Pelvic Inflammatory Disease (cont.)
How is pelvic inflammatory disease diagnosed?
PID is difficult to diagnose because the symptoms are often subtle and mild.
Many episodes of PID go undetected because the woman or her health care provider
fails to recognize the implications of mild or nonspecific symptoms. Because
there are no precise tests for PID, a diagnosis is usually based on clinical
findings. If symptoms such as lower abdominal pain are present, a health care
provider should perform a physical examination to determine the nature and
location of the pain and check for fever, abnormal vaginal or cervical
discharge, and for evidence of gonorrheal or chlamydial infection. If the
findings suggest PID, treatment is necessary.
The health care provider may also order tests to identify the
infection-causing organism (e.g., chlamydial or gonorrheal infection) or to
distinguish between PID and other problems with similar symptoms. A pelvic
ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the
pelvic area to see whether the fallopian tubes are enlarged or whether an
abscess is present. In some cases, a laparoscopy may be necessary to confirm the
diagnosis. A laparoscopy is a minor surgical procedure in which a thin, flexible
tube with a lighted end (laparoscope) is inserted through a small incision in
the lower abdomen. This procedure enables the doctor to view the internal pelvic
organs and to take specimens for laboratory studies, if needed.
How is pelvic inflammatory disease treated?
PID can be cured with several types of antibiotics. A health care provider
will determine and prescribe the best therapy. However, antibiotic treatment
does not reverse any damage that has already occurred to the reproductive
organs. If a woman has pelvic pain and other symptoms of PID, it is critical
that she seek care immediately. Prompt antibiotic treatment can prevent severe
damage to reproductive organs. The longer a woman delays treatment for PID, the
more likely she is to become infertile or to have a future ectopic pregnancy
because of damage to the fallopian tubes.
Because of the difficulty in identifying organisms infecting the internal
reproductive organs and because more than one organism may be responsible for an
episode of PID, PID is usually treated with at least two antibiotics that are
effective against a wide range of infectious agents. These antibiotics can be
given by mouth or by injection. The symptoms may go away before the infection is
cured. Even if symptoms go away, the woman should finish taking all of the
prescribed medicine. This will help prevent the infection from returning. Women
being treated for PID should be re-evaluated by their health care provider two
to three days after starting treatment to be sure the antibiotics are working to
cure the infection. In addition, a woman's sex partner(s) should be treated to
decrease the risk of re-infection, even if the partner(s) has no symptoms.
Although sex partners may have no symptoms, they may still be infected with the
organisms that can cause PID.
Hospitalization to treat PID may be recommended if the woman (1) is severely
ill (e.g., nausea, vomiting, and high fever); (2) is pregnant; (3) does not
respond to or cannot take oral medication and needs intravenous antibiotics; or
(4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess). If
symptoms continue or if an abscess does not go away, surgery may be needed.
Complications of PID, such as chronic pelvic pain and scarring are difficult to
treat, but sometimes they improve with surgery.
Next: How can pelvic inflammatory disease be prevented? »
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