Why does water collect in the abdominal cavity? Causes and treatment of abdominal ascites - why does fluid accumulate? Causes of fluid accumulation in the abdominal cavity

Content

The accumulation of fluid in the abdomen is called dropsy or ascites. Pathology is not an independent disease, but only a consequence of other diseases. More often it is a complication of liver cancer (cirrhosis). The progression of ascites increases the volume of fluid in the abdominal cavity, and it begins to press on the organs, which aggravates the course of the disease. According to statistics, every third dropsy is fatal.

What is abdominal ascites

A symptomatic phenomenon in which a transudate or exudate collects in the peritoneum is called ascites. The abdominal cavity contains part of the intestine, stomach, liver, gallbladder, spleen. It is limited to the peritoneum - a shell, which consists of an inner (adjacent to the organs) and external (attached to the walls) layer. The task of the translucent serous membrane is to fix the internal organs and participate in metabolism. The peritoneum is abundantly supplied with vessels that provide metabolism through the lymph and blood.

Between the two layers of the peritoneum in a healthy person, there is a certain volume of fluid, which is gradually absorbed into the lymph nodes in order to make room for new ones to enter. If, for some reason, the rate of water formation increases or its absorption into the lymph slows down, then the transudate begins to accumulate in the peritoneum. Such a process can occur due to multiple pathologies, which will be discussed below.

Causes of fluid accumulation in the abdominal cavity

Often abdominal ascites occurs in oncology and many other diseases, when the barrier and secretory function of the peritoneal sheets is impaired. This leads to the filling of fluid in the entire free space of the abdomen. The constantly increasing exudate can be up to 25 liters. As already mentioned, the main reason for damage to the abdominal cavity is its close contact with the organs in which a malignant tumor is formed. The tight fit of the folds of the peritoneum to each other ensures rapid capture of nearby tissues by cancer cells.

The main causes of abdominal ascites are:

• peritonitis;
• mesothelioma of the peritoneum;
• peritoneal carcinosis;
• internal organ cancer;
• polyserositis;
• portal hypertension;
• cirrhosis of the liver;
• sarcoidosis;
• hepatosis;
• hepatic vein thrombosis;
• venous congestion with right ventricular failure;
• heart failure;
• myxedema;
• gastrointestinal diseases;
• drift of atypical cells into the peritoneum.

Among women

The fluid inside the abdominal cavity in the female population is not always a pathological process. It can collect during ejaculation, which occurs monthly in women of reproductive age. Such liquid dissolves on its own without posing a health hazard. In addition, purely female diseases that require immediate treatment - inflammation of the reproductive system or ectopic pregnancy - often become the cause of water.

Intra-abdominal tumors or internal bleeding provoke the development of ascites, for example, after an operation, due to trauma or caesarean section. When the endometrium lining the uterine cavity grows uncontrollably, due to which it goes beyond the female organ, then water also collects in the peritoneum. Endometriosis often develops after viral or fungal infections of the reproductive system.

In men

In all cases of dropsy in the stronger sex, there is a combination of disorders of important body functions that lead to the accumulation of exudate. Men often abuse alcohol, which leads to cirrhosis of the liver, and this disease provokes ascites. Also, the occurrence of the disease is facilitated by such factors as blood transfusions, injections of narcotic drugs, high cholesterol levels due to obesity, multiple tattooing on the body. In addition, the following pathologies become the cause of dropsy in men:

• tuberculous lesion of the peritoneum;
• endocrine disorders;
• rheumatoid arthritis, rheumatism;
• lupus erythematosus;
• uremia.

In newborns

The fluid in the abdomen collects not only in adults, but also in children. More often, ascites in newborns arises from infectious processes occurring in the mother's body. As a rule, the disease develops in the womb. The fetus may have liver and / or biliary tract defects. Because of this, bile stagnates, which leads to dropsy. After birth in an infant, ascites can develop against the background of:

• cardiovascular disorders;
• nephrotic syndrome;
• chromosomal abnormalities (Down's disease, Patau's syndrome, Edwards or Turner);
• viral infections;
• hematological problems;
• congenital tumors;
• serious metabolic disorder.

Symptoms

Signs of abdominal ascites depend on how quickly the ascites fluid collects. Symptoms may appear on the same day or over several months. The most obvious sign of dropsy is an enlarged abdominal cavity. This causes an increase in body weight and the need for larger clothing. In a patient, in an upright position, the abdomen hangs down like an apron, and in a horizontal position, it is spread out on both sides. With a large volume of exudate, the navel protrudes.

If portal hypertension has become the cause of dropsy, then a venous pattern forms on the anterior peritoneum. It occurs due to varicose veins of the umbilical veins and esophageal varices. With a large accumulation of water in the abdomen, internal pressure increases, as a result of which the diaphragm moves into the abdominal cavity, and this provokes respiratory failure. The patient has pronounced shortness of breath, tachycardia, cyanosis of the skin. There are also common symptoms of ascites:

• pain or a feeling of fullness in the lower abdomen;
• dyspepsia;
• fluctuation;
• peripheral edema on the face and limbs;
• constipation;
• nausea;
• heartburn;
• loss of appetite;
• slow motion.

Stages

In clinical practice, there are 3 stages of dropsy of the abdomen, each of which has its own signs and characteristics. The degree of development of ascites:

1. Transient. The initial development of the disease, the symptoms of which cannot be noticed on their own. The volume of the liquid does not exceed 400 ml. Excess water is detected only during instrumental examinations (ultrasound examination of the abdominal cavity or MRI). With such volumes of exudate, the work of internal organs is not disturbed, therefore the patient does not notice any pathological symptoms in himself. At the initial stage, dropsy can be successfully treated if the patient adheres to the water-salt regime and adheres to a specially prescribed diet.
2. Moderate. At this stage, the abdomen becomes larger and the volume of fluid reaches 4 liters. The patient already notices alarming symptoms: the weight increases, it becomes difficult to breathe, especially in the supine position. The doctor can easily identify dropsy on examination and palpation of the abdominal cavity. Pathology at this stage responds well to treatment. Sometimes it becomes necessary to remove fluid from the abdominal cavity (puncture). If effective therapy is not carried out on time, then there is a violation of the kidneys, the most severe stage of the disease develops.
3. Tense. Liquid volumes exceed 10 liters. In the abdominal cavity, the pressure rises greatly, problems arise with the functioning of all organs of the gastrointestinal tract. The patient's condition is deteriorating, he needs immediate medical attention. Previous therapy no longer gives the desired result. At this stage, laparocentesis (puncture of the abdominal wall) is required as part of complex therapy. If the procedure does not give effect, refractory ascites develops, which no longer responds to treatment.

Complications

The disease itself is a stage of decompensation (complication) of other pathologies. The consequences of dropsy include the formation of inguinal or umbilical hernias, prolapse of the rectum or hemorrhoids. These conditions are facilitated by an increase in intra-abdominal pressure. When the diaphragm presses on the lungs, it leads to respiratory failure. The accession of a secondary infection leads to peritonitis. Other complications of ascites include:

• massive bleeding;
• hepatic encephalopathy;
• splenic or portal vein thrombosis;
• hepatorenal syndrome;
• intestinal obstruction;
• diaphragmatic hernia;
• hydrothorax;
• inflammation of the peritoneum (peritonitis);
• fatal outcome.

Diagnostics

Before making a diagnosis, the doctor should make sure that the abdominal enlargement is not the result of other conditions, such as pregnancy, obesity, mesenteric or ovarian cysts. To exclude other causes will help palpation and percussion (finger on finger) of the peritoneum. Examination of the patient and the collected anamnesis is combined with ultrasound examination, scanning of the spleen and liver. Ultrasound excludes fluid in the stomach, tumor processes in the peritoneal organs, the state of the parenchyma, the diameter of the portal system, the size of the spleen and liver are characterized.

Liver and spleen scintigraphy is a diagnostic imaging technique used to assess tissue function. Initialization allows you to determine the position and size of organs, diffuse and focal changes. All patients with identified ascites are sent for diagnostic paracentesis with the study of ascitic fluid. During the study of pleural effusion, the number of cells, the amount of sediment, albumin, protein are counted, inoculation and Gram stain are performed. The Rivalta test, which gives a chemical reaction to a protein, helps to distinguish exudate from transudate.

Two-dimensional doppleroscopy (USDG) of venous and lymphatic vessels helps to assess blood flow in the vessels of the portal system. In case of difficultly differentiated cases of ascites, diagnostic laparoscopy is additionally performed, in which an endoscope is inserted into the abdominal cavity to accurately determine the amount of fluid, proliferation of connective tissue, and the state of intestinal loops. Plain radiography will also help to determine the volume of water. Esophagogastroduodenoscopy (EGDS) gives a good opportunity to see the presence of varicose veins in the stomach and esophagus.

Treatment of abdominal ascites

Regardless of the cause that provoked ascites, the pathology should be treated together with the underlying disease. There are three main therapeutic methods:

1. Conservative treatment. At the initial stage of ascites, drug therapy is prescribed, aimed at normalizing the liver. If a patient is diagnosed with a parenchyma of an organ of an inflammatory nature, then drugs are additionally prescribed that relieve inflammation and other types of drugs, depending on the symptoms and the disease that provoked the accumulation of fluid.
2. Symptomatic. If conservative treatment does not give results or doctors cannot prolong remission for a long time, then the patient is prescribed a puncture. Laparocentesis of the abdominal cavity with ascites is performed infrequently, since there is a risk of damage to the intestinal walls in the patient. If the fluid fills the abdomen too quickly, a peritoneal catheter is placed in the patient to prevent the development of adhesions.
3. Surgical. If the two previous treatment regimens do not help, then the patient is assigned a special diet and blood transfusion. The method consists in connecting the collar and inferior vena cava, which creates collateral circulation. If a patient needs a liver transplant, then he undergoes an operation after a course of diuretics.

Drugs

The main treatment for ascites is drug therapy. It includes long-term use of diuretics with the introduction of potassium salts. The dose and duration of treatment is individual and depends on the rate of fluid loss, which is determined by daily weight loss and visually. The correct dosage is an important nuance, since the wrong appointment can lead the patient to heart failure, poisoning, death. Commonly prescribed drugs:

• Diakarb. Systemic carbonic anhydrase inhibitor with weak diuretic activity. As a result of application, the release of water increases. The drug causes the excretion of magnesium, phosphates, calcium from the body, which can lead to metabolic disorders. The dosage is individual, it is applied strictly according to the doctor's prescription. Undesirable effects are observed on the part of hematopoiesis, immune and nervous system, metabolism. Contraindication for taking the drug is acute renal and hepatic failure, uremia, hypokalemia.
• Furosemide. A loop diuretic that causes strong but short-term diuresis. It has a pronounced natriuretic, diuretic, chloruretic effect. The regimen and duration of admission is prescribed by the doctor, depending on the indications. Among the side effects: a marked decrease in blood pressure, headache, lethargy, drowsiness, decreased potency. Furosemide is not prescribed for acute renal / hepatic failure, hyperuricemia, pregnancy, lactation, children under 3 years of age.
• Veroshpiron. Long-acting potassium-sparing diuretic. Suppresses the potassium-excreting effect, prevents water and sodium retention, reduces urine acidity. The diuretic effect appears on days 2-5 of treatment. With edema against the background of cirrhosis, the daily dosage is 100 mg. The duration of treatment is selected individually. Adverse reactions: lethargy, ataxia, gastritis, constipation, thrombocytopenia, menstrual irregularities. Contraindications: Addison's disease, anuria, lactose intolerance, hyperkalemia, hyponatremia.
• Panangin. A drug that affects metabolic processes, which is a source of magnesium and potassium ions. It is used as part of complex therapy for ascites to compensate for the deficiency of magnesium and potassium excreted while taking diuretics. Prescribe 1-2 tablets / day throughout the course of diuretics. Side effects are possible from the water-electrolyte balance, the digestive system. Panangin is not prescribed in the presence of Addison's disease, hyperkalemia, hypermagnesemia, severe myasthenia gravis.
• Asparkam. Source of magnesium and potassium ions. Reduces the conductivity and excitability of the myocardium, eliminates electrolyte imbalance. While taking diuretics, 1-2 tablets are prescribed 3 times / day for 3-4 weeks. The development of vomiting, diarrhea, redness of the skin of the face, respiratory depression, seizures is possible. Do not appoint Asparkam in case of metabolic disorders of amino acids, insufficiency of the adrenal cortex, hyperkalemia, hypermagnesemia.

Diet

With abdominal dropsy, a limited diet is needed. The diet provides for a low fluid intake (750-1000 liters / day), a complete rejection of salt intake, the inclusion in the diet of natural foods with a diuretic effect and a sufficient amount of protein. Salting, marinades, smoked meats, canned food, salted fish, sausages are completely excluded.

The menu for a patient with ascites should include:

• lean meat of poultry, rabbit;
• legumes, nuts, soy milk;
• seafood, lean fish;
• brown rice, oatmeal;
• vegetable oils, seeds;
• fermented milk products, cottage cheese;
• parsley, cumin, marjoram, sage;
• pepper, onion, garlic, mustard;
• bay leaf, lemon juice, cloves.

