Peritonitis is a potentially life-threatening condition characterized by inflammation of the peritoneum—the thin layer of tissue lining the inner wall of the abdomen and covering abdominal organs. Though it may sound like a rare diagnosis, peritonitis can emerge swiftly and often signals a medical emergency that requires immediate intervention.
This inflammation is usually the result of a bacterial or fungal infection, often stemming from a rupture in the gastrointestinal tract. Such a rupture could be due to a perforated ulcer, a burst appendix, diverticulitis, or trauma. In some cases, it may arise due to peritoneal dialysis complications or after abdominal surgery. The condition may be classified as primary (spontaneous, usually in people with liver disease), secondary (due to a perforation or injury), or tertiary (persistent or recurrent despite treatment).
The symptoms of peritonitis develop rapidly and can vary slightly depending on the underlying cause. However, the hallmark signs include:
Severe abdominal pain and tenderness: This is the most common and immediate symptom. The pain is often sharp, persistent, and worsens with movement or pressure.
Abdominal bloating or distension: Caused by inflammation or fluid accumulation.
Fever and chills: Often a sign that the body is fighting an infection.
Nausea and vomiting: May occur due to bowel involvement or systemic infection.
Loss of appetite: The discomfort and underlying infection reduce the desire to eat.
Altered bowel habits: This may include constipation, diarrhea, or the inability to pass gas.
Fatigue and confusion: As the condition progresses, systemic effects like dehydration or sepsis may result in mental confusion or weakness.
One of the most telling signs is a board-like rigidity of the abdomen. The muscles may stiffen reflexively in response to the irritation, a condition referred to as "involuntary guarding."
While peritonitis cannot always be prevented, especially in cases involving sudden gastrointestinal perforation, there are steps individuals can take to reduce risk—especially those with underlying conditions like liver cirrhosis or undergoing peritoneal dialysis.
Maintain hygiene in peritoneal dialysis: Use aseptic techniques rigorously to prevent infection.
Manage chronic illnesses: Patients with liver disease, diverticulitis, or Crohn’s disease should follow strict medical guidance to reduce complications.
Prompt treatment of abdominal pain: Early diagnosis of appendicitis or ulcers can prevent progression to rupture and peritonitis.
Vaccination and lifestyle: For those with compromised immunity, appropriate vaccinations and avoiding alcohol (which worsens liver function) are key.
Furthermore, those who have undergone abdominal surgeries must carefully follow post-operative instructions, as internal leakage or infections can lead to peritonitis.
Time is crucial when it comes to peritonitis. Immediate medical attention is vital when you notice:
Sudden, severe abdominal pain
Unexplained fever with a tender or bloated abdomen
Persistent vomiting or inability to pass stool or gas
Signs of sepsis such as low blood pressure, rapid heartbeat, or mental confusion
For patients on peritoneal dialysis, cloudy dialysis fluid, fever, or abdominal pain should be reported immediately, as these may indicate an early infection.
Peritonitis is not just another stomach issue—it is a serious, sometimes silent, emergency that demands swift diagnosis and treatment. With proper hygiene, timely medical care, and awareness of symptoms, the risks can be minimized. But once suspected, hesitation can prove dangerous. When in doubt, consult a healthcare provider without delay. Swift action can mean the difference between full recovery and severe complications—or even survival.
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