Ascites is the accumulation of fluid in the peritoneal cavity, causing abdominal swelling.
Edema is a symptom defined as excess of fluid in extracellular spaces.
Diseases and conditions that may cause edema include:
1. Congestive heart failure - the main cause
When one or both of the heart's lower chambers lose their ability to pump blood effectively as happens in congestive heart failure the blood can back up in the legs, ankles and feet, causing edema.
2. Liver Cirrhosis - the second cause
Fluid may accumulate in the abdominal cavity (ascites) and in the legs as a result of cirrhosis, a liver disease often caused by alcoholism.
3. Kidney disease.
When you have kidney disease, extra fluid and sodium in the circulation may cause edema.
The edema associated with kidney disease usually occurs in the legs and around the eyes.
4. Kidney damage.
Damage to the tiny, filtering blood vessels in the kidneys can result in nephrotic syndrome.
In nephrotic syndrome, declining levels of protein (albumin) in the blood can lead to fluid accumulation and edema.
4. Weak or damaged leg veins (chronic venous insufficiency).
One-way valves keep the blood in the leg veins moving toward the heart.
If the valves stop working properly, blood can pool in the lower legs and cause swelling.
5. Inadequate lymphatic system.
The body's lymphatic system helps clear excess fluid from tissues.
If this system is damaged for example, by cancer surgery the lymph nodes and lymph vessels draining an area may not work correctly and edema results.
A person with ascites usually has severe liver disease.
Ascites due to liver disease is caused by high pressure in the blood vessels of the liver (portal hypertension) and low albumin levels.
Cirrhosis and any illness that leads to it is a common cause of ascites.
Long-term infections with hepatitis C or B and long-term alcohol abuse are two of the most common causes of cirrhosis.
People with colon cancer, ovarian cancer, endometrial cancer, pancreatic cancer, and liver cancer may develop ascites.
Diagnosis is by Paracentesis or abdominal tap.
Treatment may include:
1. Diuretics, or water pills, to help remove the fluid; usually, spironolactone (Aldactone) is used first, and then furosemide (Lasix) will be added
2. Antibiotics, if an infection develops
3. Limiting salt in the diet (no more than 1,500 mg/day of sodium)
4. Avoiding drinking alcohol
Procedures used for ascites that do not respond to medical treatment include:
1. Placing a tube into the area to remove large volumes of fluid (called a large volume paracentesis)
2. Transjugular intrahepatic portosystemic shunt (TIPS), which helps reroute blood around the liver.
3. Patients who develop end-stage liver disease, and whose ascites no longer respond to treatment will need a liver transplant.
TABLE OF CONTENT
Introduction
Chapter 1 Ascites
Chapter 2 Interesting Facts of Ascites
Chapter 3 Treatment of Ascites
Chapter 4 Portal Hypertension
Chapter 5 Liver Cirrhosis
Chapter 6 Congestive Heart Failure
Chapter 7 Alcoholism
Epilogue