Salpingitis is the term used to describe inflammation of the female fallopian tubes. It is mostly caused by bacterial infections.
What is salpingitis?
Salpingitis is an inflammation of the fallopian tubes (uterine tuba). It can occur in only one fallopian tube or in both fallopian tubes. Bilateral inflammation is more common. In many cases, salpingitis is accompanied by ovarian inflammation (oophoritis), which physicians refer to as adnexitis. The paired fallopian tubes, also called tubules, provide an elongated connection between the uterus and the ovaries. They occur in the lower abdomen on both sides of the body. In medicine, a distinction is made between acute and chronic salpingitis. Not infrequently, endometritis (inflammation of the endometrium) also occurs in the context of inflammation of the fallopian tubes.
Causes
Bacterial infections are usually responsible for the development of salpingitis. These often lead to ascending 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 (vaginitis) or cervicitis (inflammation of the cervix). However, bacteria transmitted during sexual intercourse can also be causative for the outbreak of salpingitis. These are mostly chlamydia or gonococci. Infections caused by chlamydia primarily affect sexually active women. Another possible trigger is inadequate genital hygiene, which results in the spread of germs that are located in the anal region, such as Escherichia coli. In rare cases, salpingitis is also caused by a physician during a gynecological examination or treatment. A risk factor is the loss of the vaginal environment during menstruation, as this has a protective effect. The wearing of vaginal pessaries or IUDs as well as surgical interventions are also favorable factors. Sometimes the inflammation also spreads to the fallopian tubes via the lymph flow or the blood. Inflammatory bowel disease Crohn’s disease or appendicitis are often responsible.
Symptoms, complaints and signs
Salpingitis is characterized by abrupt onset of pain in the lower abdomen, either on one side of the body or on both halves. In addition, affected women feel generally ill and suffer from symptoms such as feelings of weakness, fatigue, and lassitude. In addition, the patients’ body temperature rises. Other accompanying symptoms include constipation, diarrhea, nausea, vomiting and flatulence. If the inflammation spreads to the intestine or urinary bladder, there is a risk of further complaints. These may include pain during urination or pain in the pelvis. If the vagina or cervix are also inflamed, there is a risk of spotting and discharge. If the inflammation of the fallopian tubes rises further, the ovaries may also be affected, resulting in adnexitis. One of the most feared complications is peritonitis. In this case, the harmful germs enter the abdominal cavity through the open connection between the fallopian tubes and the abdominal cavity and cause an inflammation that can assume life-threatening proportions. Sometimes, however, salpingitis is associated with only mild symptoms or even no symptoms at all.
Diagnosis and course of the disease
To diagnose salpingitis, the attending gynecologist performs a physical examination of the patient. During this examination, he checks the right and left lower abdomen for sensitivity to pain. For example, the fallopian tubes are extremely sensitive to pressure. If a gynecological examination is performed, the doctor checks the vaginal region and the cervix. A smear may be taken to detect the pathogen responsible. With the help of sonography (ultrasound examination), water retention, abscesses in the fallopian tube area and thickenings can be detected. If salpingitis is diagnosed at an early stage, the disease usually takes a positive course. The fertility of the affected woman is also preserved. However, the adhesion of the fallopian tubes is considered unfavorable. This not infrequently results in infertility of the affected person.Following salpingitis or adnexitis, there is an increased risk of ectopic pregnancy. Likewise, salpingitis can take a chronic course or spread to other organs.
Complications
Salpingitis can result in various complications and late effects. If the disease remains undetected for a long time, pus accumulations can form in the fallopian tubes or ovaries and worsen the course of the disease. Tubal inflammation can also spread from the fallopian tubes and ovaries to the peritoneum, causing peritonitis. In addition, there is a risk that the germs will enter the bloodstream and cause blood poisoning. This can be life-threatening. Infection with anaerobic and Haemophilus influenza pathogens is particularly dangerous. If salpingitis develops into a chronic disease, adhesions may occur as a late consequence. Such adhesions are often associated with pain and can block the ovaries and uterus. If fertilization occurs, there is a risk of ectopic pregnancy. If the fallopian tubes are completely blocked, infertility is the result. Although the adhesions can be surgically removed, bleeding, nerve injury and infection may occur. Further complications arise during therapy from the prescribed medications. For example, the antibiotics and anti-inflammatory drugs used can cause side effects and interactions and, in some cases, trigger allergic reactions. Ovariectomy, i.e. the surgical removal of the ovaries, can lead to “surgically induced menopause“. This is associated with hormone fluctuations and sudden menopausal symptoms such as migraines and nausea.
