Medicines for Peritonitis

What it is

Peritonitis is inflammation of the peritoneum — the thin layer of tissue that lines the inside of the tummy (abdomen) and covers the organs within it. It is a serious condition and a medical emergency that needs urgent treatment. It is usually caused by an infection, which often results from a problem elsewhere in the tummy that allows germs (or the contents of the gut) to enter the normally sterile abdominal cavity — for example a burst appendix (appendicitis), a burst stomach or bowel ulcer, a hole in the bowel, or other serious abdominal problems; it can also occur as a complication of certain procedures or treatments (such as peritoneal dialysis). The main symptom is severe tummy pain, which usually gets worse with any movement or when the tummy is touched, and the tummy may feel tender, rigid, or swollen. Other symptoms can include: feeling or being sick; a high temperature; a fast heartbeat; not being able to pass stools or wind; loss of appetite; and feeling very unwell, sometimes with signs of becoming seriously ill (such as confusion, breathlessness, or signs of sepsis). Because peritonitis is serious and can rapidly become life-threatening — the infection can spread into the blood (sepsis) — it needs urgent medical assessment and treatment. Treatment usually involves antibiotics to treat the infection and, very often, an operation to deal with the underlying cause (such as removing a burst appendix or repairing a hole in the bowel), along with supportive care in hospital. Because severe, worsening tummy pain with feeling very unwell can be a sign of peritonitis (or another serious cause), it needs urgent assessment — the key message is not to delay seeking help.

How it is treated

Peritonitis is a medical emergency and is treated urgently in hospital, with the priorities being treating the infection, dealing with the underlying cause, and supporting the person, because it can rapidly become life-threatening. If peritonitis is suspected — severe tummy pain that is worse with movement or touch, with a tender or rigid tummy and feeling very unwell — urgent medical help is essential and should not be delayed. In hospital, assessment includes examination, blood tests, and scans (such as CT) to confirm the diagnosis and find the underlying cause. Treatment usually involves: antibiotics given into a vein to treat the infection, started promptly; fluids and supportive care (and management of sepsis if it has developed); and, very often, an operation (surgery) to treat the underlying cause — for example removing a burst appendix, repairing a hole or perforation in the stomach or bowel, or dealing with the source of the infection — and to clean the abdominal cavity. The specific treatment depends on the cause, and prompt treatment greatly improves the outcome. For peritonitis related to peritoneal dialysis, treatment focuses on the infection and the dialysis catheter. Because peritonitis is serious and time matters, the key message is urgency: severe, worsening tummy pain — particularly with a tender or rigid tummy, feeling very unwell, a fever, or vomiting — needs urgent assessment, and delay can be dangerous. It is worth noting that tummy pain is common and usually not peritonitis, but the specific picture of severe pain worse with movement, a rigid tummy, and feeling very unwell is a warning sign that needs emergency care. The reassuring message is that, although peritonitis is a serious emergency, prompt treatment — antibiotics, surgery to deal with the cause, and supportive care — is usually effective, so recognising it and seeking urgent help without delay is the most important thing.