People with a swollen stomach or abdomen and those suffering from liver cirrhosis, often come across a word at their doctor’s clinic – ascites. A medical term of great significance, ascites is used to describe the buildup of fluid between the abdominal organs and the peritoneal cavity (lining of the abdomen). Usually seen in case of liver disease, it is mainly caused due to the leakage of serous fluid (that surrounds red blood cells) into the body. Here’s everything you should know about ascites – causes, diagnosis, symptoms, treatment and complications.
Improper functioning of the liver puts a pressure in the blood vessels, which compels body fluids to come out in the peritoneal cavity, leading to ascites. Characterized by fluid buildup in the abdomen, ascites can be caused due to a wide range of factors such as –
- High pressure in the blood vessels of the liver (portal hypertension)that cause leakage of fluid into surrounding tissues
- Low levels of albumin protein in the body
- Severe liver damage caused due to hepatitis, long-term alcohol abuse (leading to liver cirrhosis) or clots in the veins of the liver
- Cancer of the liver, uterus, pancreas, colon and ovaries
- Scarring of the tissue covering the heart
- Inflammation of the pancreas
- Kidney dialysis (in some cases) also causes ascites
Here is detailed information on kidney dialysis in India.
The symptoms of ascites develop gradually and depend on the cause of the disease. A person usually reports symptoms when more and more fluid gets accumulated in the abdomen. These include –
- Pain in the abdomen
- Abdominal bloating
- Shortness of breath
- Abdominal swelling
- Weight gain
- Liver failure (in severe cases)
The first step of diagnosis usually involves physical examination to determine the extent of abdominal swelling. It is then followed by various laboratory tests to determine functioning of the different organs in the body. The diagnostic tests involves –
- LFT (liver function test) – AST (Aspartate aminotransferase) and ALT (Alanine aminotransferase), albumin and alkaline phosphatase (ALP). Here are 6 tests to check your liver function.
- RFT (renal/kidney function test) – BUN (blood urea nitrogen) and creatinine
- Electrolyte analysis (sodium, potassium and chloride)
- Urine analysis
- Abdominal ultrasound/ sonography
The goal of the treatment is to drain out the fluid and treat the root of the problem which includes three key strategies namely –
1. Lifestyle modifications: It is mainly aimed at removing excess fluid from the body by inculcating few lifestyle changes such as –
- Limiting excessive intake of alcohol
- Lowering the amount of salt consumption through your diet (eating not more than 1500 mg salt per day)
- Cutting down on fluid intake
2. Medications: Your doctor may prescribe medications depending upon the severity of the condition and susceptibility to various infections. The commonly recommended medicines to treat this condition are –
- Diuretics: Also known as water pills, they aid in removing the excess fluid from the body.
- Antibiotics: Your doctor might recommend antibiotics if you suffer from bacterial infections in addition to ascites.
3. Surgical interventions: In case the condition is not improved by lifestyle changes and use of medications or the person is suffering from severe abdominal pain duet o ascites, your doctor might go for surgery to treat ascites. These treatment options include –
- Paracentesis: It involves insertion of a tube (stent) into the stomach to remove excess fluid.
- Transjugular intrahepatic portosystemic shunt (TIPS): In this approach, a special shunt is paced inside the stomach to improve blood flow to the liver and thus, drain the excess fluid that cause ascites.
- Liver transplantation:People suffering from end-stage liver disease or liver failure require liver transplantation to improve their condition. Read about liver transplants: Frequently Asked Questions answered by a renowned liver transplant surgeon.
If left untreated, ascites may lead to a host of other health complications due to the excess force exerted by fluid build up in the stomach. This in turn causes –
The content has been verified by Dr Mehul Thakkar, pulmonologist, practising in Mumbai.