Health Encyclopedia

Ascites

Definition

Ascites is excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity).

Causes, incidence, and risk factors

A person with ascites usually has severe liver disease. Ascites is caused by high pressure in the blood vessels of the liver (portal hypertension) and low albumin levels.

Disorders that may be associated with ascites include:

Cirrhosis
Clots in the veins of the liver (portal vein thrombosis)
Congestive heart failure
Constrictive pericarditis
Hepatitis
Liver cancer
Nephrotic syndrome
Ovarian cancer
Pancreatitis
Protein-losing enteropathy

Signs and tests

A physical examination may reveal a swollen abdomen or belly.

Paracentesis may be performed. This procedure involves using a thin needle to pull fluid from the abdomen. The fluid is tested in various ways to determine the cause of ascites.

Treatment

The condition that causes ascites will be treated, if possible.

Treatment may include:

Diuretics, usually spironolactone (Aldactone) and furosemide (Lasix), which help remove the fluid
Antibiotics, if an infection develops
Limiting salt in the diet (no more than 1,500 mg/day of sodium)
Avoiding drinking alcohol

Procedures used for ascites that do not respond to medical treatment include:

Placing a tube into the area to drain the ascites
Transjugular intrahepatic portosystemic shunt (TIPS)

Complications

Spontaneous bacterial peritonitis (a life-threatening infection of the ascites fluid)
Hepatorenal syndrome
Other complications of liver cirrhosis

Calling your health care provider

Anyone who has ascites and develops new abdominal pain and fever should contact their health care provider immediately.

References

Heidelbaugh JJ, Sherbondy M. Cirrhosis and chronic liver failure: part II. Complications and treatment. Am Fam Physician. 2006;74:767-776.

Salerno F, Cammà C, Enea M, Rössle M, Wong F. Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data. Gastroenterology. 2007;133:825-834.

Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.

Review Date:2/21/2009
Reviewed By:George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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