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Condition

Ascites (Abdominal Fluid)

Abdominal fluid build-up — finding the cause and managing safely.

Overview

Ascites is the build-up of fluid in the abdominal cavity, most commonly caused by liver cirrhosis but also by heart failure, kidney disease, infections like tuberculosis, or cancers. It causes abdominal swelling, weight gain, and breathlessness as fluid accumulates. Diagnosing the cause and ruling out infection of the fluid (spontaneous bacterial peritonitis) are the first priorities.

Common symptoms

  • Visible abdominal swelling or distension
  • Rapid weight gain or feeling of fullness
  • Difficulty breathing, especially when lying down
  • Loss of appetite, early fullness with meals
  • Discomfort or pain in the abdomen
  • Swelling in the legs or ankles

When to see a doctor

New abdominal swelling, especially with weight gain or breathlessness, needs prompt assessment. Patients with known liver disease who develop ascites need particularly close care — and any fever, abdominal pain, or confusion is an emergency, because infection of the ascitic fluid can be life-threatening if untreated.

How we help

We confirm ascites with examination and ultrasound, then perform a diagnostic paracentesis — drawing a small amount of fluid through a thin needle — to test for cause (SAAG analysis), infection, and cancer cells. Management depends on the cause: in cirrhosis, treatment is salt restriction, diuretics (spironolactone and furosemide), and large-volume paracentesis with albumin for refractory cases. We also screen for and treat the underlying disease and provide long-term surveillance.

This is general information, not a substitute for medical advice. For guidance specific to your case, please consult Dr. Ch. Saikumar or another qualified specialist.

Patient questions

Ascites (Abdominal Fluid) — common questions

Answers to the questions we hear most often about ascites (abdominal fluid).

What causes ascites?
Most commonly liver cirrhosis. Other causes include heart failure, kidney disease, abdominal tuberculosis, and certain cancers. Diagnosing the cause is the first priority — we use a diagnostic paracentesis to test the fluid.
Is ascites painful?
The fluid itself isn't painful, but the abdominal distension and pressure on the diaphragm cause discomfort, breathlessness, and difficulty eating. Infected ascites (spontaneous bacterial peritonitis) can be very painful and is an emergency.
How is ascites treated?
In cirrhosis: salt restriction, diuretics (spironolactone and furosemide), and large-volume paracentesis when needed. Refractory ascites may need TIPS (transjugular intrahepatic portosystemic shunt) or transplant.
Can ascites be cured?
Depends on the cause. Ascites from treatable causes (TB treated, heart failure managed, hepatitis treated) often resolves with cause-specific treatment. Cirrhotic ascites is managed long-term rather than cured.
What is paracentesis?
A short bedside procedure where we draw fluid from the abdominal cavity through a thin needle, either for diagnosis (small sample to test) or for relief of symptoms (large volume removed). Done under local anaesthesia, takes 20–30 minutes.
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