Ascites or excessive accumulation of fluid in the abdominal cavity is not a disease but a symptom. Ascites, which is a symptom of a disease, usually indicates that the underlying disease is advanced. What are the causes and symptoms of ascites? What is the treatment?
Ascites( ascites , Latinascites ) means excessive accumulation of serous fluid more than its normal amount in the abdominal cavity, i.e. about 150 ml. Ascites is a symptom of a disease and the process of its formation depends on the underlying condition.
Ascites - causes
The most common (80 percent of cases) cause of ascites is cirrhosis of the liver with hypertension in the portal system (i.e. hypertension in the veins draining blood from the liver).
In addition, ascites occurs in about 15-50 percent. people with cancer. The cancers most often associated with ascites are:
- ovarian cancer
- endometrial cancer
- breast cancer
- colorectal cancer
- stomach cancer
- pancreatic cancer
About 80 percent of patients with this diagnosis develop ascites.
Other possible causes of ascites are: portal vein thrombosis, congestive circulatory failure, nephrotic syndrome, pancreatitis (and other inflammations), tuberculosis, intestinal perforation, extensive burns, kwashiorkor (malnutrition of the body resulting from too little protein in diet).
Ascites - symptoms
There are three stages of ascites.
Grade 1 ascites (mild) does not cause any noticeable symptoms. They can only be recognized by ultrasound.
Second degree ascites (moderate) is manifested by an increase in the circumference of the abdomen, which is "diffuse", and by touching it, you can feel the displacing fluid. In addition, the patient complains of discomfort and distension in the abdomen. Weight gain is also noted.
Difficulty sitting down and trouble walking appear over time. The abdomen becomes very large and tense (3rd degree ascites - advanced), the navel is smoothed, and the vessels may be visible through the thin and shiny skin on the abdomenvenous.
Other symptoms of ascites depend on the cause of its formation.
For example, in the course of liver cirrhosis, the accompanying symptoms will include :
- jaundice
- itchy skin
- gynecomastia, i.e. excessive development of male mammary glands
If the cause of ascites is circulatory failure, the following may appear:
- shortness of breath
- swelling of the lower limbs
- exercise intolerance
- needing to urinate at night (nocturia)
In turn, diseases of the digestive system with ascites can manifest themselves:
- nausea
- vomiting
- burning in the esophagus
- flipping
- persistent gas
- abdominal pain
Ascites - diagnosis
The doctor conducts a physical examination, during which he taps the patient's abdomen. In the case of ascites, the suppression of the percussion sound and the bubbling symptom are characteristic - the doctor places the left hand in the lower part of the right half of the abdomen and taps the fingers of the right hand on the lower left part of the abdomen, towards the examiner's left hand. In the case of ascites, a wave of fluid hits the wall of the right side of the abdomen and is sent to the examiner's left hand.
The doctor may also order an ultrasound scan (USG), computed tomography (CT), echocardiography or other imaging tests (depending on the disease causing ascites). Blood tests and paracentesis, i.e. a puncture of the abdominal cavity to collect fluid for testing, are also performed.
Ascites - treatment
The therapy includes treatment of the underlying disease, which causes ascites, and symptomatic treatment, which includes:
- diuretics
- low sodium diet
- fluid drain (in advanced form of ascites, with painful, tense abdominals and shortness of breath)