Inflammation of the appendages (i.e. fallopian tubes and ovaries) is correctly called adnexitis. This is a fairly common disease that many women face at least once in their lives.
Any infectious disease, which reduces immunity, can provoke inflammation of the appendages. Although it also happens that the cause of its development is unprotected sexual contact during menstruation or immediately after an intrauterine intervention.
Adnexitis first manifests itself in an acute form, while the body temperature rises significantly, sharp pains occur in the lower abdomen, which can give to the lower back, the menstrual cycle is disturbed.
In the absence of adequate treatment, the acute form becomes chronic. Symptoms in this case become less pronounced, but there is a risk of impaired reproductive function. Therefore, a patient with inflammation of the appendages needs competent treatment. And the sooner she goes to the doctor, the better.
Reasons for the development of adnexitis and their influence on the choice of treatment strategy
The most common cause of adnexitis is infectious disease. Usually we are talking about pathogenic microflora. These are tubercle bacillus, bacteria that cause diphtheria, as well as gonococci (in such cases they are diagnosed with specific adnexitis).
However, inflammation of the appendages can also be caused by Escherichia coli, staphylococci, streptococci, various opportunistic microflora (for example, a fungus that normally can exist in the female body for a long time without causing any negative effects, but under the influence of certain factors it actively multiplies and causes disease). These pathogens provoke the so-called nonspecific adnexitis.
There are also factors that are provocateurs of this disease:
- severe pregnancy and childbirth with complications;
- various intrauterine procedures, for example, installation of a spiral or abortion;
- recent removal of the appendix due to its inflammation;
- hypothermia of the body, which leads to a decrease in immunity;
- stress
- non-observance of personal hygiene.
Sometimes the cause of adnexitis becomes such seemingly unrelated to the reproductive system of the disease as diabetes. In this case, in order for the inflammation of the appendages not to become chronic, it is necessary to treat the underlying pathology.
Adnexitis treatment: basic principles
Adnexitis treatment is a process that requires an integrated approach. First you need to establish the cause of the disease, which requires laboratory tests, because you need to determine the pathogen and evaluate its resistance to various antibiotics.
Most often, treatment of acute or subacute adnexitis is carried out in a hospital setting, and with a chronic form, treatment is possible at home. In this case, antibiotics or antibacterial drugs are prescribed, as well as immunomodulating, desensitizing and anti-inflammatory drugs. This is necessary in order to improve blood microcirculation, relieve pain and inflammation. Physiotherapeutic methods are prescribed only when the temperature becomes normal.
With timely medical attention, the duration of the course of treatment is 2-3 weeks. Theoretically, it can be treated at home. However, adnexitis therapy requires bed rest. At home, this is possible only if relatives take over all the responsibilities - cleaning, cooking, etc. Otherwise, there will be no talk of peace. In addition, it should be remembered that during the treatment of adnexitis, sex is absolutely prohibited.
In the treatment of a chronic form, non-steroidal anti-inflammatory drugs, immunocorrectors or biostimulants, vitamins, enzymes are prescribed.
An important role is played by non-drug methods of treatment. This, for example, medical gymnastics, special massage and intimate warming, other physiotherapeutic procedures. Antibiotics in the chronic form are rarely prescribed - only in those cases when pathogenic bacteria that are the causative agents of the disease have been detected.
Despite the fact that chronic adnexitis occurs in a milder form than acute, it can be more difficult to treat it, if only because antibiotics do not help. Remains anti-inflammatory drugs and various physiotherapeutic methods. This, for example, ultrasound and magnetic therapy, electrophoresis, other procedures whose action is aimed at improving trophism and microcirculation in tissues.
Mud therapy is considered an effective method, but only if the woman does not have benign neoplasms in the pelvic organs.
Drug treatment for inflammation of the appendages: antibiotics
Unfortunately, in recent years, many pathogenic microorganisms have acquired resistance to antibiotics most commonly prescribed for adnexitis. Basically we are talking about tetracycline drugs.
Many doctors today prescribe "Doxycycline" as a tool with minimal side effects and at the same time quite effective. In addition, unlike other drugs in this group, Doxycycline is eliminated quite quickly from the body. But in general, tetracyclines will not be the best choice - both due to the developed resistance of pathogenic microbes, and because of the large number of side effects.
