What is Ascites?

 

Ascites is the buildup of fluid in your abdomen. This extra fluid makes your stomach swell. Ascites is a symptom of an underlying condition, such as tuberculosis, kidney disease, pancreatitis, heart failure, cirrhosis, or cancer. Approximately 80% of patients who experience liver cirrhosis develop ascites.

 

What Causes Ascites?

 

Various chronic conditions can cause ascites. Ascites is common in people experiencing cirrhosis of the liver and is often an indicator of liver failure. 

 

Some other common causes may include:

 

  • Portal hypertension (high pressure in your liver’s blood vessels)

  • Cancers in the abdomen

  • Portal vein thrombosis (vein clots occurring in the liver)

  • Congestive heart failure

  • Pancreatitis

  • Kidney dialysis

 

When pressure builds up in your liver’s veins, blood flow in the liver gets blocked. Over time, this prevents your kidneys from removing the excess salt from your body, causing fluid tension and buildup.

 

What are the Symptoms of Ascites?

 

As more fluid accumulates in the stomach, signs, and symptoms of ascites may include:

  • Abdominal pain

  • Jaundice (yellow eyes and skin)

  • Bloating

  • Rapid weight gain

  • Swelling of the ankles

  • Shortness of breath and difficulty breathing

  • Nausea

  • Tiredness

  • Constipation

  • Feeling full

 

Complications of ascites can include:

  • Spontaneous bacterial peritonitis (infection of the ascitic fluid, which can be life-threatening)

  • Hepatorenal syndrome (kidney failure)

  • Weight loss and protein malnutrition

  • Confusion and decreased alertness

How are Ascites Diagnosed?

 

A physical exam can determine the amount of swelling in the stomach. Additional tests can be ordered by your gastroenterologist to assess the health of your kidney and liver, including blood tests, an abdominal fluid sample analysis, or an abdominal ultrasound.

 

Your GI doctor can then withdraw some of the fluid from your belly with a thin needle to determine the cause of ascites. This procedure is called paracentesis.

What is the Treatment for Ascites?

 

Ascites cannot be reversed or cured. However, treatments are available to decrease complications of ascites. When possible, treating the underlying condition that is causing ascites is recommended. 

 

There are also lifestyle changes that can reduce fluid build-up, including:

  • Avoiding alcohol

  • Reducing sodium intake (no more than 1500 mg/day)

  • Reducing the amount of fluid you drink

 

Medication may be available, including diuretics to eliminate extra fluid from your body, and antibiotics to treat any infections.

 

When necessary, surgical procedures are also available. These can include:

  • Inserting a tube into the stomach to drain large amounts of fluid

  • Placing a shunt or tube inside the stomach to repair blood flow to the liver.

  • Liver transplant (if end-stage liver disease is causing ascites. 

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