Peritonitis

I have a question about peritonitis. My mom has been recently hospitalized and seems to be doing worse since she entered the hospital. She has been on Pd for 3 years without problems. She is very careful and I am surprised that she developed this. My question is, has anyone suffered with this and been forced to come off of PD? My moms site is leaking and the antibiotics they are giving her do not seem to be working. I thought maybe someone here might be able to shed some light on this topic to me becasue I am worried. Any feedback at all would be helpful. Thanks

You don’t say what she was admitted for in the first place. Is her original reason for admission making her feel worse? Have they done cultures to see if your mother does have an infection and if so what kind of bug is causing it? It’s very important to find this out. They must find out what antibiotic the bug that’s causing her peritonitis is sensitive to since that antibiotic will kill the bug whereas another antibiotic may not have any effect. Infections can cause the peritoneal membrane not to work like it should.

Is your mother’s abdomen swollen and is that why fluid is leaking around her catheter? When your mother drains out the fluid, is more fluid coming off than is going in? What is the doctor telling you and your mother about why the exit site may be leaking? Leaking around the catheter site is not a common problem in PD.

What has happened with her kidney and other labs since she was admitted? If they have gotten worse, what how does her doctor explain that and what does he/she say are options for improving them?

I’m not a doctor, but if your mother is doing worse than she was when she came in, it’s seems possible that toxins are building up in her body and she may need hemodialysis to get rid of them because the infection may be making PD not work as well as it needs to.

My mom was admitted for the peritonitis. She had cultures taken twice and the doctors say that she now needs to take antibiotics oraly as well. I have been asking questions like crazy and seem to be getting knowhere. I have asked the doctors and the Capd nurses what was going on with her leaking and they said it was from the infection. I personally agree with you. I think my mother is filling up with toxins and needs some hemo to clear it up. It just aggrivates me that it takes two days to figure out stuff in the hospital. I knew what was going on right away. I am also mad that her doctors do not make it a point to communicate what is going to happen with the famliy.And as far as options, I presented them to my moms doctor and she said, thats probably what will happen. My mother is not herself and has been on pain killers since she entered the hospital. Should I be more agressive in making sure evryone is doing all they can? I feel like I am in a bad movie and knowone is listening or communicating with each other!!!

I am sorry you mother is facing this issue. I must also say that while she has been on PD for 3 yrs. with no infection is amazing, she has done well. BUT she does have this infection now sadly. I think you need to help advocate for herself, but if she is to sick this will be hard. DO YOU have Power of Attorney? So many Dr.'s, Hospitals now will not talk to anyone because the HIIPAA laws :?: regardless I think you should be more aggressive with her Dr.'s. and at the same time REMIND them who they are there for and why…

Infection is tricky, I think if caught early it can be be eliminated, but as mentioned the STRAIN she has and the anti biotic they are using is most important. The infection can also get INTO the internal tubing making it almost impossible to get rid of. Tunnel infection is also a big concern. I battle peritonitis with my daughter’s cath. for months, months. She had been on PD for 2 yrs. I did Vancomycin everyday for days on end, to have the infection clear and one wk. later it was back, months this went on. Vanco. controlled it but never deleted it completly, even took Gentomycin to no avail. It was steady downward sprial and she was feeling so sick and so tired… finally we chose to try another PD Cath. We did 48 straight hrs. of PD, along with IV anti biotics. Her cath. was pulled and we hoped she could go 7 days without dialysis, she was watched carefully… she made 4 days and her Potassium went up. She had a NEW PD cath replaced the 4th day off and used it that night, she still has this new cath. and it will be almost one yr. now. ONE infection a few months ago. I can tell you once they pulled her cath, gave her the anti biotics and the new cath. was in , one wk. later she was like NEW… thank god. So maybe you could ask your mom how she feels about PD or if she chooses going to hemo. I prefer PD but I did at one point concider the NEW HOME HEMO. Since she has done PD at home, if she has to do hemo maybe HOME HEMO would an option. If she is use to PD then ask her Dr.'s about replacing her Cath, but don’t wait, and make sure they KNOW the strain they are fighting and using the correct anti biotics. If this infection is into the tubing it can be an ongoing battle that you may as well face now. I so feared my daughter loosing her Cath, fear of the UN KNOWN but it turned out ok, bumps along the way but she is so much better now and still on PD.

