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 often results from high pressure in certain veins of the liver (portal hypertension) and low blood 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 overuse over many years Alcohol overuseAlcoholic liver disease is damage to the liver and its function due to alcohol abuse.ImageRead Article Now Book Mark Article Fatty liver disease (metabolic associated steatohepatitis (MASH) previously called 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, bile ducts, and liver.Other conditions that can cause ascites include:Clots in certain 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 health care provider 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 collectionA 24-hour urine protein measures the amount of protein released in urine over a 24-hour period.ImageRead Article Now Book Mark Article Electrolyte levels Kidney function tests Kidney function testsKidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...ImageRead Article Now Book Mark Article Liver function tests Liver function testsLiver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...ImageRead Article Now Book Mark Article Tests to measure the risk of bleeding and protein levels in the blood Urinalysis Abdominal ultrasound CT or MRI scan of the abdomen Blood test to determine the cause of any liver failure leading to ascites.Your provider may also use a thin needle to withdraw ascites fluid from your belly. This procedure is called an abdominal tap or paracentesis. The fluid is tested to look for the cause of ascites and to check if the fluid is infected. Sometimes a large amount of fluid is removed to make you more comfortable.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 that often eventually causes poor liver function. It is the most advanced stage of chronic liver disease. You we...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 infection Talk to your provider 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 an abdominal tap or 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 severe 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 in the abdomen. Peritonitis is present when...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, contact your 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, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.National Institute of Diabetes and Digestive and Kidney Diseases website. Cirrhosis. www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Updated June 2023. Accessed October 10, 2024.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 - InDepth(In-Depth)Hepatitis - InDepth(In-Depth)Heart failure - InDepth(In-Depth) Review Date: 8/12/2024 Reviewed By: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, 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. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. 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AscitesPortal 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 often results from high pressure in certain veins of the liver (portal hypertension) and low blood 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 overuse over many years Alcohol overuseAlcoholic liver disease is damage to the liver and its function due to alcohol abuse.ImageRead Article Now Book Mark Article Fatty liver disease (metabolic associated steatohepatitis (MASH) previously called 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, bile ducts, and liver.Other conditions that can cause ascites include:Clots in certain 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 health care provider 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 collectionA 24-hour urine protein measures the amount of protein released in urine over a 24-hour period.ImageRead Article Now Book Mark Article Electrolyte levels Kidney function tests Kidney function testsKidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...ImageRead Article Now Book Mark Article Liver function tests Liver function testsLiver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...ImageRead Article Now Book Mark Article Tests to measure the risk of bleeding and protein levels in the blood Urinalysis Abdominal ultrasound CT or MRI scan of the abdomen Blood test to determine the cause of any liver failure leading to ascites.Your provider may also use a thin needle to withdraw ascites fluid from your belly. This procedure is called an abdominal tap or paracentesis. The fluid is tested to look for the cause of ascites and to check if the fluid is infected. Sometimes a large amount of fluid is removed to make you more comfortable.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 that often eventually causes poor liver function. It is the most advanced stage of chronic liver disease. You we...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 infection Talk to your provider 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 an abdominal tap or 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 severe 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 in the abdomen. Peritonitis is present when...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, contact your 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, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.National Institute of Diabetes and Digestive and Kidney Diseases website. Cirrhosis. www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Updated June 2023. Accessed October 10, 2024.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.
