What Is Ascites? | Gastroenterology


Overview of ascites

Ascites is the formation of an abnormal amount of fluid inside the abdomen (belly). This is a common problem in patients with cirrhosis (scarring) of the liver. Approximately 80% of patients with liver cirrhosis develop ascites. Ascites means the formation of fluid in the stomach, often due to severe liver disease.

The medical definition of peritoneal Abnormal accumulation of fluid in the cavity. It is caused by a variety of diseases and conditions, for example, cirrhosis of the liver, cancer in the abdomen, circulatory failure, and tuberculosis.

What are ascites symptoms?

It is often accompanied by fullness, swelling of the belly, and rapid weight gain. Other symptoms are usually:

  • Difficulty breathing
  • Nausea
  • Swelling of the legs and ankles.
  • Indigestion
  • Vomiting
  • Acidity
  • Lack of appetite
  • Fever
  • Hernia

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

What are the causes of ascites?

It is most often caused by scarring of the liver, also known as cirrhosis. The spots increase pressure within the blood vessels of the liver. The increased pressure forces the fluid into the abdominal cavity, resulting in the formation of ascites.

Ascites risk factors

Liver damage is the biggest risk factor. Some causes of liver damage are:

  • Cirrhosis
  • Hepatitis B
  • History of alcoholism

Other conditions that can increase your risk of escalation:

  • Cancer of the ovary, pancreas, liver or endometrium
  • Heart or kidney failure
  • Pancreatitis
  • Tuberculosis
  • Hypothyroidism

Diagnosis of ascites

Diagnosis takes multiple steps. Your doctor will first check for swelling in your abdomen.

They then use imaging or another testing method for the liquid. The tests you may receive include:

  • Ultrasound
  • Computed tomography
  • Magnetic resonance
  • Blood test
  • Laparoscopy
  • Angiography

Your doctor will use a needle to draw fluid from your abdomen and test it. This process is called paracentesis. This will help your doctor find out what is causing your condition so they can treat it properly. Your doctor will refer you to a liver specialist, who can discuss a liver transplant.

Treatments options for Ascites

Your doctor may prescribe “water pills,” also known as diuretics, to help remove excess fluid from your body.

Two of the most common urinations:

  • Furosemide (LASIX)
  • Spironolactone (Aldactone)

They both help your kidneys excrete more sodium and water.

If changes to your diet and prescribed urination don’t help, or if your symptoms are severe, your doctor may need to use paracentesis to remove large amounts of excess fluid through a needle inserted into your stomach. When you are done with this, you should follow a low diet of salt and fluids, otherwise, the liquid will come back.

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


In severe cases, a permanent tube called a shunt is implanted in the body. Divert blood flow around the liver. Your doctor may recommend a liver transplant if the ascites does not respond to treatment. It is commonly used for end-stage liver disease.

Complications of ascites

Complications associated with this disease include:

  • Abdominal pain
  • Pleural effusion, or “water on the lung”; can lead to difficulty breathing.
  • Hernias, such as inguinal hernias.
  • Bacterial infections, such as spontaneous bacterial peritonitis.
  • Hepatorenal syndrome.

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