Ascites causes treatment prognosis. Abdominal ascites in oncological diseases: causes, symptoms, treatment and prognosis. Symptoms of ascites, photo - clinical manifestations

Violate the function of not only the organ where cancer cells develop. With malignant lesions, in most cases, complications arise that significantly complicate the course of the disease.

These complications include ascites. This term refers to the accumulation of excess fluid in the abdominal cavity, with such a violation, the stomach can increase several times.

What is this disease?

If a person has an oncological disease, then the probability of developing ascites reaches 10%. Fluid accumulation does not occur with all malignant lesions.

Most often, ascites accompanies:

1. Malignant neoplasms and

With ovarian cancer, the probability of ascites formation reaches 40%, and in 50% of women with this oncological lesion, women die from ascites.

The accumulation of a large volume of fluid in the abdominal cavity leads to an increase in intra-abdominal pressure, which provokes a displacement of the diaphragm into the chest cavity. Such a pathological violation of the anatomy of the internal organs limits the respiratory function of the lungs, negatively affects the work of the heart, blood circulation.

The accumulated fluid pushes back the organs of the peritoneum and, therefore, does not change their functioning for the better. Massive and long-term non-removable ascites causes the loss of a large amount of protein.

In connection with all the ongoing changes, ascites causes a lot of complications - and respiratory failure, metabolic disorders. All these pathologies significantly worsen the course of the underlying disease.

Causes

In the abdominal cavity of a healthy person, there is always a small amount of circulating fluid.

This fluid prevents the internal organs from sticking together and allows the intestinal loops to move freely, without friction.

The exudate produced in the peritoneum is absorbed here, that is, the body itself controls the process of fluid production.

In some diseases, including oncology, the resorptive, secretory and barrier functions of the peritoneal sheets are violated and then either too much fluid is produced or it is not completely absorbed back.

This leads to the filling of the free space of the abdominal cavity with an increasing amount of exudate, in severe cases, its volume reaches 25 liters.

With the above oncological diseases, due to the proximity of organs, cancer cells can penetrate into the peritoneum and settle on its visceral and parietal sheet. Developing cancer cells disrupt the resorptive function of the peritoneum, the lymphatic vessels cannot fully cope with their task, and the fluid produced begins to accumulate.

So ascites is gradually formed, the defeat of the sheets of the peritoneum by malignant cells provokes development.

As already mentioned, the main reason for the defeat of the peritoneum in oncological diseases is its close contact with those organs where malignant neoplasms are formed.

But in addition to this, the causes of ascites in oncology also include:

• Tight fit of the abdominal folds to each other. This ensures that cancer cells quickly capture adjacent tissues.
• Abundant arrangement of blood and lymphatic vessels in the peritoneum, which only increases and accelerates the transfer of cancer cells.
• The drift of atypical cells into the peritoneum during surgery.
• Germination of a malignant tumor through the walls of the peritoneum.

A course of chemotherapy can provoke the development of ascites; in the last stages, fluid accumulation often occurs for a reason.

With liver damage by metastases or with primary cancer of this organ, the cause of fluid accumulation lies elsewhere - the venous system of the organ is compressed, and the natural outflow from the intestine is disturbed. This type of ascites, as a rule, is formed quickly and is difficult.

Symptoms of the disease

The formation of abdominal ascites in most patients with cancer occurs gradually, over several weeks or even months. Therefore, the first signs of this formidable complication are ignored.

Clinically, ascites begins to manifest itself after a sufficiently large amount of fluid accumulates in the abdominal cavity, this complication manifests itself:

• Feeling of fullness in the abdomen.
• Abdominal pains of different character and duration.
• Belching and heartburn.
• Nausea.

Visually, you can pay attention to the gradually increasing belly, in a vertical position it hangs down, and in a horizontal position it spreads on the sides. Stretching the skin of the abdominal wall allows you to see a network of blood vessels and a protruding navel.

Pressure on the chest causes shortness of breath and interruptions in the work of the heart. With ascites, it is difficult for a person to bend over, fasten shoes, put on trousers.

Photo of ascites of the abdominal cavity in a man

But still, with ascites, which occurs as a complication of a malignant lesion, those symptoms that occur in the primary focus come to the fore in people. And more often this is what leads to the fact that oncological ascites is detected already with a large accumulation of fluid.

Ascites in ovarian cancer and its causes

With cancerous lesions of the ovaries, the most severe consequences are caused precisely by ascites. Fatal outcome in the accumulation of fluid in the abdominal cavity occurs in 50-60% of cases.

The development of ascites in ovarian oncology occurs in advanced cases, that is, when metastases move to the abdominal cavity and liver.

The accumulating fluid, in turn, increases the size of the ovarian tumor, and this may result in its rupture and the release of exudate into the abdominal cavity. Ascites, which is formed as a complication of ovarian cancer, leads to swelling of the lower half of the abdomen, the genital area. Edema passes to the legs.

The accumulation of fluid at first does not cause pronounced changes in well-being, but then severe pain may appear, perceived by the patient as an attack of appendicitis. The development of ascites in ovarian cancer should not be ignored, the sooner treatment begins, the greater the chance of a favorable outcome for this complication.

