Ascites
Ascites is the abnormal buildup of fluid in the abdomen, most often caused by cirrhosis and portal hypertension. This fluid accumulation can cause swelling, discomfort, and breathing difficulties.
At The Medical Group of New Jersey, our hepatology specialists diagnose the underlying cause of ascites and create personalized treatment plans that help reduce fluid buildup, prevent infection, and improve comfort and mobility.
Symptom Onset & Initial Evaluation
Ascites usually develops gradually as liver disease progresses. Common symptoms include:
- Increasing abdominal size or bloating
- Rapid weight gain from fluid accumulation
- Shortness of breath or pressure when lying down
- Swelling in the ankles or legs
- Loss of appetite or early fullness after eating
During your evaluation, your hepatologist will review your medical history, medications, and symptoms. A physical exam and imaging tests help determine how much fluid is present and whether infection or cancer might be contributing factors.
Diagnosis
Your hepatologist can often suspect ascites based on your symptoms and a physical exam. To confirm the diagnosis and find out what’s causing the fluid buildup, additional tests may be ordered:
- Ultrasound or CT scan: These imaging tests confirm the presence and amount of fluid in the abdomen and help detect underlying liver or blood vessel changes.
- Paracentesis: A simple, low-risk procedure where a small sample of fluid is removed from the abdomen and tested for infection, cancer cells, or chemical imbalances.
- Blood tests: Evaluate liver and kidney function, sodium levels, and other markers that help guide treatment.
At The Medical Group of New Jersey, all imaging and diagnostic procedures are coordinated on-site, ensuring prompt, accurate results and a seamless care experience.
Treatment
The goals of treatment are to relieve discomfort, prevent infection, and treat the underlying liver disease that causes ascites. Your care plan will be tailored to the severity of your condition and your overall health.
Lifestyle & Medication Management
- Low-sodium diet: Reducing salt intake helps decrease fluid buildup and swelling.
- Diuretics (“water pills”): Encourage your body to eliminate extra salt and fluid naturally.
- Avoiding alcohol and NSAIDs: Prevents further strain on the liver and kidneys.
Procedures & Advanced Options
- Therapeutic paracentesis: Safely removes larger amounts of fluid to ease abdominal pressure and improve breathing.
- TIPS procedure (Transjugular Intrahepatic Portosystemic Shunt): A minimally invasive procedure that creates a new pathway for blood flow through the liver, lowering the pressure that causes ascites when medications are no longer effective.
- Antibiotic therapy: Used to prevent or treat spontaneous bacterial peritonitis (SBP), a serious infection that can occur in ascitic fluid.
- Liver transplantation: Recommended for patients with advanced liver disease or ascites that does not respond to other treatments.
Our hepatology team combines medical therapy, nutritional counseling, and minimally invasive procedures to provide effective, compassionate care that improves comfort and quality of life.
Ongoing Management & Long-Term Care
Managing ascites is an ongoing process that requires close follow-up. Your hepatologist will recommend:
- Routine weight checks to monitor fluid changes
- Regular blood tests for kidney and electrolyte balance
- Repeat paracentesis when needed for comfort
- Ongoing monitoring for complications such as infection or kidney dysfunction
Our multidisciplinary team provides long-term support, nutritional counseling, and access to advanced interventions to help patients live more comfortably while managing chronic liver disease.