Ascites

Ascites is a condition in which excess fluid builds up in the abdomen (belly). Peritoneum is a sheet of tissue, which covers the abdominal organs, such as the stomach, intestine, liver and kidney. There are two layers in the peritoneum, and ascites develops when fluid accumulates between these layers. The characteristic symptoms of ascites are a protruding abdomen and the rapid increase of body weight. Other symptoms are swelling in the legs and ankles, breathing difficulties, fatigue, and abdominal discomfort and bloating. Ascites rarely occurs in healthy people, and it often occurs in people suffering from liver cirrhosis (scar in the liver). About half of the people with cirrhosis will develop ascites. Liver cirrhosis is the common cause of ascites. Other diseases that may develop it include kidney failure, heart failure, cancers, and infections. In cirrhosis, the liver cannot function properly. The decrease in liver function combines with portal hypertension (higher blood pressure to the portal vein) to cause ascites. The higher-pressure blocks blood flow to the liver resulting in the leakage of fluid out of the veins into the abdomen and builds up there. Ascites is detected with physical investigation along with an ultrasound imaging or a CT scan. Examining the abdominal fluid can help confirm the possible cause of ascites. Sodium restricted diet is very important to treat ascites. Treatment often includes a low-salt diet and diuretics, a class of drugs that helps fluid and sodium leave the body. In some cases, diuretics and a low-salt diet cannot effectively improve the condition, and a transjugular intrahepatic portsystemic shunt (TIPS) or a liver transplantation may be needed. People with ascites should avoid high-salt foods, limit nonsteroidal anti-inflammatory drugs that affect the kidney, stop drinking alcohol, and treat hepatitis B or C, if requires. [Hussain Md. Shahjalal]