Ascites involves accumulation of abnormal amount of fluid within the abdomen. This is considered as a prevalent issue among individuals with cirrhosis of the liver. Most individuals with cirrhosis develop ascites.
In most cases, individuals who have ascites end up with a large-sized belly and experience a rapid increase in weight. Some also develop swelling of the ankles along with shortness of breath.
What are the causes of ascites?
Ascites is basically an outcome of a series of events. Cirrhosis of the liver is the typical cause of ascites. Once cirrhosis develops, blood flow through the liver is blocked. Take note that this blockage causes an increase in the pressure within the main vein that supplies blood from the digestive organs to the liver. This condition is called portal hypertension.
Ascites develops once portal hypertension occurs. The kidney could not eliminate enough sodium from the body via urine. Inability to get rid of the body of salt causes the buildup of fluid in the abdomen, thus resulting to the development of ascites.
The typical risk factors for ascites include diseases that can lead to cirrhosis of the liver such as hepatitis C, hepatitis B and alcoholism or alcohol abuse. Other conditions that can lead to the accumulation of fluid include kidney failure and congestive heart failure. In addition, cancer that affects the organs in the abdomen can also result to ascites.
The condition is diagnosed based on physical examination, blood testing, medical history, ultrasound, CT scan and paracentesis.
Paracentesis is a procedure where a needle is inserted via the abdominal wall and fluid is aspirated. The fluid is checked for any indications of infection, cancer or other health conditions.
- Infection – The buildup of fluid in the gut due to ascites can become infected with bacteria. Once this occurs, the condition is known as spontaneous bacterial peritonitis. This can cause abdominal pain and fever. A diagnosis is made by taking a sample from the abdominal cavity. The condition requires treatment with intravenous antibiotics. After recovery, treatment with long-term oral antibiotics is required to prevent the infection from recurring.
- Abdominal pain, discomfort and difficulty breathing – These can manifest if too much fluid accumulates in the abdominal cavity. In most cases, it can disrupt with the ability of the individual to eat, perform daily activities and walk.
- Fluid in the lungs (hepatic hydrothorax) – The abdominal fluid builds up in the lung (usually on the right side) which results to cough, shortness of breath, hypoxemia and/or chest discomfort. The treatment involves the removal of the abdominal ascites through paracentesis.
- Kidney failure – If cirrhosis of the liver worsens, it can lead to kidney failure.
Ideal treatment options for ascites
It is important to limit the intake of salt in the diet. A vital step to take is to significantly reduce the intake of salt. The recommended limit is 2,000 mg or less in a day. Consulting a dietitian is also ideal since the salt content in food is hard to determine. In addition, salt substitutes (those that do not contain potassium) can be used.
In some cases, diuretics are required in managing ascites. Just make sure that the individual will take these medications as prescribed. The commonly used diuretics include furosemide and/or spironolactone. Remember that these medications can lead to issues with the electrolytes as well as kidney function. Take note that both diuretics and reducing the salt intake are required in effectively managing ascites.