Ascites is the abnormal buildup of fluid in the abdomen. The condition is typically associated with liver diseases such as cirrhosis, but may also manifest as a symptom of peritoneal mesothelioma, other cancers, kidney failure, heart failure and pancreatitis. Ascites may also be referred to as hydroperitoneum, peritoneal cavity fluid, peritoneal fluid excess or abdominal dopsy.
The degree of symptoms felt by a patient will vary depending on the volume of fluid in the abdomen. Small levels of peritoneal cavity fluid result in no noticeable symptoms. Larger volumes may result in a swollen abdomen, loss of appetite, abdominal discomfort, swollen ankles and shortness of breath. Identifying these symptoms is often the first step in diagnosis.
After examining the abdomen and discussing symptoms, the doctor may tap the exterior of the abdomen. If he or she hears a dull sound, it is an indicator of fluid buildup. Once identified, the doctor attempts to determine the cause of ascites. If this is not immediately clear, an ultrasonography may be required. Furthermore, paracentesis may be used to extract a sample of the ascites so that it can be examined.
During diagnosis, the doctor will attach a grade to the ascites to indicate the severity. There are three levels of ascites, each differing in the amount of fluid that is present in the system. These classifications are:
Grade 1: minimal buildup that is only visible through ultrasound
Grade 2: medium buildup accompanied by bulging of abdominal flanks
Grade 3: substantial buildup that is directly visible
Treatment Process for Ascites
Treating ascites typically amounts to bed rest and adhering to a salt-restricted diet. Diuretics will also be prescribed to help flush the fluid out through the urinary tract. If the ascites is severe, therapeutic paracentesis may be required. This involves inserting a needle into the abdomen to remove the excess fluid.
Related: The National Cancer Institute has details on a clinical trial of a treatment for malignant ascites.