Salpingitis is an inflammation of the female fallopian tubes. It is mostly caused by bacterial infections.
What is salpingitis?
Salpingitis causes the fallopian tubes (tuba uterina) to become inflamed. It can occur in just one fallopian tube or in both fallopian tubes. Bilateral inflammation is more common. In many cases, salpingitis is accompanied by inflammation of the ovaries (oophoritis), which doctors call adnexitis. See wholevehicles for What are the Meanings of Larva Migrans Cutanea.
The paired fallopian tubes, also called tubes, create a longitudinal connection between the uterus and the ovaries. They are found in the lower abdomen on both sides of the body. In medicine, a distinction is made between acute and chronic salpingitis. Endometritis (inflammation of the lining of the uterus) often occurs as part of an inflammation of the fallopian tubes.
Causes
Bacterial infections are usually responsible for the development of salpingitis. These often lead to rising inflammation. This means that the inflammation of the affected organ spreads to neighboring body structures. In the case of salpingitis, the fallopian tubes are then affected. In most cases, the disease is a consequence of endometritis, colpitis (vaginal inflammation) or cervicitis (inflammation of the cervix).
But bacteria that are transmitted during sexual intercourse can also be the cause of the outbreak of salpingitis. These are mostly chlamydia or gonococci. Chlamydia infection primarily affects sexually active women. Another possible trigger is insufficient genital hygiene, which results in the spread of germs that are settled in the anal region, such as Escherichia coli.
In rare cases, salpingitis is also caused by a doctor as part of a gynecological examination or treatment. The risk factor is the loss of the vaginal environment during menstruation, as this has a protective effect. Wearing vaginal pessaries or spirals and surgical interventions are also beneficial. Sometimes the inflammation spreads to the fallopian tubes via the lymphatic flow or the blood. The inflammatory bowel disease Crohn’s disease or appendicitis are often responsible for this.
Symptoms, Ailments & Signs
Salpingitis is characterized by abruptly occurring pain in the lower abdomen, which can appear on one side of the body or on both halves. In addition, the affected women feel generally ill and suffer from symptoms such as feelings of weakness, tiredness and exhaustion. In addition, the patient’s body temperature increases. Other accompanying symptoms are constipation, diarrhea, nausea, vomiting and flatulence.
If the inflammation spreads to the intestines or the urinary bladder, there is a risk of further symptoms. This can be painful urination or pain in the pelvis. If the vagina or cervix is also inflamed, there is a risk of spotting and discharge. If the fallopian tube inflammation continues to rise, the ovaries can also be affected, resulting in adnexitis.
One of the most feared complications is inflammation of the peritoneum (peritonitis). The harmful germs penetrate the abdominal cavity via the open connection between the fallopian tubes and the abdominal cavity and cause an inflammation that can be life-threatening. Sometimes salpingitis is associated with only mild or even no symptoms at all.
Diagnosis & course of disease
To diagnose salpingitis, the treating gynecologist performs a physical examination of the patient. He checks the right and left lower abdomen for pain sensitivity. The fallopian tubes are extremely sensitive to pressure. If a gynecological examination is carried out, the doctor checks the vaginal region and the cervix. A swab can be taken to identify the responsible pathogen.
With the help of a sonography (ultrasound examination), accumulations of water, abscesses in the fallopian tube area and thickening can be detected. If salpingitis is diagnosed early, the disease usually takes a positive course. The fertility of the affected woman is also preserved. However, sticking together of the fallopian tubes is considered unfavorable.
This often results in infertility in the patient. Following salpingitis or adnexitis, there is an increased risk of an ectopic pregnancy. Salpingitis can also take a chronic course or spread to other organs.
Complications
Salpingitis can have various complications and long-term effects. If the disease remains undetected for a long time, accumulations of pus can form in the fallopian tubes or ovaries and worsen the course of the disease. The fallopian tube inflammation can also spread from the fallopian tubes and ovaries to the peritoneum and trigger peritonitis.
There is also a risk that the germs will get into the bloodstream and cause blood poisoning. This can be life threatening. Infection with anaerobes and Haemophilus influenza pathogens is particularly dangerous. If salpingitis develops into a chronic disease, adhesions can occur as a late consequence. Such adhesions are often associated with pain and can block the ovaries and uterus.
If fertilized, there is a risk of an ectopic pregnancy. A complete blockage of the fallopian tubes results in infertility. Although the adhesions can be surgically removed, bleeding, nerve damage, and infection may occur. Further complications arise from the therapy from the prescribed medication.