When antibiotics treat ovarian inflammation in women, drugs from the macrolide group are also used. They are often prescribed orally, because such drugs in the stomach are practically not destroyed. Due to the long half-life, they remain in the body for a long time and can even accumulate, which increases the efficiency of their use. From this group, “Klacid” and “Sumamed” are considered the best choice, their effectiveness has been proved by many studies.
The advantage of these drugs is that they act on some pathogenic microorganisms that remain “undetected” by other drugs, because they live inside the cells, causing inflammatory processes.
Another group of antibiotics that is prescribed to treat inflammation of the appendages and ovaries in women is fluoroquinolones. Their advantage is that resistance to them develops at an extremely slow pace, so that the drug will not need to be changed. In this group, "Lomefloxacin", "Ofloxacin", "Norfloxacin" are considered the most effective means.
Very often, in the treatment of adnexitis, not one, but two antibiotics from different groups are prescribed at once. This is due to the fact that inflammation of the appendages is rarely caused by only one pathogen, much more often we are talking about several pathogenic microorganisms at once, both of the aerobic and anaerobic groups. To combat aerobes, Tinidazole and Metronidazole can be used.
With symptoms of ovarian inflammation, antibiotic treatment yields positive results. In this case, drugs in various forms of release can be used - both in the form of intramuscular injections, and in the form of solutions for intravenous administration. Usually, antibiotics for injection are first prescribed, then - tablets in tablet form. Candles are used in such cases much less often.
But there are antibiotics that are mainly available in capsules - these are Zedex and Ceftributin. They are considered the most effective against pathogens such as streptococci, gonococci and enterococci.
The fluoroquinolones mentioned above — Ciprofloxacin and Ceftriaxone — can be given in the form of injections or in tablet form. They cope with almost all types of microorganisms.
A wide range of actions are also Azithromycin and Zoomax. In any case, the dosage and route of administration should be selected by the doctor. Of course, this takes into account contraindications to such drugs, the patient’s allergies, etc.
It is especially important to choose the right antibiotic during pregnancy. It is impossible to avoid taking such pills in the treatment of inflammation of the ovaries (right, left, or both), since the disease can lead to miscarriage or premature birth. Since self-medication is contraindicated for women in the situation, we will refrain from providing even fact-finding information about the prescribed drugs. Only a doctor can assess the likely risks and draw up a treatment regimen.
This is the treatment for patients with ovarian inflammation. In men, inflammation of the appendages of the testicles (orchoepidimitis) is also often diagnosed. For treatment, all the same antibiotics are prescribed, but taking into account the clinical picture and the characteristics of the patient's body.
Other drugs for adnexitis
In some cases, if the causative agent of the disease is a fungus, agents such as Nystatin, Miconazole and Fluconazole are used. The first two drugs are designed for a course of 10-15 days. The last medicine is for 5 days maximum.
As for desensitizing drugs (women are prescribed complex treatment for ovarian inflammation), Betamethasone and Tavegil are recommended. The latter is the first generation antihistamine and can cause drowsiness, which should be considered when taking the drug.
Of the anti-inflammatory drugs, drugs such as Diclofenac (in the form of a rectal suppository) or Nimesulide (Nise), which are drunk in tablets, are usually prescribed.
It is recommended to take vitamins, primarily antioxidants (these are vitamins A, E and ascorbic acid). It is also important to take vitamins of group B. The doctor will help you choose the complex (Vitrum or Triovit are usually prescribed).
Another group of drugs used to treat ovarian inflammation in women is biogenic stimulants. Their action is based on substances of animal and plant origin, formed only in natural conditions. They are usually needed for accelerated tissue regeneration. Such stimulants include, for example, aloe vera.
Adnexitis Diet
In the treatment of ovarian inflammation at home, an important role is played by therapeutic nutrition. The diet is built in accordance with the principles of a hypoallergenic diet. This means that the following products will have to be excluded from the menu:
- cow's milk;
- egg white;
- chocolate;
- citrus fruits, kiwi, other exotic fruits;
- shrimp and seafood.
At the same time, spicy dishes and smoked foods are prohibited, since they only exacerbate the inflammatory processes. Sweets, baked goods, coffee - all this is limited.
