A peritonitis, abdominal inflammation or peritonitis is a painful inflammation of the peritoneum. The disease can be fatal if left untreated and should be examined and treated by a doctor as soon as possible if it is suspected. Typical symptoms and signs of peritonitis are severe pain in the upper abdomen when moving and tension in the abdominal wall.
What is peritonitis?
The peritonitis is known in medical circles as peritonitis. The peritoneum is the peritoneum, which does not always have to be completely affected by inflammatory processes.
In addition to locally limited inflammation that only affects certain organ areas, so-called generalized or diffuse peritonitis is characterized by a different course of the disease.
The ending -itis denotes the fact that it is an inflammatory process. Deviating forms are observed in peritonitis.
Different influencing factors can be considered as the cause of peritonitis. The inflammatory processes of the peritoneum can result from the penetration of disease-causing bacteria from the outside. These can be carried over into the abdominal wall, for example, by the unintentional flow of examination media such as X-ray contrast substances or intestinal contents.
Peritonitis is often a secondary disease of other causal diseases in the abdomen. In this context, accumulations of bacteria from pus and inflammation centers from adjacent organs can get into the peritoneum. Typical triggers are, for example, acute appendicitis or when a stomach ulcer has penetrated the wall of the stomach. In rather rare cases, peritonitis can result from injuries to neighboring hollow organs during medical examinations, so that their contents spill onto the peritoneum.
It is astonishing that pathogens that are transported via the blood and lymph systems also settle on the peritoneum and can cause peritonitis there. Depending on the possible causes of peritonitis, a distinction is made between primary and secondary peritonitis.
Symptoms, ailments & signs
Peritonitis causes severe abdominal pain, and often a fever occurs. The abdominal wall is very tense and sensitive to pressure and those affected try to take a relieving posture due to the severe pain that relieves the severe pain. There are two types of peritonitis that can have different symptoms: localized peritonitis and diffuse peritonitis.
With local peritonitis, the abdominal pain occurs in the abdominal area that is causing the inflammation. A defensive tension can be felt at this point. With appendicitis, for example, the pain is usually limited to the right lower abdomen. The pain can be accompanied by nausea, constipation, and fever.
With diffuse peritonitis, the abdominal pain occurs all over the abdomen and the abdominal wall is hard, and those affected bend over in pain. Gastric and intestinal disorders occur. Because the entire abdomen is affected, the symptoms of diffuse peritonitis are more dramatic.
Symptoms of septic shock may include low blood pressure and a fast heartbeat, breathing problems, high fever, and cold sweats. Since the signs are not always clear, an urgent medical examination must be carried out, because diffuse peritonitis is life-threatening if it is not treated immediately.
The course of the disease in the respective types of peritonitis is characterized by more or less specific and general symptoms of inflammation.
Those affected initially complain about the typical symptoms of an infection. You feel dull and limp, suffer from loss of appetite and a reduced general well-being.
Typical forms of peritonitis are the painful symptoms in the upper abdominal area that occur in the stages. With manual palpation, the stomach feels hard and shows a lot of tension. Immense pain occurs even when the abdominal wall is pressed in slightly.
As the disease progresses, the patients usually show nausea and nausea. There is also a clear decrease in body temperature in the extremities and a pale face. The pain makes breathing difficult and sluggish, so the heartbeat is increased. In many cases, peritonitis causes a fever.
Peritonitis is already a serious illness and needs to be clarified quickly by a doctor in any case. Severe inflammation of the peritoneum can lead to serious complications despite treatment of the cause, such as respiratory arrest as a result of sepsis or kidney failure. In the course of the disease, there may also be wound healing disorders and, as a result, an intestinal obstruction and severe adhesions and adhesions in the gastrointestinal tract and abdomen.
The complications are exacerbated by the triggering disease, which in the case of peritonitis is usually a ruptured appendix or an intestinal obstruction. If the peritonitis is treated surgically, it can lead to bleeding, chronic pain and allergic reactions. A scar hernia also rarely occurs, through which stool, digestive juices and pus can get into the abdominal cavity. Often this is combined with further inflammation and other life-threatening complications.
Common secondary diseases of peritonitis are abscesses, sepsis or intestinal paralysis, which lead to death in up to 30 percent of those affected. However, if the inflammation is survived well, the risk of further complications decreases rapidly. Even a long time after the treatment, gastrointestinal complaints and movement-dependent abdominal pain can occur.
When should you go to the doctor?
