic;
latent (asymptomatic, or sluggish).

The disease can be diagnosed at any age. Both young girls who are not sexually active and older women who have gone through menopause turn to doctors for help.

Symptoms of inflammation of the appendages

In the case of the development of inflammation of the appendages in women, the presence of certain symptoms depends on certain factors:

pathogenicity of the ingested microorganism, its type;
from the course of the disease, whether it is an acute process, with pronounced symptoms, or chronic, with erased, barely noticeable symptoms;
the ability of the girl's body to resist microorganisms and fight the inflammatory process, from the state of the immune system.

For acute form women complain of the following symptoms:

tense abdomen in the lower sections;
, giving sometimes to the legs or lower back;
elevated body temperature (it can reach 39 degrees);
change in the menstrual cycle (the occurrence of sudden bleeding or delayed menstruation);
vaginal discharge that is different from normal (they may be greenish-purulent or yellowish, profuse or frothy).

An incompletely cured disease in the acute period can turn into chronic inflammation of the appendages, the symptoms of which depend on the period of remission or exacerbation. Every second woman with chronic adnexitis has the following pathological changes:

menstrual irregularities;
sexual dysfunction;
concomitant diseases of the urinary organs (,), etc.

During the period of exacerbation, all the symptoms characteristic of acute adnexitis resume.

Chronic adnexitis

Chronic adnexitis develops as a result of untimely or poor-quality treatment of the acute form of the disease, it occurs with periodic seasonal exacerbations. This form of inflammation of the appendages is characterized by the presence of dull, aching pain in the lower abdomen, radiating to the vagina and lumbar region. Palpation of the abdomen determines moderate pain.

Due to structural and functional changes in the ovaries (lack of ovulation, hypoestrogenism), chronic inflammation of the appendages in women is accompanied by menstrual irregularities, which manifests itself as oligomenorrhea (scanty menstruation), polymenorrhea (abundant menstruation), algomenorrhea (painful menstruation). Also, patients may complain of a lack or decrease in sexual desire, the appearance of pain during intercourse.

Diagnostics

The above symptoms may be present in other diseases of the genital organs, therefore, only a gynecologist can make an accurate diagnosis after examining the patient, collecting an anamnesis, and the results of laboratory and instrumental studies:

Ultrasound of the uterus and appendages;
PCR diagnostics (vaginal smear), which allows to establish genital infections;
colposcopy (examination of the vagina and its walls);
bakposev;
tomography;
laparoscopy.

Signs of inflammation of the appendages can be determined by the results of a blood test. In inflammatory processes, the blood formula changes significantly,. In addition, during a gynecological examination at a gynecologist's appointment, a woman feels severe pain in the ovaries and uterus.

Effects

Any inflammation of the appendages is dangerous because the following complications are possible:

development into a chronic form;
infertility, as a result of the adhesive process, in which there is obstruction of the fallopian tubes and anovulation;
a fairly high risk of ectopic conception;
purulent complication (tubo-ovarian formation) - purulent fusion of the ovaries and tubes, followed by an abscess.

Prevention

Regularly visit the gynecologist, without resisting the examination on the chair, take smears.
Avoid hypothermia by dressing appropriately for the weather, changing after swimming, avoiding sitting on cold objects.
If abortion is necessary, do so early or with medication or mini-abortion (avoid curettage).
Treat teeth, intestines and other foci of chronic infection.
Use barrier methods of contraception.
Timely treat gynecological diseases.
Follow the rules of a healthy diet.
Follow the rules of intimate hygiene.
Avoid douching.
Avoid stress.

Thus, inflammation of the appendages is a serious disease that requires timely treatment, which involves strict adherence to medical prescriptions.

Treatment of inflammation of the appendages

When diagnosing inflammation of the appendages, treatment in women should be comprehensive: a combination of medications with physiotherapy, gynecological massage, osteopathy, and physiotherapy.

The main point in the treatment of inflammation are antibiotics. They are selected with a wide spectrum of action and a maximum half-life. In addition, the woman herself needs to monitor her lifestyle (proper nutrition, abstinence from sexual activity, physical education, smoking and alcohol should be avoided).

The disease cannot be started, since the inflammatory process soon passes into the chronic stage, which leads to infertility.

Antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages is the first and main condition that must be met for a favorable outcome of the disease. How to treat inflammation of the appendages, the dosage and number of doses for each particular woman is determined by a specialist, however, we will give you the most commonly prescribed pairs of medicines:

Nitroimidazole derivatives (for example, Metronidazole) to eliminate anaerobic flora that can live in an anoxic environment, such as gonococci (causative agents of gonorrhea);
Inhibitor-protected penicillins (Amoxiclav), 3rd generation cephalosporins (Ceftriaxone), macrolides (Erythromycin), etc., which affect the aerobic (living in an oxygen environment) flora;
Antifungal drugs (eg Diflucan, Nystatin).

