My patient suffer 6 times peritonitis and culture for E-COLI.because he is DM patient with very slow bowel movement,what can i do to prevent his peritonitis again?

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SUNG FENG SHIN, Nurse from Taiwan asked
My patient suffer 6 times peritonitis and culture for E-COLI.because he is DM patient with very slow bowel movement,what can i do to prevent his peritonitis again?

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You have to look for the underlying cause for such frequent E coli peritonitis, which includes exit site or tunnel tract infection, and colonic pathology. Ba enema or colonosocopy is needed. Diverticulosis is probably the commonest pathology that you may find. There has no strong data for preventive therapy for diverticulosis related peritonitis. Prevention of constipation and straining of bowel is most important. I often try using regular lactulose to soften the feces and maintain regular bowel opening.

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