The antibiotics and anti-inflammatory drugs used can cause side effects and interactions and sometimes trigger allergic reactions. An ovariectomy, i.e. the surgical removal of the ovaries, can lead to a “surgical menopause”. This is associated with hormonal fluctuations and sudden menopausal symptoms such as migraines and nausea.
When should you go to the doctor?
Lower abdominal pain, heavy vaginal bleeding and fever indicate salpingitis, which must be clarified by a doctor. If the symptoms do not go away on their own or are accompanied by other symptoms such as pain during sexual intercourse or back pain, it is best to consult a gynecologist. If the above signs occur in connection with a chlamydia infection, a doctor should be consulted immediately.
The doctor can prescribe antibiotics and various general measures that should lead to a speedy recovery. During therapy, close consultation with the doctor is necessary, since salpingitis can provoke complications that require independent treatment.
Increasing pain indicates spread of inflammation to the ovaries. Then inpatient treatment may be necessary. The same applies to pressure pain in the abdomen, which can indicate abscess formation. Other contacts are the gastroenterologist or an internist. If you have severe symptoms, you should go to the nearest hospital to be on the safe side. Comprehensive therapy with broad-spectrum antibiotics should lead to a reduction in symptoms within a week.
Treatment & Therapy
As part of the treatment of salpingitis, it is important to improve the symptoms and preserve the functionality of the fallopian tubes. The disease is usually treated in a clinic. The patient receives antibiotics such as ceftriaxone, doxycycline, metronidazole or amoxicillin for a period of 10 to 14 days. In the case of a chlamydial infection, tetracyclines or macrolides are administered.
If there is a suspicion of an anaerobic infection, the therapy often consists of the administration of metronidazole and anti- inflammatory drugs. The treatment of the partner is also considered sensible. To combat the pain, the patient receives non-steroidal anti-inflammatory drugs such as diclofenac or ibuprofen. If conservative treatment of acute salpingitis does not lead to improvement, laparoscopic surgery may be necessary.
An abscess puncture or drainage of the Douglas space is performed. In older women who are no longer planning a family, a salpingectomy and hysterectomy are also possible. Sometimes an ovariectomy is performed as well. Even with the chronic form of salpingitis, surgery is often required. The therapy results, however, often take a disappointing course.
Prevention
To prevent the development of salpingitis, the use of condoms is recommended during sexual intercourse. In addition, consistent sexual hygiene should always be guaranteed. In this way, the risk of salpingitis can be reduced.
Aftercare
Follow-up care for salpingitis takes place after the inflammation of the fallopian tubes has healed. It usually takes two to three weeks for the symptoms to completely subside. The doctor must then be consulted again, who can clarify the symptoms and discharge the patient. If there are no complications, no further investigations are indicated.
If the inflammation spreads to the ovaries or the peritoneum, further medical examinations are necessary. The follow-up care then includes a thorough physical examination as well as a blood draw and a patient consultation. During the patient consultation, the risk of transmission of the causative bacterial pathogens may also be pointed out.
In particular, sexually active women who have repeatedly suffered from salpingitis must adjust their genital hygiene. In the case of repeated illnesses, information is also provided about the early symptoms of the illness. The doctor explains the associated pain so that a quick response can be made if the disease returns.
If infertility is suspected after recovering from salpingitis, the gynecologist should be consulted. Possible scarring of the tube wall can be detected by CT and, under certain circumstances, surgically repaired. The gynecologist or internist takes care of the aftercare of salpingitis.
You can do that yourself
Salpingitis is primarily treated medically. The patient must take the medication as prescribed and inform the doctor of any discomfort and unusual symptoms. In the case of abscesses or treatment failure, inpatient treatment may be necessary.
If the disease progresses positively, general measures such as drinking enough and avoiding sexual contact apply. Pain in the lower abdomen can be treated with warm, moist compresses. It is also important to ensure that you empty your bladder and bowels regularly. If you have an antibiotic illness, you need to take antibiotics. Then rest and avoidance of cold and other irritants on the immune system are particularly important. Affected women should discuss the individual measures with their gynecologist. If salpingitis is detected early and treated adequately, it should subside within seven to ten days.
With a complicated course of treatment, skin changes may occur. These can also be treated with home remedies. Aloe Vera is ideal for redness and itching. Chamomile poultices from the household can help. Homeopathy also offers various globules. Homeopathic remedies should only be taken after consulting a doctor.