What Is the Treatment for Ascites?

Ascites, a condition in which fluid builds up in the abdominal cavity, can be treated in a number of different ways. One treatment that provides patients immediate relief is a procedure called a paracentesis, which directly removes fluid from the abdomen. The treatment for ascites can depend on the underlying reason why the fluid buildup occurred, as this should be addressed. Other treatments for ascites include giving medications called diuretics, maintaining a low-sodium diet, and restricting daily fluid intake.
Often the most effective short-term treatment for ascites is a procedure called a paracentesis, where a needle is inserted through the front of the abdomen and fluid is drained. This procedure can be done for diagnostic purposes, where the fluid is removed from the abdomen and tested in the laboratory to help determine why the fluid buildup occurred. It can also be done to reduce symptoms by decreasing the tension present in the abdomen, giving the patient some relief. Although a paracentesis effectively controls the symptoms of ascites, it does not address the reasons why the fluid built up in the abdomen. If a paracentesis is done without making any other changes in the treatment of the affected person, the fluid will build up again.
Doing an initial paracentesis for diagnostic purposes is an important aspect of the treatment for ascites. The evaluation of this fluid can yield important information that can help determine the reason the ascites developed. One of the most important aspects of treating ascites is to address the underlying disease process. For example, metastatic cancer can cause ascites, and this abdominal fluid collection will never be fully resolved until the cancer is treated. Similarly, if the ascites is due to liver disease, the health of the liver should be addressed in order to cure the ascites.
Part of the treatment for ascites often involves supplying the patient with medications called diuretics. These drugs help to increase urination, thus decreasing the total amount of fluid present in the body. Often two diuretics, called spironolactone and furosemide, are given on a daily basis to treat ascites. Patients given these medications should be monitored by a health care professional because they can cause imbalances in the blood concentration of minerals such as potassium and sodium.
Another aspect of treatment for ascites is altering the affected patient’s diet. A low-sodium diet is a critical aspect of treatment because eating excess salt can lead to fluid retention, and thus worsening of the ascites. Patients should also limit their daily fluid intake to a certain extent. Typically they are advised to drink less than 50 ounces (1,500 milliliters) of fluids daily.

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