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Peritonitis Treatment in Bristol, VA

Peritonitis Treatment in Bristol, VA

*WARNING: this condition is potentially life-threatening. If you or someone you know is experiencing these symptoms, don't wait. Call 911 or go to the nearest emergency room right away. *

Have you recently had surgery, dialysis, or an injury to your stomach area and now have abdominal pain, vomiting, fever, and chills? It could be peritonitis, an inflammation of the thin layer of tissue covering the inside of your abdomen and organs called the peritoneum.

If you're on dialysis or have recently had surgery and are showing peritonitis symptoms, don't wait—get emergency medical attention right away. Peritonitis can be treated with antibiotics to address the infection or with surgery to remove the infected tissue.

Peritonitis is a potentially life-threatening condition. To speak with a peritonitis specialist today in Bristol, call (423) 482-8711 or contact AWAREmed Health and Wellness Resource Center online.

What are the symptoms of peritonitis?

Common symptoms of peritonitis include:

  • abdominal pain, tenderness, and swelling
  • fluid in the abdominal cavity (ascites)
  • fever
  • chills
  • fatigue or weakness
  • nausea and vomiting
  • loss of appetite
  • diarrhea
  • constipation or inability to pass gas
  • decreased urination
  • increased thirst

If you're receiving dialysis, peritonitis can cause additional symptoms like cloudy dialysis fluid, white flecks, strands, or clumps (fibrin) in the dialysis fluid, or an unusual odor.

If peritonitis isn't treated immediately, the infection can spread through your bloodstream (bacteremia) and lead to worse problems, such as an infection throughout the body that causes shock and organ failure, called (sepsis ). Other complications of peritonitis include:

  • organ failure from a lack of blood (shock)
  • loss of brain function when the liver can no longer remove toxins from your blood (hepatic encephalopathy)
  • progressive kidney failure (hepatorenal syndrome)
  • dead bowel tissue (gangrenous bowel)
  • dangerously low blood pressure (septic shock)
  • shortness of breath (if the pressure expands to the lungs)

What causes peritonitis?

There are different types of peritonitis, each with its own causes:

  • secondary peritonitis: the most common type, it's caused by a leakage or hole in an abdominal organ—like the appendix—from injury, as well as ulcers or bowel strangulation; the infection then enters the peritoneum
  • primary peritonitis/spontaneous bacterial peritonitis (SBP): the ascites is caused by an infection in the peritoneum, mostly from cirrhosis , as well as heart failure, systemic lupus, and kidney disease
  • tertiary or tuberculosis peritonitis: caused by the bacterium Mycobacterium tuberculosis (TB)
  • chemical peritonitis/sterile peritonitis: caused by leakage of sterile fluids that irrigate the peritoneum, like bile, blood, or barium used during procedures and tests
  • peritoneal abscess: caused by an infected fluid collection (diverticulitis) that is next to organs (most often the colon) and/or the peritoneum

Other peritonitis causes include:

  • feeding tubes: can create holes in your digestive system
  • paracentesis: removes fluid from your abdomen to test for ascites, a complication of severe liver disease; complications can cause peritonitis
  • peritoneal dialysis: removes waste from the kidneys; infection can occur due to unclean surroundings, poor hygiene, or contaminated equipment
  • sepsis: infection in your bloodstream that can spread to your abdomen
  • trauma or accidents: falling or car accidents can puncture your organs
  • inflammation of the pancreas
  • Crohn's disease
  • appendicitis
  • pelvic inflammatory disease in women
  • complications to surgical procedures like gastrointestinal surgery, colonoscopy, or endoscopy

How is peritonitis diagnosed?

Because peritonitis can be life-threatening, early diagnosis is important. Ways to make a peritonitis diagnosis include:

  • physical exam: includes touching or pressing abdomen
  • complete blood count (CBC): checking to see if you have a high white blood cell count, a sign of infection
  • imaging test: x-rays, ultrasound, or CT scans can search for holes in your abdomen
  • fluid analysis: taking a sample of fluid inside your peritoneum for further analysis

Peritonitis treatment

Treatment for peritonitis usually involves medication and surgery. If there is no known cause of your peritonitis, a multidisciplinary approach with an infectious disease specialist is recommended.1

Antibiotics are used to treat the infection, and pain medication is typically given to relieve your discomfort. In all cases of peritonitis (including tertiary or tuberculosis peritonitis), broad spectrum antibiotics should be started as soon as possible.1

Types of peritonitis antibiotics include clindamycin, metronidazole, and vancomycin. Side effects of these antibiotics can include bladder pain, agitation or confusion, nausea, and fever. The type and duration of your antibiotic therapy will depend on the severity of your condition and the type of peritonitis you have, though the treatment duration may be about 5-10 days.