Low-fat meats and vegetables (except starchy) are recommended, and both are best served in boiled or stewed form.
An important role is played by compliance with the drinking regime. During the period of the disease, heavy drinking is recommended. And it can be not only mineral water without gas. Doctors advise a rosehip broth, lingonberry and cranberry fruit drinks, weak black tea without sugar, but with lemon.
In addition, while a woman is taking antibiotics, sour-milk products, even low-fat yogurts or kefir, will have to be excluded from the diet, since they reduce the effectiveness of the drugs.
But vegetables and fruits in the diet should be as much as possible in order to normalize the digestive processes and ensure regular bowel movement.
Physiotherapeutic methods for treating inflammation of the appendages
Practice shows that antibiotics do not always help in the treatment of adnexitis, especially when it comes to its chronic form. Therefore, at present, doctors are in search of new drugs and effective physiotherapeutic methods.
Among the options that have already found wide application today include:
- various types of gynecological irrigation (hydrogen sulfide, carbon dioxide, radon);
- laser therapy, in which the ilium is treated with a helium-neon laser;
- electrophoresis using copper, zinc, magnesium and iodine;
- magnetotherapy of the corresponding area;
- mud applications , etc.
One of the most effective methods for adnexitis is considered to be plasmapheresis, in which the patient’s own plasma is replaced with fresh donor plasma.
This technique is mainly used for a long-lasting chronic form of inflammation, when internal intoxication syndrome develops and blood microcirculation is disturbed. Such procedures are recommended in the first phase of the menstrual cycle, the number of sessions the doctor selects individually.
DLG
Some experts prescribe what is popularly called intimate warming, but correctly this technique is referred to as DLH - dosed local hyperthermia. This is an auxiliary physiotherapeutic procedure in which heat is treated. It is prescribed for many inflammatory gynecological diseases. For her, a nozzle is taken, which is inserted into the vagina, due to which local heating of the problem area is provided.
The number of procedures and temperature conditions are assigned in each case individually. But with each subsequent time there is a gradual increase in temperature. The maximum heating level is +54 ° C. At the same time, women who went through this procedure claim that it does not cause discomfort.
One of the main indications for this method is inflammation of the appendages, regardless of what pathogens it was caused by, whether bacteria or viruses are the cause of the infection. However, there are contraindications. These include, for example, any neoplasms of the mammary gland and organs of the reproductive system, endometriosis, cervical erosion, pregnancy. Also, the procedure is not performed during menstruation.
A gynecological massage is also performed using the apparatus used for DLH. The fact is that the device can operate in mechanical vibration mode, and this helps to normalize the function of the ovaries and even allows you to get rid of small and loose adhesions, if any. And gynecological massage increases the effectiveness of using any medications. But before you sign up for this procedure, you must go through an examination with a specialist, and the doctor will most likely send pelvic organs for ultrasound.
Spa treatment of adnexitis
With a prolonged course of chronic inflammation of the appendages, spa treatment is often prescribed. Besides the fact that it helps relieve stress and increase immunity, microcirculation in tissues improves, and recovery processes pass faster.
At resorts, methods such as therapeutic mud, baths with various extracts and healing waters, and vaginal irrigation are usually used. The latter are also usually carried out using sulphide or sodium chloride waters. The duration of the course is usually prescribed by a doctor. But with hydrotherapy, on average, 10-12 procedures are shown, and with mud therapy - at least ten.
Holidays at sea are also considered beneficial. But you can go to the coast only if at least eight weeks have passed since the last exacerbation.
It is very important to observe safety rules. You can spend no more than 20 minutes in sea water, and when you go ashore, you need to immediately change your swimsuit to dry. And of course, it is recommended to avoid overheating - it can be no less dangerous than hypothermia.
Inflammation of the appendages: treatment with folk remedies
It is clear that where antibiotics are the main treatment method, folk remedies simply do not work, since they cannot be considered quite effective. However, traditional medicine recipes can be used along with drugs as adjunctive therapy.
