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Diagnosis and treatment of inflammation of the appendages in women

The gynecologist carefully examines the patient and meticulously asks about the signs of the disease with which she came to the clinic. IN mandatory a smear of vaginal discharge from the mucous membranes and a smear from the cervix are studied, detailed analysis urine and blood, bacterial culture. This is how you can accurately determine which microorganisms organized the inflammation of the appendages, and treatment is based on the results of all tests.

Blood test for inflammation of the appendages

This is a crucial study that allows not only to count the number of lymphocytes and leukocytes, which serves as a marker of inflammation and an indicator of infection. It is also important to determine in the laboratory a positive or negative reaction HIV and many other diseases that are transmitted purely sexually. Only then can treatment of inflammation of the appendages in women be started if infections with HIV, syphilis, gonorrhea, chlamydia and others that require special and immediate treatment are completely excluded.

excite inflammatory process many factors can with the help of certain agents that are dormant for the time being. These are any microorganisms - from protozoa, bacteria, viruses, microscopic fungi. Also, even toxins, waste products of these microorganisms, can influence the appearance of inflammation of the appendages in women. Therefore, a blood test is prescribed, both general and biochemical, where it is given full transcript leukocyte formulas.

There are cases when a blood test does not show inflammation of the appendages; the analysis does not show it. This happens precisely in those cases when the disease has been going on for a long time and its character is sluggish, because the woman took some independent measures to cure it. She did not succeed in recovery, but spoiled the clinical picture. However, this also happens because the blood itself is unhealthy.

Occasionally, the analysis shows a positive result in the absence of any inflammation of the appendages: if the blood is taken after a large physical activity, if before taking the tests a woman could not resist and ate something (but you can’t drink, smoke, or eat food). Also false positive reaction A blood test of a woman experiencing stress can reveal inflammation of the appendages.

Definitive diagnosis of inflammation of the appendages

IN modern conditions diagnosing this disease is not as difficult as it used to be, since there is such a study as ultrasound (ultrasound). With its help, you can see everything that happens in the pelvic area and draw appropriate conclusions. But if even this study fails to detect inflammation of the appendages in women, there is one more method left - the last link of research. This is laparoscopy.

If the diagnosis remains uncertain, gentle surgery- a puncture is made and abdominal cavity a light guide is introduced. Then you can directly examine the condition of all the pelvic organs, and the inflammation of the appendages hiding all the symptoms will certainly be detected. If an emergency condition of the body requires it (for example, with abscesses), you can immediately proceed to surgery from diagnostic testing.

How to treat inflammation of the appendages in women

First of all, antibiotics are chosen; here doctors do not even wait for all the results of studies and tests. As soon as clarifications regarding the types and types of microflora are received from the laboratory, a antibacterial therapy. All subsequent test results simply expand the assignments already made. Thus, in the treatment of inflammation of the appendages in women, symptoms are the determining factor.

Antibiotics are taken according to a precise schedule. Positive result should appear much earlier than the end of treatment for inflammation of the appendages, since these drugs are very strong, but under no circumstances should the prescribed cycle be interrupted. A certain dose of antibiotics is needed in the body for the infection to be defeated. Otherwise, pathogenic microorganisms will simply go into hibernation, and then the disease will become chronic and most intractable. During treatment of inflammation of the appendages, a woman must abstain from any sexual intercourse. And all sexual partners, without exception, should also undergo the same treatment. Otherwise, the infection will continue in the second round.

It is also necessary to avoid stress, physical overload and hypothermia. To keep the lower back and pelvic organs warm, doctors recommend a special back belt “LEONARDA”, which can be bought in pharmacies in Russia and on Apteka.ru (free delivery to your nearest pharmacy, where you live, throughout Russia). These products made from LEONARDA camel wool are patented and certified, which confirms their medical purpose. By themselves, they participate in treatment as an auxiliary means, and not the main one. However, they have a warming effect and retain heat well.

Inflammation of the appendages: inpatient or outpatient treatment?

If the disease is not acute stage, most patients are treated at home, attending only prescribed procedures, that is, on an outpatient basis. However, if the inflammation of the appendages goes through one of the severe phases, as well as if the course of treatment was completed on an outpatient basis, but did not achieve the goal, especially if the woman is pregnant, mandatory hospitalization will be required. In fact, it’s easier this way, and the course of the disease is better controlled; the injection regimen is followed.

