What is ascites?

Ascites is a buildup of fluid in your lower abdomen. The fluid causes swelling. Ascites can signal a more serious problem in your body.

What causes ascites?

• Liver disease, such as cirrhosis or hepatitis
• Cancer
• Congestive heart failure
• Blood clots in the veins that enter and leave the liver

What are the signs and symptoms of ascites?

• Rapid weight gain and swelling
• Swollen abdomen
• Shortness of breath
• Nausea
• A feeling of fullness after eating little food
• Stretch marks and bulging veins on the abdomen

How is ascites diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Tell him or her about your medical history and any medicines you take. He or she may ask about alcohol use, drug use, sexual activity, or blood transfusions you may have had. You may need any of the following:

• Blood and urine tests may show infection, kidney function, or provide information about your overall health.
• An ultrasound or CT may show the fluid in your abdomen. You may be given contrast liquid to help your organs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
• A paracentesis is a procedure used to take a sample of fluid from your abdomen. The fluid is tested for the cause of your ascites and to check for infection.
• A 24-hour urine collection may be ordered by your healthcare provider. You will use a container to hold all of your urine collected over 24 hours. The urine must be kept cold until it is tested. Ask your healthcare provider for more information about this test.
• Other tests to find the cause of your ascites may be needed. Tests such as endoscopy, biopsy, or laparoscopy of your lower esophagus or liver may be used. These tests help healthcare providers plan the best treatment for your ascites.

How is ascites treated?

Ascites treatment usually combines medicines with changes to your nutrition. You may need any of the following:

• Medicines help decrease the fluid in your abdomen, prevent or fight an infection, or prevent more damage to your liver.
• Limit the amount of sodium (salt) and liquid in your diet. This will help decrease the fluid in your abdomen. Ask your healthcare provider or dietitian for more information.
• Procedures:
  • A paracentesis is a procedure used to drain the extra fluid from your abdomen through a needle. You may need more than one paracentesis.
  • Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to treat large ascites when you cannot have paracentesis. Your healthcare provider uses a catheter (plastic tube) to increase blood flow through your liver. This helps to reduce the fluid in your abdomen.
  • A peritoneovenous shunt is a procedure used to drain the extra fluid into a large vein to be absorbed by the body. The shunt is a tube placed in your abdomen and connected to the vein.
  • Liver transplant may be needed if your liver damage is severe.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

• furosemide
• Lasix
• Bumex
• Aldactazide
• Demadex

View more treatment options

How do I manage my symptoms?

• Do not drink alcohol or take medicines that contain alcohol. Alcohol worsens the damage to your liver. Your symptoms may improve after you stop drinking. Ask your healthcare provider for information if you need help to quit drinking alcohol.
• Follow your low-sodium plan. A dietitian can help you create a low-sodium diet. He or she may suggest lemon juice or herbs to flavor your food. Avoid salted butter or margarine, milk, cheese, and canned or frozen foods. Ask about salt substitutes.
• Weigh yourself each day in the morning. Keep a record of your weights. Take this record to your follow-up visits.
• Limit activity as directed. You may need to limit your usual daily activities until your symptoms have resolved. Ask your provider if you have any limits to your activity.
• Ask about NSAIDs, such as aspirin and ibuprofen. NSAIDs may not be safe if you have trouble urinating. Ask your healthcare provider if NSAIDs are safe for you. These medicines can cause stomach bleeding or kidney problems if they are not taken correctly.

Call your local emergency number (911 in the US) if:

• You have trouble breathing.
• You feel confused, faint, or lose consciousness.
• You vomit blood or see blood in your bowel movement.

When should I call my doctor?

• You feel pain in your abdomen.
• You have a fever.
• You are losing more or less weight than expected.
• You are urinating less than usual.
• You feel dizzy or lightheaded.
• You develop tiredness, dry mouth, nausea, or vomiting.
• You have muscle cramps or twitches.
• You have questions or concerns about your condition or care.

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