What Is Ascites (Excess Abdominal Fluid)? In Which Cancers Does It Occur and How Is It Treated?

Ascites is the accumulation of fluid in the abdomen. Its medical term is ascites, read as “asit” in Turkish; however, it is not the same as acid in chemistry. Abdominal ascites can occur when the liver does not work properly or when cancer spreads to the abdominal lining. Ascitic fluid fills the space between the organs and the abdominal lining, which can cause swelling and pain.

Ascites is the medical term for fluid accumulation in the abdomen.

It can occur when blood pressure becomes too high in the portal vein, which carries blood from the digestive organs to the liver. This increased pressure reduces kidney and liver function, causing fluid to build up.

It occurs in 80% of people with liver problems or cirrhosis.

Ascites can also develop in cancers that spread to the abdominal lining and in advanced abdominal cancers because of impaired permeability of the abdominal lining’s fluid.

What Are the Symptoms of Ascites?

Excess fluid in the abdomen may cause bloating, making the abdomen feel tight and uncomfortable.

Symptoms of ascites can develop over a few weeks or even days. Although small at first, the swelling may become more severe.

Symptoms of abdominal ascites may include:

• abdominal pain
• bloating
• constipation
• indigestion
• loss of appetite
• frequent urination
• shortness of breath
• extreme fatigue
• back pain

What Causes Ascites?

Cirrhosis is the most common cause of ascites.

Other possible causes include:

• kidney failure
• heart failure
• infection
• pancreatitis (inflammation of the pancreas)
• portal vein thrombosis (blockage of the vein carrying blood from the digestive system to the liver)

Ascites and Belly Fat

Although ascites may resemble belly fat, doctors can distinguish between the two.

Both ascites and fat can shift, but they feel different. A doctor may examine a person’s abdomen while they are lying down and standing. The shape of the abdomen may suggest that it contains fluid rather than fat.

A person with ascites may also have a hard, swollen abdomen. They may experience rapid changes in weight and body shape. These changes occur much faster than a person typically gains body fat (the rate of weight gain).

Is Abdominal Ascites Life-Threatening?

In most cases, ascites itself is not life-threatening. However, its cause may be a more serious condition that can be life-threatening, such as liver failure.

For people with ascites as a complication of cirrhosis, the risk of death at 1 year is around 15%, rising to as much as 44% at 5 years.

If ascites is left untreated, it can cause various problems. For example, an infection may develop in the fluid in the abdomen. This can be dangerous if not properly managed.

How Is Ascites Treated?

There are various treatments for ascites. Your doctor will decide which options best suit a person’s condition.

Sodium Reduction (Salt Removal)

People with abdominal ascites are advised to restrict sodium (salt) in their diet. Patients with this problem should generally aim to consume less than 2000 milligrams of sodium per day.

Diuretics (Water Pills)

Many people with ascites benefit from diuretics, also called water pills. These help remove excess fluid from the body, reducing swelling.

The medicines most commonly used for this purpose are furosemide (Lasix) and spironolactone (Aldactone).

Paracentesis

Paracentesis is a simple procedure performed by a doctor. It involves inserting a needle into the abdomen to remove excess fluid.

If an infection is also suspected, the doctor may take a small fluid sample for testing. However, if a person has substantial swelling, the doctor will drain a larger amount of fluid. Patients with abdominal ascites can even have a paracentesis catheter fitted so that fluid can be drained daily.

How Is Ascites Diagnosed?

Diagnosis depends on how much fluid is present in a person’s abdomen. Doctors can often diagnose ascites through a physical examination. However, ultrasound and computed tomography are the imaging methods that show the amount of ascites quickly and most accurately.

Doctors will examine the fluid for signs of cancer and infection to determine the cause of fluid accumulation.

Summary

Ascites is fluid accumulation in the abdomen. It usually occurs as a complication of liver disease.

Treatment is selected according to the cause of ascites. If a patient’s ascites is caused by infection, antibiotics may treat it.

In people with chronic ascites, paracentesis may improve quality of life.

Symptoms of abdominal ascites include bloating, indigestion, constipation, and shortness of breath. Although it can be treated with medicines and simple procedures, it may recur in people with a chronic condition.