The first signs of peritonitis are quite unspecific. Typically, the condition is accompanied by upper abdominal pain, fever, nausea, paleness, loss of appetite, and general weakness. It is important to seek medical advice as quickly as possible, as some of the forms can be serious or even life-threatening, depending on the cause of the peritonitis. A clarification as early as possible with identification of the causes can therefore save lives.
Peritonitis can be caused, for example, by acute appendicitis, by a gastric ulcer, by spreading bacteria from sources of inflammation into the abdominal cavity or by intestinal contents that can get into the abdominal cavity after injuring the small intestine. Combating or eliminating the underlying disease or injury is extremely important for a promising therapy.
A targeted therapy as early as possible presupposes that the sick person who suffers from the symptoms described above go to the doctor immediately. Competent contact persons can be experienced general practitioners or internists who can carry out initial clarifications about the anamnesis and an ultrasound examination and who can advise or decide on further diagnostic and therapeutic steps. Waiting longer for days can lead to significant complications such as kidney failure or blood poisoning (sepsis) and other life-threatening conditions.
Treatment & Therapy
In general, peritonitis is a disease that should not be underestimated, as it can lead to life-threatening restrictions if left untreated. If the disease is recognized in good time by going to the doctor, various therapies can be helpful. However, it must be weighed up whether it is an acute occurrence that only the emergency doctor can treat, because in many cases peritonitis can be fatal.
The forms of therapy are intensive, because there are options for surgical intervention and therapy with intensive medical means. Acute peritonitis is always treated surgically. In the case of a very severe clinical picture with signs of bacterial poisoning, intensive medical care may be unavoidable as a subsequent therapy due to the possibly foreseeable risks.
Within drug treatment, drugs such as high-dose pain medication and so-called post and secondary ventilation are extremely useful. Antibiotics are also used against peritonitis.
Since peritonitis often develops rapidly into a medical emergency, follow-up care is usually included in the treatment. Immediate emergency calls are essential. Acute, but as yet undiscovered, abdominal causes are responsible for the classic symptoms of peritonitis. These must be treated immediately because of the danger to life. In addition, peritonitis can cause organ damage later on.
In most cases, peritonitis cannot be relieved without surgery. In addition, appropriate measures and rapid action must be taken to prevent sepsis from occurring postoperatively. The subsequent treatment with antibiotics already represents part of the necessary aftercare. The healing process of the surgical wound and the underlying trigger must also be observed.
In rare cases, inflammation develops on the peritoneum without a recognizable trigger. Here, a careful differential diagnosis must rule out a trigger requiring surgery. Subsequently, the affected person is cured with antibiotic therapy in the follow-up care. The earlier treatment is given, the sooner the patient can recover from the life-threatening emergency situation.
Outlook & forecast
The prognosis for peritonitis depends on the severity of the disease, the type of medical care, and the age of the patient. There is a good chance of recovery if the disease can be recognized early and treated as an inpatient.
There are also good prospects for freedom from symptoms if the inflammation was acquired as a consequence of the removal of the appendix. Having a strong immune system and leading a healthy lifestyle increases the patient’s chances of a quick recovery. If there are no other chronic illnesses or symptoms of inflammation, the patient is normally symptom-free again within a few weeks.
The younger and healthier a patient, the better the prognosis for peritonitis. In addition, the chances of a cure for the serious illness increase with hospital treatment. The possibilities of outpatient medical care are not sufficient enough to bring about the fastest possible recovery.
A prognosis for an organ breakthrough is less optimistic. If the inflammation spreads throughout the abdomen due to the organ rupture, the body often does not have the resources necessary for healing. Despite very good medical care, the organism cannot mobilize sufficient self-healing powers.
You can do that yourself
Peritonitis is usually a medical emergency that requires surgical treatment. In addition, the symptoms and complaints can be alleviated through a number of self-measures and home remedies.
After the surgical procedure, bed rest and rest apply. In most cases, a radical change in diet is also necessary to avoid diarrhea and abdominal pain. After four to six weeks, the abdomen should have calmed down and the usual diet is possible again. Some natural resources can be used to speed up recovery.
Effective medicinal plants are arnica, witch hazel, chamomile and juniper. Taken in the form of teas or hot baths, these plants have anti-inflammatory and analgesic effects. A decoction made from bibernelle, holly, cowslip and ormennig has a similar effect.
A localized peritonitis can rarely be treated with a zero diet and bed rest. However, the prerequisite for self-treatment is that the triggering disorder has been diagnosed and responds to similar treatment measures. In general, possible triggers should be determined and recorded for a later visit to the doctor. As a result, and by avoiding irritating foods, a complication-free treatment of peritonitis is possible.