The peritoneum is the tissue that lines the abdominal cavity that houses stomach, intestines and other organs. An inflammation of the peritoneum mainly due to bacterial or fungal infection and sometimes with chemical irritation is called peritonitis. It may also occur due to rupture of abdominal cavity or as a complication of some disease. Acute abdominal pain appears as the typical symptom of peritonitis. If left unattended, it could be life-threatening.
People undergoing peritoneal dialysis or suffering from a prolonged, chronic infection are more likely to develop peritonitis. Prompt medical attention is required to treat the disease as the chances of getting cured gets dim with increasing delay. Although a severe condition, peritonitis could be treated effectively with medications. However, a few cases may require surgery as well.
Common symptoms of peritonitis include:
- Painful or tender belly that gets worse while touching or during movement.
- Bloated belly (abdominal distention), feeling full.
- Fever and chills.
- Passing little or no stools or urine.
- Excessive fatigue.
- Nausea and vomiting.
- Shortness of breath.
Upon developing peritonitis, peritoneal dialysis patients may present one of the following symptoms:
- Dialysis fluid turns cloudy or contains white clumps.
- Area where the tube is inserted becomes red or swollen.
In case of negligence, the infection could spread into the blood and other organs leading to multiple organ failure and even death.
Depending on the origin of infection, peritonitis is commonly of two types:
- Spontaneous peritonitis that develops due to direct infection of the peritoneum. Having liver disease or undergoing peritoneal dialysis increases the risk of developing spontaneous peritonitis.
- Secondary peritonitis arises when an injury or infection elsewhere inflames or infect allows the pathogens to enter into the peritoneum. Causes that could possibly introduce pathogens to the peritoneum resulting in secondary peritonitis include:
– Ruptured appendix or stomach ulcers
– Perforated walls of stomach, intestine or gall bladder
– Diseases of the digestive system like Crohn’s disease and diverticulitis
– Abdominal inflammatory disease or pancreatitis
Although both types of peritonitis are life-threatening, spontaneous forms are relatively more serious and more likely to lead to death as compared to the secondary peritonitis. People suffering from kidney failure who require peritoneal dialysis are more likely to develop peritonitis. Having a history of the disease also makes a person vulnerable.
The primary aim of treatment is to combat the infection and to prevent it from spreading to other body parts. Treatment may also require medications for the secondary cause of infections as well.
Antibiotics are commonly prescribed to treat infections. The dose and kind of antibiotics depend on the type of peritonitis and the stage of disease. Pain-relieving medications, intravenous fluids, oxygen and even, blood transfusion may be required to relieve from the associated symptoms and discomfort.
In few cases, where the person does not seem to respond to medications, surgical measures may be necessary. The infected tissue is surgically removed to exclude the source of infection and also to prevent the infection from spreading. In peritoneal dialysis patients, appearance of peritonitis should be taken seriously.