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Ascites: Symptoms, Causes & Treatment

Ascites: Symptoms, Causes & Treatment

Ascites

What is Ascites?

Ascites is the medical name for abnormal accumulation of fluid in the abdominal cavity. This fluid occupies the space surrounding the lining of the abdomen and its organs like the kidneys, stomach, bowels and spleen (x). This fluid buildup results in abdominal swelling that advances over a few weeks, but can also develop in a few days.

Why Do People Get Ascites?

When people suffer from a severe liver disease, ascites and liver damage often occur. Some of the causes of liver damage include cirrhosis, hepatitis B or C and alcohol abuse. The main cause of ascites is, in fact, liver cirrhosis. Once it occurs, cirrhosis causes a blockage of blood circulation through the liver. This blockage causes portal hypertension — an increase in pressure in the portal vein that transports blood from the gut to the liver. Once this pressure builds up, it makes it hard for kidneys to get rid of excess salt from the body, which in turn results in fluid buildup in the abdomen, causing ascites (x).

Symptoms and Side Effects of Ascites

Symptoms of ascites may manifest slowly or immediately, depending on the underlying cause of the fluid accumulation. Ascites can cause a lot of discomfort as a result of a distended abdomen. Individuals suffering from ascites may experience symptoms such as nausea (x), heartburn (x), indigestion (x) and loss of appetite (x).

The pressure exerted on organs located on the abdominal area can also cause a swollen stomach, fatigue, bloating, breathlessness and the need to pass urine often. Other symptoms also include swelling of the lower legs and ankles, rapid weight gain and hemorrhoids (x).

Types of Ascites

Ascites is split into two types based on the quantity of protein contained in the fluid. Another system used in the classification is based on the quantity of albumin found in the ascetic fluid compared to the amount of serum albumin (x, x). The two types of ascites are:

  • Transudative ascites – causes include hepatic cirrhosis, alcoholic hepatitis, heart failure and hepatic failure
  • Exudative ascites – causes include peritoneal carcinomatosis, peritonitis and inflammation of the pancreas or biliary system

Dangers Associated with Ascites

Ascites can cause a number of health issues. For example, it is not uncommon if bleeding from the lower intestine occurs (x). Kidney failure has also been observed, as have malnutrition and malignancy (x, x, x).

Diagnosing Ascites

A doctor can diagnose ascites by performing a physical exam or questioning a patient about their symptoms. The doctor may do some tests to examine the abdomen including:

  • Ultrasound. This is when a doctor uses sound waves to create a picture showing the inside of the abdomen (x).
  • X-rays. These are important diagnostic imaging tools that help examine the accumulation of fluid in the lungs (x).
  • Computerized Tomography scan, known as a CT scan. This produces a 3-dimensional photo of the internal body organs using X-rays (x).
  • MRI scans. Radiologists apply Magnetic Resonate Imaging when ultrasounds fail to reveal the cause of ascites (x).
  • Blood tests. Doctors carry out these tests to evaluate the functioning of kidneys and liver (x).

Causes of Ascites

Cirrhosis

Medical science has found that the most regular cause of ascites is
advanced liver disease. An impairment of the liver tissue is replaced by fibrosis or scar tissue. The scar tissue is formed as the liver tries to restore itself when it’s injured. Doctors consider this to be cirrhosis, which then leads to dysfunction of the liver, scarring of the liver, bleeding and accumulation of fluid in the abdomen (x). Cirrhosis has no severe symptoms, but ascites can occur once the disorder has advanced. One of the most common complications of cirrhosis is ascites.

Hepatitis B or C

People usually contract hepatitis B and C through unprotected sex. It is also possible to get it through contact with infected blood. A person infected with hepatitis B can develop severe damage to the liver. They then develop liver inflammation, which may cause cirrhosis or interfere with blood flow through the organ. An estimated 350 million people live with hepatitis B while approximately 3.9 million Americans currently live with hepatitis C. Doctors treat these two diseases with antiviral drug therapies (x).

Alcohol Abuse

Drinking high quantities of alcohol is one of the most common causes of ascites. Too much alcohol can result in alcohol-related liver disease. It makes the liver become sensitive and swollen. Alcohol abuse results in alcohol hepatitis, or inflammation of the liver. Some symptoms of alcohol-related liver disease include nausea, fatigue, swollen legs, jaundice and weight loss. Once inflammation occurs, there is a likelihood that the liver will not carry out its normal function such as getting rid of toxins from the body. Blood purification will also not take place as it should. This then interferes with normal waste excretion from the body, which in turn will cause ascites (x, x).