If an abscess that appears during the course of inflammation of the appendages threatens to rupture, it is necessary surgical intervention. This, of course, also happens in a clinical setting and most often urgently, and not in a planned way. Also, the operation ends in failure of antibiotics, when the course of treatment for inflammation of the appendages is completed, and the result is unsatisfactory. But this happens quite rarely.

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– manifesting as somatic, but having a psychogenic origin, diseases and functional disorders. IN this group included hypertonic disease, bronchial asthma, rheumatoid arthritis, neurodermatitis, thyrotoxicosis, myocardial infarction, migraine, bulimia nervosa, anorexia and other pathologies. Most frequent symptoms– pain, disruption of the breathing cycle and heartbeat, skin rashes. Specific diagnostics includes a conversation with a psychiatrist and psychological testing. Treatment involves psychotherapy and medication correction.

General information

The word “psychosomatic” translated from ancient Greek means “belonging to body and soul.” Psychosomatic diseases belong to the group mental disorders, despite the fact that they manifest themselves at the physiological level. Interest in the close connection between the somatic and mental spheres arose in the time of Hippocrates. The concept of “psychosomatics” was introduced into science in early XIX century, active research into this group of diseases has been carried out since the mid-20th century. Data on the prevalence of psychosomatic disorders (PSD) are inaccurate, since there is no clear conceptual framework, and the classification remains imperfect. Epidemiological indicators, according to various experts, range from 0.5 to 66%.

Causes of psychosomatic disorders

Psychosomatic diseases develop on the basis of physiological predisposition - the readiness of an organ or system to functional impairment. External psychogenic cause become destructive personal characteristics, relationships with other people, psychological trauma – various factors, generating and supporting negative emotions:

• Intrapersonal conflict. The clash of desires and opportunities, responsibilities and needs contributes to the accumulation of emotional stress. Often the conflict remains unconscious.
• Negative experience. Psychosomatic manifestations arise as a result of traumatic childhood experiences. Unprocessed situations from the past are sources of anxiety.
• Secondary benefit. Physiological disorders are formed due to a person’s subconscious need to be in the “sick” position. The disease provides increased attention and care to others, and allows you not to go to school or work.
• Suggestion. A psychosomatic disorder can develop after suggestion or self-hypnosis. The process unfolds on a subconscious level, information about the disease is accepted without critical evaluation.
• Personality traits. In a situation conducive to emergence of PSR, people often find themselves with infantilism, isolation, uncertainty, unstable self-esteem, dependence on external assessment. The basis of the disorder is the predominance of negative experiences, affective tension, and lack of skills in productive interpersonal relationships.
• Identification. Close emotional contact with a sick person can cause PSD. The development of symptoms is based on unconscious copying.
• Self-punishment. Psychosomatic deviations can be formed due to feelings of guilt, shame, and self-hatred. Unconscious self-aggression at the body level helps reduce tension in the emotional sphere.

Pathogenesis

The general scheme of development of psychosomatic disorders is as follows: in the presence of a physiological predisposition to disruption of the functioning of a certain organ (target organ), an external stress factor leads to the accumulation of affective tension, activating the vegetative nervous system and neuroendocrine shifts. First, the speed and purposefulness of neurohumoral transmission is distorted, blood supply disorders occur, and then the functioning of the organ is disrupted. On early stages changes occur at the functional level and are reversible. With prolonged systematic exposure to a negative causative factor, they become organic and tissue damage occurs.

Classification

Psychosomatic disorders can be divided into several groups. IN clinical practice the most common classification is based on the distinction etiological factor, semantic content of the leading symptom, functional structure psychosomatic connection. According to it, there are three large groups AKP:

• Conversion disorders. Functional and structural disorders are formed on the basis of a neurotic conflict that receives secondary somatic processing. Physical illness serves as a solution tool social problems. Characteristic development of disorders is the type of loss of function - paralysis, blindness, deafness, vomiting.
• Functional syndromes. Disturbances arise at the level of functions, pathophysiological structural changes are absent in organs. Clinical manifestations mosaic, include cardiovascular, respiratory symptoms, disorders of the digestive tract, musculoskeletal system, and endocrine system.
• Psychosomatosis. This group includes true psychosomatic disorders - diseases caused by psychogenic factors. Traditionally, these include cases bronchial asthma , ulcerative colitis, essential hypertension, neurodermatitis , rheumatoid arthritis , stomach ulcer And duodenum, coronary heart disease , thyrotoxicosis , obesity And diabetes mellitus 2 types.

