Ascites is a common complication of cirrhosis. It happens due to the effects of portal hypertension and leads to fluid buildup in your abdomen. Ascites can be treated with medications, procedures, and dietary changes.
Cirrhosis is a type of liver disease where scarring has led to permanent damage to the liver.
There are several complications of cirrhosis. One of these is ascites, a buildup of fluid within the abdomen. Ascites is the most common cirrhosis complication, with about
Keep reading below to learn more about how cirrhosis leads to ascites. We’ll also discuss symptoms to know about, the risks associated with ascites, and how ascites is treated.
Cirrhosis itself happens due to things that damage the liver over time. Some of the most common causes of cirrhosis
- heavy alcohol consumption, referred to as alcohol-associated liver disease
- metabolic dysfunction-associated steatotic liver disease (MASLD), previously called nonalcoholic fatty liver disease (NAFLD)
- chronic (long-term) infection with the hepatitis B or hepatitis C virus
In cirrhosis, the liver becomes scarred. This interferes with its ability to function effectively.
The buildup of scar tissue limits or blocks blood flow in and around your liver. This causes a rise in blood pressure in the portal vein, which carries blood from several abdominal organs to the liver. Doctors call this portal hypertension.
The effects of portal hypertension cause blood vessels to widen, a process called vasodilation. As the body tries to compensate, it can eventually lead to:
- retention of water and sodium (salt)
- lower blood flow to the kidneys
- low levels of albumin, an important protein made by the liver, in the blood
While all of this is occurring, it promotes the leakage and accumulation of fluid into your abdomen. When enough fluid has built up, it’s known as ascites.
If you have only a little fluid buildup in your abdomen, you may not experience any symptoms.
However, as more fluid accumulates, you’ll develop bloating or swelling in your abdomen that gets worse as time passes. You may also notice:
- an increase in waist size
- unintended weight gain
- a pushed-out belly button
As it worsens, ascites can also lead to symptoms like:
- abdominal discomfort or pain
- feeling full right after eating, called early satiety
- indigestion or nausea
- shortness of breath
- edema (swelling) in your legs, ankles, and feet
Ascites can cause serious complications. One common complication is spontaneous bacterial peritonitis, which happens when bacteria that are typically present in your digestive tract enter ascites fluid and cause an infection.
If left untreated, spontaneous bacterial peritonitis can lead to sepsis. Sepsis is a life threatening reaction of your body to an infection.
Other potential complications that can happen with ascites include:
- hernias in your abdomen
- pleural effusion, where fluid builds up in the space between your lungs and chest wall
- hepatorenal syndrome, a type of kidney failure associated with liver disease
Make an appointment with a doctor if you have any symptoms of cirrhosis. Aside from ascites, these can include:
- fatigue
- weakness
- reduced appetite
- nausea and vomiting
- unintended weight loss
- pain in the upper right part of your abdomen
- itchy skin
- jaundice, a yellowish discoloration of the skin or whites of your eyes
- very dark urine
- easy bruising or bleeding
- swelling in your legs, ankles, or feet
- confusion or problems with thinking and memory
If you already have an ascites diagnosis, get prompt medical attention if you have symptoms of spontaneous bacterial peritonitis, which can include:
Ascites is treated based in its severity. It can be graded on a scale of 1 to 3, with grade 3 ascites being the most severe.
To treat ascites in people with cirrhosis, a doctor may prescribe medications that remove extra fluid from the body, such as diuretics. They may recommend adopting a low-salt diet.
If a lot of fluid has accumulated in your abdomen, a healthcare professional can also drain it through a procedure called paracentesis. In paracentesis, a technician uses ultrasound to guide a needle into your abdomen in order to drain away excess fluid.
Fluid typically comes back after paracentesis, so the procedure must often be repeated. If medications and paracentesis aren’t effective, a transjugular intrahepatic portosystemic shunt (TIPS) procedure may be performed.
During a TIPS procedure, the portal vein is connected to another vein in the body. This helps to reduce the effects of portal hypertension, which can, in turn, reduce ascites.
At what stage of liver disease can ascites appear?
Cirrhosis is the most severe stage of liver disease. There are two types of cirrhosis, compensated and decompensated. Ascites occurs during decompensated cirrhosis. This is the type of cirrhosis with severe cirrhosis symptoms.
How long can you live with ascites if you have cirrhosis?
Ascites is associated with a poor outlook. Roughly 30% of people who develop ascites are alive after 5 years.
What’s the newest treatment for ascites?
Researchers continue to investigate new ways to treat ascites and to improve outlook. One of the newer types of treatment is the TIPS procedure, which helps to reduce the portal hypertension that contributes to ascites.
Ascites is the most common complication of cirrhosis. It involves the buildup of fluid in your abdomen due to the effects of portal hypertension.
Some people with mild ascites may not notice symptoms. As more fluid accumulates, you can start to experience noticeable abdominal bloating, weight gain, and discomfort.
Ascites can be complicated by potentially serious bacterial infections and is associated with poor outlook. Available treatments include medications, dietary changes, and procedures to reduce fluid accumulation.