The first three to four days before the condition normalizes, all these drugs are administered as injections. Then you can switch to tablet forms and reduce the dose.

Concomitant treatment

In addition to the appointment of antibacterial drugs, detoxification therapy is carried out (intravenous infusions of saline solutions, glucose, hemodez, rheopolyglucin and others in a volume of 2-3 liters).

Relief of pain, and reduction of the inflammatory process is carried out with the help in the form of tablets. These are Diclofenac, Ibuprofen, Ketarol and other drugs. Be sure to prescribe vitamins C and B, as well as allergy pills.

When removing an acute process and in the treatment of chronic inflammation of the appendages without exacerbation, physiotherapy is widely used: electrophoresis of copper and zinc in the phases of the menstrual cycle, electrophoresis with lidase or iodine, ultrasound, high-frequency pulsed currents (SMT, DDT). Also in rehabilitation treatment, immunomodulators, autohemotherapy, injections of aloe, FIBS, Longidase, and so on are used. In chronic adnexitis, spa treatment is indicated - mud, paraffin, therapeutic baths and douching.

Candles for inflammation of the appendages

To reduce signs such as inflammation, pain, swelling, and temperature, special suppositories are used that can relieve inflammation. They can also prescribe such suppositories that are able to strengthen the immune system, and this is very important for any illness. Also, these drugs cleanse the body of harmful substances.

All candles are prescribed by a doctor, but in any case, such treatment will be additional.

Folk remedies

At home, you can use some folk recipes:

Take 4 teaspoons of finely chopped buckthorn roots, Chernobyl and peony, add 3 teaspoons of burnet roots and elecampane. After that, pour 2 tablespoons of the resulting mixture with half a liter of boiling water. Boil for half an hour on low heat, and then let cool for half an hour. After strain and you can add a little honey for taste. Take the drug should be half a cup 3-4 times a day.
One tablespoon chopped dry grass boron uterus pour a glass of boiling water. Insist 2 hours. Strain. Take 1/3 cup 3 times a day half an hour before meals. The course of treatment is 1 month. After a monthly course of treatment of adnexitis with a pine forest uterus, it is advisable to drink another infusion for 2 months - from the field yarutka grass. 1 st. l. herbs pour a glass of boiling water, leave for 4 hours, strain. Drink 1 tsp. 30 minutes before meals 4 times a day.
Buldenezh should be collected at the very beginning of flowering (until insects have started in them). Tincture of them has excellent antiseptic, anti-inflammatory and analgesic properties. A liter jar is filled with inflorescence balls, filled with vodka and sent for 15 days to a dark, cool place. The lower abdomen is rubbed with this tincture, and the inflorescences are applied in the form of compresses.
Take flowers of coltsfoot, sweet clover, centaury in equal proportions. Mix, pre-grinding, pour boiling water, let it brew for an hour, then strain the broth through cheesecloth and drink half a glass twice a day. During treatment, abstinence from sexual intercourse is recommended.

Remember that folk remedies are only an addition, and in no way can replace drug therapy prescribed by a specialist.

Inflammation of the appendages can develop in a woman at any age. This infectious pathology can affect both girls and elderly women, inflammation occurs in the ovaries, uterine tubes, while the uterus itself is not affected. Adnexitis - as doctors call this pathology - leads the list of "female" diseases.

A particular danger of pathology lies in the consequences - about 25% of cases end in infertility. The disease begins to develop when pathogenic microorganisms are activated under the influence of external or internal factors. Inflammation of the appendages can occur both in acute and chronic form. Since the uterine appendages are a paired organ, the inflammation can be unilateral or bilateral.

Causes

Pathogenic and opportunistic microorganisms can give a "push" to the progression of the inflammatory process. Doctors distinguish between specific adnexitis, which is caused by gonococci, tuberculosis bacillus and diphtheria bacteria, as well as nonspecific salpingo-oophoritis, which is caused by staphylococci, E. coli, streptococci, mycoplasmas, chlamydia, fungi and viruses.

The following factors can contribute to the development of inflammation of the appendages:

appendectomy;
stress and hypothermia;
complicated childbirth in history;
promiscuous sex life;
non-compliance / violation of the rules of intimate hygiene;
abortions, hysteroscopy, insertion / removal of the spiral and any intrauterine procedures;
HIV infection, diabetes mellitus, previous infectious diseases and any chronic foci of infection in the body - all this leads to a decrease / weakening of the defenses.

