What’s spontaneous bacterial peritonitis?

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Spontaneous bacterial peritonitis (SBP) is an infection that occurs in some patients with ascites, a condition in which fluid builds up in the abdomen. It tends to occur more commonly in patients with cirrhosis, and the condition can radically complicate liver conditions, leading to serious problems for the patient. Like other forms of peritonitis, spontaneous bacterial peritonitis is treated as a medical emergency, requiring prompt treatment and intervention for the best possible outcome.

The condition appears to be caused by the emergence of bacteria in the fluid associated with the ascites. These bacteria colonize the peritoneum, a membrane that lines the abdominal cavity and body organs, causing an infection to spread. Because ascites tends to make the abdomen tender and swollen, it is sometimes difficult to tell that peritonitis has set in. The patient develops fever, chills, and a general feeling of malaise, and spontaneous bacterial peritonitis can sometimes present very subtly.

A doctor can diagnose spontaneous bacterial peritonitis by taking a sample of the fluid from the ascites and testing it for the presence of bacteria. Medical imaging can be used to confirm that the patient does indeed have spontaneous bacterial peritonitis, rather than peritonitis caused by another problem, such as organ rupture. Once the diagnosis is confirmed, the patient is given a course of antibiotics designed to tackle the infection.

Surgery is usually unnecessary or even particularly helpful in spontaneous infectious peritonitis. The patient may be given anti-inflammatory drugs to manage the swelling and pain associated with peritonitis, and he or she will be closely monitored for any complications. If the condition clears up with antibiotics, an ultrasound imaging study of the liver may be done to determine whether or not the organ has been damaged by the infection. Because people with cirrhosis already have degraded livers, the damage is a serious potential complication of spontaneous infectious peritonitis.

If a patient has ascites, they may be monitored for early signs of SBP. Some physicians recommend antibiotic prophylaxis to prevent infection, and patients who have experienced spontaneous bacterial peritonitis should take antibiotics until the ascites resolves, to prevent recurrence of the prophylaxis. This condition is one of several complications associated with severe cirrhosis and the development of ascites, illustrating the importance of taking care of your liver and addressing liver problems at an early stage.

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