Effects

Ascites in oncology is dangerous in itself, but in addition to this, it can cause other complications, these include:

• Spontaneously developing bacterial peritonitis.
• Respiratory failure.
• Hydrothorax.
• Intestinal obstruction.
• and her crush.
• Prolapse of the rectum.
• hepatorenal syndrome.

All of these complications must be treated as soon as possible, otherwise they significantly aggravate a person’s well-being and can lead to his death.

Diagnostics

Patients with oncological diseases should always be under the control of a doctor, and the oncologist, depending on the location of the neoplasm, should already assume the likelihood of complications.

Ascites can be suspected by external signs, patient complaints, palpation and percussion of the abdomen are of no small importance.

Mandatory assignment of instrumental methods:

• ultrasound. In addition to fluid, this study can reveal the presence of tumors, their location, changes in the structure of internal organs.
• Tomography. This method is necessary to determine the amount of fluid and its location in the abdominal cavity.
• Laparocentesis. After anesthesia, the abdominal wall is punctured just below the navel and the fluid is pumped out. The procedure is prescribed for therapeutic and diagnostic purposes. Part of the exudate is sent for analysis, where the presence of albumins, glucose, types of cellular elements, and pathogenic microflora are determined.

stages

Depending on the amount of accumulated exudate, three stages of ascites are distinguished:

• Transient ascites - fluid in the abdominal cavity no more than 400 ml. At this stage, there may be only bloating.
• Moderate ascites is exposed when the exudate in the abdominal cavity is not more than 5 liters. At this stage, the complication is manifested by clinical symptoms in the form of a violation of the digestive organs, shortness of breath. In the absence of treatment of ascites, the development of peritonitis, respiratory and heart failure is possible.
• tense or resistant ascites is characterized by accumulation of up to 20 liters of fluid. The patient's condition is serious, the work of vital organs is significantly disrupted.

How to treat abdominal ascites in oncology?

Ascites of the abdominal cavity, which develops as a complication of an oncological disease, should be treated together with the underlying disease.

It is also important to start eliminating excess fluid in the first two weeks of its formation, since delaying therapy leads to the development of a host of complications. Excess fluid can be removed with a puncture and pumping it out - laparocentesis, by taking diuretics.

Compliance with a special diet will help reduce intra-abdominal pressure, reduce the likelihood of further production of excessive exudate.

Effective only if ascites is provoked. With cancer of the stomach, ovaries and the use of chemotherapy drugs does not give a pronounced positive result.

Laparocentesis

Laparocentesis of the abdominal cavity with ascites is a puncture of the peritoneal wall with a special instrument and the collection of fluid for analysis or its pumping out.

Usually, in oncological disease, laparocentesis is prescribed if there is no effect from the use of diuretics, another indication is tense ascites.

The procedure takes place in several stages under local anesthesia:

• The patient is in a sitting position, the surgeon treats the intended puncture site with an antiseptic and then an anesthetic.
• First, after an injection of an anesthetic, an incision is made in the abdominal wall and muscles. It is carried out along the white line of the abdomen, retreating from the navel down by 2-3 cm.
• The final puncture is made with rotational movements using a trocar. A flexible tube is attached to the trocar through which fluid will drain.
• If the puncture is done correctly, then a tense stream of liquid will be released.
• Excess fluid is pumped out very slowly, it is necessary to constantly monitor the patient's condition. As the fluid is removed, the nurse should tighten the abdomen with a sheet or towel, this is necessary so that the pressure in the abdominal cavity decreases slowly.
• After evacuation of the exudate, a sterile bandage is applied to the wound.

Laparocentesis allows you to remove up to 10 liters of fluid at a time. But in this case, the patient is shown the introduction of albumin and other medications in order to reduce the likelihood of developing renal failure.

If necessary, temporary catheters can be placed in the peritoneum, and the accumulated fluid will drain through them. The installation of catheters greatly facilitates the well-being of cancer patients, but threatens with a drop in blood pressure and the formation of adhesions.

Laparocentesis may not always be performed. Contraindications for puncture include:

• abdominal organs.
• Severe flatulence.
• The recovery period after the operated ventral hernia.

Laparocentesis is performed on an outpatient basis. After the procedure and in a satisfactory condition of the patient, he can be released home.

Diuretics

Of the diuretics, oncological patients with developing ascites are prescribed Diacarb, Furosemide or Veroshpiron for a long course.

A combination of two diuretics is also possible and it is necessary to drink them, even if there is no visible diuretic effect at the beginning of treatment.

When using diuretics, it is also necessary to take preparations containing potassium, otherwise the development of disturbances in water and electrolyte metabolism can be provoked.

Diet food

Properly organized nutrition for abdominal ascites will help reduce the accumulation of fluid.

It is necessary to minimize the addition of table salt to dishes and limit fluid intake. But it should be borne in mind that the body cannot be completely without salt.

It is useful to introduce foods rich in potassium into the diet:

• Spinach.
• Carrot.
• Baked potato.
• Fresh green peas.
• Dried apricots.
• Raisin.
• Grapefruit.
• Asparagus.
• Oatmeal.

