Throughout our lives, various diseases can develop—some more frequently, others less so. Likewise, there are also signs indicating we might have a more serious illness, which worry us more than usual.

But even though these are alarming, once we become ill, it’s necessary to know what procedures should be followed so treatment can be carried out in the best possible way and, thus, recovery comes as quickly as possible. This is the case with ascites, for example.

It is a sign of disease in the body that few people truly know the real effects and severity of, as well as its treatment. Keep reading to learn more about this little discussed condition, which can cause serious harm to your health.

What Is Ascites?

Ascites1, also known as “water belly,” is the accumulation of fluid in the abdominal region of the body, more specifically in the peritoneal cavity, which is the space between the abdomen itself and the tissues lining it.

Depending on the amount of fluid that has accumulated, the patient exhibits “swelling” in this area, and this abdominal distention causes the belly to grow, resembling that of a pregnant woman.

It is important to note that ascites itself is not a disease; rather, it is usually associated with other diseases, especially those related to the liver, but it can also occur due to pancreatic problems, some infections, and even certain types of cancer.

Types of Ascites

Ascites can be classified into two types: exudative and transudative. This classification is related to the composition of the fluid in the peritoneal region, specifically the amount of proteins such as albumin.

There are also three other types of ascites.

  • Fetal ascites: When fluid accumulates in the abdomen of a fetus or newborn.
  • Chylous ascites: When the accumulation of fluid occurs due to a blockage in the lymphatic channels.
  • Pancreatic ascites: When the accumulation is caused by chronic pancreatitis.

What Causes Ascites?

Ascites occurs when our blood vessels, for some reason, are unable to keep fluid inside them, allowing it to leak into areas such as the peritoneum, which typically has a low or no concentration of fluid.

Most often, this “leakage” occurs mainly due to three factors: increased pressure in the veins in the abdominal region (often caused by thrombosis and varicose veins), a drop in the protein albumin—which acts as a barrier to keep fluid within the blood vessels—and when the patient has salt and water retention in the kidneys2.

Usually, these three factors are related to other diseases, most of them directly connected to excessive alcohol consumption, in other words, liver cirrhosis, thrombosis, hepatitis, among many others.

Symptoms of Ascites

Since it is a sign of another disease, the symptoms of ascites are quite varied, depending on the underlying illness. However, the main symptoms of ascites include:

  • Swelling of the abdominal region;
  • Excessive weight gain;
  • Nausea and vomiting;
  • Abdominal pain.

Loss of appetite and even difficulty breathing are also common.

How Is Ascites Diagnosed?

When symptoms appear, the patient should seek medical care, which may be provided by an endocrinologist, gastroenterologist, hematologist, or a general practitioner.

Depending on the amount of fluid accumulated, the diagnosis can be made directly in the office by palpating the abdominal area. However, when there is only a small amount of fluid, this method is not sufficient.

The doctor should order a complete blood test or imaging exams such as ultrasound, and even an abdominal tap (paracentesis).

Is Ascites Curable?

The cure for ascites depends on curing the underlying disease. In other words, without treating this first, ascites cannot be cured and may return several times. Depending on the stage of the underlying disease, ascites may need to be treated for a long period.

Treatment for Ascites

Everything will depend on the treatment of the underlying disease. However, to reduce the amount of fluid in the abdominal region, the doctor may prescribe diuretics to help the patient eliminate some of the fluid.

Antibiotics may be prescribed if the fluid becomes infected, and the patient should also follow a diet that mainly restricts salt and stop drinking alcohol entirely.
For more serious cases, a procedure called frequent therapeutic paracentesis3 is recommended, which involves puncturing and draining the fluid. This treatment is the most effective, as it removes a large amount of fluid at once, though local anesthesia is required. Paracentesis can also be used as a diagnostic method.

Complications of Ascites

When left untreated, ascites can progress and cause more severe problems. That’s why it’s always important to see a doctor as soon as you notice any of the symptoms and begin treatment quickly.

Another extremely important point is to identify the underlying disease causing the ascites so that it can also be properly treated.
Some of the most common complications of ascites are:

  • Bacterial peritonitis
  • Sepsis
  • Hepatic encephalopathy

Let’s talk a bit more about each of these.

Bacterial Peritonitis

Bacterial peritonitis is caused by the proliferation of bacteria in the peritoneal region where the fluid is accumulated, leading to an infection.

Sepsis

Sepsis is a consequence of untreated bacterial peritonitis, resulting in a widespread infection that can be fatal.

Hepatic Encephalopathy

Hepatic encephalopathy is caused by poor liver function, when the organ can no longer remove toxins from the blood. If not treated quickly, this complication can lead to mental confusion and even coma.

Often, we only realize we’re ill because of a sign our body gives us. In the case of ascites, the sign itself is already a major complication of another disease, which is not a good sign.

The good news is that treatments exist not only to lessen the effects of ascites, but also to control the condition. Taking care of your health is the most important thing you can do in your life—because without it, you can’t do anything else.

So, if you have any symptoms of ascites or suspect something similar, seek medical help as quickly as possible. Remember: The earlier diseases are detected and treated, the greater the patient’s chances of improvement.

See also: Is a Crooked Belly during Pregnancy Normal?
Photo: Max Pixel