
Introduzione
Pelvic Inflammatory Disease is an infection of the genital tract and reproductive organs in women. It most often occurs when the causative organism, mostly bacteria spread from the vagina to the uterus, fallopian tubes or ovaries. This infection may happen naturally or it can be sexually transmitted. PID is most common in sexually active women in their reproductive age.
PID is the leading cause of infertility for women in the United States. The signs and symptoms of pelvic inflammatory disease can be subtle or mild. Some women don’t experience any signs or symptoms. As a result, many women might not realize they have it until having trouble getting pregnant or until the development of a dull & chronic pelvic pain. Symptoms may also be confused with conditions like appendicitis, ectopic pregnancy, or ovarian cysts. It can be diagnosed during a pelvic exam or through pelvic ultrasound or laparoscopy. Treatment involves antibiotics and antimicrobial agents. More than one cycle of treatment will be needed to clear PID completely in many women.
Signs & Symptoms
Signs and symptoms may be subtle or mild. Some women will not have any symptom at all. When signs and symptoms of PID are present, they most often include:
- Pain (mild to severe) in the lower abdomen and hip
- Abnormal or heavy vaginal discharge that may have an unpleasant smell
- Abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles
- Pain during intercourse
- Fever, sometimes with chills
- Painful, frequent or difficult urination
Cause
Most common cause is infection from a bacterium like Gonorrhoea or Chlamydia
Risk factors
Being a sexually active woman younger than 25 years old
Having multiple sexual partners
Being in a sexual relationship with a person who has more than one sex partner
Having sex without a condom
Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and might mask symptoms
Having a history of pelvic inflammatory disease or a sexually transmitted infection
After the insertion of an intrauterine device (IUD). This risk is generally confined to the first three weeks after insertion.
Fisiopatologia
Most cases of PID are presumed to occur in 2 stages. The first stage is acquisition of a vaginal or cervical infection. This infection is often sexually transmitted and may be asymptomatic. The second stage is direct ascent of microorganisms from the vagina or cervix to the upper genital tract, with infection and inflammation of these structures.
The mechanism (or mechanisms) by which microorganisms ascend from the lower genital tract is unclear. Studies suggest that multiple factors may be involved. Although cervical mucus provides a functional barrier against upward spread, the efficacy of this barrier may be decreased by vaginal inflammation and by hormonal changes that occur during ovulation and menstruation.
In addition, antibiotic treatment of sexually transmitted infections can disrupt the balance of endogenous flora in the lower genital tract, causing normally non-pathogenic organisms to overgrow and ascend. Opening of the cervix during menstruation, along with retrograde menstrual flow, may also facilitate ascent of microorganisms.
Intercourse may contribute to the ascent of infection through rhythmic uterine contractions occurring during orgasm. Bacteria may also be carried along with sperm into the uterus and fallopian tubes.
In the upper genital tract, a number of microbial and host factors appear to influence the degree of inflammation that occurs and, thus, the amount of subsequent scarring that develops. Infection of the fallopian tubes initially affects the mucosa, but inflammation may rapidly become transmural. This inflammation, which appears to be mediated by complement, may increase in intensity with subsequent infections.
Inflammation may extend to uninfected parametrial structures, including the bowel. Infection may extend via spillage of purulent materials from the fallopian tubes or via lymphatic spread beyond the pelvis to produce acute peritonitis and acute perihepatitis (Fitz-Hugh−Curtis syndrome).
Diagnosi
No single test can accurately diagnose pelvic inflammatory disease. Instead, a any of the following methods will be used:
- medical history including sexual habits
- Signs and symptoms
- A pelvic examination
- Blood and urine tests
- Ultrasound
- Vaginal swab tests or pap smear tests
- Endometrial biopsy.
Trattamenti
Proper treatment with medicine can get rid of the infection that causes pelvic inflammatory disease. Any scarring or damage to the reproductive tract due to PID can’t be reversed. Treatment for PID most often includes:
- Treatment for partner is also important as it can be sexually transmitted.
- Temporary abstinence.
- Surgery is rarely needed, such as in cases of a ruptured abscess.
Prognosi
Prognosis is good in acute cases, but approximately 25% of patients diagnosed with acute PID develop long-term sequelae. The risk for sequelae is increased if the patient has recurrent episodes of PID. Tubal factor infertility (TFI) – TFI occurs in approximately 8-19% of women after one episode of PID
Complicazioni
Scar tissue and pockets of infected fluid (abscesses) developed in the reproductive tract. These can cause permanent damage to the reproductive organs.
Complications from this damage might include:
- Ectopic pregnancy.
- Chronic pelvic pain.
