Inflammatory diseases of the female genital organs

Inflammation of the vaginal cervix. Symptoms are nagging pain in the lower abdomen, purulent or mucous discharge, pain during urination and sexual intercourse. Inflammation of the cervix, or cervicitis, refers to inflammation of the narrow lower part of the organ. A healthy uterus is normally covered with epithelium that produces a mucous secretion. This substance plays a protective role and prevents infections from entering the internal cavity. When the secretory function of cells is disrupted, active growth of pathogenic microflora occurs, and symptoms of cervical inflammation develop.

According to statistics, cervicitis is diagnosed in 30% of women of childbearing age. The pathology can be in the cervical canal, then they talk about endocervicitis, or in the vaginal part of the cervix – exocervicitis. The peak incidence is recorded in the age group of 17-28 years, when a woman exhibits maximum sexual activity and rarely uses barrier contraception.

Treatment of cervical inflammation in the initial stage is carried out using conservative methods and does not require radical measures. The prognosis is favorable. But for this, a woman must undergo regular medical examinations and consult a gynecologist when the first symptoms of the disease appear.

You can get examined for signs of cervicitis in Moscow at the Alfa Health Center clinic.

Signs of cervical inflammation

Patient complaints are different for acute and chronic cervicitis.

The main symptoms of inflammation in the cervix:

• purulent or mucous discharge from the genitals;
• pain, heaviness in the uterine area;
• discomfort, burning in the genitourinary tract, aggravated by sex and urination;
• a slight rise in temperature to 37-37.2ºС.

In some cases, the inflammatory process occurs without pronounced clinical signs and is determined by the results of a gynecological smear.

Diagnosis of cervicitis at the Yauza Clinical Hospital

Gynecologists at the Yauza Clinical Hospital diagnose cervicitis after examination, based on medical history, colposcopy results, laboratory tests (smear microscopy, bacteriological culture for microflora and sensitivity to antibiotics, PCR, etc.). When examined for cervicitis, hyperemia (redness) of the mucous membrane, swelling, inflammatory discharge, and ectopia may be present. Colposcopy allows you to study the condition of the mucous membrane in detail and track the dynamics during the treatment process. In acute cervicitis, a cytogram of a smear from the cervical canal and a scraping from the cervix reveals a large number of leukocytes, lymphocytes, and altered epithelial cells. At the same time, it is important not to miss precancerous cell changes, especially if PCR diagnostics reveal oncogenic strains of the papilloma virus (HPV). PCR will help identify other dangerous infections (herpes virus, chlamydia, mycoplasma, etc.) based on the genetic material of their pathogens.

Causes of cervicitis

Inflammation of the cervix and appendages can be caused by the following factors:

• sexually transmitted disease: gonorrhea, trichomoniasis, chlamydia and other infections;
• microorganisms that are normally present on the vaginal mucosa;
• mechanical injuries during gynecological operations, conization, childbirth, from the use of the uterine ring, treatment with iodine, dimexide, and other means;
• hormonal disorders;
• antibiotic treatment, chemotherapy courses;
• allergy to latex or substances used in condoms;
• diseases of the female genitourinary system: colpitis, endometritis, cystitis, erosion and others.

A common cause of cervical inflammation is independent, uncontrolled use of antibiotics. Medicines inhibit the beneficial microflora of the vagina and reduce local immunity. Organisms resistant to antibiotics appear in a woman’s biota. These are the most complex cases of mixed infections that require an individual treatment plan.

Risk factors such as young age and frequent changes of sexual partners are also noted.

Symptoms of gastritis development

Inflammation of the external tissues of the stomach manifests itself in various signs, which in some cases are not very pronounced. The main symptom can be considered pain in the solar plexus area, which is aggravated by eating certain foods, taking certain liquids or medications that are aggressive to the mucous membrane of the organ.

Sometimes the pain may, on the contrary, appear between meals, and become dull after eating it. Spicy foods, alcohol, and carbonated drinks lead to an exacerbation of the disease and therefore their use during gastritis is contraindicated. In addition to the sensation of pain, the patient is plagued by symptoms such as belching, vomiting and heartburn.

Types of cervicitis due to inflammation

• Purulent. Occurs when infected with a sexually transmitted disease. Purulent cervicitis is characterized by mucous discharge with an unpleasant odor and involvement of nearby organs and tissues in the process.
• Viral. The mucous membrane becomes inflamed when infected with cytomegalovirus, human papillomavirus or other pathogens. The disease may be accompanied by itching and the appearance of polyps.
• Bacterial. Cervicitis develops from vaginosis, when active proliferation of pathogens of the natural microflora of the vagina occurs. Infection from a sexual partner is possible.
• Atrophic. The cause of the disease is thinning of the mucous membranes. Atrophic cervicitis often occurs in women during menopause.