Symptoms of psychosomatic disorders

The clinical picture of PSR is varied. Patients complain about dysfunctions of individual organs and systems or talk about multisystem symptoms. Widespread pain various localizations– retrosternal, head, abdominal, articular, muscular. With instrumental and laboratory examinations, the causes pain syndrome are not detected. Some patients, after psychotherapeutic analysis, notice that symptoms arise during emotional tension, stress, after conflict situations. Other common complaints are rapid heartbeat, shortness of breath, a feeling of heaviness in the back and limbs, dizziness, hot and cold flashes, chills, diarrhea, constipation, heartburn, decreased libido , erectile disfunction , fast fatiguability, weakness, nasal congestion, cough.

Conversion symptoms are characterized by loss of function. This species Women are more susceptible to disorders. The main manifestations are respiratory spasms, paralysis, loss of tactile sensitivity, psychogenic muteness, deafness, blindness. In children and adolescents, pre-neurotic, vegetative-dystonic and actual somatic disorders develop. Preneurotic symptoms include tics, night enuresis , insomnia, unreasonable screams and crying. Psychosomatic vegetative dystonia is accompanied by dizziness, fainting, shortness of breath and rapid heartbeat. Children with psychosomatic disorders often experience thirst, nausea and vomiting after eating, and suffer from skin itching, rashes. Psychosomatic decreased immunity occurs frequently respiratory infections.

Complications

In the absence of adequate therapy, psychosomatic disorders develop according to their somatic counterparts. Functional deviations are transformed into stable structural changes (at the tissue, organ level). The patient’s normal functioning is disrupted, and there is a constant need for the use of symptomatic medications - painkillers, antihypertensives, bronchodilators and others. Serious illnesses limit the patient’s physical and social activity, making him dependent on others, in need of care and help in everyday life.

Diagnostics

Making a diagnosis of PSD is a long and labor-intensive process. First of all, patients turn to somatic doctors, undergo all possible physical, instrumental and laboratory examinations, medications and other methods of treatment. Finding the cause of symptoms can take anywhere from several months to several years. According to recent studies, about 30-50% of cases remain undiagnosed; patients maintain satisfactory health by controlling symptoms with medication. The remaining part of the patients is referred by somatic doctors ( therapists , cardiologists , neurologists) To psychiatrist. Specific examination includes the following methods:

• Conversation. The psychiatrist collects anamnesis and clarifies the symptoms. Determines the presence of traumatic situations, stress influences, intrapersonal and interpersonal conflicts. Characteristic signs neurotic disorder, high emotional tension of the patient.
• Questionnaires. Tests to study the emotional and personal sphere confirm high level anxiety, neuroticism. Hypochondriacal, hysterical, and psychasthenic personality traits are often identified. An adapted version of the MMPI, Eysenck personality questionnaires, and Cattell's 16-factor personality questionnaire are used.
• Projective techniques. Picturesque, color tests and tests of interpretation of situations reveal the patient’s conscious and subconscious experiences, which are the basis of PSR, and are widely used in examining children. A set of techniques may include the method of color choices (modified Luscher test), the method of unfinished sentences, the Thematic Apperception Test, a drawing of a person, a family.

, hypnosis. The first stage of treatment is aimed at removing existing problems (conflicts, consequences of trauma, stress) from the subconscious. After this, the connection with the state is restored own body, the ability to manage well-being.

. If there are concomitant emotional and behavioral disorders, the psychiatrist prescribes medications for temporary relief of symptoms (until the effect of psychotherapy appears). The use of antidepressants, anxiolytics, psychostimulants, behavior disorder correctors, and stress protectors may be indicated.

Rehabilitation. His immediate environment is involved in the process of restoring the patient’s health. Parents, spouses, children receive counseling psychological assistance, where the mechanisms of the disease and conditions that promote recovery are discussed. The efforts of relatives should be aimed at maintaining productive, emotionally open relationships, conflict resolution, assistance and psychological support for the patient.

Prognosis and prevention

The positive effect of psychotherapy is most likely when initial stages psychosomatic disorder– the earlier diagnosis and treatment are carried out, the more favorable the prognosis. Easiest to correct functional disorders, with anatomical and structural changes, prolonged medication assistance. Measures to prevent PSD come down to general psychoprophylactic measures. It is important to be able to resist stress, build productive, open interpersonal relationships, not suppress negative emotions, but experience them and draw conclusions.