Peritonitis is a serious condition that happens when the lining of the abdomen (called the peritoneum) becomes inflamed or infected. This lining surrounds your stomach, intestines, and other organs, and helps them move smoothly. When it becomes irritated, the infection can spread quickly and become life-threatening if not treated immediately.
In many cases, peritonitis happens when something inside the abdomen leaks or bursts, such as the appendix, bowel, or gallbladder. Because it can develop suddenly and worsen fast, it is considered a medical emergency.
Through Hope Plus, patients in Uganda can connect to licensed healthcare providers in minutes for urgent medical advice or guidance on what to do next. Whether you are experiencing severe abdominal pain, vomiting, or swelling, Hope Plus can help you reach a professional who will direct you to the right care quickly and safely.
Key Takeaways
- Peritonitis is an infection or irritation of the lining inside your abdomen.
- It is often caused by leakage or bursting of internal organs such as the appendix or bowel.
- Common symptoms include severe continuous pain, swelling, fever, and vomiting.
- It is a medical emergency that requires immediate hospital treatment.
- Early care can prevent dangerous complications like shock or organ failure.
Causes of Peritonitis
Peritonitis can be caused by infections or chemical irritation. The most common reasons include:
Infectious causes
- A burst appendix or perforated ulcer, which allows stomach contents to leak into the abdomen.
- A perforated bowel due to blockage or injury.
- Perforated gallbladder with infected bile.
- Perforation of the uterus, sometimes following unsafe procedures.
- Tuberculosis or typhoid ulcers that spread infection to the abdomen.
- Post-surgery infections after abdominal operations.
- Cancer (malignancy) that weakens internal tissues and causes leakage.
Chemical causes
- Leakage of urine, blood, bile, or digestive juices into the abdominal cavity, which irritate the lining even without infection.
Symptoms to Watch For
Peritonitis usually causes very severe symptoms that worsen quickly. Common signs include:
- Severe and continuous abdominal pain, sometimes spreading across the whole stomach.
- Abdominal swelling (distension) or bloating.
- Fever and vomiting.
- Fast heartbeat, sweating, and low blood pressure (signs of shock).
- Tight, hard (rigid) abdomen that is very painful to touch.
- Rebound tenderness – when pressing the abdomen and releasing causes sharp pain.
- Reduced urine output or dark urine.
- Absent bowel sounds – the stomach may stop making its usual gurgling noises.
Anyone with these symptoms should go to the nearest hospital immediately. Do not try to eat, drink, or take painkillers without medical advice.
How It Is Diagnosed
Doctors will first examine your abdomen and then carry out tests such as:
- Abdominal X-ray or ultrasound to look for air, fluid, or abscesses.
- Blood tests to check for infection, kidney and liver function, and electrolytes.
- Culture and sensitivity tests to identify the bacteria causing the infection.
These tests help identify where the infection started and how serious it is.
Treatment and Management
Peritonitis always requires urgent hospital care. Before and during referral, health workers may begin emergency treatment to stabilise the patient.
Treatment usually includes:
- Hospital admission for close monitoring.
- Intravenous (IV) fluids such as normal saline or Ringer’s lactate to replace lost fluids and maintain blood pressure.
- Nil by mouth (nothing to eat or drink) to rest the stomach.
- A tube through the nose (nasogastric tube) to remove stomach contents and reduce vomiting.
- Oxygen therapy if breathing is affected.
- Pain relief using strong medicines such as pethidine or morphine (given by injection).
- Antibiotics to control infection, for at least 7 days, including:
- Ceftriaxone given through a vein once daily.
- Gentamicin to cover more bacteria.
- Metronidazole to fight infection from gut bacteria (given via IV and later by mouth when possible).
Once the patient is stable, doctors will perform surgery (exploratory laparotomy) to find and correct the cause of the infection, such as closing a burst appendix or repairing a perforated bowel.
After surgery, care focuses on:
- Good nutrition to help healing.
- Early movement (ambulation) to prevent complications.
- Rehabilitation and follow-up to ensure full recovery.
Prevention Tips
Although not all cases can be prevented, you can lower your risk of peritonitis by:
- Seeking immediate care for severe or persistent abdominal pain.
- Avoiding unsafe abortions and ensuring any medical procedures are done by qualified professionals.
- Completing treatment for infections like typhoid or tuberculosis.
- Following post-surgery instructions carefully to prevent infections.
- Avoiding unnecessary use of non-prescribed drugs or herbal products that may harm your stomach or liver.
Frequently Asked Questions (FAQs)
1. Is peritonitis contagious?
No. Peritonitis itself is not contagious, but the infections that cause it, like typhoid or tuberculosis, can be.
2. Can peritonitis heal on its own?
No. It always requires urgent hospital treatment, usually with antibiotics and sometimes surgery.
3. What happens if I delay going to the hospital?
Delaying treatment can lead to shock, organ failure, or death. It is a medical emergency that must be treated quickly.
4. Can I eat or drink if I suspect peritonitis?
No. You should not eat or drink anything until a doctor advises, as this can worsen the condition.
5. How long does recovery take?
Recovery depends on how early treatment starts and what caused the infection. With prompt treatment, most patients recover within weeks.
6. Is peritonitis common in Uganda?
Yes, it occurs frequently, especially due to burst appendix, typhoid ulcers, or unsafe procedures that cause abdominal infection.
7. Can peritonitis be prevented after surgery?
Yes. Following post-surgery care, taking prescribed antibiotics, and keeping the wound clean help prevent infection.
