Peritonitis: Care Instructions

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Your Care Instructions

Peritonitis is an infection of the lining of the belly (peritoneum). It causes pain and swelling inside the belly. It may also cause a fever. The infection can be serious if it is not treated.

This type of infection can happen in people who use peritoneal dialysis (PD). PD uses a dialysis fluid and the lining of the belly to filter toxins from the blood. The fluid enters and leaves the belly through a soft tube, or catheter. The place where the catheter comes out of your body is the dialysis access. You may get peritonitis if the catheter is not sterile. You can also get it if the area around the access is not clean.

Peritonitis can also be caused by:

  • Bacteria escaping into the lining of the belly from a hole in the intestine, such as a burst appendix.
  • Too much fluid in the belly due to scarring of the liver (cirrhosis). Bacteria can grow easily in this fluid.

Your doctor will give you antibiotics to treat the infection. If you use PD and the infection is minor, the antibiotics may be added to the dialysis fluid. The doctor may give you a new access while the old one heals. Or you may start using hemodialysis instead of PD. Hemodialysis uses a machine instead of the lining of the belly to filter waste from the blood.

If the infection is from a hole in the intestine, you may have surgery to remove pus and infected tissue from the area.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • If you have a PD catheter, take steps to help prevent infections.
    • Keep your access clean and dry. Check it every day for signs of infection.
    • Keep the end of your catheter covered when it is not in use.
    • Always wash your hands before you touch your catheter.
    • Avoid swimming and bathing unless your dialysis team has told you it is okay. Always clean and dry your catheter and access right away after you get wet.
    • Follow your doctor's instructions for showering.

When should you call for help?

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have symptoms of new or worsening infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the access site.
    • Pus draining from the access site.
    • A fever.
  • You have nausea and vomiting.
  • You have belly pain that gets worse when you move or cough.
  • Your belly is bloated or swollen.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • The dialysis fluid looks cloudy or is a different colour.
  • Fluid does not flow through the catheter.
  • You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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