Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.
Portal hypertension - ascites
Ascites results from high pressure in the blood vessels of the liver (portal hypertension) and low levels of a protein called albumin.
Diseases that can cause severe liver damage can lead to ascites. These include long-term hepatitis C or B infection and alcohol abuse over many years.
People with certain cancers in the abdomen may develop ascites. These include cancer of the colon, ovaries, uterus, pancreas, and liver.
Other conditions that can cause this problem include:
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.
Many other symptoms of liver failure may also be present.
Exams and Tests
Your doctor will do a physical exam to determine the amount of swelling in your belly.
You may also have the following tests to assess your liver and kidneys:
Your doctor may also use a thin needle to withdraw ascites fluid from your belly. The fluid is tested to look for the cause of ascites.
The condition that causes ascites will be treated, if possible.
Treatments for fluid build-up may include lifestyle changes:
You may also get medicines from your doctor including:
Procedures that you may have are:
People with end-stage liver disease may need a liver transplant.
Complications may include:
When to Contact a Medical Professional
If you have ascites, call your health care provider right away if you have:
Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 156.
Runyon BA. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 91.
Runyon BA; AASLD Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: Update 2012. American Association for the Study of Liver Diseases. 2013.
Review Date: 11/20/2014
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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