Ascites

Symptoms

The hallmark symptom of ascites is abdominal swelling. As the fluid accumulates, the abdomen may appear increasingly distended and feel tight or firm. Other signs and symptoms can include:

• Rapid weight gain
• Shortness of breath due to pressure on the diaphragm
• Loss of appetite
• Nausea and vomiting
• Abdominal pain
• Difficulty breathing when lying down

Diagnosis

Doctors diagnose ascites through a physical examination to assess for abdominal swelling and a fluid wave test. This test involves placing two fingers on one side of the abdomen and gently tapping the other side. If fluid is present, a wave will be felt traveling across the abdomen.

Additional tests may be performed to determine the underlying cause, such as:

• Blood tests: Liver function tests to assess liver health and blood protein levels.
• Ultrasound: To visualize the abdomen and detect the presence and amount of fluid.
• Abdominal paracentesis: A procedure involving inserting a needle into the abdomen to withdraw a fluid sample for analysis.

Treatment

There is no cure for ascites itself, but treatment focuses on managing the underlying condition and reducing the fluid buildup. Common approaches include:

• Diet: A low-sodium diet helps reduce fluid retention.
• Diuretics: Medications that promote urination to remove excess fluid from the body.
• Fluid removal: In severe cases, a procedure called paracentesis may be needed to remove large amounts of fluid from the abdomen.
• Liver transplant: In some cases, a liver transplant may be necessary to address the underlying liver damage.
• Image guided drainage (Click here to read more on Ultrasound/ CT guided drainage of abdominal / visceral fluid collections / ascites)

Complications

Left untreated, ascites can lead to serious complications, such as:

• Spontaneous bacterial peritonitis (SBP): A potentially life-threatening infection of the fluid in the abdomen.
• Hepatorenal syndrome: A condition where the kidneys progressively malfunction due to impaired blood flow from the liver.
• Increased risk of malnutrition: Ascitic fluid can make it difficult to absorb nutrients properly.