Excessive leucorrhea, back pain and lower abdominal distension

The occurrence of excessive leucorrhea, lower back pain and lower abdominal distension is closely related to the gynecological diseases pelvic inflammatory disease and cervicitis. These two diseases have similar symptoms. However, each person's situation is different, and the possible causes are definitely different. We need to have a comprehensive understanding of the conditions of these two diseases, and then make judgments based on other physical manifestations, so that we can finally find the cause.

Clinical manifestations of chronic pelvic inflammatory disease

1. Symptoms

(1) Chronic pelvic pain. Scar adhesions caused by chronic inflammation and pelvic congestion often cause lower abdominal distension, pain, and lumbar pain. It often worsens after fatigue, long periods of standing, sexual intercourse, and before and after menstruation. In severe cases, it will affect work.

(2) Infertility and ectopic pregnancy Adhesion and obstruction of the fallopian tube can cause infertility and ectopic pregnancy. The incidence of infertility after acute pelvic inflammatory disease is 20% to 30%. And as the disease progresses, the infertility rate shows an upward trend.

(3) Menstrual abnormalities Endometritis often presents with increased leucorrhea, irregular menstruation, heavy menstrual bleeding, dysmenorrhea, and sexual discomfort. Pelvic congestion can cause increased menstrual flow. Ovarian dysfunction can cause menstrual disorders.

(4) Systemic symptoms are often not obvious, sometimes only a low-grade fever and fatigue. Due to the long course of the disease, some patients may experience symptoms of neurasthenia, such as lack of energy, general discomfort, insomnia, etc. When the patient's resistance is poor, acute or subacute attacks are likely to occur.

2. Physical signs

General signs: the uterus is often retroverted, with limited movement or adhesions; or the fallopian tube is thickened and tender; or a cystic mass is palpable; or there is sheet-like thickening and tenderness beside the uterus, etc.

(1) If it is endometritis, the uterus will be enlarged and tender. If it is salpingitis, the fallopian tube will be felt on one or both sides of the uterus, and it will be slightly tender.

(2) If it is hydrosalpinx or tubo-ovarian cyst, a cystic mass will be felt on one or both sides of the pelvic cavity, and movement will be restricted.

(3) If it is pelvic connective tissue inflammation, the uterus is often retroverted and flexed, with limited movement or adhesion fixation. There are patchy thickening and tenderness on one or both sides of the uterus. The uterosacral ligaments are often thickened, hardened, and tender.

Clinical manifestations of chronic cervicitis

1. Increased leucorrhea

Sometimes it is the only symptom of chronic cervicitis. It is usually thick mucus or purulent mucus. Sometimes the secretions may contain blood or a small amount of blood, and there may also be contact bleeding. Vulvar itching may be caused by irritation from leucorrhea.

2. Pain

Pain often occurs in the lower abdomen or lumbosacral region, and sometimes in the upper abdomen, thighs and hip joints. It worsens during menstruation, bowel movements or sexual intercourse, especially when the inflammation extends posteriorly along the uterosacral ligament or along the bottom of the broad ligament of the uterus, forming chronic parauterine connective tissue inflammation. The pain is even worse when the cardinal ligament of the cervix thickens. Whenever the cervix is ​​touched, it immediately causes pain in the iliac fossa and lumbosacral region. Some patients may even experience nausea, affecting their sexual life.

3. Bladder and bowel symptoms

Chronic cervicitis can spread through the lymphatic channels or directly spread to the bladder trigone or the connective tissue around the bladder. As a result, as soon as there is urine in the bladder, there is an urge to defecate, and symptoms of frequent urination or difficulty urinating appear, but the urine is clear and the routine urine test is normal. In some cases, the inflammation continues to spread or pass through the lymphatic pathways connecting the cervix, bladder trigone, and ureters, causing secondary urinary tract infection. Intestinal symptoms are less common than bladder symptoms, and some patients experience pain during bowel movements.

4. Other symptoms

Such as irregular menstruation, dysmenorrhea, pelvic heaviness, etc.