Folk remedies for treating inflammation symptoms

Chamomile infusion will help with increased acidity.

Medicinal plants are successfully used to combat the symptoms of many serious diseases. Inflammation in the intestines was no exception.

Today, remedies to alleviate the symptoms of this disease can be found in any pharmacy. Let us list the most effective of them:

• To combat bloating and stabilize stool, mix fennel fruits, caraway seeds and chamomile flowers in equal proportions. The resulting mass is poured with boiling water. The liquid is filtered and taken after meals (maximum three times a day).
• In case of increased acidity in the stomach, prepare a tincture from pharmaceutical preparations of chamomile, elecampane, valerian, yarrow, cucumber, alder, calendula, licorice and marshmallow. The listed ingredients are mixed, poured with boiling water and placed in a water bath for 5 minutes. The finished liquid is filtered and drunk half a glass at a time before each main meal (that is, three times a day).
• For low acidity, other herbs are used. In this case, the tincture is prepared from collections of linden, marshmallow, chamomile, fennel and elecampane. The ingredients are mixed and placed in boiling water. The liquid is infused and filtered. They do not drink the drug regularly, but as a pain reliever (in other words, only during exacerbations of the disease).
• Plantain juice and honey will help reduce inflammation in the intestines. The mentioned components are mixed in a ratio of 2 to 1 and drunk three times a day (a tablespoon at least an hour before a major meal).
• Enemas based on a 3% solution of boric acid and calendula also help well with inflammation. For one session, take a tablespoon of each component. It is best to give such an enema before bedtime.

Treatment of cervicitis

To select an adequate treatment regimen for cervical disease, the duration, severity of the disease, and cause are taken into account. If cervicitis is infectious, therapy will also be required for the sexual partner.

To treat acute inflammation of the cervix, your doctor may prescribe:

• Antibiotics of the fluoroquinolone or macrolide group. At the same time, it is recommended to take antifungal drugs that will prevent the development of candidiasis;
• Means for restoring microflora. A woman is prescribed medicinal suppositories, gels with lactobacilli;
• Immunomodulators. The drugs strengthen local immunity and help beneficial microflora resist the effects of antibiotics. Immunomodulators are taken in the form of powders or tablets;
• Hormonal medications with estrogens to regenerate the thinned mucous layer;
• Physiotherapy: endocervical electrophoresis, magnetic therapy, irradiation of the cervix with ultraviolet light, laser, microwaves, low-frequency ultrasound. Treatment is primarily aimed at restoring microcirculation of blood and lymph in the affected tissues. For chronic inflammation of the cervix, physiotherapy is carried out in courses several times a year to prevent exacerbation.

In rare cases, surgery is indicated. As a rule, the operation is performed in cases of severe and extensive inflammation, when the woman did not seek diagnosis at the onset of the disease. For treatment, the method of cryodestruction, diathermocoagulation or chemical coagulation of pathological areas is used.

Particular attention is paid to the treatment of exacerbation of cervicitis in pregnant women. The doctor carefully selects medications and calculates the dosage to eliminate risks to the fetus.

general characteristics

Diseases of the oral mucosa can be infectious, inflammatory, viral or fungal. When an infection enters the oral cavity, the mucous membrane is the first to suffer. It can become inflamed, bleed, and become thinner. Conventionally, such diseases are classified as stomatitis. But besides stomatitis, there are many more problems that lead to deterioration in human health.

In almost all of the diseases described below, the symptoms will be similar: pain, rashes of various types, discoloration of the tissues of the oral cavity.

Oral diseases can be treated by a dentist, ENT specialist or therapist. When the first symptoms appear, you should consult any of these doctors for examination.

Why is cervical inflammation dangerous?

Self-medication risks complications, so only a doctor should decide how to treat a woman. If the patient does not seek help in a timely manner, acute cervicitis becomes chronic. A woman faces consequences such as erosion, miscarriage, and spread of the inflammatory process to the appendages. The risk of developing cancer increases. Chronic cervicitis leads to the formation of adhesions and infertility. Patients often experience chronic pelvic pain, menstrual irregularities and other manifestations that reduce quality of life.

