Ascitis: Definition, Causes and Treatments

What is it?

Ascites can be defined as the accumulation of fluid (usually serous fluid that is a pale yellow and clear liquid) in the abdomen. The treatment of ascites depends on the underlying cause.


Ascites can also manifest due to a type of cancer called malignant ascites. These ascites are typically a clear manifestation of advanced cancers in different organs.

Also, some factors can affect the flow of circulating blood and can be perceived as low by the sensors in the kidneys since the formation of ascites can deplete the volume of blood. In rare cases, increased blood pressure can cause blood clots in the abdominal region, so it is common for patients with ascites to notice an increase in their abdominal perimeter.

Because most cases of ascites are due to liver disease, patients with this condition should be asked about the risk factors for their liver disease. These include the following:

  • Excessive alcohol consumption in the long term.
  • Chronic viral hepatitis or jaundice.
  • Intravenous drug use.
  • Multiple sexual partners. Advanced liver disease or cirrhosis.
  • Patients with alcoholic liver disease alternate between heavy drinking and abstinence and may experience ascites cyclically.

When a patient with a very long history of stable cirrhosis develops ascites, the possibility of superimposed hepatocellular carcinoma (CHS) should be considered.

Obesity, hypercholesterolemia, and diabetes mellitus type 2 are the causes of non-alcoholic steatohepatitis, which can progress to cirrhosis quickly.


Patients with a history of cancer, especially gastrointestinal cancer, are at risk for malignant ascites, related malignancies that are often painful, while cirrhotic ascites are usually painless.

Patients who develop ascites of established diabetes or nephrotic syndrome may have nephrotic ascites.



Principles should be established in treating ascites in patients with diet and prescription diuretics (water pills). Also, set the restriction on dietary sodium intake. In most cases, this approach needs to be combined with diuretics. Salt restriction alone is generally not an effective way to treat ascites.


Diuretics increase the excretion of water and salt from the kidneys. Furosemide Lasix is ​​recommended for the diuretic regimen. This can be increased gradually to obtain an adequate response at the maximum dose of 400 milligrams. The time the patient can tolerate the medication is in the morning; it is usually recommended to prevent frequent urination during the night.