Surgical methods

When ascites progresses and treatment does not help, then in especially advanced cases, surgical treatment is prescribed. Unfortunately, even with the help of an operation it is far from always possible to save a patient's life, but today there are no other methods. The most common surgical treatment:

1. Laparocentesis. Exudate is removed through a puncture of the abdominal cavity under ultrasound control. After the operation, drainage is installed. In one procedure, no more than 10 liters of water is removed. In parallel, the patient is injected with drip saline solutions and albumin. Complications are very rare. Sometimes infectious processes occur at the puncture site. The procedure is not carried out for blood clotting disorders, severe bloating, intestinal trauma, ventral hernia and pregnancy.
2. Transjugular intrahepatic shunting. During the operation, the hepatic and portal veins are artificially communicated. The patient may experience complications in the form of intra-abdominal bleeding, sepsis, arteriovenous shunting, liver infarction. An operation is not prescribed if the patient has intrahepatic tumors or cysts, vascular occlusion, obstruction of the bile ducts, cardiopulmonary pathologies.
3. Liver transplant. If ascites has developed against the background of liver cirrhosis, then an organ transplant may be prescribed. Few patients have a chance for such an operation, since it is difficult to find a donor. The absolute contraindications for transplantation are chronic infectious pathologies, severe disruptions in the work of other organs, and oncological diseases. Graft rejection is among the most severe complications.

Forecast

Joining ascites to the underlying disease significantly aggravates its course and worsens the prognosis of recovery. The pathology is especially unfavorable for older patients (after 60 years) who have a history of renal failure, hypotension, diabetes mellitus, heptocellular carcinoma, hepatic cell failure or liver cirrhosis. The two-year survival rate of such patients is no more than 50%.

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Ascites is the presence of free fluid in the abdominal cavity that accumulates outside organs and tissues.

Ascites can develop as a result of a large number of diseases of organs and systems (not only the structures of the abdominal cavity). But in 75% this condition is a complication of liver cirrhosis.

This pathology is also called dropsy of the abdomen.

Table of contents:

Causes of ascites

There are about a hundred conditions and diseases that can cause the accumulation of free fluid in the abdominal cavity. The main ones are:

• cirrhotic degeneration of the liver;
• malignant tumors of various organs;

The three causes of ascites are 90% of cases of this pathology. Other reasons for the accumulation of free fluid in the abdomen are as follows:

Also, ascites can occur due to the progression of a number of chronic specific diseases - primarily:

• tuberculous inflammation of the peritoneum;
• inflammation of the serous membranes (those that produce the biological fluid that lubricates the membranes);
• some diseases of the gastrointestinal tract - first of all, this (a disease with the formation of multiple seals), chronic, sarcoidosis (a disease of many organs with the formation of nodules similar to granulomas).

Inflammation of the serous membranes, provoking ascites, can occur with diseases such as:

Newborns and infants are also at risk of developing ascites. This often happens due to congenital pathologies - primarily such as:

• congenital edema resulting from incompatibility in blood type or Rh factor between mother and child. Such children die almost immediately after birth;
• congenital tissue edema, which has arisen due to latent blood loss during intrauterine development;
• failure in the development or functioning of the liver and biliary tract due to their congenital disorders;
• loss of plasma protein due to its excessive release into the lumen of the small intestine;
• Kwashiorkor is a disease of starving children, which is based on a lack of protein in food.

A number of factors have been identified that do not directly lead to the accumulation of fluid in the abdomen, but contribute to the development of ascites. First of all, these are:

• chronic alcohol abuse, even with a low degree - for example, with the so-called beer alcoholism, when a person has been drinking a portion of beer every day for years;
• chronic (not only);
• the use of injecting (injected into tissues or bloodstream) drugs;
• blood transfusion, which is carried out with violations;
• Type 2 (a type of diabetes mellitus, which develops due to the fact that the interaction of insulin, which breaks down blood sugar, with tissues is disrupted);
• increased amount.

Development of pathology

The peritoneum, which lines the inside of the abdominal cavity and wraps a number of its organs, normally secretes a small amount of serous fluid, which is similar in composition to blood plasma. This fluid is necessary so that the internal organs, which are quite compactly located in the abdominal cavity, do not stick together, and so that there is no friction between them. During the day, serous fluid is secreted and absorbed by the peritoneum many times. Its increased production and impairment of absorption and lead to the accumulation of free fluid in the abdomen.

This is a common mechanism for the onset of ascites; in a number of pathologies, it may differ. The way excess fluid accumulates in the abdomen can be clearly illustrated by the example of liver cirrhosis:

Ascites is dangerous in that it forms a so-called vicious circle - the process of excessive fluid formation and impaired absorption is triggered, but it is difficult to get out of this state, because the breakdown of some mechanisms provokes the breakdown of others, which further contribute to the growth of ascites:

• if the veins are compressed, the body tries to unload them, and excess fluid is sent to the lymphatic system, but it can also cope with the excess load to a certain level - then the lymph pressure rises, fluid from the lymphatic vessels seeps into the abdominal cavity;
• as fluid from the blood vessels rushes into the abdominal cavity, this leads to a decrease in blood volume and blood pressure. To compensate for this condition, the body produces more hormones. But due to the increased production of hormones, blood pressure rises. The fluid is poorly retained in the vessels and rushes into the abdominal cavity - ascites grows.

When damaged by a tumor or an inflammatory process, some membrane begins to produce more fluid than it can absorb back - this becomes the cause of ascites. In addition, the tumor and edematous tissue due to inflammation press on the lymphatic vessels, not allowing the lymph to move freely through them, the liquid part of the lymph rushes into the tissues and cavities - including the abdominal one.

If heart failure has developed, then the blood flow is disturbed not only in the heart, but also in the veins of the liver and peritoneum. Plasma from the vessels passes into the abdominal cavity. The peritoneum is not ready to absorb additional fluid - ascites occurs.

Ascites symptoms

Depending on the provoking disease, the signs of ascites can develop both suddenly and gradually, over several months. So, when the portal vein is blocked by a thrombus, the amount of free fluid in the abdominal cavity grows very quickly, with protein starvation - gradually. Symptoms appear if 1 liter of fluid has accumulated in the abdomen.

The main signs of ascites are:

• feeling of fullness;
• enlargement of the abdomen;
• weight gain;
• Difficulty with physical activity - in particular, when trying to bend forward;

If the abdomen increases in size very quickly, it means that the lymphatic vessels are squeezed.

Dyspeptic shifts that appear with ascites are explained by the fact that the increasing amount of free fluid presses on the digestive organs, which prevents them from performing their functions. Signs such as:

Shortness of breath in the early stages of ascites occurs during exercise. As the amount of free fluid in the abdomen builds up, it presses on the lungs and heart, causing shortness of breath even at rest.

Puffiness is explained by mechanical compression of the veins and a violation of the blood flow in them, followed by the release of fluid into the tissue. With ascites, mainly in men, the scrotum can sometimes swell.

If ascites has arisen due to, then characteristic signs of intoxication appear (poisoning of the body with the waste products of the tubercle bacillus). This:

• general weakness;
• unexplained fatigue that occurs even at rest;
• decrease in body weight. In this case, the patient looks very characteristic: thin arms and legs and a large belly.

If ascites has arisen due to protein deficiency, then it is not very pronounced, a significant increase in the abdomen is not observed. But this condition is characterized by:

• swelling of the upper and lower extremities;
• - it arises because fluid, in addition to the abdominal cavity, accumulates in the pleural cavity, constricting the heart and lungs and thereby impairing their work.

Diagnosis of ascites

The patient's complaints with ascites are quite typical. Even more characteristic are the data of the physical examination of the patient - examination, palpation of the abdominal wall, tapping and listening to the abdomen with a phonendoscope. Based on their combination, it is not difficult to diagnose ascites.

The inspection data are as follows:

The following sign is indicative - if one palm is put on the patient's side, and the fingers of the other hand push the other side, then fluctuations ("waves") of the liquid inside the abdomen will be felt.

If you tap the abdomen, the sound will be dull, as, for example, on a tree - in the lower abdomen, if the patient is standing, and in the lateral sections, if he is lying.

With a significant accumulation of fluid in the abdominal cavity, when listening to the abdomen, it is possible to ascertain the subsidence of intestinal noises.

Patient complaints, medical history (eg, liver or cardiovascular disease), and physical examination are often sufficient to diagnose ascites. Instrumental and laboratory research methods are used additionally to confirm the diagnosis and determine the cause of ascites.

Of the instrumental methods for diagnosing ascites, the following are used:

In the diagnosis of ascites, such laboratory research methods are highly informative as:

In addition, if treatment is started, the daily dynamics (changes) of the patient's weight should be monitored; for this, the patient is periodically weighed. In 24 hours, he should lose approximately 500 grams. It should also be borne in mind that the amount of fluid taken (in the form of tea, juices, soups, etc.) should be slightly more than the amount allocated (at normal body and air temperatures).

Complications

As a complication of other pathologies, ascites, in turn, can also lead to complications. The most common are:

• (in case of suppuration of fluid in the abdominal cavity);
• the transition to refractory ascites - one that does not respond to treatment with diuretics. It can develop with severe cirrhosis of the liver, liver cancer, kidney disease, and so on;
• discharge of fluid through an umbilical hernia.

Ascites treatment

Free fluid can be easily removed from the abdominal cavity - but the causes of ascites will remain. So full treatment of ascites is the treatment of diseases that provoked its occurrence.

Regardless of what triggered ascites, the general purposes are as follows:

• bed or half-bed (with getting out of bed only in case of physiological necessity);
• restriction, and in advanced cases - the complete exclusion of sodium from food. This is achieved by limiting (or excluding) use.

If ascites has arisen due to, then with a decrease in the amount of sodium in the blood, the intake of liquid in various forms (tea, juices, soups) is also limited - up to 1 liter.

Drug therapy depends on the disease that triggers the ascites. The general purpose, regardless of the cause of ascites, is diuretic drugs. This can be either a combination with potassium supplements, or potassium-sparing diuretics. Also appoint:

• when - hepatoprotectors (drugs that protect liver cells);
• with a low amount of protein in the blood - protein preparations that are administered intravenously drip . As an example - albumin, fresh frozen plasma (it is injected if disorders of the blood coagulation system are observed with ascites);
• when - drugs that support the work of the heart (they are selected depending on what is the cause of the failure)

Surgical methods for the treatment of ascites are used for:

• significant accumulation of free fluid in the abdominal cavity;
• if conservative methods show little or no performance.

The main surgical methods used for ascites are:

Prevention of ascites

In order to prevent the development of ascites, it is necessary to identify and treat in advance diseases and conditions that can provoke it.

Prognosis for ascites

The prognosis for both health and life depends on the disease that provoked ascites. It worsens with:

• over 60 years of age;
• lowering blood pressure;
• loss of protein (in particular, if the amount of albumin in the blood is below 30 grams per liter);
• diabetes mellitus;
• ascites resistant to the use of diuretics.

In most cases, the presence of ascites means that the disease that provoked it is neglected. 50% of patients with ascites die within 2 years of its onset... If a form that is insensitive to diuretics has developed, half of the patients die within six months.

Oksana Vladimirovna Kovtonyuk, medical commentator, surgeon, consultant physician

Water in the abdomen is an alarming symptom that the doctor diagnoses on an ultrasound scan. It is recommended to undergo such an examination if the patient notices an increase in the abdominal cavity. Such a complaint should not be ignored by a specialist, since with advanced clinical pictures, cancer progresses with a fatal outcome.

• Abdominal ascites
• What is ascites
• How to treat ascites
• Diet for ascites
• How to treat abdominal ascites: patient experiences
• Choosing the right diet for ascites and its treatment with traditional medicine
• Causes
• Symptoms
• Diagnostics and treatment
• Diet
• Treatment with folk remedies
• Ascites in oncology
• Causes and mechanism of development
• Symptoms
• Stages
• Diagnostics
• Surgical intervention
• Treatment of abdominal ascites with folk remedies
• Symptoms and Causes
• Diet
• How to treat ascites at home?
• Causes
• Ascites - fluid in the abdomen
• Symptoms
• Drug treatment
• Folk remedies
• Power features
• Course and prognosis
• Prophylaxis

What is ascites

This is a dangerous diagnosis, which is characterized by an increased accumulation of fluid in the abdominal cavity. Other important organs in the body, such as the lungs and heart, can be affected by ascites. The problem is not inflammatory. The volume of fluid accumulated in the peritoneal region can reach liters. The people call this disease "frog belly", prone to a malignant course. For 75% of all clinical pictures, this is a complication of progressive cirrhosis, and the main goal of treatment is to suppress alarming symptoms and prolong the period of remission.

Why does fluid accumulate in the abdominal cavity

The peritoneum lining the walls of the abdominal cavity secretes a small amount of fluid that is chemically similar to blood plasma. It is necessary for the normal functioning of internal organs, otherwise they would stick together. The liquid is absorbed and released throughout the day, but under the influence of pathological factors, this natural process can be disrupted. With an imbalance, intra-abdominal pressure increases, the abdomen increases in size. An urgent diagnosis is required, followed by complex therapy.

Causes of abdominal ascites

This disease is a complication of liver cirrhosis and not only. In the body, it progresses gradually, at first it does not manifest itself in any way. Abdominal ascites is difficult to treat successfully. However, healing occurs if the main pathogenic factor is eliminated. The causes of ascitic disease are unexpected, the most common among them are presented below. This:

• heart failure;
• malignant neoplasms;
• impaired pressure of the portal vein of the liver;
• abdominal tuberculosis;
• development of mesothelioma, pseudomyxoma;
• disruption of the endocrine system;
• diseases like a woman (from the field of gynecology).

Why does abdominal dropsy occur in newborns?

Abdominal ascites can progress at any age, and babies suffering from a characteristic ailment are no exception. The pathological process is exacerbated even in the prenatal period, characterized by congenital hepatic dysfunction. Such a disease is caused at such a young age by infectious diseases of a pregnant woman. Among these are the following diagnoses:

The risk group includes newborns whose mothers during pregnancy abused drugs, medications, alcoholic beverages, and chemical reagents. In addition, ascites progresses in the case of blood transfusions of pregnant women, obesity, type 2 diabetes mellitus. So that from the first days of life the child does not fall ill with abdominal ascites, it is not recommended for a pregnant woman to do permanent makeup or tattoos.

