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Ascites

Written by Dr. Vidya Viswanath, M.B.B.S, M.D. | Medically Reviewed by dr. simi paknikar, MD on Sep 15, 2020
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Ascites is fluid collection in the peritoneum usually as a consequence of liver damage commonly seen in cirrhosis. Cancers and tuberculosis can also cause Ascites due to peritoneal spread of the disease.

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Ascites (pronounced a-sigh –tees) means fluid collection in the belly or abdomen. It is derived from the Greek word ‘askos’ which means sack or bag. The patient shows the presence of a huge and tense abdomen. He may suffer from other problems like breathlessness as well.

Ascites

The most common cause of Ascites is a liver condition called cirrhosis. When the liver is damaged due to any cause, it tries to adapt till the insult to the liver reaches a stage where the destruction to the liver tissue is irreversible. The liver becomes lumpy and is filled with scar tissue. Over time, the liver becomes a nodular, shrunken mass which loses its function and is called a cirrhotic liver.

Blood is carried from the digestive tract to the liver via the portal vein. This flow is hampered in cirrhosis, as a result of which a condition called portal hypertension occurs.

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In certain cancers and in tuberculosis, ascitic fluid is present in the abdominal cavity as a result of involvement of the peritoneum or the lining of the abdomen by the disease process. The liver can be normal in these situations.

Complications of Ascites include infection, kidney failure, hepatic encephalopathy, hernias and pleural effusion.

Ascites kidney failure

Ascites is treated depending on the underlying cause. A low-salt diet and diuretics are recommended in patients with cirrhosis. Tapping of the excess fluid is carried out while taking adequate precautions to prevent any complications. Some patients require liver transplantation. Patients with cancer may require chemotherapy, radiotherapy or surgery.

References:

  1. Guarner C, Runyon BA. Ascites. In: McNally PR,eds GI/Liver Secrets Plus, 4th 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, 11th 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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Dr. Deshmukh Parag
Dr. Deshmukh Parag
MBBS, MD, DNB, IDCCM, CCEBDM
5 years experience
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Dr. Pankaj Kumar
MBBS, MD, DM Gastroenterology
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