Peritonitis – Symptoms, Causes, Diagnosis and Treatment

What is Peritonitis?

Peritonitis is a condition that leads to the inflammation of the peritoneum, the inner lining of the abdominal wall. This inner lining of the abdominal wall is known to cover the organs of the abdomen. Peritonitis is caused either due to fungal or bacterial infection. Peritonitis requires immediate medical attention. If left untreated, it can give rise to acute infection that spreads throughout the body. Apart from bacterial or fungal infection leading to peritonitis, it can also be caused by peritoneal dialysis therapy.

What are the Symptoms of Peritonitis?

The common symptoms of peritonitis include: 

• Pain in the abdomen
• A feeling of fullness or bloating
• Appetite loss
• Fatigue along with confusion
• Diarrhea and low output of urine
• Difficulty in the passage of stool

In the case of patients receiving peritoneal dialysis therapy, the symptoms also include:

• Dialysis fluid is of an unusual color with white flecks
• Dialysis fluid contains clumps of fibrin
• Dialysis fluid has an unusual odor

When to See a Doctor?

You should consult a doctor if you observe any of the symptoms of peritonitis listed above.

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Sometimes, peritonitis is caused due to the bursting of the appendix or abdominal injury caused by trauma, such as accidents. In such cases, patients should seek immediate emergency medical assistance.

What are the Causes of Peritonitis?

Peritonitis can be caused due to various reasons. A few common causes of peritonitis are: 

• Peritoneal dialysis: Peritoneal dialysis involves the use of catheters for the removal of waste products from the blood in cases of kidney malfunction. Infection occurs during peritoneal dialysis mainly due to bad hygiene, contaminated equipment, and poor environmental conditions.
• Pancreatitis: Pancreatitis is the inflammation of the pancreas commonly brought about by bacterial infection. If the infection spreads outside the pancreas, it can lead to peritonitis.
• Diverticulitis: Diverticulitis is the infection of diverticulosis. These are small pouches of the digestive tract. If these pouches rupture, they cause spillage of the waste from the intestine into the abdominal cavity, resulting in peritonitis.
• Ulceration, perforation of the colon, and rupture of the appendix: Any of these three conditions allow bacteria to cause peritonitis.
• Trauma: Any injury or trauma can cause bacteria or other chemicals of the body to enter the abdominal cavity and cause peritonitis.
• Liver cirrhosis: Peritonitis can also be caused by liver cirrhosis. Liver cirrhosis sometimes causes fluid to build up in the abdominal cavity, leading to bacterial infection and finally results in peritonitis.

How can Peritonitis be Prevented?

Peritonitis caused mainly due to peritoneal dialysis can be prevented by the following methods:

• Keeping the catheter clean
• Washing hands thoroughly before handling the catheter
• Storing supplies in a highly sanitized area
• Wearing surgical masks while performing dialysis fluid changes

How can Peritonitis be Diagnosed?

The diagnosis of peritonitis can vary, depending on the factor that causes it. For peritonitis caused due to peritoneal therapy, the symptoms are adequate for the doctor to diagnose peritonitis. For peritonitis caused due to other infections, doctors may prescribe certain tests to confirm the diagnosis. Common tests used to diagnose this type of peritonitis are:

• Blood test: In this test, a blood sample is collected and sent to the laboratory for the analysis of the white blood cell count. If a high count is found, it suggests the presence of an infection. Sometimes, blood cultures are also performed to detect the presence of bacteria in the blood.
• Imaging test: X-ray, ultrasound, or CT scan may be prescribed by the doctor to detect holes in the gastrointestinal tract.
• Peritoneal fluid analysis: In this test, fluid from the peritoneum is collected for patients undergoing peritoneal dialysis or those who have fluid buildup in their abdomen. On examination, if the fluid shows a higher blood cell count, it indicates the presence of an infection. Sometimes, a culture of the fluid is also done to detect the presence of bacteria.

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How is Peritonitis Treated?

Peritonitis is mostly treated with the help of antibiotics along with supportive care. Serious cases may require hospitalization. The commonly used methods of treatment of peritonitis are: 

• Antibiotics: Antibiotics are prescribed to prevent the infection from spreading. Both type and duration of antibiotic therapy depend on the severity of the infection.
• Surgery: In acute cases, surgery is needed for the removal of the infected tissue.

In cases of peritonitis arising from peritoneal dialysis, doctors may suggest dialysis through some other way for a few days until the infection heals. Despite such measures, if peritonitis persists, dialysis should be switched to a different form completely.

Conclusion

Peritonitis is a condition that affects the peritoneum of the abdominal cavity. Peritonitis can be caused by different factors and comprises various symptoms. The treatment of peritonitis is done mostly with the help of antibiotics. However, acute cases may need hospitalization. Peritonitis, if left untreated, can lead to sepsis, a life-threatening infection.

Frequently Asked Questions (FAQs) 

How long does peritonitis take to develop?

Peritonitis that develops due to the accumulation of body fluids requires 24-48 hours to develop.

Which antibiotic is used to treat peritonitis?

The most commonly used antibiotic to treat peritonitis is the beta-lactam group of antibiotics.

What foods should be taken during peritonitis?

Foods rich in calcium and vitamin B should be taken in this condition. Refined foods should be avoided.