Prevention

To prevent painful symptoms, experts recommend following the universal rules of oral hygiene:

• use properly selected toothbrushes, use them systematically, and also avoid bad habits, especially smoking.
• It is recommended to control your diet: in some cases, oral irritation may be caused by excessive consumption of oranges, lemons, etc.
• the habit of cleaning seeds with teeth rather than with hands can become unfavorable for the oral cavity.

Inflammation of the cervix during pregnancy

Cervicitis occurs in two out of three pregnant women at different stages of gestation. The disease is acute, not only the vaginal wall becomes inflamed, but also the labia. Women complain of burning, itching in the perineum, and discomfort. Inflammation of the cervix during pregnancy is one of the factors of miscarriage, so it is necessary to consult a doctor as soon as possible.

Cervicitis in this case is chronic. A woman may not be aware of inflammation until pregnancy, when the pathology manifests itself against the background of natural immunodeficiency.

Manifestations of diseases of internal organs on the mucous membrane of the mouth, tongue and lips

Diseases of the mucous membrane (MU) of the mouth, tongue and lips are one of the important and complex areas of practical medicine. Patients often find themselves in difficult clinical situations when they receive untimely and inadequate care. The fact that the human body is a complex, hierarchical, dynamically self-governing formation, the stability of which is due to the simultaneous functioning of a number of organs and systems, began to escape the attention of the doctor.

The existing relationships between lesions of the mucous membrane of the mouth, lips, tongue and systemic pathology should alert both patients and dental and somatic doctors. In the medical literature, a large group of tongue diseases are presented that occur separately, without affecting other parts of the oral cavity: desquamative glossitis (“geographical” tongue), black (“hairy”) tongue, folded tongue, rhomboid glossitis [1].

Changes in the condition of the mucous membrane of the mouth and tongue can occur and be detected both before other clinical manifestations of systemic diseases, and simultaneously with them. In many systemic (somatic, general) diseases, the oral mucosa reacts with the appearance of various types of disorders: disorders of tissue trophism, bleeding, swelling, dyskeratosis . Some manifestations of pathology in the mucosa of the mouth and tongue clearly indicate one or another type of organ or systemic disorder and are of great diagnostic value. However, in most cases, despite the different etiology and pathogenesis, the manifestations of systemic diseases on the oral mucosa are not specific in nature and are characterized by similar, sometimes outwardly identical clinical signs, which creates difficulties in their recognition.

Often occurring lesions of the oral mucosa due to diseases of the gastrointestinal tract, cardiovascular system, endocrine pathology, deficiency of vitamins (especially group B), macro- and microelements can attract the attention of specialists in various fields. Since changes in the mucous membranes of the mouth and tongue can occur and be detected earlier than other clinical manifestations of systemic diseases or simultaneously with them, patients themselves often turn to a dentist. In turn, gastroenterologists, endocrinologists, cardiologists, and hematologists can involve a dentist for consultation and joint supervision of patients with lesions of the oral mucosa, lips and tongue.

In this regard, we consider it necessary to share our clinical observations. This message may be useful to specialists whose professional interests relate to the diagnosis of these diseases and the treatment of such patients. Our previous publications were devoted to these issues [2–10]. The latest report [11] provided data on cancer screening for diseases of the oral mucosa, tongue and lips.

During our many years of clinical practice, changes in the CO of the mouth, tongue and lips were observed in the pathology of various organs and systems of the body, and metabolic disorders. Lesions of the mucous membranes of the mouth, lips and tongue are most often found in diseases of the gastrointestinal tract. In this case, ulcerative, aphthous and necrotizing stomatitis develop. The best studied in this regard are language changes characterized by a number of features:

• coated tongue (Fig. 1), which is detected most often (with exacerbation of gastritis, gastroesophageal reflux disease, peptic ulcer, pancreatitis, enteritis and colitis, the amount of plaque increases);
• swelling of the tongue, diagnosed by tooth marks on its lateral surfaces, usually associated with enteritis and colitis;
• changes in the papillae of the tongue, manifested in the form of hyperplastic and atrophic glossitis;
• desquamation of the epithelium (sometimes in this case they talk about desquamative glossitis (Fig. 2), which some authors regard as an “independent disease of the tongue”);
• paresthesia and disorders of taste sensitivity, often accompanying not only diseases of the digestive system, but also developing as a result of an imbalance of vitamins and pathology of the autonomic nervous system.

