Ascites, treatment and prevention

Ascites: the causes, the symptoms. What are the most serious forms and what are the most appropriate treatments to prevent and treat this disorder.

The term ascites indicates the collection of excessive fluid in the abdominal cavity. In normal situations, the presence of liquids in minimal quantities does not cause problems, on the contrary, it helps not to create friction both between the internal organs and between the organs themselves and the abdominal wall. When, precisely, this fluid increases excessively (known as "ascitic fluid), it can be the sign of various pathologies.

Ascites, causes

This condition occurs more in people with liver disease, especially cirrhosis. Ascites can also occur in individuals with tumors involving the abdominal organs. The other causes are due to:

  • Alcoholic liver disease
  • Viral hepatitis
  • Tuberculosis
  • Heart failure
  • Peritoneal Carcinoma
  • Pancreatitis

Ascites, symptoms

Symptoms vary according to the cause that triggered the disorder. The mild form of ascites is usually asymptomatic. In the most severe forms they can present the following symptoms:

  • Fatigue
  • Abdominal pain
  • Abdominal swelling
  • Lack of appetite
  • Weight loss
  • Difficulty in breathing
  • Fever, nausea and vomiting if it is a bacterial infection

Only through a careful medical examination is it possible to diagnose ascites. The doctor will be responsible for prescribing blood tests and abdominal ultrasound

More severe forms of ascites can lead to the following complications:

  • Spontaneous bacterial peritonitis is typical of liver cirrhosis and should generally be treated with antibiotics
  • Hepatorenal syndrome which in extreme cases involves liver transplantation
  • Hepatic hypertension whose treatment consists in placing an intrahepatic transjugular portosystemic shunt in order to reduce portal hypertension

How to treat ascites

For the treatment of ascites, the aim is to gradually reduce the volume of ascitic fluid (no more than 500 ml per day) in order to avoid hemodynamic imbalances.

In this sense, it is good to follow some dietary rules which consist of avoiding alcohol, limiting the consumption of salt in order to avoid fluid retention. Diuretic drugs are usually prescribed to expel excess fluids. In case of lack of improvement, it may be necessary to aspirate liquids by paracentesis. Let's see more in detail!


If ascites is caused by excessive alcohol consumption, it will be necessary to drastically change your eating habits and lifestyle. If you are addicted to alcohol, it may be helpful to join a support group.

Reducing salt may also be necessary, especially in the case of portal hypertension. The same is true for fluid consumption which should be moderate. Even the water must be drunk only in small quantities, but with a much higher frequency.

Pharmacological treatments

If necessary, we opt for the drug treatment which consists of taking:

  • Diuretics: which will allow you to eliminate excess fluid.
  • Antibiotics: in the event that there is an infection of the ascitic fluid they will help to fight it
  • Evacuative paracentesis: consists in the evacuation of the liquid, which is aspirated with a syringe through the abdomen. This is the first treatment for ascites under tension, as it rapidly improves the haemodynamic picture. This is a palliative measure to ease the discomfort and pain of those affected.
  • Albumin: should be administered especially in cirrhotic subjects, together with paracentesis.

If you opt for natural diuretics to drain the fluid accumulated in the abdomen, it is best to consult your doctor first. Avoid do-it-yourself treatments for ascites. Always follow your doctor's recommendations and do not take action without first consulting him. This applies to any pathology or disorder!


In addition to the drug treatment, it is also good to rest. Ascites is very annoying and can cause a lot of discomfort and discomfort. So keep comfortable postures and limited to burden the abdominal area.

However, you do not have to completely reduce your activities. Doing a little physical activity helps prevent further water retention and therefore an improvement in ascites.

Useful recommendation: if you suffer from ascites always remember to carry out periodic and regular checks in order to keep the progress of the disease under observation.

Video: Ascitic Fluid Analysis (May 2021).