How does the accumulation of fluid in the abdominal cavity manifest?

The main symptom of peritoneal ascites is free fluid in the abdominal cavity that collects and is not naturally excreted. Such a sign of the disease provokes an increase in the abdominal cavity in size, and over time this process only progresses. At first, the patient does not notice the characteristic changes in appearance, but then he cannot strain and relax his stomach. Additional symptoms of ascites are as follows:

• abdominal pain;
• signs of dyspepsia;
• increase in body weight;
• shortness of breath when walking;
• big belly;
• heartburn, belching;
• fluctuation;
• a state of general discomfort;
• increased swelling of the limbs.

How is fluid accumulation in the abdomen diagnosed?

Determining ascites by visual inspection and palpation of the abdominal cavity is very problematic. A description of the symptoms is necessary to collect anamnesis data, but such actions by a specialist are not enough for a definitive diagnosis. It is necessary to undergo a clinical examination, visualize the foci of the transudate, determine the nature, stage of the pathological process. Diagnostics includes the following methods:

1. Ultrasound. Helps to assess the systemic blood flow of the portal vein, the presence of cirrhosis of the liver, tumors of the peritoneum. The method is non-invasive, painless, but at an early stage of ascites is not very informative.
2. Radiography. This diagnostic method visualizes foci of ascites, determines the volume of fluid, the boundaries of the abdominal cavity. On the screen you can see liver cirrhosis and tuberculosis, suggest heart failure.
3. Laparocentesis. An invasive method that involves the collection and further study of ascitic fluid in the laboratory. Additionally, a liver biopsy (puncture) is performed to identify the etiology of the pathological process.
4. CT and MRI. Both methods accurately determine abnormal fluid effusion, and they diagnose pathology in hard-to-reach parts of the abdominal cavity. Laparocentesis complements complex diagnostics.
5. Angiography. This is a type of X-ray, when a contrast agent is injected into the vessels to determine the etiology of the pathological process. This method can determine cirrhosis even at an early stage.

How to treat ascites

Having performed X-ray and angiography, the doctor can make a prognosis, determine an effective treatment regimen. The approach to the problem is complex, and for advanced clinical pictures, it does not exclude an operation to remove oncology, laparocentesis. It all depends on the signs and symptoms, the diagnosis, the recommendations of a specialist. At first, doctors strive to remove the focus of pathology conservatively, but if the fluid continues to accumulate in the abdominal cavity, it is definitely impossible to do without surgery. Otherwise, oncology only progresses.

How is abdominal dropsy treated therapeutically

The main goal of drug therapy for ascites is to remove fluid accumulation in the abdominal cavity in a non-invasive way. Treatment is appropriate at an early stage, when the peritoneum is not yet completely filled with transudate. With ascites, the doctor prescribes diuretics, calcium preparations. In the first case, we are talking about such medicines as Veroshpiron, Diacarb, Lasix, Torasemid, after which the water in the abdominal cavity disappears. In the second - calcium tablets, Panangin and Asparkam. Additionally, it is recommended to use multivitamin complexes.

How to remove fluid in the abdomen with surgical methods

If ascites is diagnosed in an advanced stage, you cannot do without an operation to pump out the transudate. In this way, you can temporarily remove a large belly, but if the cause of the disease is not eliminated, its symptoms will very soon remind of themselves again. It is important to understand that we are talking about oncology, and you cannot do without an operation. Surgical intervention for ascites involves the following steps:

1. Laparocentesis. An abdominal puncture is performed to further drain the ascitic fluid. The procedure can take several days and requires hospitalization of the patient.
2. Transjugular intrahepatic shunting. The surgeon forms an artificial duct between the hepatic and portal veins to ensure water exchange and stabilize intra-abdominal pressure.
3. Liver transplant. The operation is appropriate for oncology, advanced degree of cirrhosis.

Diet for ascites

To exclude serious health complications, nutritional therapy is necessary. In addition, a properly selected diet for ascites reduces the accumulation of fluid in the abdominal cavity, prolongs the period of remission, and eliminates alarming symptoms. The main emphasis is required to be made on food ingredients that contain a large amount of potassium. This:

Video: dropsy of the abdominal cavity in humans

The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment based on the individual characteristics of a particular patient.

Abdominal ascites is a pathological condition in which fluid enters it and is retained there in excess. This process can develop rapidly or proceed in a chronic form. He is never independent and always accompanies severe concomitant diseases, for example, cirrhosis, tuberculosis or cancer with metastasis.

How she treated ascites with medication Olga, 62 years old

My mother developed ascites at the age of 62. Health problems began about three years ago, when her legs began to swell, and a couple of years ago she was first admitted to the hospital, where excess fluid was eliminated with the help of diuretics. It was then that he was diagnosed with cirrhosis of the liver. After the diagnosis was made, she was referred to a hepatologist, but after a superficial examination, he did not find any serious pathologies and advised her to continue drinking diuretics.

The history of the treatment of ascites with folk remedies Gregory, 48 years old

I have chronic pancreatitis. In general, he did not give me any particular health problems. I just have to observe and drink certain medications from time to time. But a couple of years ago, my body scared me in earnest. After relaxing at sea under the scorching sun and, I confess, with some irregularities in the menu, I began to experience an exacerbation of pancreatitis. I decided, as usual, to take medicine and go to the doctor for examination after returning home. But my condition worsened, my stomach began to appear.

• Bean pod decoction. It is a good diuretic. For cooking, you should use the husk from 30 pods. They need to be filled with water in an amount of about a liter and put to boil. After 10 minutes, the broth is removed from the heat and infused for 20 minutes. The mixture is filtered and cooled. You need to take the product 200 grams at a time. The first portion - at five in the morning, the second - half an hour before breakfast, the third - half an hour before lunch, the fourth - no later than eight in the evening.

After such treatment, I significantly improved my health, and I have not had any exacerbations for two years. The main thing is to pass all examinations on time and monitor your well-being.

• Read a review of the complex remedy for hemorrhoids Proctonol
• How to lose 20 kg - real reviews of Guarchibao

The history of ascites treatment with dietary nutrition Vyacheslav, 53 years old

At the beginning of the year, my gallbladder was removed. Almost immediately after the operation, my stomach began to "inflate". As a result, I was diagnosed with ascites. In addition, a few years ago I had an acute form of hepatitis (infected in the dentist's office).

How he cured ascites with herbal decoctions Nikolay, 42 years old

Until the age of 40, I was pretty drunk. Now, of course, I repent, but it seemed to me that this would not play a significant role in my life. And only when I had the first attack of liver failure against the background of alcohol intoxication and doctors literally pulled me out of the other world, I realized that I needed to change something in my life.

Source: The Right Diet For Ascites And Its Treatment With Traditional Medicine

Ascites is a rather unusual condition, but it can be recognized by the patient's appearance. In this case, excess fluid accumulates in the abdominal cavity. To rid the body of excess fluid, you need to start treatment on time, as well as adhere to a diet, when the first symptoms appear, it is important to consult a doctor in time.

Ascites manifests itself as an accumulation of fluid in the abdominal cavity.

Increased pressure in the portal vein can often provoke ascites, which is typical for liver diseases, thrombosis, compression of the branches of the portal vein or trunk, heart failure. Sometimes this condition can become an indicator of alimentary dystrophy, general edema syndrome in kidney disease, and also result from damage to the abdominal cavity.

This pathology can provoke increased intra-abdominal pressure and push the diaphragm into the chest cavity. This leads to disruption of the activity of the abdominal organs, the movement of the lungs during breathing worsens, the resistance to blood flow increases, and cardiac activity is disturbed.

In some cases, ascites progresses rapidly, for example, with cancer of the liver or peritoneum, with portal vein thrombosis, in others, it goes unnoticed, for example, with liver cirrhosis.

Often, ascites becomes a consequence of liver cirrhosis, because there is a delay in blood filtration, so a part of the liquid fraction of blood is squeezed out into the abdominal cavity.

Ascites in liver cirrhosis appears due to insufficient work of the protein-synthesizing function. The lack of albumin affects the ability of the blood to keep its liquid part in the vascular bed. The liquid, penetrating through the veins, enters the abdominal cavity. An increase in sodium in the body can also provoke fluid retention due to the fact that the liver cannot cope with the neutralization of certain substances.

Symptoms

The main symptom of ascites is bloating.

The main symptom of this disease is abdominal enlargement, or rather, bloating. The reason is that liquid accumulates in it, which practically does not come out. A person understands that he is not healthy when he does not fit into clothes of the usual size. Usually, this condition is accompanied by two more pathologies. Most often, this is a disruption of the intestines and indigestion.

Moderate ascites usually manifests itself in the form of edema of the lower extremities, there is an expansion of the chest, umbilical and inguinal hernia. The patient feels heaviness in the abdomen, heartburn, shortness of breath, problems with stool. These are symptoms of a pathology that develops over weeks and months.

Tense abdominal ascites is characterized by the appearance of a round belly with shiny, tense, smooth skin. In this case, the skin of the hernial sac is capable of thinning and tearing, which will lead to the release of ascitic fluid. The patient may develop respiratory and heart failure. The fluid can become infected and cause peritonitis, which can be fatal.

Diagnostics and treatment

Ascites is diagnosed with abdominal ultrasound

Timely diagnostics will allow to identify the cause and stage of the pathology, as well as to determine the treatment. This requires a general examination with palpation and auscultation of the abdomen, ultrasound, abdominal X-ray, computed tomography, as well as puncture and study of ascitic fluid.

Treatment of ascites should begin with restricting sodium intake; no more than 1 g of table salt should be consumed per day. The patient must comply with bed rest. If neither one nor the other helps, then diuretics are connected to the treatment process. Usually, preference is given to spironolactone, triamterene, amiloride, etc. They are mild and do not cause side effects, so surgical intervention can be avoided.

Surgical intervention is indicated in 5-10% of patients who are refractory to drug therapy. During surgery, peritoneovenous shunting is used, which can result in serious complications such as fever, intravascular coagulation, or occlusion of the shunt. Bypass surgery is not performed on those who suffer from infected ascites, high serum bilirubin, hemorrhoidal bleeding, hepatorenal syndrome.

Diet for ascites includes a ban on baking

Diet for abdominal ascites plays an important role in treatment. Fresh baked goods, salt, pastries and puff pastry should be excluded from the diet. If you don't have the strength to give up bakery products, then you can afford the bakery products of yesterday's production. You should also exclude fried, fatty meat and poultry, stew, smoked meats, offal and sausages. At the same time, it is recommended to eat turkey, chicken or rabbit meat; dishes that include minced meat are also acceptable.

Broths must be prepared from chicken, after removing the skin. First courses should be served as pureed soups. With ascites, it is forbidden to eat borsch, meat, fish and mushroom broths. It is permissible to add fish to the diet only boiled or steamed.

The use of fatty dairy products is undesirable, therefore, whole milk is completely excluded, and low-fat sour cream is permissible only in the form of a dressing, there should also be no fatty and salty sauces in the diet. Patients are allowed boiled porridge cooked in diluted milk. Millet, legumes, sorrel, cabbage, garlic, mushrooms, rice, radish, onions, turnips are prohibited.

From sweets, you can only afford marshmallows, jam or jelly. Dieters should not drink coffee and cold drinks.

Treatment with folk remedies

Bean pod decoction is a famous folk remedy for ascites.

Ascites can only be cured by treating the underlying cause. is primarily due to the fact that excess fluid is removed from the bloodstream. In this case, fluid from the abdominal cavity returns to the vessels to replenish losses. To do this, you need to use diuretic preparations and decoctions. In this case, it is necessary to replenish the loss of potassium by consuming baked or boiled fruit and vegetable decoctions.

• Bean pod decoction is an excellent diuretic. Take the husk of 15 beans, pour 1 liter of water, boil for 10 minutes. Then leave for 20 minutes, then strain. The first portion of the broth (200 ml) should be taken at 5 o'clock in the morning, if possible earlier. The second 200 ml - half an hour before breakfast, the third part - half an hour before lunch, use the remaining 200 ml until 8 pm. It is not recommended to drink any other liquid on this day. Use within three days, if it does not help, you need to change the medicine.
• Parsley broth. To do this, boil 300 g of fresh parsley in 1 liter of water. Then cool and strain the broth. You need to take it every hour in the morning, continue the treatment for 3 days.
• Apricot broth. Prepared from fresh or dried apricots. Pour one glass of apricots with 1 liter of water, cook for 40 minutes, then strain. You need to drink 250-400 ml of broth per day.
• Diuretic teas. Mix equal parts bearberry and hernia grass. Pour half a glass of this mixture with 300 g of water, boil for 15–20 minutes. Then cool and strain. Drink ready tea before meals in the morning.
• If ascites in men touches the testicles, then you can mix calendula and baby cream in equal proportions. Lubricate the testicles with the prepared mixture, put gauze on top, then put on the adjacent swimming trunks.
• Bathroom with birch infusion. To do this, you need 20 g of birch leaves or buds, pour 200 ml of boiling water, leave for 6 hours. Then add the infusion to the bath and take it for 30 minutes.
• Therapeutic massage is recommended to be done daily. In this case, you first need to rub the stomach with sunflower or linseed oil clockwise, and then against.
• If possible, you can sit by the fire, that is, you need to evaporate the liquid by any available means.

