Patient's question:
Detailed medical condition and consultation purpose: Lower back and waist pain, overall fatigue, white discharge in a white paste-like consistency, mild pain in the lower right abdomen.Duration and onset of the current illness: The lower back and waist pain, along with abnormal discharge, began on December 15th. Mild pain in the lower right abdomen started in the evening of December 16th and has persisted to the present.
Medical history: Infection after a miscarriage surgery last October, which led to adnexitis and pelvic inflammatory disease.
Previous diagnoses, treatments, and outcomes: Intravenous azithromycin for one week, followed by oral antibiotics. The condition was cured. First follow-up question: Menstruation has been irregular due to low estrogen levels recently.
Doctor's answer:
(1) Eliminate various routes of infection, maintain cleanliness and dryness of the perineum, rinse the external genitalia with clean water every night, and ensure dedicated basins for each person. Do not insert fingers into the vagina or wash the external genitalia with hot water, soap, or other substances. During pelvic inflammatory disease, there is an increase in leukorrhea volume, which is viscous, so it is necessary to change underwear frequently and avoid tight or synthetic underwear.(2) During menstruation, post-abortion, and after gynecological surgeries such as IUD insertion or removal, vaginal bleeding must be avoided. Sexual activity, swimming, tub baths, and saunas are strictly prohibited. Sanitary pads should be changed frequently, as the body's resistance is lowered during this period, making it easier for pathogens to cause infections.
(3) Patients diagnosed with acute or subacute pelvic inflammatory disease must strictly follow medical advice and actively cooperate with treatment. Rest in bed or adopt a semi-recumbent position to facilitate localized inflammation and discharge of secretions. Chronic pelvic inflammatory disease patients should also avoid overexertion, maintain a balance between rest and activity, and reduce sexual activity to prevent symptom worsening.
(4) During fever reduction, patients often sweat profusely. It is important to keep warm and maintain dryness of the body. After sweating, change clothes immediately and avoid exposure to air conditioning or direct drafts.
(5) Pay attention to observing leukorrhea volume, quality, color, and odor. Leukorrhea with increased volume, yellowish and viscous discharge, and a foul odor indicates a more severe condition. If leukorrhea changes from yellow to white (or light yellow), volume decreases, and odor normalizes (slightly acidic), it suggests improvement.
(6) Acute or subacute pelvic inflammatory disease patients must maintain smooth bowel movements and observe stool characteristics. If pus is present in the stool or there is a sense of urgency with incomplete defecation, seek immediate medical attention to prevent the rupture of a pelvic abscess into the intestinal wall, which could cause acute peritonitis.
(7) Some patients with chronic pelvic inflammatory disease may self-medicate with antibiotics for minor discomfort. Long-term use can disrupt vaginal flora, leading to increased leukorrhea with a curd-like appearance. In such cases, seek medical attention to rule out candidal vaginitis.
(8) Pelvic inflammatory disease patients should pay attention to dietary care and enhance nutrition.