One frequent side effect of cirrhosis is ascites. It results in fluid accumulation in your belly and is caused by the symptoms of portal hypertension. Medication, surgery, and dietary modifications can all be used to treat ascites.

Cirrhosis is a form of liver disease in which the liver has been permanently damaged by scarring.

Cirrhosis can lead to several issues. Ascites, or an accumulation of fluid in the belly, is one of these. Ascites are the most frequent consequence of cirrhosis, occurring in 5–10% of cirrhosis patients annually.

To find out more about how cirrhosis causes ascites, continue reading below. We will also go over the symptoms to be aware of, the dangers of ascites, and the treatment of ascites.

What are the causes of ascites in people with cirrhosis?

Cirrhosis itself is caused by factors that gradually harm the liver. The following are a few of the most frequent causes of cirrhosis:

• excessive alcohol use, often known as alcohol-related liver disease
• previously known as nonalcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD)
• persistent (long-term) hepatitis B or hepatitis C viral infection

The liver is scarred with cirrhosis. This makes it more difficult for it to operate efficiently.

Scar tissue accumulation restricts or stops blood flow to and from your liver. The portal vein, which transports blood from various abdominal organs to the liver, has an increase in blood pressure as a result. Physicians refer to this gateway as hypertension.

Vasodilation is the term for the widening of blood vessels brought on by portal hypertension. The body’s attempt to make up for it may ultimately result in:

• retention of water and sodium (salt)
• lower blood flow to the kidneys
• low levels of albumin, an important protein made by the liver, in the blood

It encourages fluid to leak and build up in your abdomen while all of this is going on. Ascites is the term used when sufficient fluid accumulation occurs.

What are the symptoms of ascites in people with cirrhosis?

You might not have any symptoms if there is only a small amount of fluid accumulation in your abdomen.

But as more fluid builds up, you’ll have abdominal bloating or swelling, which will worsen with time. You might also observe:

• an increase in waist size
• unintended weight gain
• a pushed-out belly button

Ascites can also cause the following symptoms as it worsens:

• abdominal discomfort or pain
• feeling full right after eating, called early satiety
• indigestion or nausea
• shortness of breath
• edema (swelling) in your legs, ankles, and feet

What are the potential complications of ascites in people with cirrhosis?

Serious consequences can arise from ascites. Spontaneous bacterial peritonitis is a frequent consequence that arises when bacteria that normally reside in your digestive tract infiltrate ascites fluid and cause an infection.

Sepsis may result from spontaneous bacterial peritonitis if treatment is not received. A potentially fatal response to an illness is sepsis.

The following are additional possible ascites complications:

• hernias in your abdomen
• fluid accumulation in the area between your lungs and chest wall, known as a pleural effusion
• One form of kidney failure linked to liver illness is called hepatorenal syndrome.

When to get medical help

If you experience any cirrhosis symptoms, schedule a visit with a physician. In addition to ascites, they may consist of:

• fatigue
• weakness
• reduced appetite
• nausea and vomiting
• unintended weight loss
• discomfort in your upper right abdomen
• itchy skin
• a yellowish staining of the skin or whites of the eyes is called jaundice.
• very dark urine
• easy bruising or bleeding
• swelling in your legs, ankles, or feet
• confusion or problems with thinking and memory

If you already have a diagnosis of ascites, get medical help right once if you have any of the following signs of spontaneous bacterial peritonitis:

• fever
• chills
• abdominal pain or tenderness
• confusion

How are ascites treated in people with cirrhosis?

The degree of ascites determines how it is treated. Ascites are ranked from 1 to 3, with grade 3 being the most severe.

A doctor may administer diuretics or other drugs that drain excess fluid from the body to treat ascites in cirrhosis patients. They could advise switching to a diet reduced in sodium.

A medical expert can also perform a technique called paracentesis to drain any excess fluid that has accumulated in your abdomen. During paracentesis, a technician inserts a needle into your abdomen using ultrasound guidance to remove extra fluid.

After paracentesis, fluid usually returns, therefore the process frequently needs to be repeated. A transjugular intrahepatic portosystemic shunt (TIPS) operation may be used if paracentesis and medication are ineffective.

The portal vein is joined to another vein in the body during a TIPS operation. Ascites may be lessened as a result of this lessening of the symptoms of portal hypertension.

Frequently asked questions about cirrhosis and ascites

At what stage of liver disease can ascites appear?

The most serious stage of liver disease is cirrhosis. Cirrhosis comes in two varieties: compensated and decompensated. When cirrhosis is decompensated, ascites develop. The symptoms of this kind of cirrhosis are quite severe.

How long can you live with ascites if you have cirrhosis?

Ascites are linked to a negative perspective. After five years, about 30% of patients with ascites are still alive.

What’s the newest treatment for ascites?

Researchers are still looking at new approaches to treating ascites and enhancing prognosis. The TIPS surgery is one of the more recent forms of treatment that helps lower the portal hypertension that causes ascites.

Takeaway

The most frequent side effect of cirrhosis is ascites. It involves fluid accumulation in the belly brought on by portal hypertension.

Some individuals with minor ascites might not have any symptoms. Weight gain, pain, and visible stomach bloating may begin as more fluid builds up.

Ascites are linked to a poor prognosis and can be exacerbated by potentially dangerous bacterial infections. Medication, dietary modifications, and surgeries to lessen fluid accumulation are among the available treatments.