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Source: oncology

Ascites is a serious complication of various diseases, in which a large volume of fluid accumulates in the abdominal cavity. The detected ascites in oncology seriously complicates the course and treatment of the underlying disease, worsens the prognosis. In patients with oncological diseases of organs in contact with the sheets of the peritoneum, the average probability of fluid effusion into the abdominal cavity is 10%.

Tumors of which organs are accompanied by ascites?

The accumulation of excess fluid in the abdominal cavity accompanies about half of all cases of ovarian cancer in women. It also complicates the course of neoplasms:

The severity of the patient's condition does not depend on whether the primary tumor is the cause of the pathology or its metastasis. Signs of increased intra-abdominal pressure, diaphragm elevation, and reduced respiratory movements of the lung tissue are added to the manifestations of cancer. As a result, the conditions for the work of the heart and lungs deteriorate, heart and respiratory failure increases, which brings the lethal outcome of the disease closer.

Causes and mechanism of development

The abdominal cavity is formed by 2 leaves. One of them (parietal) lines the inner surface, and the other (visceral) surrounds the nearest organs. Both leaves produce a small amount of liquid secretion by their glandular cells. With its help, small local inflammation is eliminated, organs and intestines are protected from friction.

The fluid is constantly being renewed as the excess is absorbed by the epithelium. Accumulation is possible if the balance of this state is imbalanced. In 75% of cases, patients with ascites have liver cirrhosis. This disease has the maximum number of etiological factors leading to pathology.

These include an increase in hydrostatic pressure in the vessels under the influence of stagnation in the venous and lymphatic systems due to cardiac dysfunction and a drop in oncotic pressure in the blood due to liver function damage and a decrease in the albumin protein fraction.

Abdominal ascites in oncology does not exclude these mechanisms as an addition to the main damaging factor - hyperfunction of the abdominal epithelium with tumor lesions of the peritoneal sheets. The growth of malignant cells causes irritation and nonspecific inflammation.

The most significant role of seeding with malignant cells in ovarian and uterine cancer in women. The complication in these cases makes the general condition of the patients so difficult that they die with an increase in abdominal ascites.

Patients with oncology have a corresponding look

Of considerable importance is the direct compression of the liver tissue by the tumor and the creation of conditions for portal hypertension. With an increase in venous pressure, the watery part of the blood is discharged into the abdominal cavity.

Cancer intoxication is accompanied by a lack of oxygen in the cells (tissue hypoxia). The kidney tissue is very sensitive to any changes and reacts by reducing filtration. This sets in motion the mechanism of action of the antidiuretic hormone of the pituitary gland, which retains sodium and water.

Some authors distinguish hepatic and extrahepatic mechanisms in the pathogenesis of ascites. Using the example of malignant growth, we see how these causes complement each other. The suction function of the peritoneum and lymphatic vessels is impaired.

An example of local changes is abdominal lymphoma. This tumor is accompanied by impaired patency of the intra-abdominal lymphatic ducts. From these, the fluid passes directly into the abdominal cavity.

The provoking causes of ascites in oncological diseases can be such an anatomical feature as the close location of the folds of the peritoneum (adherence), the abundance of blood and lymphatic vessels, which causes the rapid spread of malignant growth to adjacent tissues.

The drift of atypical cells into the peritoneal cavity during surgery, internal germination of the walls of the peritoneum by a malignant tumor, as well as a course of chemotherapy can stimulate the sweating of fluid.

Symptoms

In cancer patients, ascites develops gradually over several weeks or months. Patients experience symptoms when a significant amount of fluid has accumulated. The main symptoms are:

• bursting heaviness in the abdomen;
• belching after eating;
• heartburn or nausea;
• dull abdominal pain;
• shortness of breath at rest, especially when lying down.

These signs are associated with the rise of the dome of the diaphragm, violation of the peristalsis of the esophagus, intestines, reflux reflux of the acidic contents of the stomach into the esophagus. Some patients complain of attacks of cardiac arrhythmias. During observation, the attending physician reveals an enlarged abdomen. In a standing position, he goes down, the navel protrudes.

During examination on the couch, the abdomen is flattened to the sides

For patients with "hepatic" ascites, a "jellyfish head" pattern is characteristic due to the formation of dense dilated veins around the navel. The accumulation of fluid creates difficulties when bending, shoeing.

Unfortunately, it is still not uncommon for young women with a neglected ovarian tumor to be identified who were confident for a long time in their pregnancy, this was facilitated by the cessation of menstruation.

The accumulated liquid itself presses on the tumor and causes decay. Metastasis in the venous system and heart failure is manifested by a difficult outflow of blood to the heart. This leads to swelling of the feet, legs, external genitalia.

All the symptoms described do not develop in isolation. In the first place are the signs of a malignant tumor. Ascites requires additional treatment, since it becomes more dangerous to live with its manifestations due to the possibility of other complications.

Regardless of the reasons, 3 stages are distinguished during the course of ascites. They are also typical for patients with cancer:

• transient - the patient feels only bloating, the volume of accumulated fluid is not more than 400 ml;
• moderate - the amount of exudate in the peritoneum reaches 5 liters, all the described symptoms appear, various complications are possible;
• tense - ascites accumulates 20 liters or more, is considered stable (resistant), it is impossible to treat with diuretics, accompanied by a serious condition, disrupts the work of the heart and breathing.

The transient stage is almost not felt by the patient

What complications can follow ascites?

The severity of the underlying disease in the event of the appearance of ascites reduces the patient's chances of recovery. The risk of dangerous complications increases even more. These include:

• bacterial peritonitis - the addition of an infection causes acute inflammation of the peritoneum;
• intestinal obstruction;
• the appearance of hernias in the area of ​​the white line of the abdomen, navel, in the groin with possible pinching;
• cardiac decompensation;
• accumulation of fluid between the pleural sheets - hydrothorax with acute respiratory failure;
• development of hepatorenal syndrome;
• hemorrhoidal bleeding, prolapse of the lower rectum.

Diagnostics

A complication such as ascites is presumed in the course of cancer. When supervising the patient, the doctor is obliged to weigh. The increase in mass against the background of pronounced weight loss of the arms, legs, body raises suspicion of hidden edema.

With an increase in the abdomen, the doctor conducts a percussion study, a dull sound changes localization depending on the position of the body

If you make a jerky movement with your hand on one side of the abdomen, then in the presence of fluid, the second hand will feel a wave in the opposite side. Additional studies serve as objective confirmation:

• Ultrasound - allows you to identify 200 ml of fluid in the abdominal cavity, at the same time serves as a control over changes in the internal organs;
• plain X-ray and tomography - require good preparation of the patient before examination, reveals fluid when changing the position of the body;
• laparocentesis - a puncture of the anterior abdominal wall in order to pump out fluid and its laboratory analysis, the procedure is both therapeutic and diagnostic, it allows you to identify the degree of seeding of the peritoneum, the composition of the exudate, the presence of microflora.

Problems of ascites treatment in oncology

Therapy for ascites, theoretically, should primarily consist in suppressing the growth of malignant cells in the peritoneum. Then you can expect the removal of the irritating mechanism and the restoration of the function of fluid absorption.

But in practice, chemotherapy methods help to reduce ascites only with neoplasms in the intestine, and when localized in the liver, stomach, uterus, ovaries, they remain ineffective.

It remains to control the intake and excretion of fluid with food, to rely on the optimal conditions for the action of diuretics (diuretics). You can remove excess water with a restrictive diet. The patient is prescribed a salt-free diet, all dishes are prepared without salt, in agreement with the doctor, it is possible to add salt to a plate.

Spicy seasonings, heavy fatty foods, everything cooked fried are excluded. The volume of fluid consumed is calculated by diuresis (the amount of urine excreted per day). At the same time, the menu should contain foods that provide the body with protein and potassium. Therefore it is recommended:

• boiled lean meat and fish;
• cottage cheese, kefir with good tolerance;
• baked potato;
• dried apricot compote, raisins;
• carrots, spinach;
• oatmeal.

How is diuretic treatment carried out?

Do not overdo it in prescribing diuretics. There is a well-known recommendation of doctors to drink more liquid for any intoxication. This also applies to cancer. Removing a large volume of water from the body increases the general intoxication with the decay products of malignant cells, therefore, weight loss while taking diuretics by 500 g per day is considered acceptable.

The choice of diuretics and dosage is always up to the doctor. You cannot change drugs yourself, violate the regimen. The most effective is the combination of Furosemide, Veroshpiron and Diacarb.

After ingestion of one tablet, the action begins an hour later, lasts up to six hours

Furosemide (Lasix) belongs to the group of loop diuretics. The action is based on blocking the reabsorption of sodium and chlorine in the tubules and loop of Henle, the excretory apparatus of the kidneys. Simultaneously removes potassium. In order not to disturb the balance of electrolytes and not to cause attacks of arrhythmia, potassium preparations (Panangin, Asparkam) are prescribed.

Veroshpiron, unlike Furosemide, is a potassium-sparing drug. It contains spironolactone (adrenal hormone). It is with the help of the hormonal mechanism that it is possible to remove excess fluid without potassium. The tablets take effect 2–5 days after the start of administration. The residual effect lasts 3 days after discontinuation of the drug.

Diacarb is a targeted drug. It is especially indicated for the prevention of cerebral edema, less effective in the process of urine output. Its action begins 2 hours after ingestion. It is associated with blocking the enzyme carbonic anhydrase in the tissues of the kidneys and brain.

Surgical intervention

Most often, the procedure of laparocentesis is used to remove the accumulated fluid in the peritoneal cavity in the resistant stage of ascites. The method is considered surgical, although it is owned by therapists in specialized departments.

The essence of the technique: the patient sits on a chair, the stomach around the navel is treated with iodine. A solution of Novocaine is injected at a point about 2 cm below the umbilical ring to provide local anesthesia. After that, a puncture of the abdominal wall is made with a special instrument (trocar). The appearance of fluid indicates that it has entered the peritoneal cavity. A tube is connected through which the liquid is pumped out by gravity.

Up to 10 liters of liquid are removed once. Against the background of a gradual decrease in the abdomen, the sheets are pulled together to prevent the collapse of the patient. In some cases, if it is impossible to immediately withdraw a large volume of fluid into the peritoneal cavity, a drainage tube is inserted and closed until the next time. Thus, the procedure is repeated 2-3 days in a row.

During laparocentesis, it is necessary to monitor sterility, since the risk of infection of the peritoneum and peritonitis increases

Laparocentesis is not performed:

• with adhesions of the abdominal cavity;
• against the background of pronounced flatulence;
• during the recovery period after hernia repair.

Peritoneovenous bypass grafting consists in connecting a special tube of the abdominal cavity with the superior vena cava, through which, when the patient breathes, fluid flows into the venous bed. Deperitonization - excision of areas of the peritoneum to provide additional pathways for fluid removal.

Omentohepatophrenopexy - excision of the omentum fused to the anterior abdominal wall and suturing it to the diaphragm or liver is necessary if the omentum interferes with laparocentesis.

Folk remedies in the treatment of ascites

In folk healers, herbal tinctures are described that help reduce ascites in cancer. Doctors treat them extremely negatively, because often patients, believing in fabulous results, abandon the main treatment.

However, in the absence of real help from the ongoing therapy of a patient with cancer, it is understandable. Therefore, we provide a list of plants that, according to herbalists, can help:

• astragalus membranous;
• swamp calamus root;
• spurge;
• clefthoof grass root;
• Siberian prince herb;
• marsh saber.

Before purchasing herbal tea, it is better to consult a doctor and carefully read the composition

The overall survival rate of patients with ascites in oncological diseases gives disappointing figures - only half of the patients will live for two years. The final outcome is either better or worse than the expected period.

It depends on the patient's response to treatment, age, the presence of chronic diseases of the kidneys, liver, heart, the nature of tumor growth. Ascites in the initial stage with tumors is treated much more effectively. Therefore, in the treatment of malignant neoplasms, early diagnosis of complications should be envisaged.

Source: Abdominal Ascites Using Folk Remedies

Ascites is an abnormal accumulation of fluid in the abdominal cavity. Normally, there is always a small amount of serous substance in the abdomen, which is necessary for the free placement of intestinal loops and their temporary movement during human movements. It also protects organs from friction and premature wear.

If serous fluid accumulates in large quantities, it becomes a threat to human life and health. In the initial stages of the disease, there is a real opportunity to remove excess fluid with the help of diuretics and a certain diet. Timely treatment of ascites with folk remedies is quite effective. In many cases, it avoids serious complications in the future.

Symptoms and Causes

Ascites, as a rule, does not occur on its own, but is a symptom of another (underlying) disease. The disease can be caused by:

• cirrhosis of the liver;
• disturbances in the work of the cardiovascular system;
• malignant tumors.

Depending on the cause and severity of the disease, the abdomen can increase gradually or sharply. The amount of accumulated liquid can be small, medium or very large. In advanced cases, up to 25 liters of excess fluid can form in the abdominal cavity. The main symptoms of ascites are:

• there is an increase in the size of the abdomen;
• there is a feeling of bloating and heaviness;
• in the prone position, the stomach becomes "flattened", but at the same time protrudes on the sides;
• there are periodic pulling pains in the stomach and intestines;
• swelling may occur in other parts of the body (usually focused on the legs);
• with a large abdomen, the navel protrudes;
• body weight increases rapidly due to the accumulation of excess fluid.

If ascites is not treated, bacterial peritonitis may develop, an infectious inflammation of the peritoneum, which can only be treated surgically and can be fatal. To prevent this, you need to promptly seek medical help if alarming symptoms appear. After the examination and diagnosis, it is possible to agree with the doctor on the options for treating ascites using folk remedies at home. At the initial stages of the disease, these methods are not inferior in effectiveness to pharmaceutical drugs. What is important, they have practically no side effects, that is, they are safe.