The diet must be designed in such a way as to comply with the restrictions regarding the underlying disease.

How long do patients live?

The development of ascites not only seriously worsens the well-being of a cancer patient, but also aggravates the course of the underlying disease.

The two-year survival rate of patients with dropsy is only 50%, and this is subject to timely treatment of the complication. The prognosis of the course of ascites is worsened by the patient's advanced age, the presence of a large number, a tendency to hypotension, and renal failure.

Video about abdominal ascites:

Update: December 2018

The accumulation of fluid in the abdominal cavity, due to which there is an increase in the abdomen, is called ascites. This condition is not so common, but its development almost always indicates the presence of a serious illness. It can occur with damage to the liver, heart, kidneys and a number of other organs. The main thing in this case is to determine the cause of its development in a timely manner and carry out the correct treatment.

In the vast majority of cases, people with ascites are long-term patients who are aware of their diseased organ. However, there are cases when this condition is the debut of the disease. You can learn modern information about what can cause ascites, modern methods of diagnosis and treatment from this article.

Causes of ascites

This condition can occur due to a large number of different diseases, but most often, the cause of ascites lies in one of the three organs - the liver, heart or kidneys. Their defeat is accompanied by the accumulation of fluid throughout the body, including in the internal organs, under the skin and in the abdominal cavity. More exotic causes include some hormonal disorders, tuberculosis, damage to the lymphatic vessels and a number of other pathologies.

Liver damage

Liver disease is the most common cause of ascites. The accumulation of fluid in the abdominal cavity can occur when its cells are damaged or due to compression of the portal vein.

Liver cells produce a large number of substances every minute, including albumins, proteins, some vitamins (A, E, D, K), "useful" cholesterol, blood clotting substances, etc. The protein produced by the liver is necessary to retain fluid in the lumen of blood vessels. It attracts water, so that a healthy person does not experience swelling. When cells are damaged, the amount of protein produced decreases, due to which the liquid begins to sweat through the wall of blood vessels into tissues and cavities (abdominal, thoracic, pericardial, etc.).

Also, the cause of ascites can be compression of the portal (portal) vein. This is a large vessel, which is located on the posterior surface of the liver, in a small notch. With an increase in the body, the vein can be strongly compressed, which leads to an increase in blood pressure on its walls. Because of this, the liquid is “squeezed” through the vein and enters immediately into the abdominal cavity.

The table below describes liver diseases in which there is a malfunction of the cells, an increase in the organ, or both. With the development of ascites, they must be excluded first.

Despite the large number of various liver diseases, it is possible to make a correct diagnosis based on the patient's condition and the results of some studies. Which ones? Information about this is provided below.

Heart failure

Blood moves through the body due to the continuous work of the heart and blood vessels. If the functions of the heart muscle are disturbed, the blood flow begins to slow down, which leads to its stagnation and the release of fluid into organs and tissues. First of all, edema occurs on the legs and arms. However, with severe heart failure, the liquid part of the blood can accumulate around the internal organs and in the abdominal cavity.

Ascites against the background of cardiovascular diseases can occur when:

Damage to the heart muscle. Due to a decrease in the number of working cells and their replacement with connective tissue, organ failure may occur. Damage can be caused by:

• any form of coronary heart disease, including heart attack and angina pectoris;
• infections (endo-, peri- and myocarditis);
• autoimmune diseases (lupus erythematosus, scleroderma and others);
• amyloidosis - a metabolic disorder in the body, due to which a pathological protein (amyloid) is deposited in the walls of organs;
• injuries and injuries of the body.

Overloading of the heart. Some diseases lead to increased pressure on the walls of the organ and their stretching. Such an overload can occur due to blood retention in the ventricles / atria or with increased pressure in the vessels. Overload can be caused by:

• Hypertension, with a late start of therapy or improper treatment. After the diagnosis is made, the patient must constantly take drugs that reduce pressure, and periodically visit the local therapist (1 time per year). If you lose control over the course of the pathology (with constantly elevated pressure), you must re-contact the doctor;
• Arterial hypertension, which can occur with hormonal disorders (Itsenko-Cushing's syndrome, hyperthyroidism, etc.), damage to the kidney tissue, damage to the brain;
• Congenital and acquired malformations, such as ventricular/interatrial septa, stenosis or valve insufficiency, stenosis or coarctation (expansion) of the aorta, and others.

Cardiomyopathies. This is a group of genetic diseases in which the structure of the heart wall is disturbed. There are two options - either it becomes too thick (hypertrophic form), or becomes thinner (dilated form).

Heart failure is a condition that requires proper and timely treatment. The development of ascites in the pathology of the heart is always an unfavorable sign, indicating an insufficient volume of therapy or a severe course of the disease.

Kidney damage

This organ performs a large number of functions, one of which is the removal of excess fluid and toxins from the body. During the day, the kidneys filter about 180 liters of blood. When the kidney tissue is damaged, this process is disrupted, which leads to the accumulation of fluid in various parts of the body: on the legs and arms, on the face, in the abdominal cavities, heart and in the internal organs.

This condition is aggravated by the constant loss of protein in the urine, which occurs due to the destruction of the renal filter. Since there is less protein in the blood vessels, the arteries and veins cannot hold all the liquid part of the blood. As a result, edema becomes even larger and spreads throughout the body.