MY BEST TO YOUR MOTHER & YOU.

Thank you so much for your advice and support. I am glad to hear that your daughter is doing well now too. I do not wish this situation upon anyone. Well, the doctors found out that it was a Staph infection inside her tubing. They removed her Cath yesterday and today put her temp cath in for hemo. I just left the hospital. I am unable to stay with her for her Hemo treatment and she is scared. Its a whole different ball game in hemo and I can tell she is counting the days for a new cath to be put in so she can return to PD. Her Capd nurses have been wonderful and told me that she will have the option to chose which form she wants to stay with. Her infection is almost gone, she is eating and has all her strenght back. But the first hemo treatment ia scary for her. She has to go for 3 1/2 hours 3 times a week. I also just found out that the area we live in does not support home hemo because of the expenses. I am just glad that she is alive and whatever needs to be done for her is done. Again, it is such a comfort to know I am not alone in this and I thank everyone for thier support.

I am so glad to hear that the problem was identified and your mother is feeling better. I hope your mother can get back to PD really soon.

If at some point (way) down the road she needs to do hemodialysis, check the Find a Center database on the Home Dialysis Central home page and look for clinics that offer any kind of home hemodialysis. People contact us to update their listings to add home hemodialysis and new clinics open up all the time. Remember that after training, you only need to go to the clinic once a month so the home training program doesn’t have to be in your neighborhood.

well, its been about three weeks maybe more? and my mom is still in the hospital. turns out she has some kind of blockage in her intestines and she cant keep anything down at all. The doctors actually put a special tube into her nose to try to remove air trapped inside. she has a Gi doctor now and he seems to think the blockage could be caused from her binders. heres the thing, my mom is super clean and careful so I do not think she got this infection from the outside in. Like they thought. I think this underlying problem casued it from the inside out. Unfortunatly my mom has a team of doctors who all say different things. Too many chefs spoil the broth as far as Im concerned. I was just wondering if anyone else here has had simliar problems with their binders As far as irritable bowles and blockages. The doctors seem to think that this is quite common. News to me?

Phosphate binders can and do cause constipation. Another thing you mentioned earlier can cause constipation and that’s pain medication. Is your mother still on pain meds?

Most dialysis patients take stool softeners or stool softeners with laxatives to keep their bowels moving. Dietitians can advise patients about things to do to stay regular. This is especially important for PD patients because constipation can affect how well the fluid flows through the catheter.

I’m not a doctor, but I would have thought that long before 3 weeks had passed they’d have figured out that she had a blockage and figured out what to do to clean her out. What is their plan for fixing this problem? If she’s unable to keep food down, I assume they’re giving her IVs or tube feedings. However, the longer she stays in the hospital, the more debilitated she’s going to get. If the doctors don’t have a good plan, I might about transferring her to a hospital that has more experience treating PD patients with intestinal blockage.

Thank you Beth
Let me tell you, my sister and I were just about ready to transfer her and get a new set of doctors. But we just got a phone call from the specialist who said she has an Ileus, which is when part of the intestines stops working. It is usually caused by an abdominal operation or peritonitus. They have my mom on iv for fluids, she has a nasogastric tube down her nose to stimulate her intestines back into working. We just found out today that her normal doctor is on vacation for 3 weeks. So, my mom is being passed around to his associates. I am relieved they think they got the problem, but annoyed at the fact that common sense did not kick in. I am not a doctor or nurse and I have been saying it was her bowels for months. The doctors thought it to brought on by her binders at first, then they thought it was infection, after 4 cat scans and numerous x rays, they finally got somewhere. My sister and I still think it was unacceptable how long this went on. And, on top of it all, my mothers younger brother died last week of a traumatic brain injury. I think the added stress along with eveything else just made the problem worse. Hopefully, she will be comming home soon!

Be assertive!!! This is YOUR mother and no one will look out for her like you will. Do not worry about being overly concerned…demand attention and answers for her! You must be her advocate and voice!
Cfourhorses

Another problem that can cause peritonitis is constipation. If you have alot of clogging down there, the faeces can travel across the membrane into the dialysis fluid, and cause infection. This could be what caused it.