Ascites and Fluid Buildup

Ascites is fluid buildup in the abdomen. It is uncomfortable and can reduce breathing function and urination. Ascites is usually caused by portal hypertension, but it can result from other conditions. Swelling can also occur in the arms and legs and in the spleen. Although ascites itself is not fatal, it is a marker for severe progression. Infection of this fluid, called peritonitis, can be deadly. Once ascites occurs, only half of patients survive after two years. Some physcians even believe that ascites signals the need for liver transplantation, particularly in alcoholic cirrhosis.

Nearly all patients with ascites can benefit from the following measures:

  • Restricting salt. Nearly EVERYTHING has salt in it! Start reading labels and calculating <2000 mg of sodium a day.

Sodium Restricted Diets

No Added Salt PDF Document (Four gram sodium) - this diet is low in salt content.
Low Sodium Diet PDF Document (Two gram sodium) - this diet is restricted in salt.

  • Abstaining from alcohol.  (Sometimes abstaining from alcohol is enough to reverse this complication.)
  • Taking diuretics, usually spironolactone (Aldactone) and furosemide (Lasix). Previously, spironolactone was usually given alone, but experts now use it by itself only in patients with minimal fluid buildup. Patients should be monitored carefully for dehydration and high or low potassium levels, kidney failure, or encephalopathy. Weight loss from diuretics usually should not exceed 1 or 2 pounds per day, but there is no limit for patients with massive swelling.

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