Not every kidney disease can cause this fluid retention. The following pathologies most often lead to the destruction of the renal tissue and disruption of the filtration process:

• Glomerulonephritis. This term is understood as a whole group of diseases that are united by several signs. First - they almost always lead to the destruction of the renal filter and force the person to use hemodialysis (at the final stage). The second - glomerulonephritis is an autoimmune disease that develops due to a "mistake" of the body's defense systems. As a result, blood cells begin to attack and destroy healthy kidney cells;
• Tubulointerstitial nephritis (abbreviated as TIN). This is a disease in which the components of the kidney filter (tubule) die off. Most often, it occurs after poisoning with various toxins, including heavy metals, drugs, methanol and other substances. Also, cases of TINA development were noted after severe viral diseases, radiation exposure, against the background of cancer of any organ;
• diabetic nephropathy. Diabetes is not just high blood glucose levels. This is a serious disease that gradually affects the entire body, including the kidneys. In the absence of adequate treatment and constant control of sugar, the renal filter begins to slowly and irreversibly break down, which can lead to widespread edema and ascites;
• Congenital malformations of the kidneys. Polycystic, underdevelopment of the renal tissue, absence (agenesis / aplasia) of the kidney - all these conditions can cause fluid retention in the patient's body;
• Systemic disease. Lupus erythematosus, periarteritis nodosa, rheumatoid arthritis, systemic scleroderma are rare but serious diseases that damage the connective tissues of the human body, including the kidneys;
• Hypertonic disease. Constantly elevated pressure negatively affects the work of all organs, but primarily on the heart and kidneys. Hypertension that is not treated or treated incorrectly inevitably leads to kidney shrinkage and dysfunction.

Advanced kidney disease is almost always difficult. However, ascites is only one of many symptoms. In such patients, edema develops throughout the body, the state of health, the work of the heart, brain and other organs worsens.

Other causes of ascites

Having excluded the presence of diseases of the kidneys, heart and liver, as possible causes, it is necessary to start assessing the condition of other organs. The problem may be hiding in a disturbed outflow of lymphatic fluid, a decrease in thyroid function, or damage to the peritoneum. In particular, the accumulation of fluid in the abdominal cavity can occur with the following diseases:

Symptoms

The accumulation of fluid in the abdominal cavity can be quite difficult to determine. An increase in the abdomen can occur not only with ascites, but also with pancreatitis, intestinal paresis, intestinal obstruction, pregnancy and a number of other conditions. Therefore, it is important to be able to distinguish free fluid in the abdomen from its swelling, accumulation of feces, enlargement of other organs, etc. To do this, you can use the following simple tricks:

1. Place your hands on the sides of your abdomen. After that, with one hand, lightly push the stomach 2-3 times. If the second hand felt a splash of liquid or its movement, then most likely the cause of the increase in the abdomen is ascites;
2. Assess the shape of the abdomen in two positions: standing and lying down. If a person retains a rounded shape of the abdomen and hangs down somewhat while he is standing, but in the supine position the abdomen seems to “spread” and flatten, the presence of fluid should be suspected.

Also, in addition to a direct change in the abdomen, the patient may experience a number of other symptoms of abdominal ascites, due to fluid accumulation and increased intra-abdominal pressure. The most frequent of them are:

• Difficulty breathing, including the appearance of shortness of breath or a wet cough;
• Frequent urge to urinate;
• The development of constipation;
• Constant weakness and decreased performance.

However, it should be noted that the disease will be much easier and better diagnosed if a person with a suddenly enlarged belly consults a doctor. He will be able to more reliably examine, feel and “tap” the abdominal wall and, if necessary, refer the patient for further examination or to the hospital.

How to determine the cause of ascites

In the first section, a huge number of reasons for this condition were given. To assume a diseased organ and determine the most likely disease that a person has, a comprehensive examination is necessary. It should begin with a thorough clarification of all complaints and possible harmful factors, and end with specialized diagnostics. Below, we describe the principles of this diagnosis and ways to find out the true cause of ascites.

Analysis of all complaints and harmful factors

To determine the affected organ, it is first necessary to find out if a person has specific symptoms indicating a disease of the heart, kidneys, liver, lymphatic vessels, etc. The manifestations of these diseases can be quite diverse, but they are characterized by some common features. The most characteristic of them, which help to make a diagnosis, are described in the table:

The next stage of diagnosis, after a careful questioning and examination of the patient, is the delivery of tests and instrumental examinations, such as ultrasound, X-ray, etc. In most cases, it is these methods that make it possible to establish the final diagnosis and find out the cause of the development of the disease.

Laboratory and instrumental diagnostics

Regardless of the specificity of the symptoms and the doctor's confidence in a particular diagnosis, each patient undergoes a series of studies. Why is it necessary? Diseases are often disguised as each other - lupus erythematosus can hide under the mask of glomerulonephritis or hyperthyroidism "pretend" to be hypertension. There are many such examples, which is why for the treatment of abdominal ascites it is necessary to consult a doctor and undergo all the necessary examinations. This will improve the quality of therapy and the likelihood of recovery.

