Salpingitis is the term for inflammation of the fallopian tubes. Most cases are due to an infection. The fallopian tubes are located on either side of the uterus. The hollow cavity of the fallopian tubes allow for an egg cell (ovum) that is released from the ovary to pass into the uterus. Although salpingitis is not often discussed on its own as it is part of the umbrella term pelvic  inflammatory disease (PID), it is an important cause of infertility in women.

Sometimes the term salpingitis and pelvic inflammatory disease are used interchangeably but PID can include the inflammation of any part of the female reproductive system including the ovaries, uterus and cervix as well as other structures. It is, however, uncommon for the fallopian tubes to be inflamed on its own without any of the surrounding organs to be affected. This is largely due to the fact that most cases are due to infections that travel up the vaginal tract and it is unlikely that the cervix and uterus are not also infected.

Causes of Salpingitis

Almost all cases of salpingitis are due to an infection. Of the various pathogens, most are due to a bacterial infection. The pathogen typically enters through the vagina and gradually travels upwards towards the fallopian tubes (ascending infection). The pathogens may include those that are transmitted sexually (sexually transmitted infections). The most common bacteria include streptococci, staphylococci, mycoplasma and the bacteria that causes commonly STD’s like gonorrhea and chlamydia. These bacteria cause suppurative salpingitis.

Salpingitis is almost always seen in sexually active women. If it occurs in children, sexual abuse needs to be excluded as a possible cause. However, the pathogens can reach the fallopian tubes through the lymph vessels (lymphatic spread) or even through the bloodstream (hematogenous) from distant sites. Women who recently underwent surgery, including a D&C and those who use vaginal douches are at a greater risk of salpingitis. Another type of fallopian tube infection known as tuberculous salpingitis is rare in developed nations and occurs as a consequence of tuberculosis. However, it is fairly common in countries where tuberculosis is prevalent.

Signs and Symptoms of Salpingitis

Salpingitis may be acute or chronic. Acute salpingitis typically presents with intense symptoms whereas the signs and symptoms may be mild or even barely noticeable in chronic salpingitis. The common clinical features include :

• Abnormal vaginal discharge with foul odor
• Vaginal odor
• Lower back pain
• Lower abdominal pain
• Pain that is periodic and arises more often with ovulation and sexual intercourse
• Fever
• Frequent urination
• Nausea and vomiting
• Intermenstrual spotting – bleeding between periods

Diagnosis and Treatment

Salpingitis closely resembles urinary tract infections (UTIs) which are common in women. Further tests may therefore be required although the presentation and findings upon clinical examination by a doctor may be sufficient. Women should not assume the symptoms are due to a UTI and therefore attempt to self-medicate. Blood tests, microscopic examination and culture of discharge and the vaginal mucus and sometimes even a laparoscopy may therefore be necessary. If left untreated, the fallopian tubes can be severely damaged and this can lead to abscess formation, increase the chances of ectopic pregnancy or contribute to infertility.

Oral antibiotics are effective most of the time, however, IV administration of antibiotics may be necessary in more severe infections. Surgery is rarely necessary but could be required in untreated and chronic infections. Salpingitis cannot and should not be treated with vaginal douches or topical applications inserted into the vagina.

Endometriosis is a very painful condition which is found in women of childbearing age, endometriosis occurs when the tissue which lines the uterus starts to grow outside of the uterus. This tissue will usually grow on the fallopian tubes, outer surface of the uterus, the bowels and very occasionally it can develop onto other organs in the body.

These growths are called implants and they will continue to grow, bleed and break down just as the tissue does inside the uterus, which causes the woman’s monthly period.

What problems can endometriosis cause?

The implants can cause a great deal of pain and make it extremely difficult for the women if she is trying to conceive, the implants can sometimes cause scar tissue which can interfere with the normal functioning of organs. The exact cause of endometriosis is not known but it is thought that the female hormone oestrogen makes the condition worse; it is thought that women between the ages of 20 and 40 are more likely to suffer the condition and the condition goes away after her periods stop.

What are the symptoms of endometriosis?

While some women suffer a great deal from the condition others have been known to show very little symptoms, however the more common symptoms are:

• Pain – the exact location of the pain will depend on where the implants are growing in the body, areas of pain could vary from low in the stomach, the lower back, the rectum or the vagina itself.
• Abnormal bleeding – this will vary from very heavy bleeding, spotting, bleeding between periods or bleeding during or after sex.
• Infertility problems – this can sometimes be the only symptom that a women will have and unless they seek help for infertility the condition can be there without them realising anything is wrong.

How is the condition diagnosed?

As there are many reasons for problem periods your doctor will need to ask you about your periods, any symptoms that you have, your health in the past and if there is a history of endometriosis in the family. The doctor will also probably perform a pelvic examination which will include checking both the vagina and rectum.

If the doctor thinks that you might have endometriosis then they might suggest that you take medication, if the symptoms improve while you are taking this medication then you will almost certainly have it. The only way your doctor can be absolutely positive however is to have surgery, which is called a laparoscopy.

How is the condition treated?

There are several methods of treating the condition though there is no cure, your doctor will probably suggest that you try several to see which is more effective for you. The choice of treatment will also depend on if you just want to relieve pain or if you are trying to conceive, if you are trying to conceive then surgery might be the better option, if you just need to relieve symptoms of pain then medication might be a better choice.