Learn About Spontaneous Bacterial Peritonitis

What is the definition of Spontaneous Bacterial Peritonitis?

The peritoneum is the thin tissue that lines the inner wall of the abdomen and covers most of the organs. Peritonitis is present when this tissue becomes inflamed or infected.

Spontaneous bacterial peritonitis (SBP) is present when this tissue becomes infected and there is no clear cause.

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What are the alternative names for Spontaneous Bacterial Peritonitis?

Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis

What are the causes of Spontaneous Bacterial Peritonitis?

SBP is most often caused by infection in fluid that collects in the peritoneal cavity (ascites). The fluid buildup often occurs with advanced liver or kidney disease.

Risk factors for liver disease include:

  • Very heavy alcohol use
  • Chronic hepatitis B or hepatitis C
  • Other diseases that lead to cirrhosis

SBP also occurs in people who are on peritoneal dialysis for kidney failure.

Peritonitis may have other causes. These include infection from other organs or leakage of enzymes or other toxins into the abdomen.

What are the symptoms of Spontaneous Bacterial Peritonitis?

Symptoms include:

  • Abdominal pain and bloating
  • Abdominal tenderness
  • Fever
  • Low urine output

Other symptoms include:

  • Chills
  • Joint pain
  • Nausea and vomiting
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What are the current treatments for Spontaneous Bacterial Peritonitis?

Treatment depends on the cause of the SBP.

  • Surgery may be needed if SBP is caused by a foreign object, such as a catheter used in peritoneal dialysis.
  • Antibiotics to control infection.
  • Fluids given through the veins.

You will need to stay in the hospital so health care providers can rule out other causes such as a ruptured appendix and diverticulitis.

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What is the outlook (prognosis) for Spontaneous Bacterial Peritonitis?

In most cases, the infection can be treated. However, kidney or liver disease may limit recovery.

What are the possible complications of Spontaneous Bacterial Peritonitis?

Complications may include:

  • Loss of brain function occurs when the liver is unable to remove toxins from the blood.
  • Kidney problem caused by liver failure.
  • Sepsis.
When should I contact a medical professional for Spontaneous Bacterial Peritonitis?

Call your provider if you have symptoms of peritonitis. This can be a medical emergency situation.

How do I prevent Spontaneous Bacterial Peritonitis?

Steps should be taken to prevent infection in people with peritoneal catheters.

Continuous antibiotics may be used:

  • To prevent peritonitis from coming back in people with liver failure
  • To prevent peritonitis in people who have acute gastrointestinal bleeding due to other conditions
Peritoneal sample
What are the latest Spontaneous Bacterial Peritonitis Clinical Trials?
Primary Antibiotic Prophylaxis Using Co-trimoxazole to Prevent Spontaneous Bacterial Peritonitis in Cirrhosis
Summary: A multicentre, interventional, double-blind, placebo-controlled, parallel-arm, phase 3, randomised controlled trial to evaluate the use of co-trimoxazole as primary prophylaxis for spontaneous bacterial peritonitis to improve overall survival
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Clinical Study to Evaluate the Possible Efficacy and Safety of Nitazoxanide in Secondary Prevention of Spontaneous Bacterial Peritonitis in Cirrhotic Patients
Summary: the study is to evaluate the possible efficacy and safety of nitazoxanide as an adjuvant therapy in the secondary prevention of SBP in patient with cirrhosis.
What are the Latest Advances for Spontaneous Bacterial Peritonitis?
Home-based, tunnelled peritoneal drainage system as an alternative treatment option for patients with refractory ascites.
Summary: Home-based, tunnelled peritoneal drainage system as an alternative treatment option for patients with refractory ascites.
Fecal microbiota transplantation in alcohol-associated acute-on-chronic liver failure: an open-label clinical trial.
Summary: Fecal microbiota transplantation in alcohol-associated acute-on-chronic liver failure: an open-label clinical trial.
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Propranolol use in patients with cirrhosis and refractory ascites: A nationwide study.
Summary: Propranolol use in patients with cirrhosis and refractory ascites: A nationwide study.
Who are the sources who wrote this article ?

Published Date: April 02, 2020
Published By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 144.

Kuemmerle JF. Inflammatory and anatomic diseases of the intestine, peritoneum, mesentery, and omentum. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 133.

Sola E, Gines P. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 93.