Appointments for various examinations are issued, depending on the doctor's assumptions. At the moment, there is no universal analysis that could independently determine the cause of fluid accumulation. Specific studies are recommended to evaluate the performance of each system. Which ones are described below.

Treatment

Measures to eliminate ascites can be divided into 2 groups. The first is aimed at removing fluid from the abdominal cavity with the help of medicines and minor surgical interventions. The second is for the treatment of the disease that caused ascites. This process is usually much more complex and lengthy.

In some cases (for example, with cirrhosis, glomerulonephritis, cardiomyopathy, etc.), it is impossible to completely get rid of the disease, but its course can be controlled. How to do it? Individual therapy, if necessary, is selected by the attending physician. We will describe the general principles of disease therapy.

Removal of fluid from the abdomen

At the moment, there are recommendations of national associations of doctors that doctors adhere to. They include a specific algorithm through which ascites can be effectively and safely eliminated. This algorithm includes the following provisions:

Hospitalization. Treatment should be carried out in the hospital for 4 groups of patients:

• With the debut of the disease;
• With the ineffectiveness of therapy at home;
• With a large amount of fluid in the abdomen;
• With the development of complications (impaired consciousness, decreased kidney function, pressure drop, etc.)

Mode. During the first week, it is important to observe bed rest, as in a horizontal position, the excretion of excess water and sodium improves, blood flow to the kidneys is facilitated;

Food. It is necessary to limit the intake of salt (sodium chloride), since 1 g of sodium attracts 250-300 ml of water. The more it enters the bloodstream, the more water is retained in the body. For the duration of the persistence of ascites, it is not recommended to salt food. After removing the liquid, salt can be used during cooking, but food should not be added additionally;

water regime. In the absence of elevated temperature (more than 37.5 ° C), you should reduce the consumption of drinks to 1 liter / day;

Diuretic drugs. In most cases, it is necessary to start eliminating the fluid with these drugs. There are two main types of diuretics that are used for ascites. The choice between them is made by the attending physician, depending on the cause of the disease. This is a very important nuance, since prescribing the wrong medication can lead to severe heart failure, poisoning of a person and death. The most commonly used drugs are listed below:

• Loop diuretics: Furosemide, Torasemide. These are strong enough drugs that can remove a large amount of fluid from the body. However, together with water, they remove vital electrolytes - potassium and sodium. Therefore, in diseases that occur with a deficiency of these ions (for example, severe liver failure), loop diuretics are used with great caution;
• Potassium-sparing diuretics: Spironolactone, Eplerenone, Canreonate. This group acts more delicately and does not lead to significant losses of fluid and ions. On the contrary, they retain potassium in the body. Therefore, these diuretics are contraindicated in pregnancy and diseases that occur with a violation of the release of electrolytes (for example, renal failure).

Laparocentesis. Puncture of the abdominal cavity with ascites is performed only in 2 cases:

• When a large volume of fluid accumulates in the abdominal cavity. This condition is called "tense ascites". If you do not remove part of the water from the abdomen and do not reduce intra-abdominal pressure, the patient may experience compression of the internal organs, disrupt the functioning of the lungs and heart;
• With the ineffectiveness of pharmacological preparations.

In most cases, laparocentesis takes a little time - about 10 minutes. At the same time, the surgeon can remove up to 2-4 liters. It is impossible to eliminate all ascites at once, as this can lead to a drop in pressure and cause a shock in the patient. Immediately after the procedure, an intravenous infusion of albumin should be performed. This solution will help keep water within the bloodstream and prevent the re-accumulation of fluid in the abdomen.

Treating the cause of ascites

In addition to removing excess water from the body, it is also necessary to prevent its re-accumulation. To do this, it is necessary to carry out a full therapy of the underlying disease. Depending on the affected organ, the patient is referred to a doctor of a certain profile: gastroenterologist, cardiologist, nephrologist, oncologist, phthisiatrician, etc. Only the attending physician can take into account all the necessary nuances and choose the best solution. We can only describe the general principles that must be followed during therapy.

Liver

In 80% of cases, ascites occurs due to cirrhosis of the liver, which has developed against the background of viral hepatitis B, C, or a combination of both. Since these diseases do not manifest themselves for a long time, most of the liver cells have time to collapse. In its place, connective tissue grows, which compresses the vena cava and promotes the release of fluid through its walls. Other diseases lead to ascites quite rarely.

The greatest importance in the treatment of liver diseases is the elimination of harmful factors:

• If the patient has viral hepatitis, special antiviral therapy is necessary;
• With the development of autoimmune hepatitis, biliary cirrhosis or sclerosing cholangitis, glucocorticosteroids or immunosuppressants are used;
• In the presence of Budd-Chiari syndrome, it is necessary to restore the patency of the liver vessels, with the help of medications (fibrinolytics and anticoagulants) or surgery.

In addition to specific treatment, such patients must be prescribed hepatoprotectors that protect the preserved liver cells. These include:

• Ursodeoxycholic acid preparations: Ursosan, Ursofalk, Ursodez, Exhol;
• Phospholipids: Essentiale Forte, Rezalut, Essliver, Antraliv.