Infection in the uterine appendages can get in different ways:

lymphogenous - the infection penetrates the lymphatic vessels;
ascending - from the vagina and cervix;
descending path - from other inflamed organs (for example, the appendix or sigmoid colon);
hematogenous - through the blood vessels.

All these factors, to a greater or lesser extent, can contribute to the development of adnexitis.

Symptoms of inflammation of the appendages in women

Depending on the development of the disease, it is customary to distinguish between acute and chronic forms.

In an acute inflammatory process, women complain of severe pain in the lower abdomen, poor health, and elevated body temperature. During palpation, it can be noted that the size of the appendages increased, and the contours became fuzzy, mobility was limited.

With chronic inflammation of the appendages, the following symptoms occur:

Violation of the menstrual cycle. This symptom is observed in 50% of patients. Menstruation becomes painful, heavy or scanty. Sometimes there is discharge between periods;
Pain in the lower abdomen, the nature is constant or periodic. Pain is noted after hypothermia, stress, various diseases;
Decreased sex drive. Inflammation of the uterine appendage causes pain during intercourse;
Purulent or serous discharge, this symptom is affected by the severity of inflammation of the appendages.

Patients often complain of irritability and sleep disturbance.

latent form

A sluggish inflammation of the uterine appendages that does not have clear symptoms is called latent. This is the most dangerous form, since the disease can progress asymptomatically, causing only mild malaise, insomnia, and lethargy.

In the absence of severe pain, women rarely seek help from the hospital. Gynecology in this case, as a cause, is considered even less frequently. Against the background of latent adnexitis (inflammation of the appendages), processes begin in the appendages, which lead to adhesions, and then to complete infertility.

chronic stage

The chronic form of the disease is the result of an acute form that has not been treated in time. It is characterized by a recurrent course. The inflammatory process can develop due to the influence of non-specific factors, such as: overwork, stress, conflict situations, hypothermia.

Chronic adnexitis is accompanied by the following symptoms:

deterioration in general well-being;
malaise;
the appearance or intensification of pain in the lower abdomen;
temperature rise to 38 degrees;
the appearance of mucous or purulent discharge.

After a week, the symptoms of the disease, as a rule, subside, only moderate pain in the lower abdomen remains.

Almost half of women with the presence of such a disease complain of menstrual irregularities. Menstruation becomes painful, the discharge is abundant or, conversely, scarce. In addition, many suffer from disorders of sexual function: soreness at the time of sexual intercourse, a decrease or complete absence of sexual desire.

Complications of chronic adnexitis

Recurrent adnexitis in a chronic form can cause various pathologies of pregnancy (ectopic pregnancy, miscarriage) and leads to secondary infertility.

Infertility in this case can develop against the background of obstruction of the fallopian tubes (the presence of numerous adhesions) and ovarian dysfunction (menstrual irregularities, anovulation, etc.). Such infertility against the background of inflammation of the appendages can be treated, but it is extremely difficult.

With chronic inflammation of the appendages, infiltrates are often formed, sclerotic processes occur in the fallopian tubes and their obstruction, adhesions form around the ovaries.

Diagnostics

For diagnosis, the doctor examines the patient in the gynecological chair. With inflammation, palpation (palpation with a finger) of the lower abdomen causes severe pain. The gynecologist also evaluates the general blood test and smear. The smear does not always reveal the bacteria that caused the inflammation - they may no longer be in the vagina.

Ultrasound of the uterus and appendages allows you to most accurately diagnose disorders in the functioning of the organs of the reproductive system. Ultrasound of the appendages, as a rule, is carried out through the anterior wall of the abdominal cavity. Drink 1-1.5 liters of water an hour or two before the examination, as you can accurately examine the tubes and ovaries only with a full bladder.

If the gynecologist will carry out ultrasound of the appendages through the vagina, then before the examination, the bladder, on the contrary, must be emptied. Ultrasound of the uterus and appendages reveals whether the organs have increased in size and how much: the more they are enlarged, the more pronounced the inflammatory process. With adnexitis, ultrasound shows that the tubes are dilated, filled with fluid, cysts have formed on the ovaries.

How to treat inflammation of the appendages?

Treatment of inflammation of the appendages in women in a hospital is carried out and begins with the appointment of a diet with restriction of salt, pepper and carbohydrates and a regimen (bed in the early days). In acute adnexitis and exacerbation of chronic patients, cold is prescribed to the lower abdomen (relieves inflammation and pain).