Diuretic medications like chlorthalidone or hydrochlorothiazide might be able to reduce fluid retention by enabling urination. Side effects include dehydration, dizziness, and fatigue.

Emergency surgery can be used to remove infected tissue, such as an inflamed appendix . Another peritonitis operation is therapeutic paracentesis, which drains abdominal fluid with a needle.

Other treatments include:

  • a nasogastric tube inserted into the nose to help drain secretions, gas, and air in the digestive tract
  • limiting the amount of water intake immediately after the diagnosis, then drinking six to eight glasses of water per day during recovery
  • resting and getting eight to nine hours of nightly sleep

If you're on kidney dialysis, you may have to wait until the infection disappears to receive more dialysis. If the infection continues, you may need to switch to a different type of dialysis like hemodialysis, which filters your blood.

If you're on dialysis, you can prevent peritonitis by:

  • washing your hands and fingernails before touching your catheter
  • cleaning the skin around your catheter daily
  • storing your supplies in a sanitary area
  • wearing a surgical mask during your dialysis
  • not letting your pets sleep in your bed

A high antioxidant, low-salt diet can prevent complications like dehydration or worsen inflammation:

  • avoid high-sodium foods like fast foods, canned foods, frozen foods, processed meat, and soup
  • avoid inflammatory foods like sugar, refined grains, and refined vegetable oils
  • avoid caffeine, alcohol, and tobacco
  • eat antioxidant-rich fruits and vegetables like berries, leafy greens, carrots, tomatoes, bell peppers, and asparagus
  • eat probiotic foods like fermented diary (yogurt)
  • eat vitamin-B rich foods like fish, eggs, almonds, beans, and whole grains

Ask your healthcare provider if the following herbs and supplements may benefit you:

  • multivitamin that contains vitamins A, C, E, B-complex, magnesium, calcium, zinc, and selenium to address any nutrient deficiencies; side effects may include upset stomach, headache; avoid milk and calcium supplement
  • probiotic supplements to replenish good bacteria after taking your antibiotics; side effects include infections and sepsis if you have an immunosuppressant condition or leaky gut syndrome
  • adaptogen herbs like ashwagandha to help manage stress, sharpen mental acuity, and increase energy; large doses may cause stomach upset, diarrhea, and vomiting

These nutritional and herbal treatments may have contraindications with a variety of unrelated conditions:

There may also be contraindications with the following pharmaceuticals:

  • immunosuppressants like cyclosporine (Neoral, Sandimmune), muromonab-CD3 (Orthoclone OKT3), tacrolimus (FK506, Prograf), and prednisone (Deltasone, Orasone)
  • corticosteroids (glucocorticoids)
  • benzodiazepines like clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan)
  • central nervous system (CNS) depressants like lonazepam (Klonopin), phenobarbital (Donnatal), and zolpidem (Ambien)
  • NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin), naproxen (Aleve), and celecoxib
  • thyroid hormone pills
  • tretinoin or isotretinoin
  • antacids
  • antibiotics
  • a diuretic or "water pill"
  • heart or blood pressure medications
  • sulfa drugs
  • macrolide antibiotics like clarithromycin and erythromycin
  • antibiotics like rifampin and rifabutin
  • kaolin-pectin
  • alcohol-containing products like cough and cold syrups
  • products containing propylene glycol
  • lopinavir/ritonavir solutions
  • lithium medications
  • prescription weight loss drugs
  • cisapride
  • dofetilide

Reserve your appointment now

If you have abdominal pain, seek medical attention immediately. Prompt treatment can improve your peritonitis outlook by preventing serious complications. To speak with a peritonitis specialist today in Bristol, call (423) 482-8711 or contact AWAREmed Health and Wellness Resource Center online.


1. Sabrina Drexel and Daniel Tseng. "Primary Peritonitis: An Index Case of Mycoplasma Hominis Infection in a Healthy Female." International Scholarly Research Notices, Hindawi, 6 Feb. 2018, www.hindawi.com/journals/cris/2018/4587801/.

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AWAREmed Health and Wellness Resource Center


1604 Lamons Lane
Suite 202
Johnson City, TN 37604
(423) 482-8711


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