Definition of Ascites

The article contains a definition of Ascites for the general public, with information about the symptoms, types, causes, treatment and some history of Ascites. It also connects the reader with a well-known organization that researches Ascites.

Diagnosis and Definition

• You are experiencing abdominal discomfort, which may increase to actual pain. Your stomach feels bloated and stretched, and the skin covering it feels tight. You find it difficult to get a full breath, and pressure against your stomach is making you nauseous. You may have Ascites.

  Ascites is a condition that causes fluid to accumulate in the peritoneal, or abdominal, cavity, which, in turn, can cause the above-mentioned symptoms. Other names for this condition include peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum and abdominal dropsy.

  When dealing with Ascites, it is essential to emphasize that Ascites, while a serious, even life-threatening condition, is a symptom of a larger and more severe problem. While the symptom must be treated, so must the underlying cause.

Causes

• Causes of Ascites can include cirrhosis and severe liver disease, hepatitis, liver cancer, congestive heart failure, constrictive pericarditis, Meig's syndrome, hypothyroidism, vasculitis, nephrotic syndrome, pancreatitis and pancreatic and ovarian cancer. Ascites can also be a side effect from undergoing treatments such as radiation and chemotherapy, and can arise from internal bleeding after experiencing an injury.

  Ascites was known historically as "dropsy," but in contemporary medical parlance, dropsy has now become a comprehensive term for all excess fluid accumulating in the body. Ascites is a more specific term, referring to the pathology of fluid accumulating in the abdomen.

  In healthy humans, membranes lining the abdomen and protecting the organs, normally contain a small amount of fluid. Women have more fluid then men (as much as 20 mL during menstruation), but the overall amount is still small. When excess (or Ascitic) fluid builds up in the abdomen, however, the body can accumulate 1 to 4 L in mild Ascites, and 10 to 12 L in severe Ascites (tense abdomen).

  Ascitic fluid, which may come from capillaries, the liver, pancreas or the lymph system, accumulates in the abdomen as transudate or exudate. Transudate fluid can result from increased pressure in the portal vein. Exudate fluid, a fluid that is actively secreted, is usually due to inflammation or a malignancy.

Treatments

• Treatments for Ascites include salt and/or water restriction, medication (diuretics), drugs that block Aldosterone in the body (a hormone that acts to increase salt retention), fluid removal by either shunt or by needle paracentesis, and liver or kidney transplant.

  In abdominal paracentesis, a needle is used to remove a fluid sample, or to drain an abnormal accumulation. Fluid removal is often beneficial, helping to ease breathing and relieve symptoms of discomfort, but it is crucial that the underlying cause be found and treated.

  For example, the composer, Ludwig von Beethoven, underwent large-volume paracentesis in 1827 for what was called "dropsy." The procedure relieved his symptoms, but the underlying cause (liver failure) resulted in his death two days later.

History

• The condition of fluid accumulation, historically known as dropsy and now termed Ascites, was always considered a life-threatening condition.

  This condition has been both described and prescribed for throughout human history. It has even been viewed as a divine retribution for oath-breakers. Treatments existed as far back as 20 B.C., when Roman scientist and encyclopedist Aulus Cornelius Celsus is said to have developed the first known use of paracentesis to successfully treat excess fluid in the body.

Expert Insight

• In the forefront of ongoing research into Ascites is the International Club of Ascites (ICA), which was founded in 1990. The ICA focuses on "encouraging scientific research in the field of advanced liver cirrhosis and its complications (Ascites) and improving the consensus of experts on clinical definitions and recommendations on patient management," according to the ICA's mission statement. Meetings are held worldwide, and papers and theses on the subject of Ascites are available.