Better known as "water belly", ascites is the excessive accumulation of fluid in the cavities of the abdomen, thus causing the appearance of a swollen belly. First of all, it is important to know that ascites is a symptom of several diseases, which can be diagnosed from the analysis of the mentioned fluid. Check below the causes, symptoms and treatments for the problem.

Causes of ascites

Frequently, ascites manifests itself in cases of liver cirrhosis, for example, in addition to kidney dysfunction, heart disease, certain types of cancer, Budd-Chiari syndrome, and endocrine system imbalances, among others. The abdominal fluid, called ascitic, is composed mainly of protein, and depending on the health problem, may contain pancreatic juice, bile, and other substances.

Symptoms of ascites

Although it is not a disease, ascites can cause aesthetic discomfort and alter the individual's well-being. When it is a bulky ascites, the person may experience difficulty breathing as a result of the pressure of the liquid on the diaphragm. Intense pain caused by the distension of the abdominal wall can also occur. Besides these symptoms, here are some others that may arise:

• Weight gain for no apparent reason.
• Swelling in other parts of the body besides the abdomen.
• Loss of appetite.
• Nausea and vomiting.
• Indigestion.
• Weight loss.
• Liver enlargement.
• Excessive fatigue.
• Jaundice.
• Edema in the lower limbs.
• Symptoms and signs in other organs, such as changes in bowel rhythm, for example.

Diagnosis and treatment for ascites

Soon after the symptoms appear, the doctor will request an ultrasound evaluation to define the safest puncture site, usually performed with local anesthesia.

Finally, it is important to emphasize that ascites is curable; however, the treatment will depend on the associated cause. Thus, in cases whose cause originates in the liver, such as cirrhosis or kidney problems, reducing sodium (salt) in the diet is the first course of action.

Most common types of treatment

• Occasionally, it is necessary to take diuretic medications to eliminate abdominal fluid.
• Rest is usually indicated.
• If the associated disease is cirrhosis of the liver, it is necessary to stop drinking alcoholic beverages, as they further accentuate the problem.
• Hospitalization and antibiotics may be ordered by the doctor.
• If the ascites does not regress, invasive intervention, abdominal paracentesis, may be necessary. The procedure is done with local anesthesia and a needle to extract the liquid. The procedure is performed periodically, until, through clinical or surgical treatment, the cause of the problem is resolved.
• In cases of irreversible liver disease with clinical treatment, liver transplantation may be indicated.
• In cases of liver diseases in which transplantation is not indicated, or even in those indicated where the waiting period is long, a procedure through the blood vessels, called liver catheterization, can be done.

Source: Dr. Márcio Dias de Almeida, hepatologist and coordinator of the liver transplant service at Moriah Hospital.