To determine the most suitable therapy regimen for you, you need to contact a gastroenterologist. Only a doctor can choose the most suitable drugs and properly treat the disease. Self-medication is dangerous - it can lead not only to a deterioration in well-being, but also significantly reduce life expectancy.

Heart

In the treatment of heart disease, there are several areas of therapy that help eliminate the symptoms of the disease, improve the condition of the heart muscle and increase a person's life expectancy. These include fighting high blood pressure and excess blood cholesterol, preventing the formation of blood clots in arrhythmias, and protecting the heart from adverse factors.

To accomplish all these tasks, an integrated approach and joint work of the patient and the doctor is necessary. As a rule, treatment includes the following components:

It should be noted once again that the final treatment regimen is determined by the attending physician. He can adjust it at his own discretion, depending on the type and severity of the pathology, the state of the patient's body. However, the general principles of treatment that must be followed have been described above.

kidneys

Treatment of chronic kidney diseases that can cause ascites is almost always a complex and lengthy process. Depending on the specific type of disease, the issue of the need to prescribe glucocorticosteroid hormones, an operation to correct defects, permanent hemodialysis or other therapeutic measures is decided. However, the general principles of therapy for these pathologies are the same. These include the following recommendations:

1. Salt restriction. Since the excretion of electrolytes is impaired when kidney function is impaired, taking even a small amount of salt can lead to fluid retention and increase blood pressure. The maximum allowable dose for these diseases is not more than 1 g / day. This amount can be achieved by eating unsalted food and unsalted drinks;
2. Refusal of alcohol and smoking;
3. Maintain adequate diuresis. With chronic damage to the organ, toxic substances begin to accumulate in the blood of a person. They lead to sleep disturbances, constant weakness, decreased performance and poor health. Therefore, it is important to regularly use diuretics to improve the excretion of "slags";
4. Regular monitoring of toxic substances in the blood. This measure helps prevent the development of severe complications such as brain damage (encephalopathy);
5. Reducing the inflammatory process. In autoimmune diseases such as glomerulonephritis, lupus erythematosus, rheumatoid arthritis, it is necessary to reduce the body's immune functions. Due to this, the kidney tissue will be damaged much less. As a rule, glucocorticosteroid hormones (Prednisolone, Dexamethasone) or immunosuppressant drugs (Sulfasalazine, Methotrexate) are used for this purpose;
6. Reception of nephroprotective drugs. ACE inhibitors and ARBs, in addition to protecting the heart, have similar effects on the kidneys. By improving the condition of their microvessels, they prevent their further damage and keep hemodialysis away from the patient.

Most of the diseases that can cause the accumulation of fluid in the abdominal cavity are chronic and practically incurable. Despite this, a person can control their course with adequate treatment. The recommendations listed above are one component of such treatment, which can slow down kidney damage and increase life expectancy.

FAQ

Question:
Is it possible to cure abdominal ascites in oncology?

This is a rather difficult question. Removing the liquid, in most cases, is not difficult. This procedure is carried out according to the principles described above. However, eliminating a malignant tumor is much more difficult. At stages 1-2, it is possible to carry out surgical treatment followed by a course of special therapy. In the later stages, the only way out is chemotherapy, which is not always effective.

Question:
Is it dangerous to use hormones and immunosuppressants in the treatment of kidney disease?

These drugs have a side effect, in the form of a decrease in immunity. This makes it easier for the infection to enter the body. However, without the use of these medicines, destruction of a vital organ can occur, which will inevitably end in death. The benefits of hormones and immunosuppressants are greater than the risks.

Question:
How often does fluid accumulate in the abdomen due to blockage of the lymphatic vessels?

Question:
Are there folk remedies for the treatment of abdominal ascites?

Definitely not. Ascites is a sign of an advanced disease of one of the internal organs. Every person who suspects this pathology is strongly recommended to go to the hospital to see a therapist.

Question:
Are there treatment options for hypothyroidism?

Removal of fluid from the abdomen is carried out according to the principles described above. Simultaneously with these activities, doctors try to support the function of the thyroid gland, with the help of Thyroxine preparations.

Question:
What is the prognosis for life with ascites?

Each case is individual and depends on the specific disease. Therefore, only your doctor can make an adequate prognosis.

Development (pathogenesis) of ascites

In the peritoneum there is a huge number of small blood and lymphatic vessels that provide metabolism. Under normal conditions, there is always a small amount of fluid in the abdominal cavity and between the layers of the peritoneum, which is formed as a result of sweating the liquid part of the blood and a certain amount of proteins through the blood vessels. However, this fluid does not accumulate in the abdominal cavity, since almost immediately it is reabsorbed into the lymphatic capillaries (the peritoneum can absorb more than 50 liters of fluid per day). The resulting lymph through the lymphatic vessels enters the venous system of the body, returning fluid, proteins and other trace elements dissolved in it to the systemic circulation.

