Ascites
Einstein Health Glossary
ICD 10 - R18
What is ascites?
Ascites is the accumulation of fluid within the abdomen, usually resulting from portal hypertension, which may or may not be related to liver cirrhosis, as well as other heart or kidney diseases. There are other causes of ascites, such as: tuberculous ascites, chylous ascites, and pancreatic ascites.
Causes
Ascites may result from liver problems such as: liver cirrhosis, non-cirrhotic portal hypertension (schistosomiasis or "water belly"), kidney diseases, heart failure, pancreatic diseases, and neoplastic cells that may affect the peritoneum.
Symptoms
The main symptoms are increased abdominal volume and weight gain. This abdominal enlargement may also be associated with nausea, difficulty eating, bloating, and other nonspecific abdominal symptoms.
Diagnosis
The diagnosis is clinical, meaning it is made based solely on medical history and physical examination. Confirmation of small-volume ascites is usually achieved through additional tests such as abdominal ultrasound, since it may be difficult to detect through physical examination alone.
Treatment
Treatment of ascites begins with identifying and addressing its underlying cause. The main goal is to achieve a negative sodium and water balance—that is, to reduce dietary salt intake to a maximum of 2g per day. Another therapeutic method is the use of diuretics, medications that increase urine output. This leads to a forced loss of water and salt through the urine, helping to eliminate the excess from the body.
Prevention
Prevention can be achieved by monitoring and looking for signs of liver changes throughout life. Patients known to have cirrhosis or portal hypertension who have never developed ascites may benefit from a low-sodium diet.
Incidence in Brazil
Ascites is the most common complication of liver cirrhosis. It occurs in about 50% of cirrhotic patients under follow-up for 10 years. There is no specific data available to assess the incidence or prevalence in Brazil.