You have a thin layer of tissue covering the inside of your abdomen and most of its organs. This is called the peritoneum. Peritonitis is inflammation of the peritoneum. The inflammation is usually the result of a fungal or bacterial infection caused by an abdominal injury, an underlying medical condition, or a treatment device, such as a dialysis catheter or feeding tube.

Peritonitis is a serious condition that needs immediate medical attention. Prompt intravenous antibiotics are needed to treat the infection. Surgery is sometimes necessary to remove infected tissue. The infection can spread and become life-threatening if it isn’t treated promptly.

There are two types of peritonitis:

  • Spontaneous bacterial peritonitis (SBP) is the result of an infection of the fluid in your peritoneal cavity. Liver or kidney failure can cause this condition. People on peritoneal dialysis for kidney failure are also at increased risk for SBP.
  • Secondary peritonitis is usually due to an infection that has spread from your digestive tract.

Symptoms will vary depending on the underlying cause of your infection. Common symptoms of peritonitis include:

  • tenderness in your abdomen
  • pain in your abdomen that gets more intense with motion or touch
  • abdominal bloating or distention
  • nausea and vomiting
  • diarrhea
  • constipation or the inability to pass gas
  • minimal urine output
  • anorexia, or loss of appetite
  • excessive thirst
  • fatigue
  • fever and chills


If you have symptoms of peritonitis, seek medical attention right away. Delaying your treatment could put your life at risk.

Your doctor will ask you about your medical history and perform a complete physical exam. This will include touching or pressing on your abdomen, which will probably cause some discomfort.

There are other tests to help diagnose peritonitis:

  • A blood test, called a complete blood count (CBC) can measure your white blood cell count. A high white blood cell count usually signals inflammation or infection. A blood culture can help to identify the bacteria causing the infection or inflammation.
  • If you have a buildup of fluid in your abdomen, your doctor can use a needle to remove some and send it to a laboratory for fluid analysis. Culturing the fluid can also help identify bacteria.
  • Imaging tests, such as CT scans and X-rays, can show any perforations or holes in your peritoneum.

If you’re on dialysis, your doctor may diagnose you based on the appearance of cloudy dialysis fluid.



The first step in treating peritonitis is determining its underlying cause. Treatment usually involves antibiotics to fight infection and medication for pain.

If you have infected bowels, an abscess (a collection of pus), or an inflamed appendix, you may need surgery to remove the infected tissue.

If you’re on kidney dialysis and have peritonitis, you may have to wait until the infection clears up to receive more dialysis. If the infection continues, you might need to switch to a different type of dialysis.

Your treatment must begin promptly to avoid serious and potentially fatal complications.

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