General information
The term “abdomen” is used in medicine to describe an anatomical region that is filled by many important organs and structures. In women, these include the ovaries (ovary) and the fallopian tubes (tuba uterinaSalpinx). Ovaries and fallopian tubes are together known as appendages (adnexa/adnexes).
The female abdomen also includes the uterus and the vagina. All of these organs can be potential sites for inflammation in the abdomen. On the one hand, the ovary and the fallopian tube can become inflamed (pelvic inflammatory disease), on the other hand, the cervix (cervicitis), the lining of the uterus (endometritis), as well as the muscles of the uterus (myometritis).
An inflammation of the vagina is called vaginitis or colpitis. In most cases, inflammation rises from the bottom (vagina) to the top (towards the ovaries). This is why an inflammation of the vagina (vaginitis) occurs first, followed by an inflammation of the uterus (cervicitis, endometritis, myometritis) and finally an inflammation of the fallopian tubes and ovaries (pelvic inflammation).
Causes
Inflammation of the abdomen is usually caused by germs (mainly bacteria) that rise and thus spread and multiply. Causes for an inflammation of the vagina are usually a disturbed vaginal flora, which can be treated with antibiotics, tampons, strong hygiene measures (e.g. alkaline soaps), lack of female sex hormones (estrogens), vaginal foreign bodies (e.g.
piercing) or certain contraceptive methods (e.g. the diaphragm/pessary). From the vagina, the germ can now rise further towards the cervix, inflame it (cervicitis) and then spread to the lining of the uterus (endometritis) and finally to the muscles of the uterus (myometritis). However, for these structures to become inflamed, there must also be a disturbance in the normally protective barrier function of the cervix, i.e. the entrance to the uterus from the direction of the vagina.
This is often the case, for example, after a birth or miscarriage, but also after operations on the uterus and after the use of contraceptive methods (e.g. coil). The presence of benign ulcers (tumours) such as myomas or polyps in the area of the cervix can also cause inflammation. Here too, the reasons for inflammation of the fallopian tubes and ovaries are usually bacterial infections.
These can rise from the uterus via the fallopian tubes to the ovaries. However, infections via the bloodstream (haematogenic) and descending infections (e.g. via appendicitis) are also possible. Women have a high risk of developing pelvic inflammatory disease.
Inflammation often occurs shortly after ovulation or after menstruation because the cervical mucus is very soft and permeable to germs during this time. In general, sexually transmitted diseases (syphilis, gonorrhea/tripsy, genital herpes) can also lead to inflammation in the abdomen.
- Have frequently changing sexual partners
- Use oral contraceptive methods
- Under 25 years old are
- Very young at your first sexual intercourse were
- Show mucous membrane changes in the area of the cervix (cervicalectopy).
Cystitis is often caused by germs from the gastrointestinal tract.
Women are more often affected because they have a shorter urethra, and therefore the germs can penetrate the bladder more easily. Symptoms are more frequent urge to urinate and a burning sensation or pain when urinating. The doctor will diagnose the cystitis with a urine sample.
If there are white blood cells and possibly even blood or nitrite in the urine, an inflammation of the bladder can be assumed. Initially, purely symptomatic treatment with an increased fluid intake is possible. If this does not alleviate the symptoms, however, antibiotic therapy should follow.
Ovary inflammation, also called pelvic inflammatory disease, is usually accompanied by inflammation of the fallopian tubes and salping. The typical pathogens are bacteria. They can either rise through the vagina and uterus or spread from the abdominal cavity to the ovaries.
The symptoms are sudden severe lower abdominal pain with fever, nausea and vomiting. At the clinic, appendicitis must be ruled out, as it would have to be treated surgically. Ovarian inflammation can be treated with painkillers and antibiotics.
If there is fever and nausea, as well as abnormalities in the ultrasound, the ovarian inflammation should be treated in the hospital.The inflammation of the uterus can be an inflammation of the endometrium (endometritis) or the other layers of the wall. Endometritis is often associated with ovarian inflammation. Here, too, bacteria are the trigger of the inflammation.
The symptoms are similar to ovarian inflammation, with lower abdominal pain, nausea and vomiting. In addition, the inflammation of the uterus can also cause bleeding that does not coincide with the cycle. In diagnostics, gynaecological examination can cause pain when the cervix is moved.
This then speaks for an inflammation. The uterine inflammation is treated symptomatically with painkillers and antibiotic therapy. You can find more information under uterine inflammationAn inflammation of the abdomen after birth occurs when the menstrual flow cannot be properly discharged.
The causes of the lack of menstrual flow are, for example, a closed cervix or a reduced regression of the uterus due to lack of contractions after birth. The secretion accumulates in the uterus and provides an excellent breeding ground for pathogens. If an infection occurs, the clinical picture is called endomyometritis puerperalis, i.e. an inflammation of the uterine mucosa and muscles.
The symptoms are bad smelling discharge, fever and pain at the edges of the uterus. For therapy, rest and cooling of the region is prescribed. In addition, medication is given to induce the uterus to contract and therapy with antibiotics is started.
An acute inflammation of the uterus can progress to a chronic stage and thus cause a permanent, smouldering inflammation in the abdomen. The women complain of dull pressure pains in the area of the uterus. Fever is rather untypical.
However, a chronic uterine inflammation can go back to an acute stage at any time and sudden severe pain can again be associated with fever and nausea. Furthermore, after a uterus inflammation, adhesions can occur in the pelvis. If the fallopian tubes are affected, sterility can occur in up to 40% of women with the disease and the risk of an extrauterine pregnancy (ectopic pregnancy) is increased.
Due to the adhesions, chronic lower abdominal pain may also occur. The adhesions and adhesions are not limited to the pelvis. A possible further complication after an inflammation of the uterus is an adhesion of the liver with the peritoneum.
This is then called Fitz-Hugh-Curtis syndrome. In addition, pus can accumulate and encapsulate after acute uterine inflammation. Thus an abscess forms in the pelvis. Typically, the abscess is located in the Douglas space, which is located between the uterus and the rectum.
