 |
| Ascites, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Ascites or ascites is a buildup of fluid in the cavity between the membrane that lines the abdominal wall (peritoneum) and the organs in the abdomen. This buildup of fluid causes the stomach to appear enlarged. Generally, ascites is most often caused by cirrhosis of the liver.
In addition to cirrhosis of the liver, ascites can also be caused by a lack of albumin. Albumin is a type of protein that functions to bind fluids. If the body lacks albumin (hypoalbuminemia), fluid in the blood vessels will leak into the surrounding tissue, causing a buildup.
Causes of Ascites
The organs inside the abdomen are covered by a pouch or membrane called the peritoneum. Normally, the cavity within the peritoneum (peritoneal cavity) contains only a small amount of fluid. In women, the peritoneal cavity can contain about 20 ml of fluid, depending on the phase of the menstrual cycle that she is experiencing.
Ascites occurs when the amount of fluid in the peritoneal cavity is more than 25 ml. This condition is often caused by liver disease, or a decrease in the amount and production of albumin.
Liver disease can cause the pressure in the veins in the liver to increase. This condition can cause fluid to leak from the blood vessels into the surrounding tissues, including the peritoneal cavity.
Below are some liver diseases that can trigger ascites:
• Cirrhosis
Cirrhosis is the appearance of scar tissue in the liver that causes decreased liver function or liver failure.
• Acute liver failure
Acute liver failure is one of the conditions that cause ascites. This condition can occur due to injury to liver cells due to side effects of drugs or drug abuse.
• Budd-Chiari syndrome
This syndrome is caused by a blockage in the veins of the liver. This blockage causes the pressure in the blood vessels in the liver to increase (portal hypertension).
• Heart cancer
Liver cancer can make the peritoneum perforate and increase pressure within the liver. As a result, fluid can enter the peritoneal cavity. In general, ascites can occur in liver cancer that has entered an advanced stage.
Ascites can also occur as a result of other cancers that have spread (metastasized) to the liver. Types of cancer that can spread to the liver are ovarian, pancreatic, and colon cancer.
In addition to some of the liver diseases above, there are several other conditions that can trigger ascites, namely:
1. Nephrotic syndrome
Nephrotic syndrome occurs when the kidneys are damaged so that protein that should remain in the body comes out through the urine. The lack of this protein makes the pressure that keeps fluid in the blood vessels (oncotic pressure) decreases so that fluid comes out to surrounding organs.
2. Heart failure
Heart failure occurs when the heart muscle is unable to pump fluids and blood throughout the body. This condition can allow fluid to back up into the lungs or other organs and leak into the peritoneal cavity.
3. Pancreatic disorders
Pancreatic disorders that can increase the risk of ascites are acute pancreatitis and chronic pancreatitis. Chronic pancreatitis can lead to malnutrition, including protein. As a result, the oncotic pressure decreases and causes fluid to leak into the surrounding tissues, including the peritoneal cavity.
4. Irritation of the peritoneum
Irritation of the peritoneum from cancer or infection can cause fluid to leak into the peritoneal cavity.
5. Diseases of the ovaries (ovaries)
Both malignant (cancerous) tumors and benign tumors in the ovaries, such as Meigs syndrome, can also cause damage to the peritoneum so that fluid leaks into the peritoneal cavity.
6. Hypothyroidism
Although rare, ascites can also occur in people with untreated hypothyroidism. Ascites resolves when thyroid levels return to normal.
Symptoms of Ascites
Symptoms that arise when a person has ascites can appear gradually or suddenly, depending on the cause of the ascites itself. Some of the complaints that usually arise due to ascites are as follows:
- Stomach that looks enlarged and swollen like a balloon
- Bloating
- Nausea or vomiting
- Stomach ache
- Shortness of breath, especially when lying down
- Indigestion
- A burning sensation in the chest (heartburn) due to increased stomach acid
- Weight gain
In addition to the symptoms mentioned above, people with ascites can also experience swelling in the legs and ankles, swollen veins in the anus (hemorrhoids), fever, confusion, and loss of appetite.
When to go to the doctor
Check with your doctor if you experience the symptoms mentioned above. Some of these symptoms can be signs or symptoms of another disease or condition. Early detection can help doctors to treat the underlying disease ascites, before the disease gets worse.
Immediately see a doctor if you experience symptoms that suggest liver disease, such as fever, bloody or black stools, vomiting blood, easy bruising and bleeding of the skin, confusion, loss of consciousness, or yellowing of the skin and whites of the eyes (jaundice).
Ascites Diagnosis
The doctor will ask questions about the symptoms experienced by the patient and the patient's medical history. Next, the doctor will examine the patient's abdomen, including by looking at the shape of the patient's stomach when sitting or standing, as well as checking for movements and abdominal sounds.
To find out how much fluid has accumulated and find out the cause of ascites, the doctor may ask the patient to undergo investigations, such as:
- Scan with ultrasound, CT scan, or MRI, to see the presence and level of fluid, as well as to find out the cause of ascites
- Blood tests, to check liver function, kidney function, electrolyte levels, and albumin levels in the blood
- Paracentesis, which is taking ascitic fluid with a syringe to determine the number of red and white blood cells, checking albumin, amylase, and glucose levels, and detecting cancer cells
- Angiography, to check blood flow, especially in the hepatic veins
- Laparoscopy, to examine the condition of the organs in the abdomen
Ascites Treatment
Treatment of ascites aims to overcome complaints, reduce fluid buildup, and treat the underlying disease. Treatment methods that can be carried out by doctors can vary, depending on the condition and the cause itself.
