Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Ascites is a condition that occurs when fluid builds up in the peritoneal cavity. There may be several reasons, therefore ascites is a symptom of the disease, not the disease itself. The diagnosis is made after an ultrasound of the abdomen is performed.
Definition of ascites
Ascites is a condition caused by the accumulation of fluid in the peritoneal cavity (the correct amount of fluid is about 150 ml). There can be many reasons for this condition, therefore ascites itself is a symptom, not a disease entity. Serum fluid usually accumulates in the peritoneal cavity, containing 3 g / dl of protein, sodium, potassium and glucose. If there are neurophiles in the fluid – this indicates an infection, while if they are red blood cells – a neoplastic process may be suspected.
Ascites – causes
Ascites is not a disease, but a symptom of many diseases, the common feature of which is the accumulation of fluid of various nature in the peritoneal cavity. This is mainly due to the obstructed outflow of blood from the portal vein system and the reduced level of proteins from the albumin group in the blood, one of the tasks of which is to maintain fluid in the blood vessels. There can be many causes of ascites. The most common are:
- congestive heart failure,
- liver diseases with hypertension in the portal system,
- portal vein thrombosis,
- kidney failure
- inflammations of various origins,
- obstructed outflow of lymph,
- cirrhosis,
- extensive burns,
- hunger swelling,
- malignant tumors located in the abdominal and pelvic cavities.
Types of ascites
Depending on the volume of fluid accumulated in the peritoneal cavity, ailments in the form of ascites are divided into:
Grade I – mild ascites. Diagnosis of this type of ailments is possible with an ordinary ultrasound examination.
II degree – moderate ascites. We talk about this type of ascites when the fluid in the peritoneal cavity exceeds 500 ml. Patients feel that their abdomen is spilled, they feel fluid moving inside. In the diagnosis of moderate ascites, tapping on the abdomen is useful (the patient lies first on one side and then on the other side). Thanks to this examination, the doctor is able to observe how the suppression moves when the patient changes position.
Stage III – advanced. It is distinctive and easy to recognize. The patient has a large abdomen, which may also be tense and lean limbs. The umbilicus of such a separate one is smoothed, but sometimes there is an umbilical hernia, which becomes visible during coughing. The advanced form of ascites causes venous vessels to pierce the skin on the patient’s abdomen. The skin on the abdomen is thin and shiny.
Symptoms of ascites
Symptoms of ascites are primarily abdominal enlargement, weight gain, abdominal pain and a feeling of discomfort and distension in the abdomen. The abdomen is spilled to the sides, which is medically referred to as the frog’s abdomen. Over time, there may be problems with sitting and walking, gastrointestinal motility disorders (vomiting, belching, heartburn), and swelling of the lower limbs and external genitalia.
If the volume of the fluid exceeds 1,5 l, the patient may also experience shortness of breath or swelling of the lower limbs. Long-term ailment in the form of ascites can also lead to pleural effusion, i.e. fluid accumulation in the pleural cavity (more often on the right side).
Ascites – diagnosis
Ascites can be a difficult condition to diagnose, especially if the patient is additionally obese. Ascites must be distinguished from pregnancy, ovarian cysts, ovarian cancer and bladder enlargement, which often have similar symptoms.
The basic test performed in the diagnosis of ascites is Ultrasound and computed tomography. These two tests are useful, especially in obese patients or those with a low amount of fluid in the peritoneal cavity. Ascites often occur as a result of cirrhosis of the liver or a dilated portal vein and enlargement of the spleen – which is often easier to diagnose.
Diagnosis of ascites – it is a test that allows to distinguish ascites caused by portal hypertension from ascites of a different etiology. The doctor punctures the abdomen and takes fluid. The fluid is withdrawn once (with advanced ascites), and if the ailment is resistant to treatment with diuretics, diagnostics may be performed several times.
Do you need an e-Prescription or e-Waiver? Make an online appointment with a doctor even in 10 minutes, without leaving your home. Use the e-consultation option and do not wait for a distant visit date.
The indications for an abdominal puncture are:
- diagnosed ascites,
- distinguishing ascites from peritonitis,
- cirrhosis of the liver with ascites.
Before removing fluid from the abdominal cavity, the patient should urinate. During the procedure, you should lie in a reclining position with the torso raised. The doctor makes a puncture with a needle, the length of which depends on how thick our fatty tissue is and in the place where the presence of fluid has been found (usually around the navel). The amount of fluid taken is about 50-100 ml, which is then analyzed in succession. This can be done with the naked eye or with tests during which the protein concentration and the cells or bacteria present in it are determined.
How to judge the fluid with the naked eye? Well, its appearance often indicates the cause of ascites. The straw color of the fluid (it may be clear) appears most often in the case of liver cirrhosis, heart failure or in nephrotic syndrome (it may also be milky). Purulent and cloudy fluid is characteristic of peritonitis, while the different color (haemorrhagic, milky or clear) may suggest: cancer, tuberculosis, pancreatic disease.
Ascites – treatment
Treatment of ascites is primarily the causal therapy of the underlying disease. Relief measures include puncture and release of fluid (paracentesis) and administration of diuretics and a low sodium diet.
You can also consider supplementing with natural ingredients, the purpose of which is to support the functioning of the liver and increase digestive comfort.
Text: SzB
The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.
The best internist