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Fluid in the Abdomen (Ascites), ASCO's curriculum


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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