Ascites is an abnormal buildup of fluid in the abdomen. It is mainly caused by cirrhosis of the liver or cancer. How do you know if you have ascites? What are the symptoms ?
Ascites refers to the presence of water in the belly. While ascites is usually asymptomatic, the condition may cause increase abdomen and weight gain. There cirrhosis liver and some cancer are the main causes of ascites. How to know if we have ascites? how to cure ascites? When to do a puncture?
Definition: what is ascites?
“ascites correspond to the presence of water in the belly“, immediately summarizes Professor Victor de Lédinghen, hepatologist at the Bordeaux University Hospital. Ascites corresponds precisely to an accumulation (effusion in medical terms) of liquid in the peritoneum, the normally empty space that lines the abdominal organs.
What are the symptoms of ascites?
Ascites is often painless, but causes abdominal enlargement, weight gain and abdominal heaviness due to fluid accumulation. You can also find a lower limb edema and one pleural effusion (the liquid passes between the two layers of the pleura which covers the lungs).
What are the causes of ascites?
This fluid effusion is due to liver disease, cirrhosis, in nearly 80% of cases. More rarely, it can be caused by cancer. “Several types of cancer can give rise to ascites: that of stomach, colon, ovary, breast… This means that the cancer has spread to the peritoneum and is therefore relatively developed“, explains the hepatologist.
The diagnosis of ascites is not simple when it is present in small quantities. It can be laid afteran ultrasound ora scanner prescribed by the doctor in case of doubt. When ascites reaches a large volume, on the other hand, it becomes visible and easily identifiable. “It is first the patient who will realize this because he gains weight very quickly, and his belly swells“, explains Professor de Lédinghen. It is then enough for the doctor to carry out the “ice cube sign” to establish the diagnosis. “When the doctor examines the patient, he will press on the liver. In case of ascites, this one rests in the water, like an ice cube in a glass, and will therefore go down and then up again when it is pressed.“, says Victor de Lédinghen. A liquid puncture can be carried out. Fluid analysis provides information about the origin of the ascites. The presence of cancerous cells in the liquid indicates a tumoral cause, such as digestive or ovarian cancer, which must then be precisely identified.
“Look for the cause first, then try to treat it.“, explains Professor de Lédinghen. To treat ascites as such, in first intention, these are diuretics which will be prescribed to the patient, so that he can urinate in greater quantity and thus get rid of the excess liquid. And to add:the second part of the treatment consists in making the patient adopt a low-salt diet.
When to puncture ascites?
Ascites puncture is a medical technique that aims to evacuate the accumulated liquid : “we put a needle in the belly, connected to a tube. The water will pass through the needle and the pipe, then land in a jar. Exactly like siphoning off a gas tank. We thus remove up to ten liters of liquid in the most extreme cases“, explains the hepatologist. This technique is carried out in a hospital environment and lasts a few hours. “The patient will be relieved because the water compresses his organs. But if the cause is not treated, the ascites will return“, nevertheless warns Dr. de Lédinghen. In the case of cirrhotic patients whose ascites comes back very regularly, there is now prostheses called “TIPS” which prevent punctures.
To prevent ascites, you must avoid the risk factors for the diseases that are at the origin of this accumulation of fluid, starting with alcohol abusethe cause of many cirrhosis.
Thanks to Pr Victor de Lédinghen, hepatologist, Department of Hepato-Gastroenterology and Digestive Oncology, at the Bordeaux University Hospital.