Inflammatory process of the mucous membrane treatment. What causes inflammation of the cervix. How is the diagnosis

Vaginitis is one of the most common causes women's visits to the gynecologist. This disease affects the entire mucous membrane of the vagina.

Gynecological diseases are not rare. According to statistics, every third woman has some kind of disease associated with the pelvic organs. The most common ailment is vaginitis. It is characterized by inflammation of the vaginal mucosa.

Ulcerative colitis is an inflammation of the large and small intestines, which usually involves only the superficial mucosa. Inflammation spreads differently far up. If the inflammation is limited to the rectum, it is called proctitis. If the inflammation spreads to the entire large intestine, the so-called complete picture of the disease occurs.

Ulcerative colitis is thought to be caused by multiple factors, one being a multifactorial event. It should be taken for granted that environmental influences play a role, as ulcerative colitis is increasing in frequency and is much more common in the high-tech countries of the world than in all other regions. Role psychological factors is controversial.

Causes of vaginitis

most main reason, according to which the disease occurs, is the presence of diseases such as chlamydia, gonorrhea, trichomoniasis and the like.
Senile atrophy of the vagina.
Violation of personal hygiene.
The introduction of foreign objects into the vagina.
The use of antibiotics.
Chaotic sex life.
Incorrect douching.
The prolapse of the walls of the vagina.
Poor abortion.
Decreased immunity.
Allergic reaction.
Gaping of the genital slit. It may arise in connection with the personal physiological characteristics of a woman.
Beginning of sexual activity.

All of these reasons contribute to the fact that a favorable environment is created in the vagina for the reproduction of pathogenic bacteria. In addition to the above diseases, vaginitis can occur due to E. coli.

The overwhelming consensus is that while mental stress can cause an existing disease to flare up, it is not the cause of inflammatory bowel disease. Numerous studies show that due to individual location, the immune responses of the body's immune system are directed against components in the intestine.

From studies of twins and families, it is known that hereditary factors in chronic inflammatory bowel disease play an important role. For example, identical twins have a 40% higher risk of infection. For siblings and children of those affected, the risk is only 2-5%.

Symptoms of the disease

Vaginitis can be acute or chronic. In the chronic stage, the disease proceeds with mild symptoms that appear before or after menstruation.

Symptoms of acute vaginitis

A woman may notice that there is more discharge. They changed color and acquired an unpleasant smell.
The secretions became cloudy, viscous, quite often become stretchy.
If the inflammatory process has already begun, then pus is observed in the discharge.
With trichomonas vaginitis, the discharge acquires a fishy smell, becomes frothy. When vaginitis is due to a fungal infection, the discharge is white and cheesy.
There is itching in the groin area.
The labia are red in color, often increase in size.
Sexual contact brings pain.
Body temperature may rise, especially if the walls of the vagina are severely affected.
Sometimes there are unpleasant pain during urination. Pain can also be felt in the lumbar region.
There is also a burning sensation.

Symptoms of the chronic form

In addition to general symptoms such as loss of power, fatigue, loss of appetite and sometimes fever, the main signs of the disease are directly related to the intestines. The most common bleeding occurs during bowel movements. The stool is usually dark and mixed with mucus. Leakage of blood without stool may also occur. The frequency of stools can be from 10 to 20 times a day. In addition, pain is felt in the large intestine, in the middle of the lower abdomen, or in the Kreutzbeingegend. Often, patients experience pain before or immediately after passing a stool.

Abundant discharge.
Painful menstruation.
The occurrence of pronounced symptoms after hypothermia.

If the patient complains about the presence of any symptoms, she is sent for diagnostic procedures.

How is the diagnosis carried out?

First of all, the patient is listened to, and then they are examined on the gynecological chair. An experienced doctor will determine the presence of vaginitis immediately after the examination, but an accurate diagnosis requires testing.

Since iron is always lost in the blood, the bone marrow does not have the necessary iron to make new blood. The result is the so-called iron deficiency anemia. Disease symptoms occur in batches. An acute episode can last up to two months and occur several times a year. Between them there are phases that are almost asymptomatic. The general condition worsens, fatigue and pallor indicate anemia and protein deficiency. Later, poor vision, painful skin changes on lower limbs and joint inflammation.

The gynecologist may send the patient to the treatment room or take a vaginal swab during the examination. The laboratory conducts a detailed examination of the samples and determines what kind of vaginitis the patient has. In rare cases, a woman may be given additional tests, such as blood and urine tests. When the results of the study are ready, the doctor prescribes treatment.

But spontaneous healing is possible in rare cases. While no specific form of diet is recommended for chronic inflammatory bowel disease, it is natural to do everything from a nutritional standpoint so as not to irritate the intestines and supply the body with all the essential nutrients it needs.

