Ascites is a condition in which excess fluid collects in the abdominal cavity. In most cases, this occurs as a result of advanced liver failure, but it may also be due to heart failure, kidney disease, cancer and other rare medical conditions. Ascites is not really a disease, but a symptom of one of these underlying problems.

In mild cases, there are usually no symptoms. However, as more fluid accumulates, the abdomen begins to swell and may be accompanied by loss of appetite and a feeling of fullness after eating or abdominal pain. Eventually there is marked distension (protruding) of the abdomen that can resemble the later stages of pregnancy. This may cause low back pain, changes in bowel function, weight gain, difficulty taking a deep breath and fatigue. During the day, edema (swelling) may occur in the legs and pelvis as gravity pulls fluid downward. In extreme cases the fluid may extend up into the chest cavity (pleural effusion) and cause difficulty breathing.


Treatment depends on the underlying cause of the fluid accumulation. In the case of advanced liver failure or cirrhosis of the liver, there is no cure, but patients must stop all alcohol consumption as well as drugs that damage the liver, such as high doses of Tylenol and treat the underlying cause of cirrhosis.

There are several treatments that may be administered to reduce the amount of accumulated fluid:

  • Restricting sodium (salt) intake
  • Diuretic therapy (“water pills”) to increase urine production and help the body excrete extra sodium and water such as furosemide or
  • Therapeutic (“large volume”) paracentesis (using a local anesthetic to insert a needle through the abdominal wall) may be used to draw out as much fluid as possible from patients who do not respond adequately to restricted sodium and diuretic therapy

Whatever treatment is used, patients will be closely monitored by their physician to track body weight, kidney function and levels of sodium and potassium in the blood.

If your physician suspects ascites, an ultrasound or CT scan can detect small amounts of accumulated fluid even before your abdomen has become distended.

Your physician may perform a diagnostic abdominal paracentesis to draw out a small amount of fluid to be used in lab tests that may help find (or confirm) the source of the ascites. Depending on the results, these tests may point to liver or heart failure, infection or cancer, bacterial infection, tuberculosis or, in rare cases, pancreatic disease. In the case of infection, lab results also are used to determine the most appropriate antibiotic to use for treatment.

The symptoms of ascites can be very distressing and interfere with your quality of life. The condition may also put you at risk for infection and kidney disease.

The accumulated fluid is not life-threatening, but it is an indicator of advanced liver disease or other serious, potentially life-threatening underlying conditions.