What is Peritonitis? Symptoms, Causes, & Treatment

Peritonitis is a serious infection or inflammation of the peritoneum, the thin tissue that lines your abdominal wall and covers most of your abdominal organs. Think of the peritoneum as a protective layer that keeps your organs safe and helps them move smoothly against each other.

This condition requires immediate medical attention because it can quickly become life-threatening if left untreated. The good news is that with prompt diagnosis and proper treatment, most people recover completely from peritonitis.

What are the symptoms of peritonitis?

The most common symptom of peritonitis is severe abdominal pain that gets worse with movement or touch. You might notice that even gentle pressure on your belly causes significant discomfort, and you may instinctively want to lie very still.

Let's look at the full range of symptoms you might experience, keeping in mind that not everyone will have all of these signs:

• Severe abdominal pain that worsens with movement
• Abdominal tenderness or sensitivity to touch
• Bloating or swelling in your abdomen
• Fever and chills
• Nausea and vomiting
• Loss of appetite
• Diarrhea or constipation
• Difficulty passing gas
• Fatigue and weakness
• Rapid heartbeat
• Shortness of breath

In some cases, you might experience less common symptoms like confusion, excessive thirst, or very little urine output. These signs often indicate that the infection is affecting other parts of your body and needs immediate emergency care.

What are the types of peritonitis?

There are two main types of peritonitis, and understanding the difference can help you better grasp what might be happening in your body. Each type has different causes and treatment approaches.

Primary peritonitis develops when bacteria spread to the peritoneum through your bloodstream or lymphatic system. This type is less common and usually occurs in people with certain underlying health conditions like liver disease, kidney failure, or a weakened immune system.

Secondary peritonitis is more common and happens when bacteria enter the peritoneum from a hole or rupture in your digestive tract. This could be from a burst appendix, perforated ulcer, or injury to your abdomen. This type tends to be more serious because it often involves a larger amount of bacteria and contaminated material.

What causes peritonitis?

Peritonitis develops when harmful bacteria, fungi, or other microorganisms invade the normally sterile peritoneal space. The most common cause is a rupture or perforation somewhere in your digestive system that allows intestinal contents to leak into your abdominal cavity.

Here are the most frequent causes you should be aware of:

• Ruptured appendix (appendicitis)
• Perforated stomach ulcer
• Perforated colon, often from diverticulitis
• Pancreatitis (inflammation of the pancreas)
• Abdominal injury from trauma or surgery
• Perforated gallbladder
• Bowel obstruction that leads to rupture
• Pelvic inflammatory disease in women

Less commonly, peritonitis can result from medical procedures like peritoneal dialysis, where a catheter is used to clean your blood. Sometimes, bacteria can travel along the catheter and cause infection. In rare cases, the condition can develop from tuberculosis or certain autoimmune diseases.

When to see a doctor for peritonitis?

You should seek emergency medical care immediately if you experience severe abdominal pain along with fever, especially if the pain gets worse when you move or someone touches your belly. Peritonitis is a medical emergency that can become life-threatening within hours.

Call 911 or go to the emergency room right away if you have severe abdominal pain combined with any of these warning signs: high fever, rapid heartbeat, difficulty breathing, vomiting that won't stop, or signs of shock like dizziness and confusion.

Don't wait to see if symptoms improve on their own. Even if you're not completely sure, it's always better to have a medical professional evaluate severe abdominal pain promptly. Early treatment can prevent serious complications and save your life.

What are the risk factors for peritonitis?

Certain health conditions and life circumstances can increase your chances of developing peritonitis. Understanding these risk factors can help you stay vigilant about potential symptoms and take preventive measures when possible.

The following conditions and situations may put you at higher risk:

• Peritoneal dialysis treatment for kidney failure
• History of abdominal surgery
• Liver disease with fluid buildup (ascites)
• Weakened immune system from illness or medications
• Inflammatory bowel disease like Crohn's disease
• Stomach ulcers, especially if untreated
• Diverticulitis or diverticular disease
• Previous episodes of peritonitis
• Certain medical procedures involving the abdomen

Having one or more risk factors doesn't mean you'll definitely develop peritonitis. Many people with these conditions never experience this complication. However, being aware of your risk can help you recognize symptoms early and seek prompt treatment.