The most important information for the doctor is the symptoms and their impact on daily life. Therefore, it is worth doing a weekly protocol with information on the frequency of bowel movements, the condition of the stool, such as hard, soft or watery, blood in the stool, abdominal pain, general well-being, weight and body temperature.

How is vaginitis treated?

If the patient has purulent discharge, the doctor prescribes anti-inflammatory therapy. It consists in taking antibiotics or using them in the form of ointments. Also, a woman is prescribed douching. Antiseptic solutions and astringent decoctions are used for it. With the ineffectiveness of treatment and a tendency to relapse, a woman is prescribed estrogen hormones.

These observations have been made in outpatient and hospitalized allergic patients, and their finding deserves attention and sensitivity on the part of the attending physician. Ultimately, urinary tract infection increases. Allergy of the upper respiratory tract and esophagogastroduodenitis. Sinusitis and soft stools with mucus sometimes stink. Acute respiratory viral infections and soft stools, and sometimes diarrhea. Coincidence of tonsillitis with pain in the right iliac fossa, simulating appendicitis or diffuse abdominal pain.

Gastroesophageal reflux and recurrent respiratory tract infections. The emergence of a geographical language with acute viral respiratory infections. Urinary infection and vulvovaginitis associated with allergic enteropathy. The medical literature partially reports the overlap of some of these manifestations.

It is worth noting that special attention is paid to the treatment of vaginitis in pregnant women. The doctor, first of all, tries to remove the inflammatory processes, and only then treat the immediate disease. The complexity of the treatment lies in the fact that it is contraindicated for a woman in position to take antibiotics and drugs that suppress the bacteria that caused vaginitis.

Clinical association of tonsillitis and right iliac fossa pain mimicking acute appendicitis 6 It is important to be mindful of the global mucosal commitment in a given patient is that their diagnostic and therapeutic approach must be holistic and individualized.

The lack of response to the treatment of pathology associated with a particular mucosa in allergic diseases, we observe this daily in our medical practice when we ignore the adherence to another mucosa that is simultaneously compromised, for example.

In order to prevent the disease, doctors advise their patients to monitor personal hygiene, keep a measured sexual life and visit the gynecologist at least 4 times a year.

Inflammatory diseases of the external genital organs in women steadily occupy a leading position in the structure of visits to a gynecologist. About 60% of patients of various ages complain of itching, burning and vaginal discharge of various nature. And earlier, the bulk of these patients were women of mature and elderly age, but now there is a steady increase in young girls in the structure of morbidity.

Non-response in an asthmatic patient with uncontrolled rhinitis. Persistent asthma due to undiagnosed bacterial sinusitis. Otherwise it would be incompetent. For example, an otolaryngologist could not treat a runny nose if he was not treating intestinal disorders for the first time; gynecologists or urologists could not treat a high percentage of vulvovaginitis and urinary infections without first treating respiratory allergies and intestinal disorders; Similarly, a pulmonologist will not diagnose gastritis unless he finds them on purpose; and other specialties related to allergic disease.

This is due to the almost ubiquitous spread of risk factors, the combination of which inevitably develops an inflammatory process in the vagina - vaginitis. Moreover, primary chronic forms of the disease, characterized by a poor clinic, are a particular problem. Since the manifestations do not bother the woman much, she is not too in a hurry to treat the existing inflammation of the vagina.

This clinical approach pathophysiological dependence of mucosal allergic disease, completely redefine the treatment until today is established by conventional medicine, each of the mucosal immune information is not processed slightly differently, however there is an immunological information cross between them. For example, a food allergen can simultaneously cause symptoms in the digestive and respiratory systems. 7.

Food allergies can co-occur with aeroallergen allergies up to 70%8, which increases the likelihood of food cross-reactions with aeroallergens. These findings interfere with the gut as an important source of antigen generation and should therefore be taken into account when treating an allergic patient, regardless of where the allergic disease manifests itself.

The disease itself is not as dangerous as the long-term consequences of its uncontrolled course. Regardless of the pathogen, the inflammatory process tends to ascend. That is, pathological changes, while maintaining risk factors, can contact the internal genital organs. But already their defeat is much more serious in terms of course and prognosis, especially for women of reproductive age.

The experience of our research team is that after the patient makes a proper diet, healthy bowel hygiene and control of environment The allergies disappear in a high percentage. Another mistake in medical practice is to treat these symptoms as a disease. In fact, these are symptoms or signs of allergic diseases, the correct diagnosis in an allergic patient should be: an allergic disease with manifestations of esophagitis, gastritis, rhinitis, asthma, vulvovaginitis, etc. to consider an organ compromised in isolation from the rest of the body, it must be ignored that the mucosa share immunological information and that attachment to it can have consequences on the other.

