Ascites in cirrhosis of the liver in adults
Ascites is popularly called dropsy of the abdomen. Note that this ailment cannot be called an independent disease, it is rather a complication. We will tell you what ascites is in liver cirrhosis, what are the causes of its occurrence, how to deal with it. Dealing with a specialist

What is ascites

– Ascites of the abdominal cavity – the case when a pathological accumulation of fluid has formed in the abdominal cavity. The disease develops gradually, progresses over several weeks, months. Often, many patients do not even know that they develop ascites. Patients think they just got better, so the belly grows. In 75% of cases, ascites is associated with cirrhosis of the liver, in the remaining 25% it is cancer, heart problems, says gastroenterologist Olga Smirnova.

The doctor notes that the opinion “cirrhosis causes alcohol consumption” is erroneous, because chronic hepatitis, autoimmune liver damage and fatty liver disease also lead to cirrhosis of the liver.

Causes of ascites in cirrhosis of the liver in adults

When a patient first comes to the doctor, and he suspects ascites, the next under suspicion is cirrhosis of the liver. But note that if you have cirrhosis, this does not mean that ascites will occur 100%.

There are several factors that can increase the chances of developing the disease. Experts believe that at risk are people who lead an unhealthy lifestyle – use drugs and alcohol. This also includes people who have had hepatitis, those patients diagnosed with obesity of all types, people suffering from high cholesterol, type 1 and type 2 diabetes.

Symptoms of ascites in cirrhosis of the liver in adults

– At the very beginning of the disease, the patient does not even know that he has ascites. In order for the patient to notice it early, it is necessary that at least a liter of fluid accumulate in the abdomen. That’s when the rest of the symptoms of ascites with cirrhosis of the liver will begin to appear, the doctor says.

The rest of the symptoms can already be attributed to acute pain in the abdomen, accumulation of gases (when a real hurricane occurs in the stomach), constant belching, frequent heartburn, a person begins to breathe heavily, his legs swell.

– When a person has a lot of fluid inside, the stomach begins to grow, and the patient begins to suffer when bending over. The abdomen becomes like a ball, stretch marks appear, because the skin is greatly stretched. Also, some of the veins on the abdomen expand, the specialist continues. – In case of a particularly severe course of the disease, the patient may also develop jaundice, the person will feel unwell, vomiting and nausea.

Treatment of ascites in cirrhosis of the liver in adults

When ascites develops against the background of cirrhosis, hepatoprotectors are used in the treatment. Along with this, doctors prescribe symptomatic therapy to patients with ascites.

To begin with, the patient will have to give up salt. The doctor will prescribe a low-salt diet, which must be strictly observed. It implies a complete rejection of salt or the use of only 2 g per day.

Also, the doctor will prescribe drugs that make up for the deficiency of potassium in the body, and diuretic drugs for edema. The doctor will monitor the dynamics of treatment, as well as the weight of the patient.

Diagnostics

As mentioned above, if the amount of fluid in the abdomen is less than 400 ml, ascites is practically not noticeable. But it can be identified with the help of instrumental studies. Therefore, it is important to have regular physical examinations, especially if you have cirrhosis.

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To diagnose ascites, first of all, you need to see a doctor who will conduct a visual examination and palpation of the abdomen. To establish an accurate diagnosis, it is necessary to conduct an ultrasound of the abdominal cavity and sometimes the chest. An ultrasound examination will show the condition of the liver and allow the doctor to see both the ascites itself and the existing neoplasms or changes in the organ.

Dopplerography, which will show the condition of the veins.

To accurately diagnose ascites, magnetic resonance imaging or computed tomography should be performed. These studies will allow you to see the presence of fluid. In other words, to see what is not visible during an ultrasound.

In some cases, your doctor may perform a laparoscopy. The specialist will make a puncture of the abdominal wall, and the accumulated fluid will be taken for analysis.

In addition, they do a general blood test.

Modern treatments

These include:

  • sodium-free diet (complete refusal of salt or consumption of 2 g per day);
  • taking diuretics.

If the above methods were powerless and did not give any result, the patient continued to suffer, surgery may be required. A doctor with ascites can remove fluid with gradual drainage. In this case, the surgeon makes a small puncture in the abdomen and inserts a drainage tube into it.

The patient may also have indwelling catheters and subcutaneous ports placed. The liquid will be removed as soon as it gets into them. This is one of the best methods of treatment – it allows you to reduce the risk of damage to internal organs and inflammation.

Prevention of ascites in cirrhosis of the liver in adults at home

Among the measures to prevent ascites are the following:

  • timely treatment of infectious diseases;
  • healthy lifestyle;
  • giving up alcohol, smoking;
  • physical exercise;
  • proper nutrition.

A patient with cirrhosis should be regularly examined by specialists and carefully follow their instructions.

Popular questions and answers

Answered popular questions gastroenterologist Olga Smirnova:

What are the complications of ascites in cirrhosis of the liver?
Ascites always aggravates the course of the underlying disease. Most often, having ascites with cirrhosis of the liver, the following complications may develop:

the patient can get mechanical complications by compression with ascitic fluid;

● liquid may accumulate between the pleural sheets – in the pleural cavity, in other words, hydrothorax develops;

● vessels can be squeezed (inferior vena cava syndrome, compression of the renal veins);

● the appearance of hernias – often umbilical;

● displacement of organs intraperitoneally;

● accession of infection – spontaneous bacterial peritonitis;

● metabolic complications – violation of electrolyte metabolism;

● hepatorenal syndrome with impaired renal function.

When to call a doctor at home for ascites with cirrhosis of the liver?
A home doctor should be called if:

● ascites occurred spontaneously, or the abdomen began to rapidly increase in size with the appearance of various symptoms;

● elevated body temperature appeared on the background of ascites;

● urination became less frequent;

● there was disorientation in space – the patient cannot orient himself where he is, what day, month, etc. it is today.

Can ascites be asymptomatic?
Yes, this is possible, but if the volume of fluid in the abdomen is less than 800 ml. Then there will be no mechanical compression of the abdominal organs, which means that ascites can be asymptomatic.
How to eat with ascites?
● strictly adhere to a diet in which salt can be consumed in very small quantities (2 g per day), and in severe cases of ascites – a completely salt-free diet;

● limit fluid intake – no more than 500-1000 ml per day;

● limit the intake of fats in order to prevent exacerbation of pancreatitis.

A patient with ascites should have a properly balanced diet. The diet must have a sufficient amount of vegetables and fruits, you can eat both fresh and stewed, dairy products – kefir and cottage cheese. In no case do not fry food, it is better to boil or cook in the oven, a great way to have a healthy dinner or lunch is to steam food. Fatty foods, fatty meats and fish, smoked foods, semi-finished products, alcohol, canned food and pickled foods are strictly prohibited.

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