Diet and Nutrition 1. Increase ber 2. Avoid alcohol, caffeine and smoking 3. Reduce simple sugar 4. Maintain proper hydration 5. Increase chicken and cold water sh 6. Avoid fried and greasy foods 7. Increase fruits and vegetables 8. Increase legumes 9. Reduce sodium
Step #2
8. B-150 complex b.i.d. 9. Vitamin D 5,000 I.U. q.d.
Supplements 1. Lipoic acid 800 mg q.d. 2. Omega 3 fatty acids 1,500 mg q.d. 3. CoQ10 150 mg q.d. 4. Reduced glutathione 100 mg q.d. 5. Amino acid mixture with tyrosine 3,000 mg q.d. 6. Magnesium citrate 750 mg q.d. 7. Antioxidants a. Vitamin A 10,000 I.U. q.d. b. Vitamin C 1,000 mg q.d. c. Vitamin E 600-800 I.U. q.d. d. Zinc 100 mg q.d. e. Selenium 100 mcg q.d.
Step #3 Botanicals 1. Ginkgo biloba 80 mg q.d.
History Review patient’s sexual history Multiple sex partners Exposure to STI from infected partner Birth control/Barrier use
History of childbirth, pregnancy, miscarriage, or intrauterine device (IUD)
Step #1
Evaluation Abdominal exam Lower abdominal tenderness
Upper urinary tract culture Laboratory tests CBC with Diff Elevated ESR Elevated C-RP
Abnormal cervical or vaginal mucopurulent discharge
Pelvic examination Tenderness of the cervix, uterus, or adnexal with palpation/movement
Pelvic ultrasound
Test and treat infected sex partners
Treatment Overview Diet and supplementation
Botanicals Refer
Refer for antibiotic therapy or hospitalization if the patient fails to respond quickly to natural interventions
Pulsed high-frequency diathermy
Sexual abstinence is advised until infection is resolved
History of sexually transmitted infections or other bacterial, parasitic, or fungal infections
abortion,
Infection of the upper genital tract Affects the uterus, ovaries, and fallopian tubes Caused most commonly by Neisseria gonorrhea and Chlamydia trachomatis
PID may cause infertility, chronic pelvic pain, scarring of reproductive organs, increases risk of ectopic pregnancy
Ascend from the urethra to genitorurinary tract Other possible pathogens include Ureaplasma urealyticum
Can present as severe, minor, or asymptomatic Symptoms that occur are vaginal discharge with a foul oder, dysuria, pain in the lower abdomen, abnormal uterine bleeding, fever and chills, and nausea and vomiting
THE ORIGINAL INTERNIST JUNE 2016
More likely to occur prior to age 25 Due to immaturity of the cervix making it more susceptible to bacterial infection
Step #1
Diet and Nutrition 1. Increase fruits and vegetables 2. Increase chicken and cold water sh 3. Reduce saturated and trans fats 4. Avoid alcohol, caffeine and smoking 5. Elimination diet 6. Maintain proper hydration 7. Increase complex carbohydrates 8. Reduce simple sugars 9. Reduce fatty meat 10. Avoid food allergens 11. Reduce rened foods
Step #2
Douching and intrauterine devices increase the risk of developing PID
2. Chlorophyll (Douche) 10 mg q.d. 3. Beta-carotene 25,000-100,000 I.U. q.d.
Supplements 1. Antioxidants a. Vitamin A 10,000 I.U. q.d. b. Vitamin C 1,000 mg q.d. c. Vitamin E 800 IU q.d. d. Zinc 100 mg q.d. e. Selenium 100 mcg q.d.
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Sitz baths
Treatment of sexual contacts is essential to prevent re-infection
uncertain diagnostic
Pap smear Test for STI’s (syphilis, gonorrhea, chlamydia) Serum HCG Rule out pregnancy
Urinalysis Bacteria and sediment
Hospitalize if: pregnant, pelvic abscess, adenexal mass, perineal involvement for
work-up if diagnosis is
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