Diuretic folk remedies to eliminate edema

Folk remedies for eliminating edema are decoctions and infusions that have a diuretic effect. At home, you can use the following recipes for traditional medicine:

1. Collecting with bearberry. Dry and grind the bearberry and hernia, mix in equal parts. 60 g of herbal mixture, pour 0.3 liters of boiling water and cook over low heat for 30 minutes. After straining, the broth is recommended to take 300 ml in the morning on an empty stomach.
2. Broth of parsley. Pour 150 g of fresh parsley with 500 ml of hot water, bring to a boil and simmer for 15 minutes. After the product, you need to strain and take 100 ml every hour in the morning (in total, you can drink up to 0.5 liters of broth per day).
3. Infusion of horsetail and birch leaves. These components must be mixed in equal parts and pour 500 g of the resulting collection of 0.5 liters of boiling water. Keep the product on low heat for 15 minutes, then strain and drink 200 ml in the morning.
4. Bean broth. To prepare it, you need to rinse the husks from 15 pods of a legume plant and pour 1 liter of boiling water. Soak the product over low heat for 10 minutes, after which it should be infused for another 20 minutes under a closed lid. Drink the broth in equal portions throughout the day.
5. Decoction of corn stigmas. To prepare this remedy, you need 2 tbsp. l. plant raw materials, pour 200 ml of boiling water and put in a water bath for 20 minutes. After straining and cooling, the broth must be brought with boiled water to a total volume of 200 ml. It is recommended to take the healing agent 15 ml 3 times a day after meals.

Other treatments for ascites

A bath with birch buds helps to reduce the severity of edema in ascites. First you need to prepare a concentrated solution. For this, 4 tsp. birch buds need to be poured with a glass of boiling water and infused for 8 hours. Dilute the strained agent with plain hot water and take a general bath for 15 minutes. This procedure stimulates perspiration, helps to remove excess fluid from the body.

Apricots help make up for the lack of potassium, which is washed out in ascites. Since in this disease, the use of raw fruits is undesirable, a decoction must be prepared for therapeutic purposes. For 2 liters of water, you need to take 400 g of apricots, bring them to a boil and simmer for 40 minutes. After cooling, the resulting drink should be consumed in small portions. You can drink up to 400 ml of apricot medicine per day.

It is useful for ascites to take tea from viburnum with honey. To do this, take 1 tsp for a glass of hot water. canned viburnum with sugar and mix well. After cooling, you can add a little honey to the product to improve the taste.

Onion juice, which should be drunk on an empty stomach in the morning, gives a good effect. To do this, in the evening, the onion must be cut and sprinkled with sugar, overnight it will let the juice out. You need to take it in 2 tbsp. l. every morning before breakfast. Cucumber juice has a diuretic effect. It can be squeezed out of fresh vegetables and drunk 100 ml per day in small portions.

Diet

Compliance with a diet for ascites is necessary for successful treatment, since without it, no remedy will have the desired effect. From the patient's diet, it is necessary to completely exclude all semi-finished products, excessively fatty and spicy foods, baked goods and all dishes that increase gas formation. From the first courses, it is better to give preference to mashed soups, cooked in vegetable or chicken broth. Be sure to remove the skin from the chicken before cooking. The best way to prepare chicken broth is from fillet or boneless breast.

Fresh vegetables are undesirable. They need to be heat treated (boiled, steamed). Fruits can be eaten only in dried form, cook compotes and jelly from them. Juices should be diluted 1: 1 with water before use. The amount of liquid, including soups, in the diet should be limited to 2 liters per day (less, but not more). A very important point in the diet for ascites is the rejection of salt. It retains water in the body and leads to edema, so it must be completely excluded from the diet during treatment. Salt can be substituted with natural mild spices (parsley, dill, dried herbs).

With ascites, you can use fresh herbs, low-fat cottage cheese, cereals, boiled dietary meat and fish. During treatment, alcoholic beverages, strong coffee, tea, sauces and marinades should be completely excluded from the diet.

• Covering 61
• Respiratory 53
• Digestive 48
• Bloodstream 45
• Reproductive 37
• Nervous 34
• Musculoskeletal 25
• Excretory 21

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Source: Treating Ascites At Home?

Ascites is the accumulation of excess fluid in the abdominal cavity.

Serous fluid is located between the peritoneal organs and the intestinal loops, which ensures the free movement of organs. With the development of various pathologies, it can accumulate, which leads to the appearance of an ailment.

Home treatment of ascites is considered a very topical issue.

Causes

The causes of the appearance of pathology are very diverse and are always associated with abnormal processes in the body. So in what diseases does ascites occur? The following violations can lead to the development of the disease:

1. Diseases of the liver. Quite often, pathology develops with cirrhosis of the liver, malignant organ damage and the development of Budd-Chiari syndrome. Hepatitis, the use of medications or alcohol can lead to the development of cirrhosis. In any case, the disease provokes the death of hepatocytes. As a result, scar tissue replaces healthy liver cells, and the size of the organ increases. As a result, he squeezes the portal vein, which leads to the development of ascites.
2. Heart diseases. Pathology can develop with heart failure or constrictive pericarditis. Ascites is due to the fact that the enlarged heart muscle cannot pump the required amount of blood. It accumulates in the vessels, and the inferior vena cava system is no exception. Under the influence of increased pressure, fluid leaves the vessels and forms ascites.
3. Kidney pathology. Chronic organ failure leads to the development of the disease, which can be the result of a variety of anomalies - pyelonephritis, urolithiasis, glomerulonephritis. All these pathologies provoke an increase in blood pressure, sodium with liquid is retained in the body, which causes ascites.
4. Damage to the lymphatic vessels. This may be the result of traumatic injury, the presence in the body of a tumor formation that gives metastases. Also, this condition occurs due to infection with filariae - worms that lay eggs in the lymphatic vessels.
5. Lesions of the peritoneum. These include tuberculous, fungal or diffuse peritonitis. Also, the cause can be a malignant lesion of the large intestine, breast, stomach, endometrium, ovaries. Often the cause is peritoneal carcinosis, mesothelioma and pseudomyxoma of the peritoneum.
6. Polyserosite. With the development of this ailment, in addition to ascites, other symptoms appear - in particular, pericarditis, pleurisy.
7. Systemic diseases. Abnormalities such as lupus erythematosus, rheumatism, and rheumatoid arthritis can lead to the accumulation of fluid in the abdominal cavity.
8. Protein deficiency. This anomaly is one of the factors that creates the prerequisites for the development of the disease.
9. Pathology of the digestive system. These include Crohn's disease, pancreatitis, chronic diarrhea. Also, the cause of the problem can be any processes that occur in the peritoneum and disrupt the outflow of lymph.
10. Myxedeme. This anomaly is accompanied by swelling of soft tissues and mucous membranes. Its development is associated with a violation of the production of thyroid hormones - thyroxine and triiodothyronine.
11. Eating disorders. Strict diets and fasting are especially dangerous in this respect. This leads to depletion of protein reserves, which provokes a serious decrease in oncotic pressure.

In some cases, pathology is diagnosed in newborn children. It can be a consequence of fetal hemolytic disease, which is associated with an immunological conflict.

Ascites - fluid in the abdomen

Symptoms

Before dealing with pathology, you should analyze its clinical picture. Symptoms may increase gradually or appear suddenly over days or hours.

The main manifestation of ascites is a significant increase in the size of the abdomen and a noticeable weight gain. At the same time, many people complain of the appearance of bursting pains, nausea, heartburn, flatulence, belching.

As the abdomen enlarges, the navel protrudes and the skin tightens. In an upright position, the abdomen hangs down, while in a horizontal position it spreads out on the sides and protrudes in the region of the ribs.

With a significant increase in volume, severe shortness of breath, swelling of the extremities, and impaired motor activity are observed. It can be difficult for a person to bend over.

Often, patients complain of hernia and hemorrhoids. Many patients have rectal prolapse and varicocele.

Depending on the cause of the development of the disease, general symptoms may also occur:

• fever;
• enlarged veins in the abdomen;
• toxicosis;
• general weight loss against the background of an increase in the size of the abdomen;
• bluish tinge of the limbs.

In total, quite a lot of fluid can accumulate in the abdominal cavity. This figure is 5-20 liters.

Drug treatment

How is ascites treated? This question worries many people. The main drugs that are used to remove excess fluid from the body are diuretics.

The use of such funds helps to ensure the transfer of excess fluid from the peritoneum to the bloodstream. This can significantly reduce the manifestations of pathology.

At the initial stage of therapy, the patient is prescribed a small amount of diuretics. This helps to minimize the risk of adverse reactions.

The key principle of diuretic therapy is to slowly increase urine output. This will help prevent significant losses of potassium and other essential metabolites. In most cases, agents such as Veroshpiron, Aldactone, Amiloride are used.

In addition to diuretics, your doctor may prescribe potassium supplements. Also, hepatoprotectors must be included in the therapy regimen.

During the treatment period, specialists carry out daily monitoring of the patient's diuresis. If the use of drugs does not give the desired effect, they are changed to stronger drugs. It can be Dichlothiazide or Triampur.

Also, during the period of therapy, medications are necessarily prescribed that help to strengthen the walls of blood vessels. These include vitamins C and P, Diosmin.

It is useful to take funds that prevent the excretion of fluid outside the vascular bed. These include Reopoliglyukin.

To normalize the metabolism of liver cells, protein preparations are administered. Usually, concentrated plasma or a solution of Albumin having a concentration of 20% is used for this. If the disease is of bacterial origin, antibiotics are indicated.

Many people wonder if ascites can be cured. Medication can help you get rid of excess fluids. To completely cope with the disease, you need to eliminate the provoking factor.

Folk remedies

Answering the question of how to get rid of pathology, one cannot fail to mention the effective alternative methods. Of course, they will not help to completely recover from the disease, but they will significantly improve the person's condition.

Treatment of ascites with folk remedies is carried out using the following products:

1. Infusion of cherry stalks. To do this, take a large spoonful of dried raw materials, add 500 ml of boiling water and leave to infuse for several hours. The filtered agent should be consumed 200 ml 3-4 times a day. The course of therapy is 2 weeks. Then you need to take a break for a week.
2. Flax seeds. To prepare a healing agent, you need to take 4 small tablespoons of seeds, add 1 liter of water. Boil and put on low heat for a quarter of an hour. Insist for several hours and use half a glass up to 7 times a day. This recipe is highly effective. The results will be obtained in 2 weeks. This composition helps with the appearance of internal edema. The course of therapy is 1 month. Then the treatment must be repeated after 10 days.
3. Collection of herbs. To ensure normal water-salt balance and kidney function, mix equal parts of currant, rosehip, lingonberry and raspberry leaves. Pour half a glass of raw materials with 500 ml of water and cook for 10 minutes. Consume after meals instead of tea. This remedy has an excellent diuretic effect.
4. Decoction of parsley seeds. To make it, 1 large spoonful of seeds or the whole crushed plant should be mixed with 2 cups of boiling water, wrapped and left for 10 hours. Consume 1 tablespoon 3-4 times a day. The broth must be taken with caution. First, you should drink it for 2 days in a row, then interrupt for 3 days.
5. Decoction of birch leaves and buds. This remedy will give good results if the cause of the pathology is a violation of the heart. Also in this situation, it is useful to take a bedstraw infusion and consume a large amount of parsley. In addition, it is useful to include pumpkin and juice of this vegetable in the menu.
6. Broth of oat straw. After the oats begin to ripen, you need to collect fresh straw. Take 40 g of raw materials and add 1 liter of water. Drink half a glass 3-4 times a day. It is useful to take a decoction for pathologies of various origins.
7. Diuretics. If the swelling is caused by disturbances in the functioning of the kidneys, it is useful to use an infusion of corn stigmas, horsetail, bean pods. Diuretic preparations and teas are no less effective. For their preparation, it is worth taking in equal parts bearberry leaves and hernia grass, thoroughly dry and grind. Place the resulting product in a glass container and take as tea. Mix half a glass of raw materials with 2 glasses of water and cook over low heat for a quarter of an hour. Consume 30 minutes before meals.

Power features

Diet for ascites plays a key role, especially in the early stages of the disease. To achieve good results, all prohibitions must be strictly observed.

So, the following should not be eaten:

• fresh pastries from puff or pastry;
• offal;
• sausages and smoked meats;
• stew;
• fatty, fried, spicy, salty foods;
• strong meat, mushroom and fish broths;
• fatty dairy products;
• some vegetables - cabbage, radish, garlic, onion, sorrel, radish, mushrooms.

In this case, food must be complete. The menu should contain a variety of products.

It is useful to use the following:

• eggs in the form of a protein omelet;
• porridge - the exception is millet and legumes;
• puree soups based on chicken, turkey and rabbit;
• minced meat dishes;
• steamed or boiled fish;
• stale bread;
• warm drinks;
• jelly;
• marshmallow.

Course and prognosis

Many people are wondering if this ailment itself can go away.

Unfortunately, ascites does not disappear without adequate therapy, but is constantly progressing. This anomaly significantly worsens the prognosis of the underlying disease and is an unfavorable sign in terms of prognosis.

Ascites can be complicated by bleeding, peritonitis, and spleen or liver failure.

There is also a threat of brain damage due to swelling. On average, the number of deaths within 2 years with severe ascites is 50%.

Prophylaxis

In order to prevent the development of the disease, you need to engage in its prevention:

1. Correctly and promptly treat pathologies that can provoke ascites. These include hepatitis, cirrhosis, portal hypertension.
2. Follow a diet. Experts advise to limit the use of useless liquids that do not quench thirst - coffee, carbonated drinks.
3. Refuse excessive physical and psychological stress.

