How to Manage Ascites

Ascites, most commonly associated with liver disease, is the buildup of ascitic fluid inside the abdominal cavity, causing abdominal swelling and discomfort. The fluid buildup can also press against the lungs, making it harder to breathe, and the stomach, decreasing appetite.



Ascites typically manifests duraing the cirrhotic phase of liver disease, ccording to the American Liver Foundation. The approach to managing ascites is systemic and begins with dietetic changes. However, someone suffering with ascites, as a complication of liver failure, might eventually need a liver transplant.

Things You'll Need

• Salt-free diet cookbook
• Prescription diuretics
• Antibiotics

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Instructions

Managing Ascites

• 1

  Reduce your salt intake to manage ascites.

  Limit your salt intake. Patients should consume no more than 2,000 mg of sodium a day, recommends the American Association for the Study of Liver Diseases. Sodium retains fluid, causing an increase in blood volume. Increased blood volume, coupled with liver disease, can lead to portal hypertension. The pressure resulting from portal hypertension can cause ascitic fluid to leak from the liver into the stomach cavity.

  Consult a dietitian, or request a low-sodium diet from your doctor. Purchase low-sodium cookbooks, and prepare your meals without using processed foods or adding salt.

• 2

  Take prescription medication.

  Take medication to manage ascites. When diet alone does not control your ascites, your doctor might prescribe diuretics, also known as water pills. Duretics work within your kidneys to increase the expulsion of salt and water from your body, according to Michael Neal, author of "Medical Pharmacology at a Glance."

  You also might need antibiotics to treat infections. For instance, inflammation of the peritoneum can be caused by a spontaneous infection of the ascitic fluid and should be treated with antibiotics.

• 3

  Undergo paracentesis. This procedure removes peritoneal fluid from the abdominal cavity, Drs. Faried Banimahd and Irene M. Spinello explain in the November 2009 issue of the Journal of Emergency Medicine. During this inpatient procedure, fluid is removed using a needle, or, in the case of large-volume paracentesis, through a tube inserted into the abdominal cavity. Large-volume paracentesis removes more than 5 liters of fluid and requires an albumin infusion.

  Requiring paracentesis might signal a worsening of your condition, and it is likely you will need to repeat the procedure to maintain control of your ascites.

• 4

  Consider getting a transjugular intrahepatic portosystemic shunt, called TIPS, or a surgical shunt, if your physician recommends that measure. A shunt diverts blood from the portal vein, decreasing pressure and preventing serial ascites.

  Treatment-resistant ascites is an acceptable indication for TIPS, Dr. Elizabeth Verna reported in the December 2008 issue of the Virtual Mentor, a publication of the American Medical Association. Because of complications associated with TIPS, this procedure is reserved for those patients who couldn't tolerate frequent paracentesis.

• 5

  Undergo transplant surgery if steps to manage your ascites have failed. Encourage your friends and family to become organ donors. According to the Mayo Clinic, people die every day while waiting for a transplant. There simply are not enough donated organs for everyone in need.