Rice.
1. Coated tongue in a patient with chronic pancreatitis in the acute stage. Rice. 2. Desquamative glossitis in an 82-year-old patient suffering from peptic ulcer localized in the pylorus, who underwent radiation therapy for lung cancer and surgery for cancer of the rectosigmoid angle. Damage to the mucous membrane of the mouth, lips and tongue is observed with a deficiency of vitamins and microelements. The most common deficiencies in clinical practice are B vitamins and iron.

Pain, numbness, burning in the tongue, in the gums and lips are observed with hypovitaminosis B12, which is accompanied by neurological disorders and changes in hematopoiesis. Both with iron deficiency anemia and with latent iron deficiency, changes in the CO of the mouth, tongue and lips are caused by manifestations of tissue iron deficiency (sideropenia) . Patients (usually young girls and women) complain of perversion of taste sensitivity, paresthesia, burning of the tongue, pain and swelling in the tongue, sometimes difficulty swallowing dry and solid food, and choking. With severe sideropenia, the tongue, due to atrophy of the filiform and mushroom-shaped papillae, becomes smooth (“polished”, “varnished”), angular cheilitis develops, folds on the back of the tongue and trophic changes in the mouth are sometimes observed. It should be remembered that the appearance of symptoms of sideropenia often precedes a decrease in hemoglobin levels and can persist even after correction of anemia if iron therapy is insufficient.

Pain, numbness and burning in the tongue, in the gums, lips are observed with hypovitaminosis B12, which is accompanied by neurological disorders and changes in hematopoiesis (B12-deficiency anemia), so the mucus of the mouth is pale. Bright red areas of inflammation appear on the tongue, reacting to the intake of acidic foods and medications. These lesions are often localized along the edges and at the tip of the tongue, sometimes involving the entire tongue (“scalded” tongue) (the so-called Hunter-Meller glossitis). Often ulcerations and petechiae develop on the tongue. Such changes can spread to the gums, mucous membranes of the cheeks, soft palate, and less commonly to the mucous membranes of the pharynx and esophagus. Subsequently, the inflammatory phenomena subside, and the papillae of the tongue atrophy. The tongue becomes smooth and shiny (“varnished” tongue; Fig. 3).

Rice. 3. “Lacquered” tongue in a patient with B12-deficiency anemia.

With relapses of the disease, along with atrophic changes, hyperplasia of the papillae at the root of the tongue develops (hypertrophic papillitis). At the same time, leukokeratosis of the tongue and lip mucosa may be observed.

Vitamin B1 deficiency is accompanied by hyperplasia of the fungiform papillae of the tongue, paresthesia and allergic reactions of the oral mucosa. Hypovitaminosis B2 is manifested by a peculiar change in the skin, red border of the lips, mucous membrane in the corners of the mouth (angular stomatitis), oozing, maceration of the epithelium. A superficial form of desquamative glossitis is noted (triad: dermatitis, cheilitis, glossitis). With hypovitaminosis B6, symptoms of a disorder of the nervous system (polyneuritis) and the gastrointestinal tract, angular stomatitis, cheilitis, and glossitis are observed.

Lesions of the oral mucosa in diseases of the cardiovascular system are observed in more than half of patients with this pathology, in which the following are detected:

• swelling and cyanosis of the mouth and lips; in case of myocardial infarction, swelling of the tongue may be accompanied by the appearance of erosions, ulcers and “cracks”;
• vesical-vascular syndrome - the appearance (usually in older women suffering from arterial hypertension) of dense blisters (after opening, erosions form) with hemorrhagic contents on the mucous membrane of the soft palate, the lateral surfaces of the tongue, and the cheeks. It is necessary to differentiate this syndrome from pemphigus and erythema multiforme;
• ulcerative-necrotic lesions of the mouth with the formation of trophic ulcers in the absence of a pronounced inflammatory reaction in the surrounding tissues. We observed a patient with necrosis and sequestration of the body and branch of the mandible. These lesions must be differentiated from: traumatic ulcers, malignant tumors, Vincent's ulcerative necrotizing stomatitis, necrotic lesions of the mouth due to blood diseases.

The most common endocrine pathology in dentist practice is diabetes mellitus. There is a direct relationship between the severity of inflammatory changes in the oral mucosa and the course of the disease, its duration and the age of the patient. With a short duration of diabetes, the oral mucosa becomes hyperemic, swollen, and bleeds. With increasing duration of the disease, hyperkeratosis of filiform papillae and hyperplasia of fungiform papillae most often develop. The tongue is coated; hyperemic mushroom-shaped papillae in the form of reddish dots rise along the entire back of it.