The reasons

Taking into account the mechanisms of the development of the disease, acquired risk factors occupy a leading place in its development. Moreover, the main ones among them are precisely those that create conditions for reducing the protective forces of the mucous membrane:

In the first place is wide use hormonal contraception. Although it was previously indicated that its cyclic use only has a beneficial effect on the reproductive system, now the opinion has changed dramatically. The selection of the drug should be carried out only strictly taking into account all indications and contraindications.
Following is the steady growth of functional and organic gynecological diseases, leading to a violation menstrual cycle. A change in hormonal regulation at any level inevitably affects the condition of the mucous membrane and vaginal microflora.
A gradual increase in the female population of endocrine pathology - diabetes mellitus, obesity, dysfunction of the thyroid gland.
Triggering factors include a change in sexual behavior, a violation of the rules of personal hygiene, as well as a decrease in the protective forces of immunity. This is a frequent change of sexual partners, regular use of barrier contraception, irrational washing and douching, existing foci of chronic infection.

For the convenience of diagnosing and treating inflammation of the vagina, the causes of its occurrence were divided into two groups - caused by opportunistic or specific microbes.
Finally, another aspect that needs to be reviewed as research is that ascending urinary tract infection and vulvovaginitis may be associated with mucosal distress close, as in the case of constipation or allergic enteropathy, or distance, as in the case of allergic rhinosinusitis. There are already studies that mention allergic disease as a cause of vulvovaginitis 9, including an association with dust mite allergy. In my opinion this problem is very common and medical literature does not yet describe it as such.

Specific

This group of pathogens mostly consists of microorganisms transmitted mainly through sexual contact. In fact, the inflammation of the vagina caused by them is a sexually transmitted disease. Therefore, this variant of the disease develops quite acutely, and requires immediate treatment:

Let this study be the motivation for research to clarify the prevalence of this syndrome in allergic disease, establish a new definition of it and explore the relationship of the latter with other mucosal suffering processes, like, adult gastroesophageal reflux, vesicoureteral reflux, adult interstitial cystitis, constipation and endometriosis.

The scientific basis that explains the pathophysiology of the inflammatory mucosal syndrome in allergic disease is based on a new concept of modern psychoneuroendocrine immunology, which we hope to develop in the next volume. In recent publications on allergies, the focus is on rhinitis and asthma as manifestations of the same process. Confirmation by other investigators of concurrent mucosal involvement in an allergic patient would help validate a new definition of allergic disease and therefore facilitate a new therapeutic approach.

The most common trichomonas vaginitis is a specific lesion caused by protozoa. Its development is accompanied by itching, discomfort and copious frothy discharge from the vagina.
Following in frequency are inflammatory processes caused by intracellular pathogens - chlamydia or mycoplasmas. Their feature is a latent course, moderate symptoms (burning, scanty mucous discharge) are rarely noted.
Inflammation of the vaginal mucosa caused by gonococci is quite rare - cervical lesions are more typical. But with its development, a bright clinic is observed - a strong burning sensation, and the formation of copious purulent discharge.
Candida vaginitis is now also a sexually transmitted disease. Fungi of the genus Candida normally live on the vaginal mucosa, but under favorable conditions they can multiply uncontrollably, causing itching and cheesy discharge.

If any specific vaginitis is suspected, the attending physician must confirm it with the help of special diagnostic methods.
10 year prognosis for allergic rhinitis in children. Asthma and wheezing in the first six years of life. El Serag, Mark Gilger, Mark Kuebeler, Linda Rabenek. Extrasophageal associations of gastroesophageal reflux disease in children without neurological defects. Lessin, Mark, Ailawadee, Manesh and sausages. Prevalence of sensitization to food allergens in Swedish adults. Allergy: European Journal of Allergy and Clinical Immunology. Current evaluation and treatment of vulvovaginitis. Clinical obstetrics and gynecology.

Allergic vulvovaginitis due to house mites: a case report. Vulvodynia is a complex pathology and difficult to treat. It is defined as chronic vulvar pain that may be generalized or localized. They usually consult several times and different doctors before coming to a diagnosis. There are no specific tests, so the clinic and physical examination are the main tools. All of these pathologies that explain this chronic pain of the vulva should be excluded. Its etiology is multifactorial, including changes at the level of nociceptors, changes in innervation, and the presence of inflammatory factors.

non-specific

In this case, the inflammation of the vagina is caused by microorganisms belonging to the opportunistic inhabitants of the skin. Two factors lead to the development of the disease - a decrease in local immunity activity, and a decrease in the number of lactobacilli on the mucous membrane. This leads to the colonization of the “empty” place by microbes, and the formation of an inflammatory response to their introduction:

However, we cannot ignore the psychosexual aspects that can modulate or trigger vulvar pain by finding an altered substrate at the level of these tissues. Based on these aspects, today there are various treatments that are effective if we use their associates and step by step as they are strengthened among them.