Some of the treatment options that doctors can provide are:
Administration of drugs
Medicines work to reduce excess fluid in the body and treat the cause of ascites. Some of the types of drugs used are:
- Diuretics, to increase the excretion of fluids and salts from the body thereby reducing complaints and pressure in the hepatic veins
- Chemotherapy, to kill cancer cells in ascites caused by cancer
- Antibiotics, to prevent or treat infection, especially if the ascites is triggered by a bacterial infection
Medical and surgical procedures
Special medical measures to surgery can be performed to treat the disease that causes ascites as well as remove excess fluid in the abdominal cavity. Some of the medical procedures that can be done are:
- Paracentesis, to remove ascitic fluid from the abdominal cavity
- Transjugular intrahepatic portosystemic shunts (TIPS) surgery, to reduce pressure in the veins
- Surgery, to remove cancerous tissue
- Liver transplant, to treat ascites caused by very severe liver damage
Self-medication
Independent treatment is carried out to support the effectiveness of the drug in removing excess fluid from the peritoneal cavity, preventing excessive fluid absorption, as well as preventing further damage to the problematic organ. Self-care that can be done are:
- Avoid consumption of alcoholic beverages, to reduce the risk of worsening liver damage
- Limit salt consumption, to reduce body fluid absorption
- Limiting the amount of fluids that can be drunk as recommended by the doctor
Ascites Complications
Ascites that is not treated immediately can lead to complications such as:
- Infection of the fluid in the abdominal cavity or spontaneous bacterial peritonitis (SBP)
- Kidney failure due to severe liver damage (hepatorenal syndrome)
- Protein malnutrition and weight loss due to difficulty eating and drinking
- Accumulation of fluid around the lungs or pleural effusion
- Decreased consciousness due to hepatic encephalopathy
- Difficulty breathing due to fluid buildup pressing against the diaphragm
- Bowel bulge in the navel (umbilical hernia) or in the groin (inguinal hernia)
Ascites Prevention
Ascites is difficult to prevent. However, you can live a healthy lifestyle to prevent diseases that can cause ascites. The following are some healthy lifestyles that you can adopt to prevent ascites:
- Do not drink alcohol or use drugs
- Maintain ideal body weight
- Exercise regularly
- Undergo hepatitis B vaccination and HPV vaccine
- Reduce consumption of foods high in salt
- Drink enough water
- Do not change sexual partners
- Using condoms to prevent sexually transmitted infections
- Using medicines according to doctor's prescription
Related Search:
- ascites definition,
- ascites symptoms,
- what is ascites,
- ascites icd 10,
- ascites causes,
- ascites treatment,
- early stage ascites symptoms,
- malignant ascites,
- ascites fluid,
- saag ascites,
- what causes ascites,
- icd 10 code for ascites,
- ascites pictures,
- ascites meaning,
- woman mild ascites pictures,
- ascites pronunciation,
- chylous ascites,
- ascites medical term,
- woman early ascites,
- what stage of cirrhosis does ascites occur,
- ascites abdomen,
- icd 10 ascites,
- ascites vs belly fat,
- can ascites be reversed,
- define ascites,
- ascites liver,
- symptoms of ascites,
- ascites,
- how long can you live with ascites,
- ascites medical definition,
- ascites belly,
- ascites in dogs,
- ascites treatments,
- does ascites come and go,
- mild ascites pictures,
- refractory ascites,
- pelvic ascites female,
- pelvic ascites,
- will ascites go away if i stop drinking,
- how often can ascites be drained,
- ascites in abdomen,
- ascites cirrhosis life expectancy,
- stomach ascites,
- ascites in stomach,
- what does ascites feel like,
- liver ascites,
- alcoholic cirrhosis of liver with ascites,
- ascites definition medical,
- paracentesis for ascites,
- at what stage of cancer does ascites occur,
- cirrhosis with ascites icd 10,
- woman ascites or fat,
- ascites stomach,
- ascites cancer,
- ascites cats,
- ascites liver failure,
- woman ascites pictures,
- cat ascites,
- end stage cancer and ascites,
- ascites ultrasound,
- liver failure ascites,
- ascites fluid analysis,
- ascites cat,
- ascites in cats treatment,
- ascites cirrhosis,
- perihepatic ascites,
- how to pronounce ascites,
- cirrhosis with ascites,
- ascites prognosis,
- ascites in cats,
- pictures of mild ascites,
- symtoms of ascites,
- ascites dog,
- ascites in heart failure,
- ascites from heart failure,
- ascites drainage,
- what does ascites look like,
- what do ascites look like,
- mild ascites,
- cirrhosis and ascites,
- heart failure ascites,
- abdominal ascites,
- ascites with heart failure,
- ascites of the liver,
- cirrhosis of liver with ascites icd 10,
- draining ascites at home,
- ascites pancreatitis,
- pancreatic ascites,
- ascites drain at home,
- pancreatitis ascites,
- pancreatitis with ascites,
- causes of ascites,
- ascites ovarian cancer,
- ascites drainage at home,
- ascites heart failure,
- pancreas ascites,
- malignant ascites icd 10,
- liver cirrhosis ascites,
- liver cirrhosis with ascites icd 10,
- diagnosis of ascites,
