Ascites (ay-SITE-eez) is when too much fluid builds up in your abdomen (belly). This condition often happens in people who have cirrhosis (scarring) of the liver. A sheet of tissue called the peritoneum covers the abdominal organs, including the stomach, bowels, liver and kidneys. The peritoneum has two layers.
Ascites is the main complication of cirrhosis. It is a landmark of the progression into the decompensated phase of cirrhosis and is associated with a poor prognosis and quality of life; mortality is estimated to be 50% in 2 years.
Causes. Cirrhosis of the liver is the most common cause of ascites, but other conditions such as heart failure, kidney failure, infection or cancer can also cause ascites.
Ascites is the accumulation of fluid within the peritoneal cavity. In the Western world, it is mainly caused by cirrhosis (∼75%), followed by peritoneal malignancy (12%), cardiac failure (5%), and peritoneal tuberculosis (2%).
Patients with abnormal liver function who develop ascites, variceal hemorrhage, hepatic encephalopathy, or renal impairment are considered to have end-stage liver disease (ESLD).
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.
The 2-year survival rate for a patient with cirrhotic ascites is approximately 50%. Once a patient becomes refractory to routine medical therapy, 50% die within 6 months and 75% within 1 year.
Ascites is a sign that your liver is not working as it should. The survival rate five years after an ascites diagnosis is around 30% to 40%. Your healthcare provider may refer you to a liver specialist to discuss a possible liver transplant.
Those with mild ascites may have an abdomen that appears normal, whereas those with more severe ascites may have a very large distended abdomen. As the fluid accumulates in the abdominal cavity. The belly button can also protrude from the body with severe ascites.
(3) The importance of uncovering alcohol use in all patients with ascites goes beyond simply precluding liver transplantation. If patients can stop drinking, their liver function will improve and their ascites may resolve; they will also have a better prognosis. Take a dietary and drug history.
Sodium restriction (20-30 mEq/d) and diuretic therapy constitute the standard medical management for ascites and are effective in approximately 95% of patients.
Ascites may occur in other liver disorders, such as severe alcoholic hepatitis without cirrhosis, other kinds of chronic hepatitis, and obstruction of the hepatic vein (Budd-Chiari syndrome.
A person with ascites may also have a distended abdomen, which is hard and swollen. They may also experience rapid changes in weight and body shape.
Ascites is traditionally divided into transudate or exudate based on the protein content. Transudates (protein < 25 g/L) are typically due to increased leakage of fluid secondary to raised intravascular pressure.
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].
Ascites Signs and Symptoms
Ascites is usually accompanied by a feeling of fullness, a ballooning belly, and weight gain. Other symptoms often include: Shortness of breath. Nausea.
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.
At the cirrhosis stage, you may experience more symptoms of liver damage including jaundice, weakness, fatigue, appetite and weight loss, abdominal bloating, and edema in your extremities.
If cirrhosis gets worse, some of the symptoms and complications include: yellowing of the skin and whites of the eyes (jaundice) vomiting blood. itchy skin.
Patients with cirrhotic ascites have a 3-year mortality rate of approximately 50%. Refractory ascites carries a poor prognosis, with a 1-year survival rate of less than 50%. Males have little intraperitoneal fluid, females have approximately 20 mL, depending on the phase of their menstrual cycle.
People with cirrhosis in Class A have the best prognosis, with a life expectancy of 15 to 20 years. People with cirrhosis in Class B are still healthy, with a life expectancy of 6 to 10 years. As a result, these people have plenty of time to seek sophisticated therapy alternatives such as a liver transplant.
The final days of liver failure can vary, depending on the person. Someone may experience symptoms such as yellow skin and eyes, confusion, swelling, and general or localized pain. The symptoms of end-stage liver disease typically worsen as the patient becomes closer to death.