What are the possible complications of peritonitis?

Without prompt treatment, peritonitis can lead to several serious complications that can affect your entire body. The infection can spread beyond your abdomen and cause your organs to begin failing.

Here are the potential complications that doctors work hard to prevent:

• Sepsis (infection spreading throughout your bloodstream)
• Septic shock (dangerously low blood pressure)
• Organ failure, particularly kidney and liver problems
• Abscess formation (pockets of infected fluid)
• Bowel obstruction from scar tissue
• Difficulty breathing due to fluid buildup
• Blood clotting problems

The good news is that with early diagnosis and appropriate treatment, most of these complications can be prevented. This is why seeking immediate medical care for severe abdominal pain is so important for your overall health and recovery.

How is peritonitis diagnosed?

Your doctor will start by asking about your symptoms and medical history, then perform a physical examination of your abdomen. They'll gently press on different areas to check for tenderness, swelling, and signs of infection.

Several tests can help confirm the diagnosis and identify the underlying cause. Your doctor might order blood tests to check for signs of infection and inflammation, such as an elevated white blood cell count. These tests also help assess how well your organs are functioning.

Imaging studies like CT scans or X-rays can show fluid in your abdomen, organ damage, or the source of infection. In some cases, your doctor might need to take a sample of the fluid from your abdomen using a thin needle to identify the specific bacteria causing the infection.

What is the treatment for peritonitis?

Treatment for peritonitis typically requires hospitalization and involves antibiotics to fight the infection, along with supportive care to help your body heal. Most people need intravenous antibiotics for several days to ensure the medication reaches the infection effectively.

If there's a specific source of infection, like a ruptured appendix or perforated bowel, you'll likely need surgery to repair the problem and clean out infected material from your abdomen. The surgical approach depends on the underlying cause and how widespread the infection has become.

Your medical team will also provide supportive care, which might include intravenous fluids to prevent dehydration, pain medication to keep you comfortable, and oxygen therapy if you're having trouble breathing. Some people need temporary drainage tubes to remove infected fluid from the abdomen.

How to manage recovery at home after peritonitis?

Once you're discharged from the hospital, following your doctor's instructions carefully is crucial for a complete recovery. You'll likely need to continue taking oral antibiotics for several days or weeks, even if you're feeling much better.

Rest is essential during your recovery period. Start with light activities and gradually increase your activity level as your strength returns. Avoid heavy lifting or strenuous exercise until your doctor gives you the green light, which usually takes several weeks.

Pay attention to your diet during recovery. Start with bland, easy-to-digest foods and slowly add more variety as your digestive system heals. Stay well-hydrated and contact your doctor if you experience persistent nausea, vomiting, or inability to keep food down.

How should you prepare for your doctor appointment?

If you're experiencing symptoms that might indicate peritonitis, don't wait for a scheduled appointment. Go directly to the emergency room or call for emergency medical help, as this condition requires immediate attention.

For follow-up appointments during recovery, prepare a list of all medications you're taking, including antibiotics and pain relievers. Write down any symptoms you're still experiencing, even if they seem minor, as they can help your doctor assess your healing progress.

Bring a list of questions about your recovery, when you can return to normal activities, and what warning signs to watch for. Having a family member or friend accompany you can be helpful, especially if you're still feeling weak or having trouble concentrating.

What's the key takeaway about peritonitis?

Peritonitis is a serious medical emergency that requires immediate professional treatment, but with prompt care, most people make a full recovery. The most important thing to remember is that severe abdominal pain, especially when combined with fever, should never be ignored.

Early recognition and treatment are your best defenses against complications. If you have risk factors like ongoing dialysis or inflammatory bowel disease, stay alert to potential symptoms and maintain regular communication with your healthcare team.

Trust your instincts when it comes to severe abdominal pain. It's always better to seek medical attention and discover it's something less serious than to delay treatment for a potentially life-threatening condition like peritonitis.