Show Ascites is the buildup of fluid in the abdomen. The peritoneum is a membrane that surrounds the organs inside the abdomen that makes ascitic fluid. This fluid is normal in the body, but cancer can cause the peritoneum to produce too much of this fluid. This is called "malignant ascites" and it is often a sign of advanced cancer. Malignant ascites is caused by cancer that has spread to the lining of the organs inside your abdomen. It can also happen when cancer spreads to the liver. You are more likely to develop ascites if you have one of these cancers: Breast cancer Colon cancer Gastrointestinal tract cancers, such as stomach and intestinal cancers Ovarian cancer or fallopian tube cancer Pancreatic cancer Uterine cancer Ascites often causes a lot of discomfort. People with ascites may have the following symptoms: Tell your health care team if you experience any of the above symptoms. Relieving side effects is an important part of cancer care and treatment. This type of care is called palliative care or supportive care. It helps someone, with any type or stage of cancer, feel better. Your doctor may use one or more of the following tests to locate, diagnose, or plan treatment for ascites: Physical examination X-ray, which is a picture of the inside of the body Ultrasound Computerized tomography (CT or CAT) scan, which creates a 3-dimensional picture of the inside of the body using x-rays. Paracentesis, which is when a needle removes fluid from the abdomen for testing or to relieve symptoms. How is ascites managed and treated?The goal of treatment is to provide relief from uncomfortable symptoms. You may not need treatment if your ascites is not causing discomfort. Ascites treatment may have unpleasant side effects. Talk with your doctor about the benefits and risks of each option before deciding on a treatment plan. The treatment options for ascites include: Changes to how you eat. For mild discomfort, eating less salt and drinking less water or other liquids may help. Salt helps your body hold onto water. Making diet changes can be a challenge for many people. Talk to your health care team about how to make these changes. Diuretics. A diuretic is any substance that makes you urinate more often. This can help reduce the amount of fluid built up in your abdomen. Diuretics can be prescribed as medication. Most people do not experience side effects when taking a diuretic, but they can cause a loss of sleep, skin problems, fatigue, and low blood pressure. Paracentesis. Paracentesis is a procedure to remove the fluid in the abdomen. It is used to diagnose the cause of ascites (see above), but it is also used to treat it. A doctor places a needle attached to a tube into the abdomen. The fluid drains through the needle and into the tube. Often, the fluid buildup will come back after a paracentesis procedure. Your health care team may decide to do another paracentesis procedure or they may decide to use a catheter. Catheter. A catheter can be used to drain fluid. A catheter is a thin tube of plastic inserted into your pleural fluid. At home, you or your family member use the catheter to regularly drain the fluid into a bottle as instructed by your health care team. Occasionally, it may be recommended that a catheter be inserted inside the body to bypass or divert fluid from the abdomen into another part of the body. This is called a shunt or a peritoneovenous shunt. Treating the cancer. Surgery or chemotherapy used to treat the cancer can sometimes also relieve ascites symptoms. This is because the cancerous cells stop making as much fluid. Managing discomfort. Sometimes, problems caused by ascites keep coming back, even with treatment. Your health care team can help manage your discomfort by treating problems like swelling in the legs, constipation, nausea, and breathing problems. Questions to ask the health care teamConsider asking your health care team these questions about ascites:
Related ResourcesFluid Retention or Edema Fear of Treatment-Related Side Effects More InformationJAMA Oncology Patient Page: Ascites or Fluid in the Belly
Medically Reviewed by Minesh Khatri, MD on August 11, 2022 Ascites is the buildup of fluid in your belly, often due to severe liver disease. The extra fluid makes your belly swell. Ascites is usually accompanied by a feeling of fullness, a ballooning belly, and weight gain. Other symptoms often include: If you have a combination of these symptoms, see your doctor. If you have ascites, it’s often a sign of liver failure. It occurs most often with cirrhosis. Ascites happens when pressure builds up in the veins of your liver and it doesn’t work as it should. These two problems usually are caused by another condition -- cirrhosis, heart or kidney failure, cancer, or an infection. The pressure blocks blood flow in the liver. Over time this keeps your kidneys from removing excess salt from your body. This, in turn, causes fluid to build up. Any disease that causes liver damage or scarring can make you more likely to get ascites. Common risk factors for ascites include: Liver cirrhosis (scarring) due to:
The doctor will give you a physical exam and ask about your symptoms. They may perform a variety of tests, including blood work, an ultrasound, or a CT scan. If they think you have ascites, the doctor will use a needle to remove fluid from your belly for testing. This procedure is called a paracentesis. It’ll help the doctor find out what’s causing your condition so they can treat it properly. In most cases of ascites, the doctor will refer you to a liver specialist, who may discuss a liver transplant. The doctor may prescribe “water pills,” also called diuretics, to help flush the extra fluid from your body. Two of the most common diuretics are:
They both help your kidneys remove more sodium and water. If changes in your diet and prescription diuretics don’t help, or your symptoms are severe, your doctor may have to use paracentesis to remove large amounts of excess fluid through a needle inserted into your belly. When you have this done, you have to follow a low-salt, low-liquid diet, otherwise the fluid will come back. If these treatments don’t work, you may need a surgery to place a shunt in your liver or get a liver transplant. |
What causes fluid in the abdomen
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