Ascites

What Is Ascites?

Ascites is the buildup of fluid in your belly, often due to severe liver disease. The extra fluid makes your belly swell. 

Ascites Signs and Symptoms

Ascites is usually accompanied by a feeling of fullness, a ballooning belly, and fast 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. It occurs most often with cirrhosis.

Ascites Causes

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. Over time this keeps your kidneys from removing excess salt from your body. This, in turn, causes fluid to build up.

Ascites Risk Factors

Any disease that causes liver damage or scarring can make you more likely to get ascites. Common risk factors for ascites include: 

  • Viral infections like hepatitis B or hepatitis C
  • Alcohol misuse
  • Cancer in organs in the belly area
  • Kidney failure
  • Congestive heart failure

Ascites Diagnosis

The doctor will give you a physical exam and ask about your symptoms. They may perform a variety of tests, including blood work, an ultrasound, or a CT scan.

If they think you have ascites, the doctor will use a needle to remove fluid from your belly for testing. This procedure is called a paracentesis. It’ll help the doctor find out what’s causing your condition so they can treat it properly.

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

Ascites Treatments

The 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 changes in your diet and prescription diuretics don’t help, 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 belly. When you have this done, you have to follow a low-salt, low-liquid diet, otherwise the fluid will 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 Brunilda Nazario, MD on July 27, 2020

Sources

SOURCES:

Cleveland Clinic: “Ascites.”

Merck Manual Consumer Version: “Ascites.”

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

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

U.S. Department of Veterans Affairs: “Ascites (fluid in the belly).”

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