Most medical and surgical situations that doctors see are diagnosed and treated by a series of guidelines. The guidelines are developed after years of surgery and then put together by associations or groups of experts in each particular field.

Chronic pelvic pain in women is no different. Royal College of Obstetricians and Gynaecologists in the United Kingdom have drawn up a set of guidelines for doctors to follow if a woman presents with complaints of chronic pelvic pain. Here are the steps that are recommended:

Listen to the patient’s story and ask direct questions. Identify and address any specific fears, and perform a vaginal exam. If there are has been a recent change in sexual partner, any signs of pelvic inflammatory disease (PID) or and concerns about sexually transmitted diseases, send the patient for STD tests.

If there appears to be anything abnormal in the vagina exam, a laparoscopy (minor surgery to look around the abdominal area) or ultrasound should be considered.

If the vaginal exam was normal, the doctor then has to consider 5 different issues: 1- Is the pain markedly increased around the time of menstruation? 2- Does the pain vary with movement? 3- Does the pain seem like it may be irritable bowel syndrome? 4- Are there any other symptoms to do with the urinary or genital tract, or of the bowels? 5- Is there a psychological component to the pain?

1- If the pain is increased around the menstrual period, the next question is if the patient wants to get pregnant. If no, then the doctor can suggest birth control pills or a something that suppresses hormones and provides pain relief. If the patient does want to get pregnant, then fertility treatment may be necessary.

2- If the pain varies with movement, the doctor must question if the pain may be caused by nerves or by something in the musculoskeletal system (muscles, bones, etc). If it is caused by nerves, this might be managed by injections of anesthetic to the area. If it is caused by something muscular or related, there may be a referral to osteopathy or physiotherapy.

3- If the pain suggests that the problem may be irritable bowel syndrome (IBS), the doctor may suggest a high fiber diet and to try an elimination diet, which means removing one item of food at a time to see if that may relieve the pain and discomfort.

4- If there are other symptoms in the urinary or genital tract, or other bowel symptoms, it’s suggested that the doctor refer the patient to a urologist (specialist in urinary tract) or gastroenterologist (specialist in the gastrointestinal tract).

5- If the pain is made worse with emotional or psychological stress, pain relief medication should be ordered and the patient should be referred to the appropriate specialist.

There is no guarantee that these steps will provide complete relief to all patients, but the flowchart process allows the doctors to be consistent with the care they provide women with chronic pelvic pain.

~~~

If you would like to leave a comment, please go back to the original page. Thanks!

Tags: chronic pain blog, pain blog, gastroenterologist, chronic pelvic pain, vaginal exam, irritable bowel syndrom, fertility treatment, chronic pelvic pain treatment guidelines

Most medical and surgical situations that doctors see are diagnosed and treated by a series of guidelines. The guidelines are developed after years of surgery and then put together by associations or groups of experts in each particular field.

Chronic pelvic pain in women is no different. Royal College of Obstetricians and Gynaecologists in the United Kingdom have drawn up a set of guidelines for doctors to follow if a woman presents with complaints of chronic pelvic pain. Here are the steps that are recommended:

Listen to the patient’s story and ask direct questions. Identify and address any specific fears, and perform a vaginal exam.

Click here to read more.

~~~

Tags: chronic pain blog, pain blog, gastroenterologist, chronic pelvic pain, vaginal exam, irritable bowel syndrom, fertility treatment, chronic pelvic pain treatment guidelines