Ascites (fluid in the belly)

Ascites or “fluid in the belly” happens when fluid collects in the space between the organs in the belly and the belly wall.  The most common cause of ascites is a liver condition called “cirrhosis.” Cirrhosis is a disease that scars the liver.  Other causes of ascites are not as common, but can include heart problems, cancer, and certain infections.

What symptoms are caused by ascites? —  Ascites can cause:

• A big belly, which can lead to belly pain – The belly usually gets bigger over a short period of time.
• Weight gain
• Trouble breathing
• Feeling full after eating only a small amount of food

Sometimes, the ascites fluid can get infected. This can cause worse pain, fever, and sometimes confusion. If you have ascites and then get any of these symptoms, see your doctor right away.

Individuals with ascites may have a procedure called “paracentesis.” For this procedure, your doctor will put a needle into your belly and into the collection of fluid. During paracentesis your doctor will numb the area of skin where the needle is inserted with a local anesthetic. Your doctor will remove a sample of fluid and send it to a lab for tests. These tests can show what’s causing the fluid to collect and if the fluid is infected.

How is ascites treated? — Treatment depends partly on what’s causing the fluid to collect and the severity of your condition.

If you have cirrhosis, your treatment will probably involve:

• Following a low-salt (also called “low-sodium”) diet – This can help reduce the amount of fluid in your belly.
• Taking a medicine called a “diuretic” – Diuretics make people urinate much more than usual.
• Stopping your alcohol use (if you drink alcohol)
• Avoiding medicines called “NSAIDs” that can harm the liver – NSAIDs are a group of medicines that includes aspirin, ibuprofen (sample brand names: Advil®, Motrin®), and naproxen (sample brand names: Aleve®, Naprosyn®).
• Checking your weight every day – Following your weight will help your doctor monitor your condition.

Treatment also depends on your symptoms. If you have severe symptoms, symptoms that don’t get better with treatment, or symptoms that come back after treatment, you might need to have:

• Paracentesis to remove a large amount of fluid
• A procedure called “TIPS” in which a doctor puts a device in your liver that reduces fluid build-up

Both of these treatments can help improve your symptoms so you feel better.

If you have severe liver disease, your doctor will talk with you about the possibility of having a liver transplant. A liver transplant is surgery in which a doctor replaces a diseased liver with a healthy liver.