Now you know how to remove this pathology. To do this, first of all, you need to deal with the treatment of the underlying ailment that led to the appearance of ascites.

To do this, it is necessary to conduct a detailed diagnosis and strictly adhere to all medical recommendations.

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Ascites (dropsy of the abdomen) is a pathological accumulation of fluid in the abdominal cavity. The amount of transudate in this condition can be up to 20-25 liters.

Treatment of ascites is carried out by eliminating the cause of the development of the disease, as well as reducing the amount of accumulated fluid with the help of a diet; in severe cases, they resort to puncturing the peritoneum and pouring out the transudate into the external environment. In addition, the actual problem of treating abdominal ascites with folk remedies.

What is traditional medicine aimed at with ascites?

It is not very reasonable to use exclusively alternative methods of treatment to combat dropsy of the abdomen, since the pathological condition is fraught with a number of serious complications (for example, the appearance of bacterial peritonitis).

It is important to combine medical and surgical methods with the use of medicinal herbs and products that have a therapeutic effect. First of all, recipes are used, the components of which have a diuretic effect. Removing excess fluid is the basis of symptomatic therapy.

However, one should not only remove fluid from the abdomen, but also eliminate the main cause of the pathological condition. Traditional healers are also advised to take infusions and decoctions based on medicinal plants, which will strengthen the defenses of the patient's body and will help activate metabolic processes.

Foods used in the treatment of dropsy

One of the well-known products that should be on the individual menu of a sick person is pumpkin. It enhances the excretion of salts from the body, which reduces the risk of abnormal fluid retention in the abdominal cavity and the appearance of puffiness. Pumpkin reduces the load on the heart muscle, cleanses the patient's body of toxins and toxic substances.

The next important product is apricot. It is a source of potassium, which is necessary for the proper functioning of internal organs, provided that diuretics and herbal infusions are used.

Parsley is a plant bed that has powerful antioxidant properties. Eating greens in food can enhance the effectiveness of other vegetables and fruits used in the treatment of ascitic pathology.

An increase in abdominal volume, dull pain and excessive gas formation are the main symptoms of ascites.

Treatment of ascites with folk remedies

Treatment with folk remedies has always remained an urgent problem. After all, many people cannot withstand a strict diet or decide to have an abdominal puncture.

Recipe number 1. Bean pod decoction

Peel the beans (about 20-25 g) and pour the resulting pods with 1 liter of clean water. Put everything on fire and bring to a boil. Boil for another 10 minutes over low heat and let stand and cool for 40 minutes.

Take the broth inside 3 times a day, but no later than 8 pm. Due to the excellent diuretic effect, excess fluid will leave the body. In addition, you need to limit yourself in the amount of water you consume.

Recipe number 2. Decoction of parsley leaves or seeds

Pour parsley leaves or seeds (about 300 g) with 1 liter of water, bring to a boil and cook for about 15-20 minutes. After that, remove the broth from heat, cool and strain through cheesecloth. It is necessary to take the drug for 3 days every day from the very morning with an interval of 60 minutes. The total volume of liquid drunk should not exceed half a liter in 24 hours.

Recipe number 3. Horsetail and birch leaves

The components for the preparation of the drug are mixed in equal proportions, and pour 0.5 liters of boiled water. Bring to a boil, cook for 20 minutes, cool and strain the broth. Take 200 ml orally every morning for 7-10 days.

Recipe number 4. Apricot fruit compote

Fresh or dried apricots (1 glass) are poured with 1 liter of water and the compote is boiled for 40 minutes without adding sugar.

The resulting broth is separated from the fruit and filtered. Drink 1 glass of the drug every morning, with a positive effect, the dosage can be increased to 0.4 liters per day. The duration of treatment is several weeks.

Recipe number 5. Bearberry and hernia broth

Mix 2 plants in equal proportions and pour 300 ml of boiling water. Everything is cooked over low heat for 30–40 minutes, then cooled down and thoroughly filtered. The resulting broth is taken orally, 300 ml daily for 2-3 weeks in the morning before meals.

Recipe number 6. Linden and coltsfoot tea

Linden flowers and coltsfoot flowers are mixed in equal proportions and immersed in 500 ml of pure water, brought to a boil and boiled for a quarter of an hour. The finished broth is removed from the heat, insisted for another 15 minutes, cooled and taken orally 4 times a day, 100 ml warm. The duration of treatment is 10-14 days.

Linden tea with the addition of coltsfoot is an excellent option for the treatment of ascites

Recipe number 7. Birch wraps

A clean cotton cloth is immersed in a ready-made decoction of birch leaves (at the rate of 100 grams per bucket of water), the patient is completely wrapped, starting from the armpits and ending with the knees. Wrap a second dry sheet and a third layer of a woolen shawl or blanket on top as quickly as possible.

It is necessary to take a lying position, and cover the top with another blanket. The time of the procedure is at least 1.5 hours. After the end of the procedure, everything is removed, but drafts or contact with cold air must not be allowed.

Recipe number 8. Oat straw infusion

One handful of fresh straw is taken per liter of water. It is infused for 2-3 days in a dark and cool place. It is recommended to take the product, 150 ml 3-4 times a day. The infusion is effective for any accumulation of fluid in organs and tissues.

Recipe number 9. Herbal collection: nettle, plantain, St. John's wort, rose hips and bearberry

One tablespoon of the collection of herbs is poured with cold boiled water and insisted for 6-8 hours. After that, put the infusion on the fire and simmer for 15–20 minutes over low heat. The broth is filtered, cooled and taken orally, 50 ml 4 times a day.

Recipe number 10. Infusion of cherry stalks

One tablespoon of dried cherry stalks is poured with 1.5 liters of boiling water, covered and infused for 3-4 hours. The resulting liquid is filtered and taken orally in a glass 3-4 times a day. The duration of treatment should be at least 2 weeks. Then take a 7-day break and repeat the course.

Remember! Before using any folk remedy, you must consult with a specialist.

In addition, if an allergic reaction of the body or deterioration of the condition was detected during treatment with ascites drugs, therapy should be stopped immediately!

Diet for ascites is an integral treatment option. It greatly facilitates the patient's life. Food inhibitions are especially effective in the initial stages of the disease, since they largely determine the further development of the secondary condition. The diet is prescribed in combination with medication to reduce the manifestation of ascites.

Medication for ascites

The internal organs and abdominal cavity of a person are shrouded in a thin tissue - the peritoneum. Its blood and lymph vessels secrete a small amount of fluid, which is necessary for the free movement of the intestinal loops and preventing the internal organs from sticking together. This liquid is absorbed by the peritoneum itself, so the body controls this process. In case of malfunctions in the body, the process of absorption of the secreted fluid is disrupted, or a large amount is released. This pathology is called abdominal ascites or dropsy of the abdomen.

Ascites is not an independent disease - it is only a symptom of a severe disorder in the body. It always develops as a complication of other diseases.

Conservative therapy of ascites is based on suppressing the underlying disease and depends on the cause of the origin of the primary pathology. For all types of dropsy, drugs are prescribed - diuretics to normalize water-salt metabolism and reduce the formation of fluid in the abdominal cavity.

The initial course of treatment includes drugs such as: Veroshpiron, Aldactone, Spironolactone. In case of ineffectiveness of therapy with these drugs, a more potent drug Furosemide or Torasemide is added.

Drugs such as Captopril, Enalapril may be prescribed. They enhance the excretion of sodium from the body while retaining potassium.

Doses of drugs are prescribed by the attending physician individually, depending on the underlying disease and the patient's well-being. It must be borne in mind that the use of high dosages can lead to side effects.

Uncontrolled and excessive use of diuretics can put the body at risk of dehydration.

In the treatment of abdominal ascites, multivitamin complexes are prescribed, which have a beneficial effect on the functioning of the body as a whole. It is recommended to enter them in the form of injection solutions, given the impaired absorption of vitamins from the intestines.

Complicated ascites require surgical treatment. A widely used surgical procedure for ascites is laparocentesis - puncture (tissue puncture) removal of fluid from the abdominal cavity. In case of complicated ascites, an indwelling catheter is installed for prolonged withdrawal of fluid.

Treatment of ascites with folk remedies

Many people believe that one should not neglect the proven methods of treatment of traditional medicine, which has thousands of years of practical experience and is still relevant.

Treatment of ascites with folk remedies is dynamically used in complex therapy with drug treatment aimed at eliminating the main cause that provoked the development of this ailment. Natural diuretics help to remove excess fluid from the abdominal cavity and thus facilitate the work of internal organs.

Before treating ascites with traditional medicine, it is necessary to consult a doctor, since the consequences of this treatment can be significant.

Parsley with milk

You can relieve unpleasant symptoms with dropsy of the abdomen with the help of parsley with milk. When taking this remedy, fluid from the abdominal cavity leaves already for 2 days. For the broth, you need 0.5 liters of milk and a large bunch of parsley. Boil the milk, add the chopped parsley to the milk. Simmer the resulting mixture over low heat for at least 2 hours, then cool and strain. Drink the prepared potion every hour for 2 tbsp. l. Store the diuretic in a cool place.

Lemon and horseradish

An effective treatment for ascites is an infusion of lemon and horseradish. For infusion, you need to take 100 g of squeezed lemon and chopped horseradish, mix and let it brew for 1 night. Take 1 tsp. daily for 2 weeks. Store the tincture in the refrigerator.

Mother and stepmother and sweet clover

A decoction of mother-and-stepmother and sweet clover will help to cope with the accumulation of unnecessary liquid. The grass of the coltsfoot and the flowers of the sweet clover must be taken in equal proportions, chopped and mixed. For 1 tsp. you need a glass of boiling water, stand for half an hour and consume 2 tbsp. l. 3 times a day.

Red root (tea penny)

The treatment of dropsy with folk remedies such as red root (tea penny) is widespread in Tibetan folk medicine.

To prepare the infusion, you need 2 tbsp. l. Pour 0.5 liters of vodka on the finely chopped root and let it brew for 10 days. Take an infusion of 1 tsp. 3 times a day. The duration of treatment is no more than 30 days.

A popular remedy for eliminating abdominal ascites is dried apricot infusion. In addition to the main diuretic effect, it replenishes a significant part of the body's need for potassium. It is necessary to pour 200 g of well washed dried fruits with boiling water (0.5 l) and close the container tightly, or it is better to use a thermos to prepare the infusion. It must be insisted for at least 6 hours. You need to take the product 2 times a day, 150 ml.

Diuretic tea

For the preparation of diuretic tea, you can use a collection of dried raspberries, lingonberries, currants and rose hips. You need to take 4 tbsp. l. mixture, pour 250 g of boiling water and boil for 20 minutes. Let the broth cool, strain and take 2 times a day instead of tea.

Nettle can be the basis for diuretic tea. The remedy helps if it is used at an early stage of ascites. Finely chop the dried nettle roots, take 1 tsp. for 1 glass of boiling water, insist and drink 2 glasses a day.

An effective remedy for dropsy is a decoction of angelica root. For its preparation, use the dried and crushed root. To obtain a medicine, it is necessary to use dried and crushed raw materials. For the preparation of the daily rate of decoction 1 tbsp. l. root, pour a glass of water and simmer over low heat for 20 minutes. Divide the resulting broth into 3 doses.

Diet for ascites

Diet, that is, a specially designed nutritional system, is one of the main components of the treatment of many diseases.

The diet for ascites should be aimed at preventing fluid retention in the body. This requires minimizing salt intake and reducing fluid intake. When following the diet, the patient should eat boiled or steamed food.

With this ailment, a ban has been imposed on sour, spicy and fatty foods.

It is necessary to remove from the diet meat delicacies that contain the so-called hidden fats (pork skin, lard, interior fat) and smoked products. Pork and other fatty meats should be replaced with rabbit, turkey and chicken. It is not recommended to consume high-fat dairy products.

Fresh bakery products are unacceptable for this ailment. Some vegetables should be discarded:

• turnips;
• sorrel;
• radish;
• Luke;
• garlic;
• radish.

You need to forget about coffee, cocoa and carbonated drinks. You can drink weakly brewed green tea, which is not only a treasure trove of many vitamins, but also has a pronounced diuretic effect. Fruits must be included in the diet in dried form or prepared for compote. From sweets, you can only afford marshmallows or jam.

The patient's diet must necessarily contain foods containing a large amount of potassium, such as:

• spinach;
• grapefruit;
• eggplant;
• dried apricots;
• baked potato;
• asparagus;
• raisin;
• carrot;
• green pea.

Porridges that do not contain millet and legumes are allowed. It is recommended to use nuts (walnuts, hazelnuts, peanuts) after mixing them with honey.

The diet must be strictly followed, and the patient must be aware of the seriousness of proper nutrition.

In the treatment of abdominal dropsy, therapeutic fasting is effective. It should be carried out systematically and from the very onset of the disease. Fasting should be carried out once every 2 months for a week, drinking only 2 glasses of tea without sugar per day. It is recommended to do enemas every night during fasting. After this procedure, the transition to regular food should be gradual.

Abdominal ascites is a pathological process characterized by the accumulation of fluid in the abdomen, the volume of which can reach 25 liters. The cause of the pathology can be various diseases of the liver, gastrointestinal tract and other organs. The accumulated fluid may contain an admixture of pus, the so-called exudate, which indicates the development of inflammation in the body. With ascites of the abdominal cavity, treatment with folk remedies, along with taking medications, gives a positive result. But home therapy is possible only in cases where the disease is not caused by inflammatory processes, otherwise the patient's condition may worsen in the absence of necessary treatment in a clinic.

