Ascites

December 2016


Definition


Ascites is the accumulation of fluid (called effusion) in the abdomen and more specifically in the peritoneal cavity between the two layers of peritoneum (the envelope that lines the abdominal cavity), a space that is normally empty. This collection of fluid is, in the majority of cases (80%), due to cirrhosis (liver disease). More rarely, ascites is caused by cancer of the liver or stomach, liver damage, pancreatitis, advanced cardiac or renal failure.

Symptoms


Ascites is often painless, but increases the volume of the abdomen, bodyweight and abdominal fullness due to fluid accumulation. A patient will also have lower limb edema and pleural effusion (fluid passing between the two layers of the pleura, which covers the lungs).

Diagnosis


The diagnosis of ascites is not easy when manifested in small quantities. The symptoms evoked above are what the doctor must base his diagnosis on. The doctor can also perform an ultrasound or a CT scan. When the ascites reaches 2 liters in volume, it becomes visible and easily identifiable, the stomach being heavily dilated by the liquid. The disease can also be confirmed by a maneuver where the heath professional stimulates the stomach an liver and waits for a rebound stimulus that crosses the liquid. A puncture can also be performed so as to analyze the fluid and assure that it is in fact due to ascites (as opposed to another type of internal puncture).

Treatment


To treat ascites is to treat its causes. It also depends on the possibility to puncture and to drain the liquid. If necessary, a professional will set up an intravenous infusion to compensate for the lack of protein, water, sodium, potassium, calcium ... Bed rest is recommended. If the ascites is due to cirrhosis, a doctor will often prescribe a low salt diet (no more than 2.5 g per day) as well as diuretics (spironolactone). Weight loss should be monitored and should not exceed 500 g per day.

Prevention


To prevent ascites, avoid the risk factors for diseases that cause this accumulation of fluid. To avoid cirrhosis, one must avoid the excessive use of alcohol. Nonsteroidal anti-inflammatory drug consumption (including ibuprofen) should be limited in patients with cirrhosis because they are risk factors for ascites.

Related

Original article published by . Translated by Jeff. Latest update on June 3, 2013 at 01:50 PM by Jeff.
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