When should you see a doctor?
Lower abdominal pain, heavy vaginal bleeding, and fever indicate salpingitis, which should be evaluated by a doctor. If the symptoms do not subside on their own or are accompanied by other symptoms such as pain during 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 medical professional can prescribe antibiotics and mention various general measures that should lead to a speedy recovery. Close consultation with the physician is necessary during therapy, as salpingitis can cause complications that require independent treatment. Increasing pain indicates that the inflammation has spread to the ovaries. In this case, inpatient treatment may be necessary. The same applies to pressure pain in the abdomen, which may indicate abscess formation. Further contacts are the gastroenterologist or an internist. If the symptoms are severe, the patient should go to the nearest hospital to be on the safe side. Comprehensive therapy using broad-spectrum antibiotics should result in a decrease in symptoms within one week.
Treatment and therapy
As part of the treatment of salpingitis, the goal is to improve symptoms and preserve the functionality of the fallopian tubes. Treatment of the disease usually takes place in a clinic. For a period of 10 to 14 days, the patient receives antibiotics such as ceftriaxone, doxycycline, metronidazole or amoxicillin. In case of chlamydial infection, tetracyclines or macrolides are administered. If an anaerobic infection is suspected, the therapy often consists of the administration of metronidazole and anti-inflammatory drugs. Treatment of the partner is also considered useful. To combat the pain, the patient receives non-steroidal anti-inflammatory drugs such as diclofenac or ibuprofen. If conservative therapy of acute salpingitis does not lead to improvement, laparoscopic surgery may be necessary. This involves abscess puncture or drainage of Douglas’ space. In older women who are no longer planning a family, salpingtectomy along with hysterectomy is also possible. Sometimes an ovariectomy is also performed. In the chronic form of salpingitis, surgical intervention is also frequently required. However, the therapeutic results not infrequently 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 maintained. In this way, the risk of salpingitis can be reduced.
Aftercare
Follow-up care for salpingitis occurs after the inflammation of the fallopian tubes has been cured. It usually takes two to three weeks for the symptoms to completely subside. After that, the doctor must be consulted again, who can clarify the symptoms and discharge the patient. Provided that no complications occur, no further examinations are indicated afterwards. If the inflammation spreads to the ovaries or peritoneum, further medical examinations are necessary. Follow-up care then includes a thorough physical examination as well as a blood draw and a patient interview. During the patient interview, the risk of transmission of the causative bacterial pathogens is also pointed out, if necessary. In particular, sexually active women who have repeatedly contracted salpingitis must adjust their genital hygiene. In the case of repeated illnesses, information is also provided about the early symptoms of the disease. The doctor will provide information about the associated pain so that a quick response can be made if the disease returns. If infertility is suspected after salpingitis has been overcome, the gynecologist should be consulted. Possible scarring of the tubal wall can be detected by CT and may be surgically repaired. Follow-up care for salpingitis is provided by the gynecologist or internist.
What you can do yourself
Salpingitis is primarily treated by a doctor. The patient must take the medication as prescribed and inform the doctor of any discomfort or unusual symptoms. In the case of abscesses or treatment failure, hospitalization may be necessary. If the disease progresses positively, general measures such as drinking enough and avoiding sexual contact apply. The abdomen can be treated with warm, moist compresses in case of pain. In addition, it is important to ensure regular bladder and bowel emptying. In case of an antibiotic infection, it is necessary to take antibiotics. In this case, rest and avoidance of cold and other stimuli to the immune system are particularly important. Affected women should discuss the individual measures with their gynecologist. If salpingitis is diagnosed early and treated adequately, it should resolve within seven to ten days. If the course of treatment is complicated, skin changes may occur. These can also be treated with home remedies. For redness and itching, aloe vera is a good choice. From the household, chamomile compresses can help. Homeopathy also offers various globules. Homeopathic remedies should only be taken in consultation with a doctor.