Pelvic Inflammatory Disease ( PID)- Ayurvedic Treatment, Diet, Exercises,

Giriş

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

Nedenler

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.

Patofizyoloji

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).

Teşhis

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.

Treatments

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.

Prognoz

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

Komplikasyonlar

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

Disease & 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

Belirtilmemiş

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

Ateş

Bölümler

Belirtilmemiş

Prognoz

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

Yaygın olarak kullanılan ilaçlar

Varanadi kashayam

Gulguluthiktakam Kashayam

Sukumaram Kashayam

Guggulupanchapalachoornam

Kanchanaraguggulu

Saptasaram kashayam

Guduchyadi kashaym

Mevcut markalar

AVS Kottakal

AVP Coimbatore

SNA oushadhasala

Vaidyaratnam oushadhasala

Ev ilaçları

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.

Diyet

Kaçınılması gerekenler

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products – increase kapha, cause obstruction in channels and obesity

Curd – causes vidaaha and thereby many other diseases

Eklenecek

Hafif yemekler ve kolay sindirilebilir gıdalar

Green gram, soups, sesame oil, cow’s ghee

Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Davranışlar:

Protect yourself from extreme climate changes.

Aşırı güneş ışığı, rüzgar, yağmur veya toza maruz kalmaktan kaçınmak daha iyidir.

Maintain a regular food and sleep schedule.

Maintain proper personal hygiene, especially private parts.

İdrar, dışkı, öksürük, hapşırık vb. dürtüleri tutmaktan veya zorlamaktan kaçının.

Avoid sedentary lifestyle.

Yoga

Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.

Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.

Yoga, vücut içinde ve çevredeki sistemle uyumu koruyabilir.

Pavanamuktasana

Nadisudhi pranayama

Bhujangasana

Simple exercises for lungs and heart health

Tüm egzersizler ve fiziksel eforlar sadece bir tıp uzmanının gözetimi altında kararlaştırılmalı ve yapılmalıdır.

Araştırma makaleleri

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843151/

https://pubmed.ncbi.nlm.nih.gov/12179634/

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