Based on the foregoing, it follows that the accumulation of fluid in the abdominal cavity can occur in two cases - with an increase in the rate of its formation or with a decrease in the rate of its absorption. In practice, these two mechanisms are present simultaneously, that is, with various diseases of the internal organs (liver, pancreas, tumors, inflammation of the peritoneum, and so on), an increase in fluid production occurs, which certainly entails a violation of its reabsorption (absorption) as a result of compression and blockage of small lymphatic and blood vessels by cellular debris, pathogens, or tumor cells. As the disease develops, the fluid in the abdominal cavity becomes more and more, and it begins to compress the organs located there, which, in turn, can aggravate the course of the underlying disease and contribute to the progression of ascites.

It is also worth noting that in addition to fluid, proteins (as well as other trace elements) are retained in the abdominal cavity. Under normal conditions, blood plasma proteins (mainly albumins) are involved in creating the so-called oncotic pressure, that is, they hold fluid in the vessels. With ascites, a large proportion of proteins is in the ascitic fluid, and therefore the oncotic pressure of the blood decreases, which can also contribute to the release of fluid from the vascular bed and the progression of the disease.

With the progression of the disease, there is a decrease in the volume of circulating blood, since most of the fluid accumulates in the abdominal cavity. This leads to the activation of compensatory mechanisms aimed at water retention in the body (in particular, the rate of formation and excretion of urine decreases), which further increases the hydrostatic pressure in the blood vessels and also contributes to the formation of ascitic fluid.

Causes of ascites

The causes of ascites can be:

• liver cancer;
• disease (syndrome) Budd-Chiari;
• compression of the portal vein;

• oncological diseases (tumors);
• kidney disease;
• anasarca;
• violation of lymph circulation (chylous ascites);
• fetal development disorders;
• diseases of childhood;

Ascites in cirrhosis of the liver

Under normal conditions, blood from many internal organs (from the stomach, spleen, pancreas, small and large intestines) flows into the liver through the portal (portal) vein. In the liver, it passes through thin tubules (hepatic sinusoids), where it is filtered, purified and enriched with various substances (for example, proteins), after which it enters the inferior vena cava and returns to the systemic circulation. In cirrhosis, under the influence of various causative factors (for example, hepatitis B or C viruses), a large number of hepatocytes (liver cells) are damaged and destroyed. The dead cells are replaced by fibrous tissue, which significantly reduces liver function. This, in turn, leads to the activation of compensatory mechanisms, which consist in increased division of the remaining (intact) cells. However, the structure of the newly formed tissue is disturbed (in particular, there are no sinusoids characteristic of a normal liver), as a result of which the filtration capacity of the organ decreases (that is, the amount of blood that can pass through the liver per unit time decreases).

Violation of the function of the liver, as well as a change in its structure, leads to the fact that the blood cannot be filtered in full, as a result of which it begins to accumulate in the portal vein. As the disease progresses, hydrostatic pressure (that is, the pressure exerted by blood on the vessel wall) in the portal vein increases (portal hypertension develops), which disrupts the outflow of blood from the internal organs (stomach, intestines, and others). As a result of stagnation of blood in them, there is an expansion of blood vessels and an increase in the permeability of the vascular walls, which leads to the leakage of part of the fluid into the abdominal cavity.

It is also worth noting that the liver is the main site of protein formation in the body. In the later stages of the disease (when most of the hepatocytes are replaced by fibrous tissue), the protein-forming function of the liver decreases, resulting in hypoproteinemia (lack of proteins in the blood). This, in turn, leads to a decrease in oncotic blood pressure, which also contributes to the release of part of the fluid from the vascular bed.

Ascites in liver cancer

Over time, the tumor increases in size and can compress large intrahepatic vessels. Also, cancer cells can break away from the main tumor and move (metastasize) to other parts of the body, clogging the hepatic sinusoids, blood and lymphatic vessels and bile ducts. This will lead to a violation of all liver functions, increased pressure in the portal vein and the development of ascites.

Ascites in other liver diseases

The cause of ascites may be:

• Mesothelioma. This malignant neoplasm is extremely rare and occurs directly from the cells of the peritoneum. The development of a tumor leads to the activation of the immune system in order to destroy tumor cells, which is manifested by the development of the inflammatory process, the expansion of blood and lymphatic vessels and the leakage of fluid into the abdominal cavity.
• Peritoneal carcinomatosis. This term refers to the defeat of the peritoneum by tumor cells that metastasize into it from tumors of other organs and tissues. The mechanism of development of ascites is the same as in mesothelioma.
• Pancreas cancer. The pancreas is the site of production of digestive enzymes, which are secreted from it through the pancreatic duct. After leaving the gland, this duct merges with the common bile duct (through which bile leaves the liver), after which they flow together into the small intestine. The growth and development of a tumor near the confluence of these ducts can lead to a violation of the outflow of bile from the liver, which can be manifested by hepatomegaly (enlargement of the liver), jaundice, pruritus and ascites (ascites develops in the later stages of the disease).
• Ovarian cancer. Although the ovaries do not belong to the organs of the abdominal cavity, the sheets of the peritoneum are involved in the fixation of these organs in the small pelvis. This explains the fact that in ovarian cancer, the pathological process can easily spread to the peritoneum, which will be accompanied by an increase in the permeability of its vessels and the formation of an effusion in the abdominal cavity. In the later stages of the disease, metastasis of cancer to the sheets of the peritoneum may occur, which will increase the release of fluid from the vascular bed and lead to the progression of ascites.
• Meigs syndrome. This term refers to a pathological condition characterized by the accumulation of fluid in the abdominal and other cavities of the body (for example, in the pleural cavity of the lungs). The cause of the disease is considered to be tumors of the pelvic organs (ovaries, uterus).

