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When the stomach has an abnormal build-up exceeding 25 millilitres of fluid, the condition is known as Ascites. This condition arises when the liver ceases to function normally. In such a situation, fluid takes up the space between the organs and the abdominal lining. The abdomen becomes large and tense, almost sack-like.

Generally, the survival rate of Ascites is 50%, so if you do experience it, speak to your doctor immediately.

Signs and Symptoms

Ascites often causes a lot of discomfort. People with ascites may have the following symptoms:

  • Abdominal swelling
  • Weight gain
  • Loss of appetite
  • Shortness of breath
  • Bloating, feeling of heaviness
  • Painful haemorrhoids near the anus
  • Indigestion
  • Fatigue
  • Nausea
  • Changes seen in the belly button
  • Swollen ankles


Ascites is generally caused by liver scarring or cirrhosis. It increases pressure in the blood vessels of the liver. This pressure forces the fluid to enter the abdominal cavity, leading to Ascites.

Risk Factors

Liver cirrhosis, alcohol abuse, hepatitis B or C can lead to a damaged liver, which is the biggest risk factor for Ascites. Other factors include ovarian cancer, pancreatic cancer, endometrial cancer or liver cancer; TB, kidney or heart failure; pancreatitis and hypothyroidism.


  • The patient should weigh himself every day. If he gains over a kilo per day for three days consecutively, he should speak to his doctor about it.
  • Alcohol and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), should be stopped immediately. These drugs disturb the functioning of the kidneys and retain salt and water in the body.
  • A low-salt diet should be followed, not more than 2,000 mg/day.
  • Vaccination for hepatitis B should be taken.
  • Use of condoms should be practised as hepatitis is sexually transmitted.
  • Avoid sharing needles. Hepatitis can be transmitted through shared needles.

Diagnosis and Treatments

If the patient complains of shortness of breath and discomfort, it is due to the excessive build-up of fluid in the abdominal cavity.Depending on the reason for the build-up of fluid, the treatment method will be determined.

Your doctor will begin to diagnose Ascites by checking for a distended abdomen. He might then use an imaging test to check for fluid. Tests you will undergo include Ultrasound, MRI, CT scan, angiography, blood tests and laparoscopy.


Treatment for Ascites depends on the cause of the condition.


Usually, diuretics are the most effective treatment for those with this condition. With the use of diuretics, the salt and water content leaving the body increase. This creates a fall in pressure inside the veins surrounding the liver.

At this stage, the doctor will also monitor the patient’s blood picture. He will have to decrease his salt and alcohol intake.


Here, a slim and long needle helps remove excess fluid from the abdomen when inserted into the skin and then into the abdominal cavity. Since infection may arise, doctors prescribe antibiotics at this stage. This treatment is given to patients with recurrent or chronic Ascites.

Peritoneovenous Shunting

This surgical operation helps increase short-term survival in cancer patients who have not found success with paracentesis.


For chronic cases of Ascites, a shunt or tube is permanently inserted in the body. Its function is to reroute the blood flow surrounding the liver. If a patient’s condition does not improve with this, the doctor may suggest a liver transplant. This suggestion is generally made at the last stage of liver disease.

TransjugularIntrahepatic Portosystemic Shunt (TIPS)

Using this shunt, fluid is diverted from the portal vein and sent to the central blood circulation. This reduces pressure on the liver and consequently Ascites formation also reduces. A stent is placed below the skin and sent into the jugular vein and to the hepatic vein after sedating the patient.

Liver Transplant

Patients with ascites and cirrhosis are prime candidates for a liver transplant.


If one suffers from Ascites due to cancer, dietary restrictions and diuretics generally don’t prove effective. In such a scenario, Paracentesis is the first line of treatment. Here, the catheter may be left to drain so that the fluid is removed easily and the patient is not subjected to any more procedures.

Preparing for Your Appointment

Inform your doctor about all the medications you take and allergies, if any. Under his advice, you may have to stop taking NSAIDs or blood thinners before the procedure.

If lady patients are pregnant, they should inform the doctor of this as imaging tests are not performed on pregnant women.


Medical Management

For those suffering fromcirrhosis, treatment for Ascites starts with a restriction on dietary salt. Medications that play a role in getting rid of excess salt and fluid in the body are also prescribed.

Controlling body weight is also another important measure. Once diuretic therapy gives the desired results of eliminating most of the fluid from the body, medication is prescribed according to the patient’s needs. Restriction on drinking water may also be applied if low serum sodium is present in the body.

Lifestyle & Others

Patients who develop Ascites as a fallout of cirrhosis should give up drinking alcohol. If they are on medication that contains Acetaminophen, its dosage should be drastically reduced.



Now, Ascites patients can receive prompt and effective treatment. With the setting up of the Dr.Rela Institute &  Medical Centre, Chennai, liver Ascites treatment in India is now possible and at affordable prices.

This 450-bedded hospital with 130 critical care beds and 14 operating rooms also has state-of-the-art diagnostic labs to provide the best treatment for patients of all liver diseases. All this on a 36-acre expanse in a serene atmosphere of Chennai, India.

This liver hospital in Chennai has been the dream of its founder, Dr Mohamed Rela. Under his leadership, this hospital has been serving liver patients and has also provided the best care and treatment for end-stage liver disease.

Ably supported by other liver specialists with impressive track records, the world-renowned DrRela works with the best liver transplantation surgeons in India, providing cutting-edge treatments and surgery, and often being successful in increasingliver Ascites life expectancy.

It is our endeavour to wipe out all liver-related diseases in India with our updated techniques and knowledge. With our patients’ cooperation, we can only succeed.

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