How pathology manifests itself

The clinical picture in ascites shows a high level of protein and leukocytes contained in a biomaterial taken from the abdomen using a puncture. This phenomenon can serve as the beginning of the development of peritonitis - inflammation of all organs of the abdominal cavity.

Physical manifestations of ascites include:

• a sharp and unreasonable increase in the abdomen;
• protrusion of the navel, which is caused by the pressure of fluid on the walls of the peritoneum;
• with a large amount of accumulated biomaterial, a hernia may appear;
• covering the skin of the abdomen with a venous mesh.

The complaints of patients are often added:

• dyspnea;
• discomfort in the abdominal cavity;
• labored breathing.

The lungs are compressed due to the large volume of fluid, while not allowing normal breathing... A person can also feel pressure on the diaphragm of varying intensity.

Factors causing the development of abdominal ascites

Ascites is not a primary disease, but a consequence of other pathologies present in the patient's body. The reasons for its occurrence include:

• high blood pressure in the portal vein;
• metastases affecting the abdominal organs during oncological processes (carcinomatosis);
• replacement of parenchymal liver tissue with fibrous tissue, which is called cirrhosis;
• inflammatory processes in the liver due to alcohol exposure and its failure;
• abdominal tuberculosis;
• kidney disease that has developed as a result of prolonged fasting;
• heart failure;
• an acute form of pancreatitis - inflammation of the pancreas.

It is necessary to treat abdominal ascites taking into account the underlying disease. But in order to establish the exact cause of the pathology, it is necessary to undergo an examination that will show what exactly caused the accumulation of fluid. The patient also needs to pay attention to accompanying symptoms that will help narrow the range of possible diagnoses.

Diagnostics

The examination begins with a full-time examination of the patient by a doctor. The doctor collects a detailed anamnesis, which in the future will help to make the correct diagnosis. The patient is referred for examination, which includes:

• x-ray of the peritoneum;
• laparocentesis - sampling of biomaterial from the abdomen for research.

The latter procedure not only helps to find out the cause of the pathology, but also improves the patient's condition, since the amount of fluid in the peritoneum decreases and the person can breathe and move normally again for some time.

Treatment in a medical setting

As mentioned earlier, before treating ascites, you need to identify the cause that caused it and make every effort to eliminate it. But if the fluid accumulated in the abdomen threatens the patient's health and life (when its volume exceeds 15 liters), then the attending physician prescribes its urgent removal. The patient is prescribed laparocentesis - a puncture of the abdominal cavity, due to which excess biological fluid is removed from the abdomen.

Surgical intervention can provoke bleeding, intestinal perforation (the entry of its contents into the abdominal cavity), adhesions, and infection of the body.

Traditional therapy

Before the diagnosis, during the examination by specialists, the patient can treat ascites with folk remedies. Their action is aimed at removing excess fluid from the abdomen and preventing its accumulation.

Bean pods

Bean pods have a good diuretic effect... Excess fluid is removed from the body, significantly alleviating the patient's condition.

To prepare the medicine at home, you need to cleanse 15 pods of seed, place the remaining husk in a small saucepan, pour 1 liter of water and boil for 15 minutes. Let it brew for 30 minutes, drain. You need to drink the cooled medicine, so you can prepare it in the evening. Take 100 ml three times a day:

• in the morning after waking up;
• before breakfast;
• After dinner.

After three days, the result will be noticeable: the patient will breathe easier, shortness of breath will disappear and the stomach will decrease in volume.

Parsley

To prepare the medicine you need:

1. Rinse thoroughly with 300 g parsley.
2. Pour greens with a liter of hot water.
3. Put on fire for a quarter of an hour.
4. Strain.

It is necessary to take the medicine for three days. You need to drink the broth from the moment you wake up until late in the evening, the interval between doses is 1.5 hours.

Apricot

To prepare a medicinal decoction, you can use fresh or dried apricots. A glass of pitted fruits is boiled in a liter of water for 40-60 minutes, filtered and drunk daily, 200 ml. The amount of compote consumed per day can be doubled if the patient's condition improves markedly.

Diuretic and diaphoretic teas

It is possible to get rid of excess fluid in the body only through its intensive excretion. Tea with an effective diuretic effect is perfect for this:

1. Stir 3 tablespoons of hernia and bearberry, add 0.5 liters of water, bring to a boil and cook over low heat until the broth becomes dark and strong. Strain and cool. Take a glass on an empty stomach. The effect will be noticeable already on the second day.
2. Dilute a teaspoon of viburnum, rubbed with sugar, in 250 ml of warm water. Take a glass up to four times a day. Honey can be added to the product to improve its taste.
3. Not only diuretic tea will help to remove excess fluid. You can also use products that increase sweating. Similarly to the first recipe, brew a mixture of mother-and-stepmother and linden, drink 250 ml warm four times a day.

Patients should limit their daily fluid intake, therefore, in addition to diaphoretic tea, you can drink no more than 0.5 liters of water for the result to be as effective as possible.

Onion

After waking up, you need to drink 2 tablespoons of onion juice. The night before, the medium onion is cut into cubes and covered with copious amounts of granulated sugar. In the morning, you need to drain the juice and store it in the refrigerator.

Cucumber

As you know, cucumber has an effective diuretic effect. Freshly squeezed cucumber juice is drunk 2 tablespoons six times a day. It is better not to prepare a lot of juice in advance, but to cook fresh every time.

Corn silk

To remove the liquid, it is necessary to prepare a decoction of corn stigmas:

1. 2 tablespoons of dry ingredients are poured into a glass of boiling water.
2. Simmer the medicine in a water bath for half an hour.
3. The prepared product is filtered and cooled.
4. Dilute the broth with a glass of water.

The remedy should be drunk in a tablespoon after meals three times a day.

Birch infusion bath

You can treat ascites with folk remedies in combination with water procedures. A bath with an infusion of birch leaves and buds gives a good effect... It increases perspiration by flushing out excess fluid. Four tablespoons of the collection pour 250 ml of boiling water and leave to infuse overnight. An infusion of high concentration should be obtained, which can be understood by the characteristic smell. The resulting product is added to a warm bath and water procedures are taken for 20 minutes.

Nutrition

An important role in treatment is played by the regimen of food intake, as well as the quality of the food consumed. With ascites, it is important to exclude from the diet:

• puff pastry and pastry;
• instant products, stewed meat, canned food, smoked sausages, offal;
• meals high in fat;
• salt and hot spices;
• rich fatty dishes;
• roast;
• fatty dairy products;
• vegetables that irritate the stomach: cabbage, onions, turnips, radishes and others.

The patient needs to adhere to a sparing diet, which will help to avoid complications of pathological fluid accumulation in the peritoneum. The menu must include products and dishes:

• protein omelets (you can eat proteins from a maximum of three eggs per week);
• cereals, except millet;
• stewed or boiled dietary poultry (turkey, chicken);
• rabbit puree soup;
• steamed or boiled fish;
• two-day bread, crackers;
• marshmallow, jelly;
• weak tea.

Diet and traditional medicine recipes will help prevent an increase in accumulated fluid both during diagnosis and throughout the entire period of treatment of the underlying disease.

Violate the function of not only the organ where cancer cells develop. With malignant lesions, in most cases, complications arise that significantly complicate the course of the disease.

The group of these complications also includes ascites. This term denotes the accumulation of excess fluid in the abdominal cavity, with such a violation, the abdomen can increase several times.

What is this disease?

If a person has an oncological disease, then the probability of developing ascites reaches 10%. The accumulation of fluid does not occur with all malignant lesions.

Most often, ascites accompanies:

1. Malignant neoplasms, etc.

With ovarian cancer, the probability of ascites formation reaches 40%, and in 50% of this oncological lesion, women die from ascites.

The accumulation of a large volume of fluid in the abdominal cavity leads to an increase in intra-abdominal pressure, this provokes a displacement of the diaphragm into the chest cavity. Such a pathological violation of the anatomy of internal organs limits the respiratory function of the lungs, negatively affects the work of the heart, blood circulation.

The accumulated fluid pushes the peritoneal organs and, therefore, does not change their functioning for the better. Massive and long-term persistent ascites causes the loss of large amounts of protein.

In connection with all the changes that occur, ascites causes a lot of complications - both respiratory failure, metabolic disorders. All these pathologies significantly worsen the course of the underlying disease.

Causes of occurrence

In the abdominal cavity of a healthy person, there is always a small amount of circulating fluid.

This liquid prevents the internal organs from sticking together and allows the intestinal loops to move freely, without friction.

The exudate produced in the peritoneum is also absorbed here, that is, the body itself controls the process of fluid production.

In some diseases, including oncology, the resorptive, secretory and barrier functions of the peritoneal sheets are disturbed and then either too much fluid is produced, or it is not completely absorbed back.

This leads to the filling of the free space of the abdominal cavity with an ever increasing amount of exudate, in severe cases, its volume reaches 25 liters.

With the above oncological diseases, due to the proximity of organs, cancer cells can penetrate into the peritoneum and settle on its visceral and parietal leaf. The developing cancer cells disrupt the resorptive function of the peritoneum, the lymphatic vessels cannot fully cope with their task, and the produced fluid begins to accumulate.

So ascites is gradually formed, the defeat of the peritoneal sheets by malignant cells also provokes development.

As already mentioned, the main reason for the defeat of the peritoneum in cancer is its close contact with those organs where malignant neoplasms are formed.

But in addition to this, the causes of ascites in oncology also include:

• Tight fit of the abdominal folds to each other. This ensures the rapid capture of adjacent tissues by cancer cells.
• Abundant location of blood and lymph vessels in the peritoneum, which only increases and accelerates the transfer of cancer cells.
• The drift of atypical cells into the peritoneum during the operation.
• Germination of a malignant tumor through the walls of the peritoneum.

A course of chemotherapy can provoke the development of ascites; in the latter stages, fluid accumulation often occurs for a reason.

When the liver is damaged by metastases or with primary cancer of this organ, the reason for the accumulation of fluid lies in another - the venous system of the organ is compressed, and the natural outflow from the intestine is disturbed. This type of ascites, as a rule, forms quickly and is difficult.

Symptoms of the disease

The formation of abdominal ascites in most patients with cancer occurs gradually, over several weeks or even months. Therefore, the first signs of this formidable complication are ignored.

Clinically, ascites begins to manifest itself after a sufficiently large amount of fluid has accumulated in the abdominal cavity, this complication manifests itself:

• Feeling of fullness in the abdomen.
• Abdominal pains of different nature and duration.
• Belching and heartburn.
• Nausea.

Visually, you can pay attention to the gradually increasing abdomen, in the vertical position it hangs down, and in the horizontal position it spreads out on the sides. Stretching the skin of the abdominal wall reveals the network of blood vessels and the protruding navel.

Pressure on the chest causes shortness of breath and heart failure. With ascites, it is difficult for a person to bend over, fasten shoes, put on trousers.

Photo of abdominal ascites in a man

But still, with ascites, which arises as a complication of a malignant lesion, the symptoms that occur in the primary focus come to the fore in people. And more often this is what leads to the fact that oncological ascites is detected already with a large accumulation of fluid.

Ascites in ovarian cancer and its causes

With cancer of the ovaries, the most severe consequences are caused by ascites. Fatal outcome with the accumulation of fluid in the abdominal cavity occurs in 50-60% of cases.

The development of ascites in ovarian oncology occurs in advanced cases, that is, when metastases spread to the abdominal cavity and liver.

The accumulating fluid, in turn, increases the size of the ovarian tumor, and this can result in ruptures and the release of exudate into the abdominal cavity. Ascites, which forms as a complication of ovarian cancer, leads to swelling of the lower abdomen, genital area. Swelling goes to the legs.

The accumulation of fluid at first does not cause pronounced changes in well-being, but then severe pains may appear, perceived by the patient as an attack of appendicitis. The development of ascites in ovarian cancer should not be ignored, the earlier treatment begins, the more chances of a favorable outcome of this complication.

Consequences

Ascites in oncology is dangerous in itself, but in addition it can cause other complications, these include:

• Spontaneously developing bacterial peritonitis.
• Respiratory failure.
• Hydrothorax.
• Bowel obstruction.
• and pinching.
• Rectal prolapse.
• Hepatorenal syndrome.

All of these complications must be treated as soon as possible, otherwise they significantly aggravate a person's well-being and can lead to his death.

Diagnostics

Patients with oncological diseases should always be monitored by a doctor, and the oncologist, depending on the localization of the neoplasm, should already assume the likelihood of complications.

Ascites can be suspected by external signs, patient complaints, palpation and abdominal percussion are of no small importance.

Mandatory appointment of instrumental methods:

• Ultrasound. In addition to fluid, this study can reveal the presence of tumors, their location, changes in the structure of internal organs.
• Tomography. This method is necessary to determine the amount of fluid and its location in the abdominal cavity.
• Laparocentesis. After anesthesia, the abdominal wall is punctured just below the navel and the fluid is pumped out. The procedure is prescribed for therapeutic and diagnostic purposes. Part of the exudate is sent for analysis, where the presence of albumin, glucose, types of cellular elements, pathogenic microflora is determined.

Stages

Depending on the amount of accumulated exudate, three stages of ascites are distinguished:

• Transient ascites - no more than 400 ml of fluid in the abdominal cavity. At this stage, there may only be bloating.
• Moderate ascites is exposed when the exudate in the abdominal cavity is not more than 5 liters. At this stage, the complication is manifested by clinical symptoms in the form of disruption of the digestive system, shortness of breath. In the absence of treatment for ascites, the development of peritonitis, respiratory and heart failure is possible.
• Strained or resistant ascites is characterized by the accumulation of up to 20 liters of fluid. The patient's condition is serious, the work of vital organs is significantly disrupted.