Other Causes

Pericarditis

Refers to the chronic inflammation of the membrane that surrounds the heart, the pericardium. The pericardium loses its elasticity over time and becomes rigid. If not treated, it can be life-threatening. A rigid pericardium can cause symptoms of heart complication such as heart failure. Constrictive pericarditis is a cause of recurrent ascites and refractory ascites (x).

Ovarian Cancer

Women with advanced ovarian cancer are likely to have ascites. One of the reasons why fluid can develop in their abdomen is because once the cancer cells advance to the abdominal wall, they can cause irritation or inflammation, causing fluid buildup (x, x).

Liver Cancer

People with liver cancer can develop ascites for a number of reasons. The cancer cells may spread to the thin membrane that envelops the inner wall of the peritoneum, and then irritate this membrane. Liver cancer also causes the liver to manufacture less albumin, which may interfere with the body’s fluid balance.

Pancreatic Cancer

This type of cancer can cause fluid to build up in the tummy area. Due to abnormal behavior from cells, lumps or tumors can form, which can travel through the bloodstream into the lymphatic system and other parts of the body.

Tumors

These can also cause ascites by blocking the lymphatic system, which then interferes with the normal flow of the lymphatic fluid. The fluid subsequently collects in the abdominal organs (x).

Ascites mostly develops with uterine, cervical, ovarian, gastric, pancreatic or any cancer that spreads to the liver.

Ascites Symptoms

Ascites Remedies and Supplements

Coconut Water

Coconut water is rich in potassium and several other electrolytes that are necessary for the body to stay adequately hydrated (x). The water is ideal for relaxing the liver, which reduces the swelling while also purifying the blood. Coconut water also helps to control body temperature and encourages frequent urination. It is best to mix 1 tbsp of coconut powder into water, smoothies and drinks.

Dandelion Root

Consumption of dandelion root notably raises the urinary frequency and quantity in less than five hours of the initial dosage (x). People take dandelion root as an herbal diuretic packed with vitamins A, C and K, as well as potassium. Dandelion root even helps in the treatment of liver inflammation and congestion (x). Moreover, patients can consume dandelion tea or add dandelion stems to their salad.

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boils

The suggested serving size for Dandelion root is 1,000 mg (rounded 1/3 tsp) twice daily, or as otherwise directed by a physician.

Avoid Salt and Eat Organic Foods

People experiencing ascites should not eat foods with a high sodium content. High amounts of sodium lead to fluid accretion (x). Instead, eat organic foods such as fruit, vegetables, millet, poultry, seafood and red meat.

Other Remedies and Supplements

  • Garlic: It’s one of the best home remedies for treating ascites. It also reduces blood pressure (x).
  • Onion. It has diuretic properties that can help get rid of toxic fluid that builds up in the abdomen. It increases the frequency of urination (x).

How to Treat Ascites

Treatment for ascites varies depending on the cause of the condition. Some treatment methods include:

Diuretics

Also known as ‘water pills,’ patients commonly use diuretics to treat ascites, especially if they fail to respond to sodium restrictions. Diuretics help minimize the pressure around the liver or inside the veins. During this form of ascites treatment, patients should minimize their alcohol and salt intake (x).

Paracentesis

This involves the draining of fluids using a needle. Doctors then analyze the fluid to find the cause of ascites. It is an effective ascites management method in cases where there is a large amount of fluid. The fluid can be between 5 liters and 10 liters. Doctors will perform a paracentesis mainly to relieve the pressure within the abdominal organs so the patient can feel little or no discomfort (x).

Shunts

Doctors will perform this surgery for patients with extreme cases of ascites. It involves the insertion and implanting of a tube (shunt) in the body. The purpose of the shunt is to redirect the blood flow within the liver. Good flow of blood within the body ensures that organs can reach their optimal level of functionality. It improves kidney function, which then helps to get rid of excess salt from the body and stops the buildup of fluid. Doctors can also place the tube through the liver to relieve portal hypertension (x, x).

Liver Transplant

Doctors mainly reserve this approach for patients whose livers are failing from severe cirrhosis. Though uncommon, some patients often experience persistent ascites after the transplant (x, x).

Preventing Ascites

Though you cannot prevent ascites, you can lower the risks by practicing healthy living habits that protect the liver.

  • Get hepatitis B and C vaccinations.
  • Moderate alcohol consumption. This protects against cirrhosis.
  • Medications may have side effects that cause and affect symptoms. Be wary of potential side effects that may result from them.
  • You must desist from intravenous drug use.
  • Always practice safe sex.

The Bottom Line

Ascites is a condition that results from different health-related complications. You can treat or even avoid these complications to prevent ascites althogether. However, if you already have ascites, you can follow several options to prevent it from getting worse and to treat it. Be sure to visit a doctor if you believe you may be suffering from ascites.

 
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