Ascites Overview
Learn About Ascites
Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.
Portal hypertension - ascites; Cirrhosis - ascites; Liver failure - ascites; Alcohol use - ascites; End-stage liver disease - ascites; ESLD - ascites; Pancreatitis ascites
Ascites often results from high pressure in certain veins of the liver (portal hypertension) and low blood levels of a protein called albumin.
Diseases that can cause severe liver damage can lead to ascites. These include:
- Chronic hepatitis C or B infection
- Alcohol overuse over many years
- Fatty liver disease (metabolic associated steatohepatitis (MASH) previously called non-alcoholic steatohepatitis or NASH)
- Cirrhosis caused by genetic diseases
People with certain cancers in the abdomen may develop ascites. These include cancer of the appendix, colon, ovaries, uterus, pancreas, bile ducts, and liver.
Other conditions that can cause ascites include:
- Clots in certain veins of the liver (portal vein thrombosis)
- Congestive heart failure
- Pancreatitis
- Thickening and scarring of the sac-like covering of the heart (pericarditis)
Kidney dialysis may also be linked to ascites.
Symptoms may develop slowly or suddenly depending on the cause of ascites. You may have no symptoms if there is only a small amount of fluid in the belly.
As more fluid collects, you may have abdominal pain and bloating. Large amounts of fluid can cause shortness of breath. This happens because the fluid pushes up on the diaphragm, which in turn compresses the lower lungs.
Many other symptoms of liver failure may also be present.
The condition that causes ascites will be treated, if possible.
Treatments for fluid build-up may include lifestyle changes:
- Avoiding alcohol
- Lowering salt in your diet (no more than 1,500 mg/day of sodium)
- Limiting fluid intake
You may also get medicines from your doctor, including:
- "Water pills" (diuretics) to get rid of extra fluid
- Antibiotics for infections
Other things you can do to help take care of your liver disease are:
- Get vaccinated for diseases such as influenza, hepatitis A and hepatitis B, and pneumococcal infection
- Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines
Procedures that you may have are:
- Inserting a needle into the belly to remove large volumes of fluid (called an abdominal tap or paracentesis)
- Placing a special tube or shunt inside your liver (TIPS) to repair blood flow to the liver
People with severe liver disease may need a liver transplant.
If you have cirrhosis, avoid taking nonsteroidal anti-inflammatory medicines, such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). Acetaminophen should be taken in reduced doses.
Elliot Professional Services
Lawton Shick is a Hepatologist in Manchester, New Hampshire. Dr. Shick and is rated as an Advanced provider by MediFind in the treatment of Ascites. His top areas of expertise are Esophageal Varices, Visceromegaly, Hepatitis, Colonoscopy, and Endoscopy.
Southern New Hampshire Radiology Consultants PC
Daniel Sheibley is an Interventional Radiologist and a Radiologist in Bedford, New Hampshire. Dr. Sheibley has been practicing medicine for over 16 years and is rated as an Advanced provider by MediFind in the treatment of Ascites. His top areas of expertise are Pleurisy, Boils, Small Cell Lung Cancer (SCLC), Vertebroplasty, and Bone Graft.
Elliot Physicians Network
Manish Chopra is a Geriatrics specialist and an Internal Medicine provider in Manchester, New Hampshire. Dr. Chopra and is rated as an Experienced provider by MediFind in the treatment of Ascites. His top areas of expertise are Familial Hypertension, Alzheimer's Disease, Glucocorticoid-Remediable Aldosteronism, Hypertension, and Colonoscopy.
Complications may include:
- Spontaneous bacterial peritonitis (a life-threatening infection of the ascitic fluid)
- Hepatorenal syndrome (kidney failure)
- Weight loss and protein malnutrition
- Mental confusion, change in the level of alertness, or coma (hepatic encephalopathy)
- Bleeding from the upper or lower gastrointestinal tract
- Build-up of fluid in the space between your lungs and chest cavity (pleural effusion)
- Other complications of liver cirrhosis
If you have ascites, contact your provider right away if you have:
- Fever above 100.5°F (38.05°C), or a fever that does not go away
- Belly pain
- Blood in your stool or black, tarry stools
- Blood in your vomit
- Bruising or bleeding that occurs easily
- Build-up of fluid in your belly
- Swollen legs or ankles
- Breathing problems
- Confusion or problems staying awake
- Yellow color in your skin and the whites of your eyes (jaundice)
Summary: A Phase 2, multi-center, randomized, controlled, open-label study to evaluate the effects of the intraperitoneal, liposomal formulation VS-01 in patients with an acute episode of hepatic and/or extrahepatic organ dysfunctions and failures in the presence of liver cirrhosis (Acute-on-Chronic Liver Failure, ACLF) and accumulation of fluid in the abdominal cavity (ascites)
Summary: Malignant hydrothorax and ascitic fluid in advanced breast cancer often arise from metastasis to the lungs, pleura, or liver. Patients with this condition experience rapid disease progression and multidrug resistance, facing limited treatment options. Clinical guidelines offer various therapies based on molecular subtypes; however, their effectiveness can be hindered by prior treatments, patient h...
Published Date: August 12, 2024
Published By: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.
National Institute of Diabetes and Digestive and Kidney Diseases website. Cirrhosis. www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Updated June 2023. Accessed October 10, 2024.
Sola E, Gines SP. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 93.