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Excess Abdominal Fluid (Ascites)


What is fluid in the belly? — "Fluid in the belly" happens when fluid collects in the space between the organs in the belly and the belly wall (figure 1). The word doctors use for fluid in the belly is "ascites."
What causes fluid in the belly? — The most common cause of fluid in the belly is a liver condition called "cirrhosis." Cirrhosis is a disease that scars the liver. The liver is a big organ in the upper right side of the belly. Cirrhosis is usually caused by heavy alcohol use or certain liver infections.
Other causes of fluid in the belly are not as common, but can include heart problems, cancer, and certain infections.
What symptoms does fluid in the belly cause? — Fluid in the belly 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 fluid in the belly can get infected. This can cause worse belly pain, fever, and sometimes confusion. If you have fluid in your belly and then get any of these symptoms, see your doctor right away.
Will I need tests? — Yes. To look for fluid in your belly, your doctor will do an imaging test such as an ultrasound or CT scan. Imaging tests create pictures of the inside of the body.
Many people also have a procedure called "paracentesis." For this procedure, your doctor will put a needle into your belly and into the collection of fluid. (He or she will numb the area of skin where the needle goes in.) 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 fluid in the belly treated? — Treatment depends partly on what's causing the fluid to collect and how severe your condition is.
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 name: Aleve).
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.
How can I prevent more fluid from collecting in my belly? — You can help prevent more fluid from collecting by following all of your doctor's instructions about treatment.
Let your doctor or nurse know if you are having trouble following the treatment plan. For example, if you are having trouble following a low-salt diet, your doctor or nurse can recommend a dietitian (food expert) to help you.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16989 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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