- Tubal or ovarian abscess
Malattie e Ayurveda
Diseases of female genital tract are described under the heading Yonirogas. Manifested cases of PID can be compared with features described under Paripluta yoniroga.
Nidana
Holding of sneezing and belching during coitus (by woman with Pitta constitution or Pitta dominance
Purvaaroopa
Non menzionato
Samprapti
When a woman with Pitta dominance indulges in coitus holding the urge for sneezing and belching, the Vaata along with Pitta get vitiated, reach her vagina and produce the disease.
Lakshana
Swelling/inflammation in the vagina
Tenderness in vagina
Painful bleeding with yellow or bluish tinged discharge
Severe pain in the hip, inguinal area, and lower back
Febbre
Divisioni
Non menzionato
Prognosi
Kashtasadhya
Chikithsa
Ayurvedic treatment of Paripluta is managing the imbalanced Pitta and Vaata considering not to vitiate Kapha. Therapies are needed to reduce inflammation and to bring normalcy of all the three doshas locally and in the whole body. Wholesome diet and regimens along with proper dinacharya & ritucharya are also advised for complete cure.
Samana
After proper aamapaachana & agnideepana, santarpana (nutritive diet) is advised. Lepanam with sothahara dravyas
Parisheka with thriphala/naalpamara kwatha
Swedanam
Yonipichu – tampoons with medicated oils
Sodhana
Virechana
Kashayavasti
Snehavasti
Uttaravasti
Farmaci di uso comune
Sukumaram Kashayam
Guggulupanchapalachoornam
Kanchanaraguggulu
Saptasaram kashayam
Guduchyadi kashaym
Marche disponibili
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Rimedi casalinghi
Practice safe sex. Use protective measures/physical barriers.
Use safe methods of contraception.
Get regular screening tests if you are prone to PID
Avoid douche.
Dieta
- Da evitare
I pasti pesanti e gli alimenti difficili da digerire causano indigestione.
Cibi spazzatura: causano disturbi della digestione e riducono la biodisponibilità del farmaco.
Bevande gassate: rendono lo stomaco più acido e disturbano la digestione.
Cibi refrigerati e congelati - causano una digestione debole e lenta indebolendo Agni (fuoco digestivo).
Latte e prodotti lattiero-caseari - aumentano kapha, causano l'ostruzione dei canali e l'obesità.
Cagliata - causa vidaaha e quindi molte altre malattie
- Da aggiungere
Pasti leggeri e alimenti facilmente digeribili
Green gram, soups, sesame oil, cow’s ghee
Cibo fresco e caldo trattato con semi di cumino, zenzero, pepe nero, ajwain, ecc.
Protect yourself from extreme climate changes.
È meglio evitare l'esposizione a luce solare eccessiva, pioggia o polvere.
Mantenere un programma alimentare e di sonno regolare.
Maintain proper personal hygiene, especially private parts.
Evitare di trattenere o forzare gli stimoli come urina, feci, tosse, starnuti ecc.
Evitare la sedentarietà.
lo yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
L'esercizio fisico regolare aiuta a migliorare la biodisponibilità dei farmaci e degli alimenti ingeriti e porta a una salute positiva.
Lo yoga può mantenere l'armonia all'interno del corpo e con il sistema circostante.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Semplici esercizi per la salute dei polmoni e del cuore
Tutti gli esercizi e gli sforzi fisici devono essere decisi ed eseguiti esclusivamente sotto la supervisione di un medico esperto.
Articoli di ricerca
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843151/
https://pubmed.ncbi.nlm.nih.gov/12179634/
Queste dichiarazioni non sono state valutate dalla Food and Drug Administration degli Stati Uniti. Questo prodotto non è destinato a diagnosticare, trattare, curare o prevenire alcuna malattia. Consultare il proprio medico di famiglia prima dell'assunzione.
Scrittore:
Il dottor Rajesh Nair, cofondatore e consulente capo di Ayurvedaforall.com, si è laureato presso il prestigioso Vaidyaratnam Ayurveda College (affiliato all'Università di Calicut), in Kerala, India. Inoltre, ha conseguito un diploma post-laurea in Yoga Terapia presso l'Università di Annamalai.
Il Dr. Nair offre consulenze in due cliniche molto frequentate a Haripad e dintorni, Alleppey, Kerala, lo stato meridionale famoso in tutto il mondo per gli autentici trattamenti ayurvedici e per i medici. Oltre a offrire consulenze su tutti gli aspetti dei trattamenti ayurvedici, il Dr. Nair ha un interesse particolare per il Panchkarma, lo Yoga e il Massaggio.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Il Dr. Nair partecipa regolarmente a conferenze sull'Ayurveda e ha visitato la Germania per diffondere l'Ayurveda. Potete scrivere direttamente a lui
rajesh@ayurvedaforall.com
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