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This section has been reviewed and approved by the PLWC Editorial
Board, 05/05
Ascites is the buildup of fluid in the
abdominal cavity. Ascites caused by cancer is
called malignant ascites and accounts for 10%
of ascites cases. Malignant ascites
appears most often in people with breast, colon, gastrointestinal tract
(stomach and intestines), ovarian, pancreatic,
or uterine cancers.
Symptoms
Ascites can cause great discomfort. People with
ascites may experience the following symptoms:
- Weight gain
- Abdominal swelling
- Sense of fullness or
bloating
- Sense of heaviness
- Indigestion
- Nausea or vomiting
- Changes to the navel
- Hemorrhoids (a condition
that causes painful swelling near the anus)
- Ankle swelling
Diagnosis
To diagnose ascites, the doctor may examine the
abdominal area and ask about any recent symptoms. The following tests may
help diagnose ascites:
- X-ray (a picture of the
inside of the body)
- Ultrasound (an imaging
test that uses sound waves to create a picture of the inside of the
body)
- Computerized tomography
(CT or CAT) scan (an imaging test that creates a three-dimensional
picture of the inside of the body with an x-ray machine)
- Paracentesis (the removal and
analysis of fluid from the abdomen with a needle).
Treatment
The goal of treatment for ascites to is to
relieve symptoms, such as shortness of breath, abdominal pain, fatigue
(tiredness), decreased appetite, feeling full after eating little food,
or not being able to exercise. Treatment may not be needed if the ascites is not causing discomfort. The management of ascites may have unpleasant side effects, so it is
important to talk with your doctor about the risks and benefits of each
before deciding on a treatment plan.
The following treatments may help relieve ascites:
- Reducing the amount of
sodium and restricting the intake of fluids can help, although many
patients find this regimen unpleasant and difficult to follow.
- Diuretics are
medications that reduce the amount of water in the body. Although
diuretics are effective and well tolerated in most people, they may
cause unpleasant side effects in some people, including loss of
sleep, skin problems, fatigue, low blood pressure, and problems with
self-esteem.
- If ascites
is causing respiratory (breathing) problems or the diuretic
treatment stops working, therapeutic paracentesis
may be recommended.
- Chemotherapy (drugs used
to kill cancer cells) is appropriate only for people with certain
cancers, such as lymphoma or breast and ovarian cancers; however,
chemotherapy is rarely used to manage ascites.
- In rare instances,
surgery may be required, which involves placing a shunt (a device
used to bypass or divert fluid from one place to another) or
catheter (a small tube placed into a vein temporarily) to drain
fluids from the abdomen.
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