Ascites
Alternate Names : Abdominal Dropsy, Hydroperitoneum
What are the treatments for the condition?
Treatment of ascites includes treatment of the underlying disorder. Some of the general treatment guidelines followed for ascites itself are as follows:
bed rest to improve kidney function
a diet limited to 2 grams of sodium a day
fluid restricted to 1 liter a day
hospitalization to monitor the daily weight and salt balance
Diuretics, also called water pills, may also be used to treat ascites. These medications help the body excrete extra water through the kidneys. Common diuretics include spironolactone, amiloride, and triamterene. If these are not effective, stronger diuretics may be used. These stronger medicines include furosemide, thiazide, and ethacrynic acid.
Some people with massive ascites may need a paracentesis to remove excess fluid. A needle is inserted into the abdominal cavity, and extra fluid is drained out.
Most people respond to these measures. About 10% to 15% are resistant and require other methods to control the ascites.
Other individuals may need a transjugular intrahepatic portosystemic shunt, also called TIPS. This is a mesh tube that is passed through the skin of the neck and into the jugular vein. The tube is then advanced into the liver. It is pushed into the portal vein, which drains into the liver. The shunt reduces pressure and ascites formation.
In rare and selected cases, a liver transplant may be needed.
What are the side effects of the treatments?
Side effects of diuretics can include the following:
dehydration
high or low potassium levels in the blood
kidney failure
Removal of large volumes of fluid using parencentesis may cause the following conditions:
decreased kidney function
low blood pressure, called hypotension
shock
Following are some of the side effects that shunting procedures can cause:
abnormal blood clotting that may result in bleeding
change in mental functioning or level of consciousness
clotting of the shunt
infection
What happens after treatment for the condition?
In most cases, treatment of ascites is lifelong.
How is the condition monitored?
Ascites will be monitored with lab tests and regular visits to the healthcare provider. Any new or worsening symptoms should be reported to the provider.
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