What is As­cites?

Daily Trust - - HEALTH -

My un­cle who I am liv­ing with has been sick for about eight months now and his tummy has grown big even though he is los­ing weight. He is di­ag­nosed to have As­cites. Please, I need more in­for­ma­tion on this. Kather­ine U.

The or­gans of the ab­domen are con­tained in a sac or called the peri­toneum. Nor­mally the peri­toneal cav­ity con­tains no fluid, al­though in women a small amount of about 20ml. As­cites is the term used to de­note a fluid col­lec­tion in the peri­toneal cav­ity, a sit­u­a­tion that is not nor­mal.

There are a va­ri­ety of dis­eases that can cause the fluid to ac­cu­mu­late and the rea­sons that the as­cites oc­curs may be dif­fer­ent for each dis­ease. Can­cer that spreads to the peri­toneum can cause di­rect leak­age of fluid, while other ill­nesses cause an ex­cess ac­cu­mu­la­tion of wa­ter and sodium in the body. This fluid can even­tu­ally leak into the peri­toneal cav­ity.

Most com­monly, as­cites is due to liver dis­eases and the in­abil­ity of that or­gan to pro­duce enough pro­tein to re­tain fluid in the blood­stream. Nor­mally, wa­ter is held in the blood­stream by on­cotic pres­sure. The pull of pro­teins keeps wa­ter mol­e­cules from leak­ing out of the cap­il­lary blood ves­sels into sur­round­ing tis­sues. As liver dis­ease ad­vances, its abil­ity to man­u­fac­ture pro­teins is de­creased, so on­cotic pres­sure de­creases be­cause of lack of to­tal pro­tein in the body, and wa­ter leaks into sur­round­ing tis­sues. Causes 1. Cir­rho­sis de­scribes a form of liver fail­ure in which liver tis­sue that is dam­aged is re­placed by scar tis­sue. As more liver tis­sue is lost is pro­gres­sive liver fail­ure oc­curs.

2. Acute liver fail­ure can re­sult in as­cites. This may be due to any acute in­jury to liver cells in­clud­ing ad­verse re­ac­tions to med­i­ca­tions or drug abuse.

3. Budd-Chiari syn­drome is caused by the block­age of the he­patic veins (those that drain the liver). Other causes of as­cites in­clude: 1. Heart fail­ure is the in­abil­ity of the heart mus­cle to ad­e­quately pump the fluid within the blood ves­sels. This can cause a va­ri­ety of prob­lems, but most no­tably, fluid backs up into the lungs and other or­gans caus­ing them to fail. This wa­ter over­load can cause leak­age into the peri­toneal cav­ity and the for­ma­tion of as­cites.

2. Nephrotic syn­drome, in which kid­ney dam­age causes pro­tein to leak into the urine, de­creases on­cotic pres­sure and may re­sult in as­cites.

3. Di­rect ir­ri­ta­tion of the peri­toneum can cause it to leak fluid as part of the in­flam­ma­tion process. This ir­ri­ta­tion may be due to a ma­lig­nancy (can­cer) or in­fec­tion.

4. Dis­eases of the ovary can be as­so­ci­ated with as­cites. Symp­toms 1. There is a dis­tinc­tion be­tween pa­tients who de­velop as­cites be­cause of liver dis­ease and cir­rho­sis, and those who de­velop it be­cause of in­flam­ma­tion of the peri­toneum be­cause of can­cer. Liver dis­ease tends to be rel­a­tively pain­less, while can­cer pa­tients ex­pe­ri­ence sig­nif­i­cant amounts of pain. Oth­er­wise, the symp­toms are sim­i­lar.

2. There is swelling of the ab­domen to ac­com­mo­date the fluid buildup. This may make it dif­fi­cult for the di­aphragm (the flat mus­cle that sep­a­rates the chest from the ab­domen) to as­sist with breath­ing, caus­ing short­ness of the breath.

3. While a tense ab­domen filled with fluid is easy to rec­og­nize, ini­tially, the amount of as­cites fluid may be small and dif­fi­cult to de­tect. As the amount of fluid in­creases, the pa­tient may com­plain of a full­ness or heav­i­ness in the ab­domen. It is of­ten the signs of the un­der­ly­ing dis­ease that ini­tially brings the pa­tient to seek med­i­cal care.

4. In cir­rho­sis of the liver, not only does fluid ac­cu­mu­late in the ab­dom­i­nal cav­ity, but there may be leg swelling, easy bruis­ing, en­large­ment of the breasts, and con­fu­sion.

5. If the as­cites is due to heart fail­ure, there may be short­ness of breath as well as leg swelling (edema).

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