Ascites is a buildup of fluid in your abdomen. It often occurs as a result of cirrhosis, a liver disease. Talk to your healthcare provider if you have cirrhosis and notice you’re gaining weight very quickly. Your provider will talk to you about treatments, which often include a low-salt diet.
Ascites (ay-SITE-eez) is when too much fluid builds up in your abdomen (belly). This condition often happens in people who have cirrhosis (scarring) of the liver.
A sheet of tissue called the peritoneum covers the abdominal organs, including the stomach, bowels, liver and kidneys. The peritoneum has two layers. Ascites happens when fluid builds up between the two layers.
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Having a condition that causes cirrhosis puts you at greater risk for developing ascites. These conditions include:
Other conditions that can lead to ascites include:
Fluid buildup rarely occurs in otherwise healthy people. It develops as a result of other diseases, most often cirrhosis. Ascites is the most common complication of cirrhosis. About half of people with decompensated cirrhosis will develop ascites. Cirrhosis accounts for about 80% of the cases of ascites.
Cirrhosis is the most common cause of ascites. Other conditions that can cause it include heart failure, kidney failure, infection or cancer.
When you have cirrhosis, your liver doesn’t function as it should. The decrease in liver function combines with portal hypertension to cause ascites symptoms. Portal hypertension is high pressure in the portal vein that delivers blood to your liver. The high pressure causes fluid to leak out of your veins into your belly and collect there.
The main symptoms of ascites are a large belly and rapid weight gain.
Other symptoms include:
Your healthcare provider performs a physical exam and asks you about your symptoms and medical history. You will likely need blood tests or imaging tests as well.
After the initial exam, your provider will recommend other tests to confirm a diagnosis:
Limiting sodium in your diet is crucial for treating ascites. For people with ascites, recommended sodium intake is less than 2,000 to 4,000 milligrams a day.
A dietitian can help create a healthy eating plan for you. You may also need to take diuretics (water pills). These water pills help fluid and sodium leave your body.
Sometimes, diuretics and a low-sodium diet aren’t enough to improve the ascites. You may need other treatments, including:
Treatments for ascites can help improve symptoms and reduce complications. In some patients, ascites may resolve with diuretic therapy or with TIPS or liver transplant. In the case of alcohol-associated hepatitis, ascites may resolve with improvements in liver function. Follow your healthcare provider’s recommendations to stay as healthy as possible.
The best way to prevent ascites is to live a healthy lifestyle. Limit alcohol and salt, don’t smoke and exercise regularly.
If you have ascites, these steps can help you control the condition:
If you have cirrhosis, fatty liver disease, hepatitis B or hepatitis C, you may be at higher risk for ascites. Consuming a lot of alcohol can also put you at risk for health conditions such as ascites.
Ascites is a sign that your liver is not working as it should. The survival rate five years after an ascites diagnosis is around 30% to 40%. Your healthcare provider may refer you to a liver specialist to discuss a possible liver transplant.
Ascites can lead to:
Ascites is a sign of liver damage. If left untreated, it can lead to life-threatening complications. But with proper treatment and diet changes, you can manage ascites. Your healthcare provider may also talk to you about getting a liver transplant if the damage is severe.
The fluid can continue to build up. You may need to have it drained again. If the fluid builds up quickly, your healthcare provider might suggest treatment with diuretics, transjugular intrahepatic portosystemic shunt (TIPS), or liver transplant.
People with ascites should work with a dietitian to plan a sodium-restricted diet. Check food labels, and avoid high-sodium foods.
You can use several salt substitutes. However, avoid substitutes with potassium, since the medicine you may be taking for ascites can also increase potassium. A dietitian can help you plan a healthy diet and provide recommendations for salt alternatives.
In addition, you should:
If you have ascites, ask your healthcare provider:
If you have ascites, go to the emergency room right away if you have:
Ascites is a sign of liver damage. People who have cirrhosis may develop ascites. With the right treatments and diet changes, you can manage ascites and feel your best. Restricting your salt intake is one of the most effective treatments for ascites. Ask your provider about working with a dietitian to plan a salt-restricted diet and other treatment options for ascites that doesn’t respond to diuretics.
Last reviewed by a Cleveland Clinic medical professional on 05/28/2021.
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