For example, in women with ovarian inflammation, treatment with folk remedies involves the use of the following:
- Steam inhalation from a decoction of wormwood. To do this, bring to a boil 2 liters of water, throw a handful of dry wormwood in a container, keep it on low heat for about 5 minutes. Then the container (it is advisable to take a bucket or pan) should be put on the floor and sit over it for 15-20 minutes. Such warming helps relieve inflammation. The course should consist of 5-6 sessions.
- Decoction or tincture of the boron uterus (it is also called one-sided orthilia). This plant is used to treat a wide variety of gynecological diseases. Decoction of it is done as follows: dry grass is ground (it is possible in a coffee grinder), take 1 tbsp. l of this raw material and pour a glass of boiling water, bring to a boil, leave over low heat for 5 minutes. After you need to wait a couple of hours, strain the product and drink 1/3 cup three times a day 30 minutes before meals.Some herbalists suggest making alcohol tincture of the pine uterus - 50 g of herb per 0.5 l of vodka. The tool is insisted for 14 days. It is recommended to take 30-35 drops three times a day one hour before a meal.
- Applications from paraffin. For this method, 400 g of paraffin must be melted to a liquid state (this is best done in aluminum cookware). Then the fabric is moistened with paraffin and smeared with this hot composition of the lower abdomen. When this mass is applied to the skin, it is covered with a plastic wrap and a woolen blanket on top. Paraffin is kept on the body until it cools.
- Infusion of the root of the incense. To prepare this product, it is recommended to grind 50 g of this raw material, pour 0.3 l of boiling water and insist for 8 hours, and then strain. The infusion is used for douching - the procedure is repeated twice a day. In pharmacies, you can find ready-made extract of frankincense. It can also be used for douching, but then it should be diluted - 2 tbsp. l extract in 2 l of water. You can use the tool to soak a homemade swab of gauze and cotton wool.
- A decoction of the plant is a thigh. Collect raw materials during flowering. But for the broth take only dry shredded grass - 1 tbsp. l on 1 liter of hot water. The product is brought to a boil and kept on low heat for 10 minutes. The finished broth is filtered and gradually drunk with honey throughout the day. Some phytotherapists advise using this tool for douching.
Also, in the process of treating ovarian inflammation with folk remedies, they suggest using buldenezh - this is one of the varieties of viburnum. For tincture, flowers are collected that resemble large white balls. They are laid out in a liter jar to the very top, and then pour 0.5 l of vodka. The remedy is infused for two weeks. They do not drink it, but rub it in the lower abdomen, and some believe that the flowers from this tincture can be used for applications. That is, they are also applied to the problem area for a couple of hours, covered with plastic wrap.
The listed funds are suitable for the treatment of ovarian inflammation at home in the acute form of the disease. Herbal medicine is also used to treat chronic inflammation of the appendages. For example, in such cases, traditional medicine suggests taking 4 tsp. chopped buckthorn root, peony and Chernobyl, 3 tsp each. elecampane root and hemophilia and mix it all. From the resulting mixture take 2 tbsp. l raw materials and pour 0.5 l of boiling water, bring to a boil, keep on low heat for about half an hour, and then cool. After this, you need to strain the product and take 0.5 cups three times a day, adding a little honey to improve the taste.
Prevention of inflammation of the appendages
Preventing adnexitis is much easier than curing it. Meanwhile, preventive measures for inflammation of the appendages can even be called commonplace, since the main role is played by observing the rules of personal hygiene. The fact is that even if a woman has a regular partner whom she trusts, this does not guarantee protection against genital infections. Not to mention those cases when intimate relationships are episodic in nature.
To protect yourself from infection, you should buy a special antiseptic gel or spray, which can be used within the next two hours after sexual contact. This minimizes the risk of infection.
If a woman often encounters acute inflammation of the appendages, then it will be advisable to refuse tampons in favor of pads during menstruation, and it is recommended to change them no less than after 3-4 hours of use.
For intimate hygiene, you should not use ordinary soap or shower gel, since there is a risk that the vaginal microflora will suffer from them. There are special tools.
Avoiding inflammation will also help care about your own immune system. In order for it to work with maximum efficiency, it is necessary to avoid not only hypothermia, but also stress, overwork, etc. It is important to take vitamin complexes prescribed by a doctor in the cold season.
And of course, you need to regularly, at least once every six months, come to the gynecologist for a routine examination.