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Overview of ascites

Ascites is the accumulation of fluid in the abdomen lining called peritoneum. This disease causes the belly to become tender and swollen and maybe a result of cancer that has spread to abdomen or other problems associated with the liver. Ascites may be responsible for dyspnea, lack of appetite, fatigue, and abdominal pain.

Symptoms of ascites

The accumulation of fluid leads to several organs in the abdominal region pressing against each other. This can be very troubling.

The key symptoms are:

  • Abdominal swelling, discomfort
  • Lethargic and difficulty in breathing
  • Loss of appetite and a sense of fullness
  • Abdominal pressure or pain
  • Indigestion
  • Weight gain
  • Fatigue
  • Constipation
  • Nausea
  • Swelling in the ankle

Causes of ascites

There are many causes of ascites with the primary reason being cirrhosis. Many types of cancer are also responsible for ascites and in certain cases maybe the result of a heart failure. In certain rare cases tuberculous peritonitis is also responsible for ascites.

As liver disease is the main cause, ascites in most cases is caused due to heavy and long term use of alcohol. It can also be caused when the liver suffers due to viral hepatitis or jaundice and the use of intravenous drug.

Other causes of ascites include pancreatitic problems and sometimes problems like obesity, hypercholesterolemia, and type 2 diabetes mellitus can progress to cirrhosis, which in turn leads to ascites.

Risk factors for of ascites

The risk for ascites in high among individuals who are heavy drinkers of alcohol or have been consuming alcohol for a very long time. Other factors include hepatitis B, hepatitis C, congestive heart failure, kidney failure, people with bacterial infection, fungal infection and tuberculosis. Human immunodeficiency virus (HIV) and prevalence of cancer also increases chances of ascites.

Diagnosis of of ascites

A doctor would generally start with a physical examination of the patient where the medical history of the patient is careful studied. Cases of fatigue, loss of appetite, nausea, vomiting, pain, loss of stamina, and bloating indicate to ascites. A doctor may also ask for a routine complete blood count (CBC), basic metabolic profile, and liver enzymes to be performed on the patient.

A plain radiograph of the abdomen is an effective way to diagnose ascites and imaging tests like ultrasound or computed tomography can identify as little as 100 ml of free fluid.

Paracentesis, a form of body fluid sampling procedure in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid, is also another method to diagnose the disease. Nowadays the serum-ascites albumin gradient (SAAG), a system of calculation used in medicine is very helpful in determining the cause of ascites and hence helping in correct diagnosis.

Treatment of ascites

Cleveland Clinic recommends limiting the amount of salt in ones diet. Recommending a drastic reduction in salt intake it says salt should be limited to 2,000 mg or less a day. Patients can also take a class of drugs called aquaretics that stimulates the excretion of electrolyte-free water and helps people suffering from ascites.

Paracentesis, which is also a method of diagnosis can also, be a good method for treatment. This method can help get rid of the excess fluid and several liters can be removed from the body this way. However, when the amount of fluid to be drained is substantially, it may needed to be done over several sessions.

A radiological and invasive method called transjugular intrahepatic portosystemic shunt (TIPS) that aims to place a shunt (tube) between the main vein (portal vein) and smaller veins is often considered very useful in cases which do not show result to aquaretics. In cases where ascites is caused due to cancer, the treatment may include chemotherapy and surgery to get rid of the cancerous cells.

Prevention of ascites

To prevent ascites it is very important to maintain a healthy life style. One should also limit the amount of alcohol consumed. One should also take care in popping nonsteroidal anti-inflammatory drugs like ibuprofen, aspirin and indomethacin. These drugs affect the kidneys, causing water and salt to be retained by the body. Finally one should cut down on the intake of salt as much as possible and recommended limits are 2,000 mg or less a day.

Written by: healthplus24.com team

Date last updated: December 11, 2014

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