Ascites, a buildup of fluid in the abdomen, usually doesn't go away on its own and requires treatment, as it signals an underlying serious condition like liver disease (cirrhosis) or cancer; however, treating the root cause (e.g., stopping alcohol, chemotherapy) can sometimes resolve the fluid, but often ongoing management with diuretics, low-sodium diets, drainage procedures (paracentesis), or even a liver transplant is needed, because ascites tends to return.
Ascites may go away with a low-salt diet, and by taking diuretics (water pills) ordered by your provider. But sometimes a provider must drain the fluid from the belly using a special needle. If you have ascites and you suddenly get a fever or new belly pain, go to the emergency room immediately.
Case report: In this case report, we describe a rare case of amlodipine induced massive ascites in a 30-year-old male with renal transplantation. Conclusion: We aimed to create awareness that pharmacologic causes should be considered in cases of ascites of unknown aetiology.
Ascites can lead to: Chronic abdominal discomfort. The fluid buildup may lead to pain, discomfort and difficulty breathing. These symptoms can interfere with your ability to eat, walk and do daily activities.
If you have stopped drinking, your liver function will improve, and your ascites may resolve, but it is not certain. If you currently have ascites, it is a sign that your liver is struggling to function due to long-term damage from alcohol. It is difficult to say how much water retention will last if you stop drinking.
How is ascites treated?
Malignant ascites can occur in patients with colon, pancreatic, breast, and lung primaries with the development of peritoneal carcinomatosis. The life expectancy of such patients is generally limited to weeks to months after the onset of ascites.
Depending on the underlying cause, symptoms of worsening ascites may develop gradually or quickly and may include:
The most common palliative management for refractory ascites due to ESLD is large volume paracentesis (LVP), performed every 10–14 days [3].
Diuretics should be initiated in patients whose ascites does not respond to sodium restriction. A useful regimen is to start with spironolactone at 100 mg/d. The addition of loop diuretics may be necessary in some cases to increase the natriuretic effect.
Amlodipine and nifedipine are common drugs associated with vasodilatory edema. When used as monotherapy, calcium channel blockers (CCBs) are associated with a substantial risk of peripheral edema, including pedal edema, which is the most common reason for its discontinuation.
CCB-related chylous ascites is defined as white milky ascites/effluents that appear after administration of CCBs. Physicians must be aware of the possibility of chylous ascites when administering CCBs, particularly in patients with renal function impairment and ESRD patients undergoing PD.
Swelling from amlodipine is a common, but often troublesome side effect of amlodipine with 5% to 9% of people stopping amlodipine because of it. If you develop swelling with amlodipine, tell your doctor right away because they may be able to change your blood pressure medications slightly to help reduce the swelling.
Prioritize low impact exercises with ascites, such as walking, chair yoga, and gentle stretching, to minimize strain. Listen carefully to your body, recognizing and responding to warning signs like increased pain or shortness of breath.
The Alfapump system is designed to automatically and continuously move ascites from the abdomen to the bladder, eliminating the need for therapeutic paracentesis.
Assessing for fluid wave:
With your free hand, firmly tap his left flank. If ascites is present, the tap will transmit an impulse through the fluid, which you'll feel with your palm on his right flank. Document whether you noted shifting dullness or fluid wave.
The accumulation of fluid in the abdominal cavity is called ascites and is a common in patients with cirrhosis (scarring of the liver). The development of ascites can indicate serious liver disease and patients are often referred to a liver specialist.
If the ascites keeps coming back, you might have a permanent, or long-term, drain put in. You may hear it called a PleurX drain or catheter. This procedure will usually be done in hospital. A specialist nurse or doctor can talk to you about what would be the best option for you.
CURRENT GUIDELINES. The American Association for the Study of Liver Diseases recommends furosemide 40 mg daily as the first-line loop diuretic agent for the treatment of ascites.
Managing ascites
2) Moderate ascites (grade 2) can be detected on physical examination. The fluid volume is usually >500 mL. 3) Severe ascites (grade 3) causes abdominal distension accompanied by flattening of the umbilicus or umbilical hernia. Dyspnea indicates that the peritoneal fluid volume is large, up to ~5 to 15 L.
Ascites can make your tummy feel tight and very uncomfortable. It often develops over a few weeks. But it might happen over a few days. It puts pressure on the organs in your abdomen.
The most common complications include spontaneous bacterial peritonitis, hepatic hydrothorax, spontaneous bacterial empyema, and umbilical hernia.
Your doctor might prescribe you "water pills," also called diuretics, to help flush the extra fluid and salt from your body. Two of the most common diuretics used to treat ascites are: Furosemide (Lasix) Spironolactone (Aldactone)
In patients with massive ascites, death can occur due to spontaneous bacterial peritonitis, nephrotic syndrome, heart failure, or acute liver failure as a complication of cirrhotic ascites.