What to treat? The main point in the treatment of inflammation are antibiotics. They are selected with a wide spectrum of action and a maximum half-life. Since the disease is often caused by communities of microorganisms, 2 or more drugs are used in antibiotic therapy:

Cefobid 1.0 gr. 2 times a day / m in combination with gentamicin;
Clindamycin 2.0 gr. twice a day in combination with gentamicin;
Klaforan 1.0 - 0.5 gr. 2 times a day IM and gentamicin 80 mg 3 times a day IM;
Cefazolin 1.0 gr. 2 times a day in / m and ciprofloxacin 100.0 ml 2 times a day in / in;
Lincomycin 0.6 gr. 3 times a day / m;

It is mandatory to prescribe metronidazole 500 mg 3 times a day orally or metrogil 100.0 ml 2 times a day IV (if an anaerobic infection is suspected).

Antihistamines (suprastin, pipolfen, cetrin and other allergy pills).
To relieve pain and reduce signs of inflammation, non-steroidal anti-inflammatory drugs in tablets are prescribed, see the list of tablets and injections for back pain Ibuprofen (Ibuklin, Nurofen, Faspik), Ketorolac (Ketanov, Ketarol), Diclofenac (Diklak, Voltaren, Naklofen, Ortofen ), etc., and rectal suppositories (paracetamol, indomethacin, diclofenac, see anti-inflammatory suppositories in gynecology with adnexitis).
Also use vitamins (vitamin C, group B)
In addition, detoxification therapy is carried out (intravenous infusions of saline solutions, glucose, gemodez, rheopolyglucin and others in a volume of 2-3 liters).

Candles for inflammation of the appendages

In combination with tablets and injections, vaginal, rectal suppositories with anti-inflammatory action are necessarily prescribed. Candles are used with:

"Metronidazole";
"Nystatin";
"Hexicon";

Vaginal suppositories

"Betadine";
"Movalis";
"Polygynax".

Using suppositories for inflammation of the female organs, there is a quick local anesthesia, relief of pain symptoms, and the microflora is restored. Nightly douching with decoctions of chamomile, calendula, a weak solution of manganese before inserting a candle has a calming effect on inflamed tissues.

Folk remedies

If at home you decide on your own initiative to supplement the treatment with these drugs, you should definitely consult with your doctor!

One of the most popular folk remedies for chronic inflammation of the appendages is a steam bath with wormwood. To prepare it, two liters of water are poured into an enameled cylindrical container, brought to a boil, then 40-50 grams (half a cup) of wormwood herb are added. Immediately after this, the container is removed from the heat, allowed to cool slightly and brew. When the water has cooled to an acceptable temperature (so that it is still very warm, but it is no longer possible to get burned), a towel is placed on the edges of the container and sit down over it. Such procedures are very often carried out by lovers of herbal medicine for inflammation of the appendages, they are also effective for cystitis.
Both compresses and steam baths with chamomile decoction are popular - in each case, the method is selected individually.
A decoction of wormwood, prepared according to the instructions on the pharmacy package, is taken orally in a tablespoon three times a day.
Collections of medicinal herbs are widely used, which include the herb of succession, yarrow, St. John's wort, horsetail, elecampane root, calendula flowers.

In no case should this method be used for acute processes and for polycystic ovaries, as well as any neoplasms.

Nutrition rules

Adhering to a special diet is simply necessary, this will increase the body's resistance to infectious agents, as well as improve metabolic processes in the area of inflammation.

The acute and subacute stage of the disease involves a hypoallergenic diet that excludes the use of any chocolate and sweets, egg whites, mushrooms, carbohydrates, as well as limiting salt intake. Per day, 100 g of protein, 70 g of fat, 270-300 g of carbohydrates are allowed, which is approximately equivalent to 2300 kilocalories. Food is recommended to cook in two ways, by boiling and stewing.

In those periods when there is no exacerbation, the diet can be omitted, but it is still recommended to adhere to a balanced diet.

Prevention

In order not to encounter inflammation of the appendages and complications of the disease, it is necessary to observe preventive measures:

visit a gynecologist every 6-12 months;
observe personal hygiene, do not use other people's towels;
refuse casual sex;
avoid stressful situations;
do not overcool your body;
do not abuse alcoholic beverages, spicy food;
treat all diseases in a timely manner;
use a condom during sexual intercourse.

In conclusion, it is worth noting that salpingo-oophoritis is an urgent problem for many modern women. Only an attentive attitude to your body can protect you from this disease and the consequences of inflammation of the uterine appendages. If salpingo-oophoritis has made itself felt, then you should seek qualified medical help as soon as possible.