Ascites as a complication of cirrhosis

Fluid buildup in the abdominal cavity (ascites) is the most common major complication of cirrhosis. People who have alcoholic cirrhosis may develop ascites early in the course of liver disease. Those who have other forms of cirrhosis, such as that caused by viral hepatitis, may develop ascites much later. The factors that cause fluid to accumulate in the abdomen are complex, but high blood pressure in the portal vein system of the liver (portal hypertension) is an important contributor to its development.

Treatment for ascites depends on the cause. Paracentesis is a procedure used to collect and remove some of the fluid to help determine what is causing it to build up. Having ascites may lead to:

• Extreme discomfort, including abdominal pain and difficulty breathing.
• Infection of the ascitic fluid (spontaneous bacterial peritonitis).
• Increased fluid accumulation in the chest cavity (pleural effusion).
• Abdominal wall hernias, especially umbilical hernias. An umbilical hernia occurs when tissue from the inside the abdomen bulges out through a weak spot in the navel.

About 50% of people who have ascites caused by cirrhosis die within 2 years.¹ However, 90% of people with ascites caused by cirrhosis respond to treatment with a low-salt diet and medications (diuretics) that eliminate extra fluid from the body.¹

Citations

1. Runyon BA (2006). Ascites and spontaneous bacterial peritonitis. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 2, pp. 1935–1964. Philadelphia: W.B. Saunders.