What is peritonitis?
Peritonitis is inflammation of the peritoneum — a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen — that is usually due to a bacterial or fungal infection. Peritonitis can result from any rupture (perforation) in your abdomen, or as a complication of other medical conditions.
Peritonitis requires prompt medical attention to fight the infection and, if necessary, to treat any underlying medical conditions. Treatment of peritonitis usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body.
If you're receiving peritoneal dialysis therapy, you can help prevent peritonitis by following good hygiene before, during and after dialysis.
What are the symptoms for peritonitis?
Signs and symptoms of peritonitis include:
- Abdominal pain or tenderness
- Bloating or a feeling of fullness (distention) in your abdomen
- Nausea and Vomiting
- Loss of appetite
- Low urine output
- Inability to pass stool or gas
If you're receiving peritoneal dialysis, peritonitis symptoms may also include:
- Cloudy dialysis fluid
- White flecks, strands or clumps (fibrin) in the dialysis fluid
When to see a doctor
Peritonitis can be life-threatening if it's not treated promptly. Contact your doctor immediately if you have severe pain or tenderness of your abdomen, Bloating' target='_blank'>Abdominal Bloating, or a feeling of fullness associated with:
If you're receiving peritoneal dialysis, contact your health care provider immediately if your dialysis fluid is cloudy, if it contains white flecks, or strands or clumps (fibrin), or if it has an unusual odor, especially if the area around your tube (catheter) is red or painful.
What are the causes for peritonitis?
Infection of the peritoneum can happen for a variety of reasons. In most cases, the cause is a rupture (perforation) within the abdominal wall. Though it's rare, the condition can develop without an abdominal rupture. This type of peritonitis is called spontaneous peritonitis.
Common causes of ruptures that lead to peritonitis include:
- Medical procedures, such as peritoneal dialysis. Peritoneal dialysis uses tubes (catheters) to remove waste products from your blood when your kidneys can no longer adequately do so. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment. Peritonitis also may develop as a complication of gastrointestinal surgery, the use of feeding tubes or a procedure to withdraw fluid from your abdomen (paracentesis) and rarely as a complication of colonoscopy or endoscopy.
- A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can allow bacteria to get into the peritoneum through a hole in your gastrointestinal tract.
- Pancreatitis. Inflammation of your pancreas (pancreatitis) complicated by infection may lead to peritonitis if the bacteria spread outside the pancreas.
- Diverticulitis. Infection of small, bulging pouches in your digestive tract (diverticulitis) may cause peritonitis if one of the pouches ruptures, spilling intestinal waste into your abdominal cavity.
- Trauma. Injury or trauma may cause peritonitis by allowing bacteria or chemicals from other parts of your body to enter the peritoneum.
Peritonitis that develops without an abdominal rupture (spontaneous peritonitis) is usually a complication of liver disease, such as cirrhosis. Advanced cirrhosis causes a large amount of fluid buildup in your abdominal cavity (ascites). That fluid buildup is susceptible to bacterial infection.
What are the treatments for peritonitis?
You may need to be hospitalized for peritonitis that's caused by infection from other medical conditions (secondary peritonitis). Treatment may include:
- Antibiotics. You'll likely be given a course of antibiotic medication to fight the infection and prevent it from spreading. The type and duration of your antibiotic therapy depend on the severity of your condition and the kind of peritonitis you have.
- Surgery. Surgical treatment is often necessary to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from spreading, especially if peritonitis is due to a ruptured appendix, stomach or colon.
- Other treatments. Depending on your signs and symptoms, your treatment while in the hospital may include pain medications, intravenous (IV) fluids, supplemental oxygen and, in some cases, a blood transfusion.
If you're undergoing peritoneal dialysis
If you have peritonitis, your doctor may recommend that you receive dialysis in another way for several days while your body heals from the infection. If peritonitis persists or recurs, you may need to stop having peritoneal dialysis entirely and switch to a different form of dialysis.
What are the risk factors for peritonitis?
Factors that increase your risk of peritonitis include:
- Peritoneal dialysis. Peritonitis is common among people undergoing peritoneal dialysis therapy.
- Other medical conditions. The following medical conditions increase your risk of developing peritonitis: cirrhosis, appendicitis, Crohn's disease, stomach ulcers, diverticulitis and pancreatitis.
- History of peritonitis. Once you've had peritonitis, your risk of developing it again is higher than it is for someone who has never had peritonitis.
Is there a cure/medications for peritonitis?
Peritonitis is an infection within the peritoneum (a supportive membrane lining that surrounds and protects the internal abdominal organs). The condition is of 3 types: spontaneous, secondary, and tertiary.
- Antibiotics: An one-week antibiotic treatment can kill pathogenic bacteria, eliminating acute infection and reducing future complications.
- Commonly used antibiotics include carbapenems (beta-lactamase−resistant beta-lactams), beta-lactams (penicillins), cephalosporins (semi-synthetic beta-lactams), and quinolones (such as ciprofloxacin).
- Surgery. Surgery may be needed to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from further spreading. This is especially for peritonitis caused due to a ruptured appendix, stomach or colon.
- Other treatments. Other treatments for peritonitis include pain medications, fluids given through a tube (intravenous fluids), oxygen and, in some cases, a blood transfusion. The treatments depend on your signs and symptoms.
- Dialysis: Your doctor may recommend that you receive dialysis in another way for several days while your body heals from the infection. If peritonitis persists or recurs, you may need to stop having peritoneal dialysis entirely and switch to a different form of dialysis.
Infection or dehiscence of the surgical site,Enterocutaneous fistula,Abdominal compartment syndrome,Enteric insufficiency
Beta-lactams (penicillins),Carbapenems (beta-lactamase−resistant beta-lactams),Cephalosporins (semi-synthetic beta-lactams),Quinolones (such as ciprofloxacin)
Abdominal pain or tenderness,Bloating or a feeling of fullness in your abdomen,Fever,Nausea and vomiting,Loss of appetite,Diarrhea,Low urine output,Thirst