Cut back on the amount of fluids you drink. Stop drinking alcohol. Take diuretic medicines to help reduce the fluid in your body. In certain cases, your doctor may need to remove large amounts of fluid from your abdomen through a needle.
Your doctor may suggest that you visit a nutritionist to help you create a low-sodium diet. Limiting your liquids. This is also important. You may need to drink less than one liter of fluids per day to help prevent ascites from recurring, and you may have to take water pills.
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.
The mainstay to managing patients with ascites is modest salt restriction, treatment with diuretic therapy, and cessation of alcohol in patients with alcoholic liver disease. Diagnosing spontaneous bacterial peritonitis.
Diuretics. Many people with ascites benefit from diuretics, which are also called water pills. These help rid the body of excess fluid, reducing swelling. A doctor may prescribe common diuretics such as furosemide (Lasix) and spironolactone (Aldactone).
Stopping all alcohol intake, maintaining a healthy weight, exercising, not smoking, and limiting salt intake can help prevent cirrhosis or cancer that may lead to ascites. Ascites can't be cured but lifestyle changes and treatments may decrease complications.
Limit alcohol: It's best to avoid beverages that contain alcohol to reduce your ascites risk. Limit NSAID use: Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin® and Advil®) and aspirin, affect your kidneys. They can cause your body to retain excess water and salt.
Diuretic medicines, such as spironolactone and furosemide, can help get rid of fluid that has built up in the belly and other parts of the body. These medicines can help both prevent and treat problems with ascites. Your doctor may prescribe a diuretic for you to take over the long term.
The fluid causes swelling that can make the tummy feel tight and very uncomfortable. It often develops over a few weeks but might happen over a few days.
LJ Ascites is most commonly treated with a diuretic, which removes the fluid from the abdomen. The most common such agent is spironolactone (Aldactone, Pfizer), with furosemide (Lasix, Hoechst) frequently used as an adjuvant. These medications lead directly to decreased fluid in the abdomen.
Sodium restriction (20-30 mEq/d) and diuretic therapy constitute the standard medical management for ascites and are effective in approximately 95% of patients.
A normal person will produce a urine volume of somewhere between 1 to 2 liters per day, whereas cirrhotic patients with liver decompensation and ascites probably will only produce 300 to 500 mL per day due to severe salt and water retention.
The probability of survival at one and five years after the diagnosis of ascites is approximately 50 and 20%, respectively, and long-term survival of more than 10 years is very rare [8]. In addition, mortality rises up to 80% within 6–12 months in patients who also develop kidney failure [1].
The classification of ascites is based on the amount of fluid in the abdominal cavity: grade 1 ascites, or mild ascites, detectable by ultrasound examination; grade 2 ascites, or moderate ascites, characterized by a mild symmetrical abdominal distension; and grade 3 ascites, or large ascites, with significant abdominal ...
Research summary. In cirrhosis the liver becomes damaged and scarred. One of the worst aspects is the stomach swelling with fluid (ascites) causing pain and breathlessness. Once the liver is so badly damaged and a liver transplant is not possible, patients are unlikely to survive longer than six months.
At end-stage cirrhosis, ascites causes symptoms including abdominal distention, nausea and vomiting, early satiety, dyspnea, lower-extremity edema, and reduced mobility. Clinically, on investigation of a full, bulging abdomen, percussion of the flanks and checking for shifting dullness can detect ascites.
Patients with abnormal liver function who develop ascites, variceal hemorrhage, hepatic encephalopathy, or renal impairment are considered to have end-stage liver disease (ESLD).
But sometimes a provider must drain the fluid from the belly using a special needle. View our Ascites Patient Fact Sheet for more information. If you have ascites and you suddenly get a fever or new belly pain, go to the emergency room immediately.
Spironolactone is an aldosterone antagonist, acting mainly on the distal tubules to increase natriuresis and conserve potassium. Spironolactone is the drug of choice in the initial treatment of ascites due to cirrhosis.
Diuretics can have side effects such dehydration, confusion, abnormal levels of sodium and potassium and kidney damage. Therefore patients should be monitored while taking these tablets. As the liver disease progresses the ascites may no longer respond to medication. This is known as untreatable or refractory ascites.
5.2 Patients should have approximately 2–3 drainage procedures/week with up to 2 L of ascites being removed on each occasion, with a maximum 5 L of ascites drained/week. This will be sufficient for most patients.
Ascites can be temporarily reversed with treatment. Permanent reversal depends on the underlying cause. If liver failure or cirrhosis is the cause, there is no cure, and managing ascites will require continual treatment.
Patients with compensated cirrhosis have a median survival that may extend beyond 12 years. Patients with decompensated cirrhosis have a worse prognosis than do those with compensated cirrhosis; the average survival without transplantation is approximately two years [13,14].