Prevention of Ascites

Prevention of Ascites

Strict compliance with diet and diuretics along with regular follow-up is necessary to control progression of ascites. Knowledge about ascites and its complications helps the patient to cope better.

Regular follow up plays a very important role because noncompliance with diet and diuretics could lead to further worsening of the condition.

Counselling regarding compliance with treatment, abstinence from alcohol following a diet chart and educating the patient and caregiver about complications can help in reducing hospitalization of the patient.

Patient log of body weight, dose of diuretic pills, blood tests and frequency of abdominal tapping should be maintained meticulously.

Patients with cirrhosis-

• Should not self medicate with NSAIDs ( OTC painkillers)
• Should inform their treating physician about their condition before planning for any surgical procedure.
• Should keep track of their hospitalizations
• Should be screened for liver cancer by having an ultrasound examination and a blood test for AFP (Alpha Feto Protein) every six months.
• Should be vaccinated for Hepatitis A and B and the influenza virus ( with the Inactivated form of the vaccine).
• Should have an upper GI endoscopy (gastroscopy) to check for varices (enlarged blood vessels at the base of the foodpipe).

• Should report to the physician immediately if they notice black coloured stools, if they vomit blood, if they are confused or disoriented, or if they suddenly develop abdominal pain, fever or jaundice.

References:

1. Guarner C, Runyon BA. Ascites. In: McNally PR,eds GI/Liver Secrets Plus, 4^th edition, New Delhi: Elsevier, 2011:217.
2. Runyon BA, Ascites and Spontaneous Bacterial Peritonitis. In: Schiff ER, Madddrey WC, Sorrell MF eds Schiff�s Diseases of the Liver, 11^th edition, New Delhi: Wiley-Blackwell,2012:393
3. Volk ML, Fisher N, Fontana RJ. Patient Knowledge About Disease Self-Management in Cirrhosis The Am J of Gastroenterol 2013 ; 108: 302-305.

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