How to treat abdominal ascites in oncology?

Abdominal ascites, which develops as a complication of cancer, should be treated in conjunction with the underlying disease.

It is also important to start eliminating excess fluid in the first two weeks of its formation, since delaying therapy leads to the development of a lot of complications. Excess fluid can be removed with a puncture and pumping it out - laparocentesis, by taking diuretics.

Compliance with a special diet will help reduce intra-abdominal pressure, reducing the likelihood of further excessive exudate production.

Effective only if ascites is provoked. With cancer of the stomach, ovaries, and the use of chemotherapy drugs does not give a pronounced positive result.

Laparocentesis

Laparocentesis of the abdominal cavity with ascites is a puncture of the peritoneal wall with a special instrument and the intake of fluid for analysis or its pumping out.

Usually, for cancer, laparocentesis is prescribed if there is no effect from the use of diuretics, another indication is tense ascites.

The procedure takes place in several stages under local anesthesia:

• The patient is in a sitting position, the surgeon treats the intended puncture site with an antiseptic and then anesthetic.
• First, after the injection of the anesthetic, an incision is made in the abdominal wall and muscles. It is carried out along the white line of the abdomen, retreating from the navel down by 2-3 cm.
• The final puncture is performed with rotational movements using a trocar. A flexible tube is attached to the trocar through which fluid will drain.
• If the puncture is done correctly, then a tense stream of liquid will stand out.
• The excess fluid is pumped out very slowly, it is necessary to constantly monitor the patient's condition. As the fluid is removed, the nurse should tighten the abdomen with a sheet or towel to slowly release the pressure in the abdomen.
• After the evacuation of the exudate, a sterile dressing is applied to the wound.

Laparocentesis allows you to remove up to 10 liters of fluid at a time. But in this case, the patient is shown the administration of albumin and other medications in order to reduce the likelihood of developing renal failure.

If necessary, temporary catheters can be inserted into the peritoneum, which will drain the accumulating fluid. The installation of catheters greatly facilitates the well-being of cancer patients, but threatens with a drop in blood pressure and the formation of adhesions.

Laparocentesis may not always be performed. Contraindications for a puncture include:

• organs of the abdominal cavity.
• Expressed flatulence.
• The recovery period after the operated ventral hernia.

Laparocentesis is performed on an outpatient basis. After the procedure and if the patient is in a satisfactory condition, he can be sent home.

Diuretics

Of diuretics, cancer patients with developing ascites are prescribed Diacarb, Furosemide or Veroshpiron for a long course.

A combination of two diuretics is also possible and it is necessary to drink them, even if there is no visible diuretic effect at the beginning of treatment.

When using diuretics, it is necessary to take preparations containing potassium, otherwise it is possible to provoke the development of disorders in water-electrolyte metabolism.

Diet food

Proper nutrition for abdominal ascites will help reduce fluid build-up.

It is necessary to minimize the addition of table salt to dishes and limit fluid intake. But it should be borne in mind that the body cannot be completely without salt.

It is useful to introduce foods rich in potassium into the diet:

• Spinach.
• Carrot.
• Baked potato.
• Fresh green peas.
• Dried apricots.
• Raisin.
• Grapefruit.
• Asparagus.
• Oatmeal.

The diet must be formulated in such a way as to comply with the restrictions regarding the underlying disease.

How long do patients live?

The development of ascites not only seriously impairs the well-being of an oncological patient, but also aggravates the course of the underlying disease.

The two-year survival rate of patients with dropsy is only 50%, and this is subject to timely treatment of the complication. The prognosis of the course of ascites worsens the elderly age of the patient, the presence of a large number, a tendency to hypotension, renal failure.

Video broadcast about abdominal ascites:

Dropsy of the abdomen or abdominal ascites is a disease in which the abdominal cavity is filled with fluid, and the amount can sometimes reach 20-25 liters. Because of this, the patient's stomach takes on enormous dimensions, causing him a lot of suffering.

Abdominal ascites, the treatment of which depends on its complexity, is not an independently emerging disease, it can be a symptom or a complicated consequence of other ailments, for example, cancer diseases with metastases in the stomach and the like. Its appearance indicates untimely or incorrectly carried out treatment of the underlying disease. The impetus for the development of ascites is a disturbance in the circulation of blood and lymph in the abdominal cavity (with the accumulation of transudate or non-inflammatory fluid) or inflammatory processes leading to the appearance of exudate or effusion. If an increased content of protein and leukocytes is found in the fluid, this is a formidable symptom indicating infection and reproduction of microorganisms, which is fraught with the development of ascites-peritonitis (inflammation of the peritoneum).

Forms of the disease and causes

Abdominal ascites is classified according to various criteria:

1. By the amount of liquid: small, moderate, or significant.
2. By the presence of microorganisms in the liquid: sterile or infected.
3. By responsiveness to drug therapy: amenable to conservative treatment or resistant to it (refractory). If fluid re-accumulation occurs, this is a sign that ascites has become stable, requiring more radical treatment.

Most often (in 80% of cases), ascites occurs against the background of liver cirrhosis, which has reached the final stage of decompensation. This stage is characterized by depletion of liver resources, serious violations of the hepatic and abdominal circulation, that is, the appearance of favorable conditions for the accumulation of fluid.

In about 10% of cases, the causes of ascites are cancers of the peritoneal organs with metastases in the stomach, ovarian cancer in women. This terrible ailment leads to difficulty in lymph circulation and blockage of the lymph outflow pathways, as a result of which free fluid in the abdominal cavity, having no outlet, begins to accumulate. Ascites caused by oncology is quite aggressive. Usually, its occurrence directly indicates the approaching death of the patient.

About 5% of the causes of ascites are heart diseases, accompanied by decompensation of blood circulation and general stagnation of blood in the body. "Cardiac" ascites often occurs against the background of swelling of the legs, and in especially severe cases, the body swells almost completely, up to the armpits, fluid accumulates not only in the abdominal cavity, but also in the pleural cavity, that is, in the area of ​​the lungs.

In more rare cases, ascites develops against the background of kidney disease, pancreas, alcoholic hepatitis, peritoneal tuberculosis and stomach problems, for example, with its acute expansion.

Fluid in the abdomen is formed most rapidly in cancer, and most slowly in heart disease.

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Symptoms of pathology

Symptoms of ascites appear suddenly or accumulate gradually, over several months, until their combination forces the patient to undergo an examination:

1. The main symptom is an increase in the volume of the abdomen. In a standing position, the abdomen sags noticeably, in a prone position it looks spread out, with edges protruding on the sides. The navel is greatly expanded, with a very strong protrusion, an umbilical hernia may even develop.
2. Ascites, resulting from portal hypertension, is easily recognizable by the characteristic pattern of venous vessels located on the skin of the abdomen near the navel: they scatter in the form of rays. Doctors call this drawing "the head of a jellyfish."
3. Patients breathe heavily, they have clearly visible shortness of breath. Its reason is that the accumulated fluid in the abdominal cavity "raises" the diaphragm from below, reducing the volume of the chest cavity and compressing the lungs, preventing them from completely expanding when inhaling.
4. Difficulty moving, inability to bend over.

The disease that led to the development of ascites can also affect the state of health with typical general symptoms: fever, symptoms of intoxication, weight loss with an enlarged abdomen, cyanosis of the limbs, expansion of the saphenous veins on the abdomen, and so on.

A frequent consequence of ascites is an increase in intra-abdominal pressure, which, in turn, contributes to the occurrence of an umbilical hernia, hemorrhoids, varicocele, or rectal prolapse.

Is it possible to recognize the disease at an early stage?

At the initial stages of ascites, the signs of the disease are usually mild. A person is not worried about pain, he can only sometimes complain of a feeling of fullness after eating in the stomach, heaviness and discomfort in the abdomen. But these symptoms are typical for many diseases.

A more or less accurate sign indicating the accumulation of fluid in the abdominal cavity is thirst, but diabetes must be completely excluded, since thirst is one of its most characteristic signs.

The enlargement of the abdomen does not occur immediately, but when there is already at least 1 liter of fluid in the abdominal cavity. An experienced doctor may notice that in the supine position, the patient's abdomen acquires a vague shape, and when pushed from one side, the movement responds in the other, a small wave seems to pass through the abdomen. However, it is almost impossible to understand this on your own.

If ascites is suspected, only ultrasound will give an accurate answer about the presence or absence of fluid in the abdomen in the early stages.

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Intra-abdominal fluid composition

The composition of the intra-abdominal fluid is quite complex and depends on many factors, in particular, on the underlying disease that triggered the development of ascites. Even patients with the same disease have different fluid compositions. For example, with abdominal ascites, which has developed as a result of liver cirrhosis, the fluid in the early stages is saturated with protein and is of certain value to the body. Therefore, it is inappropriate to withdraw it, sometimes it is better to "return" it to the body after "processing".

That is why, during the initial diagnosis of ascites, fluid from the abdominal cavity is necessarily taken for research. The analysis will determine its composition, as well as the presence and degree of infection, which is a great danger and is often observed in patients with advanced liver cirrhosis. Infected fluid is a sign of developed ascites-peritonitis, which, if proper measures are not taken immediately, will inevitably lead to death.

Where does the infection in the abdominal cavity come from? Of course, it does not penetrate from the outside, its source is the human body itself. With prolonged presence of the intestine in a liquid medium, its walls are loosened, and their permeability increases. Infectious agents contained in feces can enter the liquid and begin to multiply in it. The symptoms of infection are fever and pain. The work of the kidneys is disrupted, followed by a coma and death of a person in just a few days. Therefore, the state of infection of the intra-abdominal fluid is very dangerous, but, fortunately, from the moment of infection it can sometimes take several weeks, which will be enough to provide the patient with the necessary assistance.

Analysis of the fluid, in addition to determining its composition and infection, helps to make an accurate diagnosis, that is, to identify the cause of ascites. The fact is that preliminary examination methods, for example, ultrasound, are not 100% reliable.

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Conservative, symptomatic and surgical treatment

Since ascites is only a consequence of the underlying disease, in order to eliminate it, it is necessary to eliminate the causes of the pathology that has arisen. For treatment, one of 3 methods is chosen: conservative, symptomatic or surgical.

With uncomplicated ascites, treatment consists of normalizing liver function. This is achieved by drug therapy aimed at suppressing inflammatory processes in the hepatic parenchyma. The patient is prescribed diuretics to increase urinary sodium excretion. Compliance with bed (sometimes half-bed) is prescribed to improve lymph drainage and reduce the amount of liver metabolites. With ascites caused by portal vein hypertension, Albumin, hepatoprotectors and plasma administration are prescribed.

Symptomatic treatment is resorted to if conservative methods are ineffective, and there is no decrease in the amount of fluid. Then laparocentesis is performed - a puncture of the abdominal wall, followed by pumping out excess fluid. The procedure is performed under local anesthesia.

In one laparoscopy session, no more than 5 liters can be pumped out. The following procedures are scheduled at intervals of 3-4 days. Each subsequent procedure is more dangerous than the previous one, as it increases the possibility of damage to the intestines. In addition, with the fluid removed from the body, protein is washed out, which provokes the further development of ascites. Therefore, symptomatic treatment of abdominal ascites is not indicated for every patient.

With the rapid accumulation of fluid, the method of treatment is the installation of special drainage catheters, which allow the fluid to be constantly drained.

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With frequent and persistent relapses of ascites, an operation is prescribed, during which the portal and inferior vena cava are connected and collateral circulation is created. If, before the operation, the removal of ascystic fluid was repeatedly carried out, plasma transfusion and a protein diet are additionally prescribed. In more severe cases, liver transplantation is necessary.

Diet

Diet for abdominal ascites is the most important factor in the successful fight against the disease at an early stage. The diet is aimed at creating a negative sodium balance and saturating the body with proteins. The consumption of salt and liquid is minimized (up to 1 g of salt and up to 1 liter of liquid per day).

From products you can not use:

• fresh pastries made from butter dough;
• fatty meats and poultry;
• sausages of all kinds, smoked and canned foods;
• strong broths made from red meat, fish, mushrooms;
• whole milk;
• hot and salty sauces;

• all types of legumes;
• millet;
• hot and pungent vegetables: garlic, turnips, sorrel, radish, onion;
• sweets, with the exception of jelly and marshmallows;
• coffee;
• alcohol;
• cold drinks.

The patient must eat:

• parsley;
• cucumbers;
• lemons;
• eggplant;
• cabbage;
• lean meat: rabbit, chicken, turkey;
• skinless chicken broth;
• boiled fish of low-fat varieties;
• eggs in the form of an omelet;
• sour cream (in very small portions);
• porridge with diluted milk;
• nuts;
• dried fruits;
• cottage cheese;
• pomegranate juice diluted with water.

Food should be steamed and without salt. Avoid fried, and eat vegetables stewed, boiled or baked.

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Forecast

In many respects, it depends on the underlying disease that caused ascites (diabetes mellitus, liver cancer, spontaneous bacterial peritonitis, and others) and the effectiveness of its treatment. However, for 50% of patients with ascites, the disease is fatal within 2 years. If diuretic drugs become completely ineffective, half of the patients live no more than six months.

Ascites is a pathology requiring urgent medical attention. If you let the disease take its course, without taking any measures, it will progress steadily. At the slightest suspicion of the presence of fluid in the abdominal cavity, an immediate examination should be carried out to confirm or exclude ascites. Timely treatment started will help to significantly alleviate the patient's condition and increase the chances of a favorable prognosis for the development of the disease.