Severe stomach pain? Learn about this dangerous condition called Peritonitis!

Imagine that you suddenly have a severe stomach ache. At first, it starts as a dull ache, but after a while, the pain becomes unbearable. The pain becomes so severe that you can't even walk, stand up straight, or move your body. Many people think that this is a normal stomach ache, gastritis. But this can be a symptom of a much more serious, even life-threatening condition called Peritonitis . So today, let's talk about this dangerous condition.

Simply put, what is Peritonitis?

There are many important organs inside our abdomen, such as the liver, intestines, stomach, and uterus. These organs are protected and held together by a thin membrane, like a polythene sheet, that covers the inner wall of the abdomen. In medicine, we call this the peritoneum .

Peritonitis is when a germ, such as bacteria, enters the peritoneum, becomes infected, becomes very swollen, and becomes inflamed. This is a medical emergency . Because this infection can quickly spread throughout the body and be life-threatening. Therefore, it is very important for you and your loved ones to know exactly what this is.

What are the symptoms of Peritonitis?

Symptoms may vary from person to person in this situation. However, there are some common symptoms that you should pay special attention to. If one or more of these symptoms appear suddenly, don't ignore it.

Why does Peritonitis occur? What are the causes?

Okay, now let's look at how an infection can enter this protective membrane called the peritoneum. There are several main ways this can happen.

1. Spread of infection from another organ (Secondary Peritonitis)

This is the most common cause. That is, an infection in another organ in the abdomen spreads to the peritoneum due to a rupture or perforation of that organ. Imagine something like this...

• Appendicitis: As most people know, appendicitis is an inflammation of the appendix. If it is not treated quickly, it can burst. Then the bacteria and contents inside it spread throughout the abdomen, causing peritonitis. This is the main cause of peritonitis.
• Peptic Ulcer/Bowel Perforation: If ulcers develop in the stomach and become deep enough to cause a hole in the stomach wall, stomach acid and bacteria can leak into the stomach.
• Cholecystitis or pancreatitis: When the inflammation of these organs becomes severe, they can become perforated, allowing bile from the gallbladder or enzymes from the pancreas to leak into the stomach.
• Gynecological problems: Infection can also spread to the peritoneum due to cases such as ectopic pregnancy in a fallopian tube, rupture of the tube, or severe pelvic inflammatory disease.
• Traumatic Injury to the Stomach: If the stomach is injured, such as in a car accident, fall, or stab wound, the intestines can be damaged and bacteria can leak out.
• After surgery: After abdominal surgery, there is a small chance that an infection will enter through the wound.

2. Other causes (Primary and Chemical Peritonitis)

Peritonitis can also occur for other reasons, such as an organ rupture, as mentioned above. These are somewhat rare.

• Ascites: Conditions such as cirrhosis of the liver, some cancers, or heart disease can cause the abdomen to fill with fluid. This excess fluid can easily become infected with bacteria, leading to a condition called Spontaneous Bacterial Peritonitis (SBP) .
• Through medical treatments: During peritoneal dialysis treatment for patients with kidney failure, bacteria can sometimes enter through the stomach tube. This risk also exists for patients who are tube fed through the nose.
• Chemical Peritonitis: This is caused by the leakage of chemicals that are not bacteria, but are present in the body but are harmful to the peritoneum. For example, stomach acid, bile, pancreatic enzymes, etc. When these enter the peritoneum, they cause inflammation.

Why is Peritonitis dangerous? What are the complications?

Peritonitis is not something that can be easily cured. If it is not treated promptly, it can lead to serious, life-threatening complications.

Simply put, sepsis is when the body's immune system's response to an infection goes out of control and begins to damage the body's own tissues and organs. This can cause dangerously low blood pressure, circulatory collapse, organ failure, and even death. That's why Peritonitis is a medical emergency.

Other complications:

• Dehydration and Electrolyte Imbalance: Things like vomiting and fever cause the body to lose water and essential salts.
• Paralytic Ileus: The function of the intestines may temporarily stop.
• Abdominal Adhesions: After the infection heals, the organs inside the abdomen can stick together, which can lead to bowel obstruction in the future.
• Effects on other organs: If the infection becomes severe, organs such as the liver and kidneys can also be affected by this infection.

How is the disease diagnosed and treated?

How does the doctor diagnose the disease?

When you go to the hospital, especially the Emergency Department (ETU) with these symptoms, the doctor will first ask you about your symptoms. Then, they will perform a physical examination, especially a thorough examination of your abdomen. They will check to see if your abdomen is hard, swollen, or painful when you touch it. The following tests may be ordered to confirm the diagnosis:

• Blood Tests: Things like the White Blood Cell Count are checked to see if there is an infection in the body.
• Imaging tests: A CT scan , ultrasound scan , or MRI scan may be ordered to see what's going on inside the abdomen. These can help determine if an organ is inflamed or if fluid is accumulating.
• Paracentesis: If the abdomen is full of fluid, a thin needle is inserted and a sample of the fluid is taken to test for infection and to determine what bacteria are present.
• Laparoscopy: Sometimes, if the diagnosis is not clear, a small camera may need to be inserted into the abdomen to see the inside directly.

What are the treatments?

Peritonitis is a condition that requires hospitalization. Treatment has three main goals: controlling the infection, treating the underlying problem that caused the infection, and preventing potential complications.

1. Antibiotics: First, broad-spectrum antibiotics are given intravenously along with saline. This helps control the infection that has spread throughout the body. Then, after tests identify the specific bacteria causing the infection, a specific antibiotic is given.

2. Surgery: Surgery is often necessary. Especially if the appendicitis has burst or a hole has formed in the intestine, the damaged part must be removed and the inside of the abdomen must be thoroughly washed and cleaned.

3. Supportive Care: This includes giving saline, painkillers, and oxygen if needed. Sometimes, a nasogastric tube may be inserted through the nose to remove the contents of the stomach.

How long does it take to heal? When should you seek immediate medical attention?

Recovery time varies from person to person. It depends on how quickly you receive treatment, the severity of the infection, and your overall health. If treatment is started early, you may recover in a few weeks. However, if you have had surgery or if the underlying cause (such as cirrhosis) is serious, it may take longer to fully recover.

Go to the nearest hospital Emergency Department (ETU) immediately. Or call the 1990 ambulance service. In peritonitis, every minute counts . Acting quickly can save your life.

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