The most common cause of ascites is liver cirrhosis.  Ascites is an accumulation of fluid in the abdominal cavity.  Ascites is a result of high pressure in the blood vessels of the liver (portal hypertension) and low levels of the protein albumin.  Diseases that cause severe liver damage can lead to ascites.   Diseases that can cause severe liver damage include long-term hepatitis C or B.  Alcohol abuse over many years can also cause liver damage that can lead to ascites.  People with certain types of cancers in the abdomen, such as cancer of the colon, ovaries, uterus, pancreas and liver, can lead to the development of ascites.   Other possible conditions that can lead to the development of ascites include: clots in the veins of the liver (portal vein thrombosis); congestive heart failure; pancreatitis; thickening and scarring of the sac like covering the heart.

The severity of symptoms associated with ascites varies depending on the case.  Symptoms may develop slowly or have a sudden onset depending on the cause of the ascites.  You may not have any symptoms if there is only a small amount of fluid in the abdomen.  Symptoms of abdominal pain and bloating increase as more fluid develops in the belly.  As large amounts of fluid collect, you may also experience shortness of breath.  A person with ascites will likely also experience many other symptoms that are associated with liver failure.

There are different possible treatments for ascites.  Treatment for the build-up of fluid may include lifestyle changes, prescribed medications, and medical procedures.  Recommended lifestyle changes include: avoiding alcohol; lowering salt intake in your diet (no more 1,500 mg/day of sodium); limiting fluid intake.  Your physician may prescribe “water pills” (diuretics) to get rid of extra fluid or antibiotics for infections.  Your physician may also perform a procedure called a paracentesis where your doctor will insert a tube in the belly to remove large volumes of fluid.  Your doctor may also place a tube or shunt inside your belly (TIPS) to repair blood flow to the liver.  Someone with end-stage liver disease may need a liver transplant.

1. “Ascites.”  MedicineNet.  WebMD.  July 13, 2009.  Web 3 June 2013.
2. “Ascites.”  PubMed Health.  National Library of Medicine, National Institutes of Health.  November 16, 2012.  Web 3 June 2013.