What Are Ascites and Paracentesis?

Maybe you don’t think too much about that expanding waistline -- other than knowing you should lose a few pounds. Your doctor may have urged you to cut down on alcohol and eat fewer goodies.

But there could be more to it.

You may want to talk to your doctor about ascites, a condition caused by severe liver disease. It causes excess fluid to build up in your abdomen, making your belly swell and protrude.


Ascites is usually accompanied by a feeling of fullness, a ballooning belly, and rapid weight gain. Other symptoms often include:

If you have a combination of these symptoms, see your doctor. If you have ascites, it’s often a sign of liver failure and occurs most often with cirrhosis.


Ascites happens when pressure builds up in the veins of your liver and it doesn’t work as it should. These two problems usually are caused by another condition -- cirrhosis, heart or kidney failure, cancer, or an infection.

The pressure blocks blood flow in the liver, which over time keeps your kidneys from removing excess salt from your body. This, in turn, causes fluid to build up.


Your doctor will give you a physical exam and will want to know more about your symptoms. He may perform a variety of tests, including blood work, an ultrasound, or a CT scan.

If he thinks you have ascites, your doctor will use a needle to remove fluid from your abdomen for testing. This procedure is called a paracentesis. It will help your doctor determine the cause of your condition, so it can be properly treated.

In most cases of ascites, your doctor will refer you to a liver specialist, who may discuss a liver transplant.


Your doctor may prescribe “water pills,” also called diuretics, to help flush the extra fluid from your body.

Two of the most common diuretics are:

They both help your kidneys remove more sodium and water.

If change in diet and prescription diuretics aren’t effective, or your symptoms are severe, your doctor may have to use paracentesis to remove large amounts of excess fluid through a needle inserted into your abdomen. This procedure must be combined with a low-salt, low-liquid diet, otherwise the fluid will simply come back.

If these treatments don’t work, you may need a surgery to place a shunt in your liver or replace it altogether.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on November 25, 2018



Cleveland Clinic: “Diseases & Conditions – Ascites.”

Merk Manual Consumer Version: “Ascites.”

University of Rochester Medical Center: “Health Encyclopedia – Ascites.”

American College of Gastroenterology: “Ascites: A Common Problem in People with Cirrhosis.”


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