Conditions we treat
Ascites: Causes, Symptoms and Treatment
Ascites is the accumulation of excess fluid in the abdominal cavity. It is not a disease in itself but a manifestation of another underlying condition, most commonly advanced liver failure. This page explains what causes ascites, the symptoms it produces as fluid builds up, how it is diagnosed and how it is treated. The gastroenterology teams at GastroPlus Digestive Disease Centre assess and manage ascites at our hospitals in Ahmedabad — Vastrapur, Nikol, Bapunagar and Bopal.
What ascites is
Ascites is a condition in which excess fluid accumulates in the abdominal cavity. It is a manifestation of another underlying disease rather than a disease on its own, so assessment always looks for the cause as well as the fluid.
The most common cause is advanced liver failure. Ascites may also occur in tuberculosis, heart failure, kidney failure, cancer and other rare medical conditions.
Symptoms of ascites
In the early stage, when only a small amount of fluid is present, there are hardly any symptoms apart from those of the underlying disease.
As more fluid accumulates, the abdomen begins to swell. This may be accompanied by loss of appetite, a feeling of fullness after eating, or abdominal pain, tightness or heaviness. It may also cause low back pain, changes in bowel function, weight gain and fatigue.
Swelling (oedema) of the legs may appear through the day as gravity pulls fluid downward. In extreme cases the fluid may extend up into the chest cavity (pleural effusion) and cause difficulty breathing.
How ascites is treated
The mainstay of treatment for ascites is treatment of the underlying cause. Where the ascites is due to advanced liver failure or cirrhosis of the liver, patients must stop all alcohol consumption as well as any drugs that damage the liver.
Alongside this, several options are used in various combinations to reduce fluid accumulation:
- Restricting sodium (salt) intake.
- Diuretic therapy (water pills) to help the body excrete extra sodium and water.
- For those not responding to the above treatment, large-volume therapeutic paracentesis — using a local anaesthetic to insert a needle through the abdominal wall — may be used.
- Close monitoring by your physician during all of the above treatments, to track body weight, kidney function and the levels of sodium and potassium in the blood.
Frequently asked
How is ascites diagnosed?
In many cases ascites is detected incidentally, when an ultrasound or CT scan is done for another reason. Based on symptoms such as fullness in the abdomen, and after a clinical examination, your physician may order an ultrasound or CT scan to diagnose ascites.
What is the treatment for ascites?
The mainstay of treatment is treating the underlying cause. Where the ascites is due to advanced liver failure or cirrhosis of the liver, patients must stop all alcohol consumption as well as any drugs that damage the liver. To reduce the fluid itself, several options are used in various combinations: restricting sodium (salt) intake, diuretic therapy (water pills) to excrete extra sodium and water and, for those not responding to these, large-volume therapeutic paracentesis, in which a needle is inserted through the abdominal wall under local anaesthetic. Throughout treatment your physician monitors body weight, kidney function and the levels of sodium and potassium in the blood.
Does anything happen if there is fluid but I have no other symptoms?
Your physician may perform a diagnostic abdominal paracentesis to draw out a small amount of fluid to be used in laboratory tests that may help find, or confirm, the source of the ascites. Depending on the results, these tests may point to liver or heart failure, infection or cancer, bacterial infection, tuberculosis or, in rare cases, pancreatic disease. Where there is an infection, the laboratory results are also used to determine the most appropriate antibiotic for treatment.
Are there other complications?
The symptoms of ascites can be very distressing and interfere with your quality of life. The condition may also put you at risk of infection and kidney disease.
Is ascites a serious condition?
The accumulated fluid is not itself life-threatening, but it is an indicator of advanced liver disease or of other serious, potentially life-threatening underlying conditions.
Where to go next
Need expert digestive or liver care?
Book a consultation with a GastroPlus specialist — same-day appointments available.