BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAscitesPortal hypertension - ascites; Cirrhosis - ascites; Liver failure - ascites; Alcohol use - ascites; End-stage liver disease - ascites; ESLD - ascites; Pancreatitis ascitesAscites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs. Causes Ascites results from high pressure in the blood vessels of the liver (portal hypertension) and low levels of a protein called albumin.AlbuminAlbumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood. Albumin c...ImageRead Article Now Book Mark Article Diseases that can cause severe liver damage can lead to ascites. These include:Severe liver damageCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.ImageRead Article Now Book Mark Article Chronic hepatitis C or B infection Hepatitis C or B infectionHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Alcohol abuse over many years Alcohol abuseAlcoholic liver disease is damage to the liver and its function due to alcohol abuse.ImageRead Article Now Book Mark Article Fatty liver disease (non-alcoholic steatohepatitis or NASH) Cirrhosis caused by genetic diseasesPeople with certain cancers in the abdomen may develop ascites. These include cancer of the appendix, colon, ovaries, uterus, pancreas, and liver.Other conditions that can cause this problem include:Clots in the veins of the liver (portal vein thrombosis) Congestive heart failure Congestive heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article Pancreatitis Thickening and scarring of the sac-like covering of the heart (pericarditis)Kidney dialysis may also be linked to ascites. Symptoms Symptoms may develop slowly or suddenly depending on the cause of ascites. You may have no symptoms if there is only a small amount of fluid in the belly.As more fluid collects, you may have abdominal pain and bloating. Large amounts of fluid can cause shortness of breath, This happens because the fluid pushes up on the diaphragm, which in turn compresses the lower lungs.Many other symptoms of liver failure may also be present. Exams and Tests Your doctor will do a physical exam to determine if the swelling is likely due to fluid buildup in your belly.You may also have the following tests to assess your liver and kidneys:24-hour urine collection 24-hour urine collection24-hour urine protein measures the amount of protein released in urine over a 24-hour period.Read Article Now Book Mark Article Electrolyte levels Kidney function tests Liver function tests Tests to measure the risk of bleeding and protein levels in the blood Urinalysis Abdominal ultrasound CT scan of the abdomenYour doctor may also use a thin needle to withdraw ascites fluid from your belly. The fluid is tested to look for the cause of ascites and to check if the fluid is infected.Use a thin needleLiver transplant is surgery to replace a diseased liver with a healthy liver.ImageRead Article Now Book Mark Article Treatment The condition that causes ascites will be treated, if possible.Treatments for fluid build-up may include lifestyle changes:Lifestyle changesCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease. You were in the hospital to treat this c...Read Article Now Book Mark Article Avoiding alcohol Lowering salt in your diet (no more than 1,500 mg/day of sodium) Limiting fluid intake You may also get medicines from your doctor, including:"Water pills" (diuretics) to get rid of extra fluid Antibiotics for infections Other things you can do to help take care of your liver disease are:Get vaccinated for diseases such as influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia Talk to your doctor about all medicines you take, including herbs and supplements and over-the-counter medicinesProcedures that you may have are:Inserting a needle into the belly to remove large volumes of fluid (called a paracentesis) Placing a special tube or shunt inside your liver (TIPS) to repair blood flow to the liver Special tube or shuntTransjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need ...ImageRead Article Now Book Mark Article People with end-stage liver disease may need a liver transplant.Liver transplantLiver transplant is surgery to replace a diseased liver with a healthy liver.ImageRead Article Now Book Mark Article If you have cirrhosis, avoid taking nonsteroidal anti-inflammatory medicines, such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). Acetaminophen should be taken in reduced doses. Possible Complications Complications may include:Spontaneous bacterial peritonitis (a life-threatening infection of the ascitic fluid) Spontaneous bacterial peritonitisThe peritoneum is the thin tissue that lines the inner wall of the abdomen and covers most of the organs. Peritonitis is present when this tissue be...ImageRead Article Now Book Mark Article Hepatorenal syndrome (kidney failure) Hepatorenal syndromeHepatorenal syndrome is a condition in which there is progressive kidney failure that occurs in a person with cirrhosis of the liver. It is a seriou...Read Article Now Book Mark Article Weight loss and protein malnutrition Mental confusion, change in the level of alertness, or coma (hepatic encephalopathy) Bleeding from the upper or lower gastrointestinal tract Build-up of fluid in the space between your lungs and chest cavity (pleural effusion) Other complications of liver cirrhosis When to Contact a Medical Professional If you have ascites, call your health care provider right away if you have:Fever above 100.5°F (38.05°C), or a fever that does not go away Belly pain Blood in your stool or black, tarry stools Blood in your vomit Bruising or bleeding that occurs easily Build-up of fluid in your belly Swollen legs or ankles Breathing problems Confusion or problems staying awake Yellow color in your skin and the whites of your eyes (jaundice) Open ReferencesReferencesGarcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 144.National Institute of Diabetes and Digestive and Kidney Diseases website. Cirrhosis. www.niddk.nih.gov/health-information/liver-disease/cirrhosis/all-content. Updated March 2018. Accessed November 11, 2020.Sola E, Gines SP. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 93.AllVideoImagesTogAscites with ovarian cancer - CT scan - illustration This CT scan of the lower abdomen shows a massive amount of free abdominal fluid (ascites) in a patient with ovarian cancer.Ascites with ovarian cancer - CT scanillustrationDigestive system organs - illustration The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.Digestive system organsillustrationAscites with ovarian cancer - CT scan - illustration This CT scan of the lower abdomen shows a massive amount of free abdominal fluid (ascites) in a patient with ovarian cancer.Ascites with ovarian cancer - CT scanillustrationDigestive system organs - illustration The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.Digestive system organsillustrationRelated Information Liver disease(Condition)Cirrhosis(Condition)Hepatitis(Condition)Pericarditis - constrictive(Condition)Heart failure(Condition)Liver cancer - hepatocellular carcinoma(Condition)Nephrotic syndrome(Condition)Transjugular intrahepatic portosystemic shunt (TIPS)(Surgery)Cirrhosis(In-Depth)Hepatitis(In-Depth)Heart failure(In-Depth) Review Date: 7/15/2020 Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.