A large number of gynecologists do not know this diagnosis. For this reason, women consult several times and with different doctors to establish a diagnosis. There are no specific diagnostic tests. Search in clinical and physical examination is the main tool for this diagnosis. Should be excluded various pathologies, which could explain the presence of chronic pain in the vulva. IOS of multifactorial etiology Undoubtedly, changes in the number of nociceptor changes and additions in innervation and the presence of inflammatory factors, which may be the starting point of ESTA pathology, as it seeks to elucidate the neuropathic theory.

The first variant of the development of the disease is more common in postmenopausal women, and is called bacterial vaginosis. It is characterized by the replacement of the normal microflora of the vagina (lactic acid bacteria) with specific rods - gardnerella. At the same time, inflammatory changes are weakly expressed, and the main complaint is moderate discharge with an unpleasant fishy odor.
The second option is more typical for women of young and reproductive age. Inflammation of the vagina occurs against the background of a decrease in protective forces, which leads to an aggressive displacement of lactobacilli by a more aggressive flora - staphylococci, streptococci, microbes of the intestinal group. In this case, obvious signs of damage are observed - redness and swelling of the mucous membrane, burning and itching, abundant mucous or purulent discharge.

Approximate knowledge of the differences between the individual forms of vaginitis allows you to start effective therapy even before obtaining the results of laboratory diagnostics.

Treatment

Help for patients with acute or chronic forms must necessarily consist of two parts. Compliance with this principle will not only eliminate the existing symptoms, but also prevent the recurrence of the disease in the future:

For any inflammation of the vagina of origin, treatment should begin with general measures. They should include the stimulation of the immune defenses - the elimination of chronic foci of infection, the normalization of diet and rest. With specific vaginitis, unprotected sexual intercourse is necessarily excluded, and systemic antimicrobial therapy is carried out.
General treatment should be effectively supplemented with local ones in order to create conditions for the mechanical removal of the pathogen from the mucous membrane. For this, local forms of preparations are used - vaginal tablets, suppositories and ointments, as well as douching with antiseptics.

Compliance with the principles and terms of treatment will eliminate the real manifestations, and the correction of risk factors will prevent their possible recurrence.

Specific

If any of the listed infections of this group is suspected, a course of general antimicrobial therapy is mandatory. The isolated conduct of only local procedures will not only not lead to recovery, but will also create conditions for the chronic course of the disease:

Trichomonas vaginitis is treated with antibiotics - derivatives of 5-nitroimidazole - Metronidazole, Ornidazole, Tinidazole. They are administered orally, as well as locally - with the help of ointment applications or suppositories.
Therapy of chlamydial and mycoplasmal inflammation of the vagina is carried out using macrolides - antibiotics that act on intracellular pathogens. Azithromycin, Clarithromycin or Josamycin are prescribed. In addition to them, local baths or douches with antiseptics - Betadine, Chlorhexidine or Miramistin are used.
Gonorrheal vaginitis is treated with combination therapy - a combination of Ceftriaxone with Azithromycin or Doxycilin is prescribed. It is also complemented by mandatory local procedures.
Treatment of candidiasis is carried out only with the help of antifungal drugs, initially applied only topically - Clotrimazole, Ketoconazole. If the result is insufficient, then the doctor prescribes another course of systemic therapy.

After clinical recovery, a second examination of smears from the vagina is performed, confirming the complete destruction of the pathogen.

non-specific

If, in case of inflammation of the vagina, the conditionally pathogenic flora was the cause, then the treatment should not be so intense, but necessarily complex. The purpose of assistance in this case is not only the elimination of the pathogen, but also the maximum fast recovery normal microflora of the vagina:

First of all, risk factors are identified - chronic infections, endocrine diseases, lifestyle features. A consultation is held regarding their further elimination, as well as the necessary appointments are given.
General and local antibiotic therapy is currently not widely used. The appointment of drugs from this group is carried out only for certain indications. Only funds are used combined action- Terzhinan, Polygynax, Neo-Penotran, a combination of Metronidazole and Clindamycin.
Baths and douching with antiseptics (Chlorhexidine, Betadine, Miramistin) are prescribed for a period of no more than 3 days. This time is enough to destroy the bulk of pathogens, without affecting the remaining lactobacilli.
Immediately after the completion of local antimicrobial therapy, eubiotics are prescribed - agents that restore normal microflora. These include drugs Vagilak, Bifidumbacterin, Lactobacterin, Biovestin.
With atrophic changes in the mucous membrane, local forms of estrogen are additionally used - Ovestin.

But still, the basis for the treatment of nonspecific variants of the disease is the modification of the health status and lifestyle of a woman. Only active identification and treatment of comorbid diseases and conditions will avoid the return of unpleasant symptoms.