Ascites is the pathological accumulation of fluid in the peritoneal space, especially the abdomen. In a healthy human body, the peritoneal space contains a minute quantity of fluid. Ascites occur due to several disorders, including cirrhosis, chronic alcohol use, IV drug use, obesity, hypercholesterolemia, type 2 diabetes, nephrotic syndrome, severe malnutrition, pancreatic ascites, and ovarian lesions.
Treatment depends on the cause of ascitic fluid accumulation. The goals are to minimize the fluid volume and decrease peripheral edema without causing intravascular volume depletion.
Some of the treatments are as follows:
- Abstinence from alcohol.
- Restriction of dietary salt; creates negative sodium balance, lowers diuretic requirement, and resolves ascites faster.
- Diuretics; spironolactone and furosemide in ratio 100:40 mg/day of dosage are the preferred diuretic agents. Diuretics enhance urine formation and remove water content.
- Antibiotics - While patients with chlamydia peritonitis are treated with antibiotics such as doxycycline, ascites caused by lupus serositis may respond to glucocorticoids.
- Paracentesis - It is a procedure in which a surgeon inserts a needle into the abdomen and removes the accumulated fluid. The procedure is for the cases only when the fluid volume is high.
- Trans-jugular Intrahepatic Portosystemic Shunt (TIPS) - A stent is inserted into the hepatoportal vein to direct fluid to bypass the liver.
Cirrhosis,Chronic alcohol use,IV drug use,Obesity,Hypercholesterolemia,Type 2 diabetes,Nephrotic syndrome,Severe malnutrition,Pancreatic ascites,Ovarian lesions
Diuretics: spironolactone and furosemide, doxyciline, glucocorticoids
Progressive abdominal distension associated with abdominal discomfort,Weight gain,Early satiety,Shortness of breath, and dyspnea and increased abdominal pressure,Fever,Abdominal tenderness