The dentist is responsible for diagnosing the early manifestations of “general” diseases, conducting a thorough examination of the patient through the efforts of somatic doctors. Folding and an increase in the size of the tongue are often noted; a combination of tongue folding with hyperkeratosis of the filiform papillae or, conversely, with their desquamation (diffuse or focal) and dryness of the mucous membrane of the tongue is possible. There is a “geographical” language. Teeth imprints are identified on the lateral surface of the tongue. With decompensation of diabetes, decubital ulcers are possible and in almost all patients changes in the lips are detected: dry mouth and red border of the lips in combination with cracks, jams, crusts, bright hyperemia, especially pronounced in the Klein zone, angular cheilitis. In the diabetes compensation phase, dry mouth and angular cheilitis disappear.

Changes in the CO of the tongue are more stable, remaining in the phase of decompensation and compensation. Oral candidiasis often develops.

Basics of medical tactics for lesions of the mouth, lips and tongue:

1. For rational treatment of diseases of the mouth, lips and tongue, a thorough examination of the patient and contact between the dentist and other specialists is required, first of all, with the therapist, as well as specialized specialists - gastroenterologist, endocrinologist, hematologist, cardiologist.
2. An axiom for the dentist should be the elimination of all unfavorable irritating factors in the oral cavity in the patient, which can support and provoke the development of the pathological process. It is unacceptable to use the so-called cauterizing agents and long-term use of the same mouthwashes.
3. Treatment of diseases of the oral mucosa must be carried out in compliance with the principles of bioethics; these diseases must be considered from the standpoint of the state of the whole organism, therefore, in most cases, one cannot limit oneself only to local effects on the lesions of the mucous membrane carried out by the dentist.
4. Treatment should begin only after at least a preliminary diagnosis has been established and meet the following requirements:

• be comprehensive;
• provide a pathogenetic approach;
• do not violate the anatomical and physiological properties of oral mucosa;
• eliminate the pain factor;
• help optimize the epithelization of lesions;
• provide for the active involvement of the patient in performing medical procedures at home.

In some diseases, changes in the color and general appearance of the oral mucosa and surface of the tongue do not have independent diagnostic significance. However, in combination with other symptoms, the appearance of the lips, tongue, and oral mucosa can help clarify the diagnosis. The prognostic significance of changes in organs and tissues of the oral cavity is great. The dentist is responsible for recognizing and diagnosing early manifestations of “general” diseases and conducting a thorough examination of the patient through the efforts of somatic doctors. We are confident that timely and correct assessment of the described conditions in the practice of doctors of other specialties is very necessary and advisable.

Literature

1. Danilevsky N. F., Leontyev V. K., Nesin A. F., Rakhniy Zh. I. Diseases of the oral mucosa. - M.: OJSC "Dentistry". — 271 p.
2. Tsepov L. M., Mikheeva E. A., Nesterova M. M. Erosive and ulcerative lesions of the mucous membrane of the mouth, tongue and lips. Tactics of a dentist // Dental South. - 2009. - No. 8 (68). — P. 10-13.
3. Tsepov L.M., Nikolaev A.I., Petrova E.V. et al. Symmetrical recurrent decubital ulcers of the mucous membrane of the lower lip in a patient with facial paraspasm // Dental South. - 2007. - No. 7 (56). — P. 28-29.
4. Tsepov L. M., Tsepova E. L. Diagnostic value of changes in the lips, oral mucosa and tongue in various diseases and pathological conditions // Dental South. - 2010. - No. 6. - P. 14-16.

A complete list of references is in the editorial office.

Doctor's recommendations

Every year, more and more women turn to us for treatment of chronic cervical inflammation. The reason is that the patient simply does not notice or ignores the first signs of cervicitis. We often detect inflammation when dealing with completely different complaints. This is dangerous for future motherhood. We recommend that couples with a history of stillbirth, frozen pregnancy, or intrauterine infection of the fetus undergo a thorough examination to identify hidden infectious agents. Only after treatment can you plan to conceive again. Miscarriages and premature births are a common consequence of cervical inflammation.

Main symptoms of stomatitis

Symptoms of stomatitis depend on its type and form, are very diverse and specific. General symptoms include redness, swelling of the mucous membrane, burning and pain in the mouth (including when eating hot, sour or spicy foods), an increase (or, conversely, a decrease) in salivation, bad breath, as well as the manifestation, in depending on the severity of the disease, specific lesions - erosions, af, ulcers.