Ascites

Ascites is a condition in which fluid collects in spaces within the abdomen. Although the most common cause of ascites is cirrhosis of the liver, cancer accounts for about 10 percent of ascites cases.

Ascites caused by cancer most often occurs with advanced or recurrent cancer of the ovary, bladder, colon, breast, pancreas or lung, and with lymphomas. Severe ascites may be painful and may make moving around uncomfortable. Ascites can set the stage for an infection in the abdomen.

What are the symptoms of ascites?

Symptoms of ascites include:

• Swelling in the abdomen
• Weight gain
• Sense of fullness
• Bloating
• Sense of heaviness
• Nausea or indigestion
• Vomiting
• Swelling in the lower legs
• Shortness of breath
• Hemorrhoids

The symptoms of ascites can resemble those of other conditions. It is important receive a diagnosis from a pediatric gastroenterologist if your child has these symptoms.

How is ascites diagnosed?

Your child’s gastroenterologist may diagnose ascites by doing a physical exam and asking about the child’s symptoms and medical history. He or she may also order tests to confirm ascites, such as:

• Taking images of the inside of the child’s abdomen using ultrasound, X-rays or a CT scan. A CT scan creates computerized images using X-rays. Learn more about imaging at CHOC.
• Removing a sample of fluid from the child’s abdomen through a needle. This fluid will be checked for signs of disease, such as cancer or an infection, and may help point to the cause of the ascites.

How is ascites treated?

The gastroenterologists at CHOC team with each patient’s referring physician and other members of their medical team to treat ascites. A number of steps may help relieve ascites and can include:

• Cutting back on salt. Our gastroenterologists work with our registered dietitians who can explain how to follow a low-sodium diet. Also, avoiding salt substitutes containing potassium can be helpful.
• Cutting back on fluids.
• Taking diuretic medicines. These medications can help reduce the fluid in the body.
• Paracentesis. Sometimes some of the fluid needs to be drained through a procedure called paracentesis. It is particularly necessary if the child is having difficulty breathing or other worrisome symptoms. The fluid can be sent for further analysis that can guide treatment.

Be sure to follow your child’s doctor’s advice for lowering salt intake—even if the child is taking diuretic drugs to reduce fluid in their body. Weighing the child daily and calling their doctor if they gain too much weight may help them manage the child’s ascites better.