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What is Ascites?

Tricia Christensen
Updated Mar 03, 2024
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Ascites is the build-up of additional fluid in the abdomen, otherwise called the peritoneal cavity. In mild cases, this extra fluid may not be easily observed, but in more serious cases, the abdomen protrudes greatly, thus providing an easy diagnosis.

This condition is most often caused by cirrhosis of the liver, generally related to alcoholism. The "beer belly" referred to by many may actually be ascites. Heart failure can lead to accumulation of fluid in the abdomen as well as in the ankles, wrists, feet and hands. Tuberculosis, pancreatitis and cancer of the abdomen can also produce it.

The greater the accumulation of fluid, the greater pressure on the diaphragm, which can cause shortness of breath. Most other symptoms associated with ascites relate directly to its underlying causes. For example, a person with this buildup and who also has persistent coughing and fever may be evaluated for tuberculosis. Yellow discoloration of the skin and mucus membranes, or jaundice, indicates liver dysfunction as the cause.

Diagnosis includes determining the presence and the cause of ascites. Physicians usually order several blood tests, among them a complete blood count, which can accurately gauge factors like liver function and blood-clotting ability. Most commonly, physicians perform a paracentesis, in which a small amount of ascitic fluid is removed via needle from the abdomen. Evaluation of this fluid can point to specific causes.

Fluid from ascites is analyzed to evaluate serum-ascites albumen gradient (SAAG). This gradient can either be low or high, and helps to determine the underlying cause of the condition. In general, high SAAG indicates liver dysfunction or heart failure. Low SAAG suggests cancer or tuberculosis.

When patients present with severe ascites, physicians use paracentesis to slowly extract excess fluid from the abdominal cavity. For mild cases, patients are often put on a low sodium diet and prescribed diuretics like furosemide, brand name Lasix.

While the patient undergoes treatment to reduce or slow the build-up of fluid, finding and treating the cause, when possible, is ultimately the best way to reduce ascites. Medical or surgical treatment of underlying heart failure will slowly reduce building fluid when heart failure is the cause. Antibiotics are given to treat tuberculosis. Anti-viral medications can help resolve some forms of hepatitis.

For ascites caused by severe cirrhosis of the liver, the only appropriate treatment may be liver transplant. Obtaining a liver transplant can be difficult for patients who have cirrhosis due to ongoing alcoholism. Unless a patient can successfully stop drinking, transplant units are reluctant to list him or her, because cirrhosis will recur if alcoholic behavior continues.

In general, when the underlying cause of ascites can be determined and treated, outlook is good, and careful monitoring can prevent recurrence. For those whose underlying conditions cannot be addressed, treatment focuses on reduction of any discomfort it causes. Unfortunately, this condition often signifies severe underlying conditions that shorten life expectancy.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Tricia Christensen
By Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.
Discussion Comments
By anon927415 — On Jan 24, 2014

My husband has ascites. He has ESRD, and now has enlarged heart and liver disease. No one seems to know where his comes from and his prognosis is grave. He has been battling it almost a year. He has lost weight and muscle mass, and is very tired. Everyone says, "sorry there is nothing else we can do". No one will give us a time frame.

By anon232270 — On Nov 30, 2011

anon172765: I am personally experiencing ascites. I've been to the ER three times in the last three weeks. Please don't give up. Research online to find your dad's symptoms. White poop? Jaundice? I finally went today and said "I want a liver biopsy." The doc didn't agree, but ordered it anyway.

Doctors aren't perfect, and although well educated, can't know everything. We really must take our health, and health of those that we love into our own hands. Find a good doctor who cares, and tell them what you want done. Then pray. God cares about your dad. Blessings to you!

By anon185262 — On Jun 10, 2011

ascites are very dangerous. Find a good doctor that will not give up on you,and that will not say that "You knew this was coming," and let you die.

By anon172765 — On May 04, 2011

So my dad has ascites by c. of the liver. His tummy looks like he is about to give birth and his legs and feet are the worst. He finally let me take him to the doctor today. They did nothing. said there was nothing for them to do. they just drew blood and took a UA, then gave him some pain killer and sent him out the door! I am so mad. I don't know what to do. Someone please help.

By Planch — On Jul 29, 2010

Ascites one of those things where the treatment can do as much harm as the disease.

Some of the most common ascites treatments, including diuretics and paracentisis, can be risky because of the chance of dehydration in the patient.

That is why it's important for doctors to monitor the patient's condition, and make sure to maintain hydration, particularly in long-term ascites treatment.

By EarlyForest — On Jul 29, 2010

Ovarian cancer and ascites are also related.

In fact, 30% of ovarian cancer patients have ascites when the disease first presents, and more than half have it at the time of death.

Ascites is one of the early signs of ovarian cancer, so women who experience swelling in their abdomen should see a doctor as soon as possible, since catching the cancer earlier gives you a better chance of beating it.

By pleats — On Jul 29, 2010

Another unfortunate cause of ascites is cancer.

Many times liver cancer will cause ascites. When the liver is damaged by cancer, blockage can occur, which can cause a buildup of fluids in the abdomen.

Liver cancer can also compromise the function of the liver, which means that it doesn't produce the proteins as it should.

Since these proteins keep blood from leaking into surrounding tissue, if there are too few of them, blood and fluid tends to leak and pool in different parts of the body; hence, ascites.

By OceanSwimmer — On Jul 16, 2010

My uncle had ascites caused by liver cirrhosis. I had never heard of ascites before then and wasn’t sure what they could do to treat it. The nurses immediately changed his diet to limit his sodium. He was also put on diuretics. They also did what was called paracentesis where they placed a needle into his abdomen to remove fluids.

As of right now, it is under control. We were told that if the above procedures didn’t work, he could be a candidate for a liver transplant. Thank goodness we haven’t had to go that route!

Tricia Christensen
Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia...
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