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Ascites

Definition

Ascites is the accumulation of excess fluid in the abdominal cavity.
Ascites
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Causes

Ascites can be caused by:

Risk Factors

Factors that may increase your chance of ascites include having any of the conditions above.

Symptoms

Symptoms may include:

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests to determine cause may include:
Imaging tests look for amount and distribution of fluid, and strctures inside abdomen. These may include:

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Dietary Changes

  • Sodium restriction—Limiting salt intake to 2,000 mg per day or less is often recommended to reduce or delay fluid build-up. More extreme restrictions in salt intake do not further improve outcomes.
  • Fluid restriction—if sodium level is too low.
  • Alcohol restriction—Ascites commonly occurs in people who have liver disease. Consuming excess alcohol can further impair liver function. Stopping alcohol use may limit the progression of ascites.

Diuretics

Diuretic medications are drugs that cause the kidneys to excrete more sodium and water in the urine. These medications are often recommended as the treatment of choice for ascites, along with sodium restriction.

Paracentesis

Ascites can be treated by inserting a hollow needle into the abdomen and removing excess fluid through the needle.

Surgery

If the other treatments are not effective and the ascites keep coming back, surgery can be done to divert blood away from the liver. If this is not successful, a liver transplant may be necessary.

Prevention

To help reduce the chance of ascites:

RESOURCES

American Liver Foundation http://www.liverfoundation.org

National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Liver Foundation http://www.liver.ca

Health Canada http://www.hc-sc.gc.ca

References

Alcohol-induced liver disease. Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/alcohol. Updated October 4, 2011. Accessed June 25, 2013.

Ascites. DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 13, 2014. Accessed June 16, 2014.

Cirrhosis. National Digestive Diseases Information Clearinghouse website. Available at: http://www.niddk.nih.gov/health-information/health-topics/liver-disease/cirrhosis/Pages/facts.aspx. Updated February 21, 2013. Accessed June 25, 2013.

Runyon BA. Care of patients with ascites. N Engl J Med. 1994;330(5):337-342.

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