Ascites

What is ascites?

When fluid builds up inside the abdomen, it is known as ascites. Fluid fills the space between the lining of the abdomen and the organs. If you experience ascites symptoms, talk to your doctor as soon as possible.

What are the causes of ascites?

There are three important causes of ascites:

• Liver disease
• Tuberculosis of the abdomen
• Cancer

Other uncommon conditions that may increase your risk of ascites include:

• Heart or kidney failure
• Pancreatitis
• Hypothyroidism

How does ascites occur in liver disease?

Liver damage leading to cirrhosis is the single biggest risk factor for ascites. Some causes of liver damage include: hepatitis B or C, a history of alcohol use, uncontrolled diabetes and obesity. Liver scarring or cirrhosis causes ascites. Ascites usually occurs when the liver stops working properly. People with cirrhotic ascites have a two-year survival rate of approximately 50 percent. This increases pressure inside the liver’s blood vessels. The increased pressure can force fluid into the abdominal cavity, causing ascites.

What are the symptoms of ascites?

Symptoms of ascites can appear either slowly or suddenly, depending on the cause of the fluid buildup. Symptoms don’t always signal an emergency, but you should talk to your doctor if you experience the following:

• sudden weight gain
• a distended (swollen) abdomen
• difficulty breathing when lying down
• diminished appetite
• abdominal pain
• bloating
• nausea and vomiting
• heartburn

How is ascites diagnosed?

Diagnosing ascites takes multiple steps. Your doctor will first check for swelling in your abdomen. Then they’ll probably use imaging or another testing method to look for fluid, including:

• ultrasound
• CT scan
• MRI
• blood tests
• laparoscopy

What is the treatment for ascites?

Treatment for ascites depends on what’s causing your condition.

• Diuretics: Diuretics are commonly used to treat this condition. They increase the amount of salt and water leaving your body to reduce pressure within the veins around the liver. While you’re on diuretics, your doctor may want to monitor your blood chemistry. You’ll probably need to reduce your alcohol use and salt intake.
• Paracentesis: This procedure uses a thin, long needle to remove the excess fluid. It’s inserted through the skin and into the abdominal cavity. There is risk of infection, so people who undergo paracentesis may be prescribed antibiotics.This treatment is used most commonly when the ascites is severe or recurrent. Diuretics don’t work as well in such late-stage cases.
• Surgery: In extreme cases, a permanent tube called a shunt is implanted in the body. It reroutes blood flow around the liver.Your doctor may recommend liver transplant if ascites does not respond to treatment. This is generally used for end-stage liver disease.

How can ascites be prevented?

Ascites can’t be prevented. However, you can lower your risk by protecting your liver with these healthy habits:

• Drink alcohol in moderation. This can help prevent cirrhosis (scarring of the liver).
• Get vaccinated for hepatitis B.
• If you are overweight, try to reduce weight.
• Control your diabetes.
• Practice safe sex. Hepatitis can be spread sexually.
• Avoid intravenous drug use. Hepatitis can be transmitted through shared needles.
• Be aware of the potential side effects of your medications. If liver damage is a risk, talk to your doctor about whether your liver function should be tested.