Ascites is a common complication of chronic liver diseases, particularly cirrhosis, characterized by the accumulation of fluid in the abdominal cavity. At our Gastroenterology Department, we specialize in the diagnosis, management, and treatment of ascites associated with chronic liver diseases, aiming to alleviate symptoms, improve quality of life, and prevent complications.

Symptoms:

Ascites can lead to abdominal distension, discomfort, and increased abdominal girth. Patients may also experience weight gain, difficulty breathing, decreased appetite, nausea, and swelling of the legs (peripheral edema). Severe ascites can cause significant discomfort and impair mobility, affecting overall well-being.

Diagnosis:

Diagnosing ascites involves a comprehensive evaluation, including medical history, physical examination, abdominal ultrasound, and laboratory tests. Diagnostic paracentesis, a procedure to sample ascitic fluid, may be performed to assess its composition and rule out other potential causes of abdominal fluid accumulation.

Treatment:

Treatment strategies for ascites aim to manage fluid retention, reduce symptoms, and address underlying liver disease. Dietary sodium restriction, diuretic medications (such as spironolactone and furosemide), and fluid restriction may help reduce fluid buildup. In cases of severe or refractory ascites, therapeutic paracentesis or placement of a transjugular intrahepatic portosystemic shunt (TIPS) may be considered to drain excess fluid and relieve symptoms. Patients with ascites require regular monitoring to assess fluid status, liver function, and the effectiveness of treatment. Complications of ascites include spontaneous bacterial peritonitis (SBP), hepatic encephalopathy, kidney dysfunction (hepatorenal syndrome), and electrolyte imbalances. Early detection and management of complications are essential to prevent disease progression and improve outcomes.

Lifestyle Modifications:

Lifestyle modifications, including alcohol cessation, weight management, and adherence to dietary recommendations (such as low-sodium diet), can help reduce the risk of fluid retention and complications associated with ascites. Patients are encouraged to work closely with healthcare providers to develop individualized treatment plans and optimize long-term management. Ascites management often requires a multidisciplinary approach, involving gastroenterologists, hepatologists, nurses, dietitians, and other healthcare professionals. Supportive care focuses on symptom management, nutritional support, psychosocial support, and education to empower patients and improve their overall quality of life.

What causes ascites in chronic liver diseases?

Ascites develops in chronic liver diseases, primarily cirrhosis, due to portal hypertension and hypoalbuminemia, leading to fluid leakage into the abdominal cavity.

 

What are the symptoms of ascites?

Symptoms of ascites may include abdominal distension, discomfort, increased abdominal girth, weight gain, difficulty breathing, decreased appetite, nausea, and swelling of the legs.

 

How is ascites diagnosed?

Ascites is diagnosed through a combination of medical history, physical examination, abdominal ultrasound, laboratory tests, and sometimes diagnostic paracentesis to sample ascitic fluid.

 

What are the treatment options for ascites?

Treatment options for ascites include dietary sodium restriction, diuretic medications, therapeutic paracentesis, placement of a transjugular intrahepatic portosystemic shunt (TIPS), and lifestyle modifications. Treatment aims to manage fluid retention, reduce symptoms, and address underlying liver disease.