Ascites in heart failure

An important feature of the vascular system is that the wall of the arteries is dense and resilient, while the venous wall is relatively thin and easily stretches with an increase in intravascular pressure. With the development of heart failure (caused by a heart attack, infection, prolonged increase in blood pressure, and so on), the pumping function of the heart muscle decreases, resulting in stagnation in the inferior vena cava system, which collects blood from the entire lower body. Due to the expansion of the walls of crowded venous vessels, as well as due to an increase in hydrostatic pressure, a certain proportion of the liquid part of the blood leaves the vascular bed and accumulates in the abdominal cavity.

Ascites in kidney disease

Ascites may be complicated by:
kidney failure
A pathological condition in which more than 75% of the functional tissue (the so-called nephrons) of the kidneys is affected. As a result, the organ can no longer fully fulfill its excretory function, so some of the by-products of life (such as urea, uric acid and others) are retained in the body. These substances are osmotically active (that is, they attract fluid to themselves) and, when penetrated into the intercellular space of tissues, lead to the development of edema.

Also, in renal failure, the blood supply to the kidney tissue is disrupted, as a result of which compensatory mechanisms are activated, aimed at increasing systemic arterial pressure and increasing the amount of blood delivered to the kidneys. Along with this, the rate of excretion of sodium and water decreases in the kidneys, which further increases the volume of circulating blood, increases pressure in the venous system and contributes to the progression of ascites.

nephrotic syndrome
This disease is characterized by damage to the kidney filter (which is normally impermeable to proteins and other large molecular substances), as a result of which the body loses a large amount of plasma proteins in the urine (more than 3 grams per day). Within a few days, this leads to a significant decrease in the oncotic pressure of the blood, as a result of which its liquid part can no longer be retained in the vascular bed and sweats into the abdominal cavity, leading to the development of ascites.

Ascites in pancreatitis

During the described process, damage to the vessels of the pancreas occurs, which causes the penetration of digestive enzymes into the blood. If treatment is not started in time, the pathological process can destroy the wall of the gland and go to the peritoneum, which will cause the development of peritonitis (inflammation of the peritoneum) and can lead to the formation of ascitic fluid in the abdominal cavity.

Ascites in peritonitis

The cause of peritonitis can be:

• rupture of a hollow organ (stomach, intestines, urinary or gallbladder);
• penetrating wound of the abdominal cavity;
• perforation of a stomach or intestinal ulcer;
• disintegration of an intestinal tumor with damage to its wall;
• migration of bacteria from other foci of infection;
• the spread of the inflammatory process from neighboring organs.

It is also worth noting that the spread of infection through the peritoneum occurs quite quickly, due to which local (local) peritonitis can quickly turn into a diffuse (common) form that affects the entire peritoneum, which, without timely and adequate treatment, can lead to the death of the patient within a few hours.

Ascites in anasarca

The cause of anasarca may be:

• Heart failure. In this case, edema and ascites develop due to a pronounced increase in hydrostatic pressure in the venous and lymphatic systems, which is due to the inability of the heart muscle to pump blood.
• Renal failure. With this pathology, the cause of water retention in the body is a violation of the excretory function of the kidneys.
• Liver diseases. With severe cirrhosis and liver failure, the concentration of proteins in the blood decreases, which can cause the development of generalized edema.
• Myxedema. It is characterized by a decrease in the concentration of thyroid hormones (thyroxine and triiodothyronine) in the blood, which is manifested by a decrease in the amount of proteins formed in the body and leads to the release of fluid from the vascular bed.
• Hyperaldosteronism. This disease is characterized by excessive formation in the adrenal glands (endocrine glands) of the hormone aldosterone. Under normal conditions, this hormone is responsible for maintaining the volume of circulating blood at a constant level, however, with its excessive secretion, there is a pronounced retention of sodium and water in the body, which contributes to the development of edema and ascites.

Chylous ascites

Also, the reason for the release of lymph into the abdominal cavity can be:

• injuries of large lymphatic vessels;
• anomalies in the development of the abdominal organs;
• previous abdominal surgery;
• tumor diseases (systemic lymphangiosis);
• chronic inflammatory bowel disease.

Ascites in the fetus

The cause of ascites in the fetus can be:

• Hemolytic disease of the newborn. This disease develops if a mother with a negative Rh factor (Rh factor is a special antigen that is present on red blood cells in certain people) will bear a fetus with a positive Rh factor. During the first pregnancy, there will be no deviations from the norm, however, during childbirth, the blood of the mother and fetus will come into contact, which will lead to sensitization of the mother's body (antibodies against the Rh factor will begin to be released in it). With a second pregnancy with an Rh-positive fetus, these antibodies will begin to affect the blood cells of the fetus, disrupting the functions of all its organs and tissues and leading to the development of generalized edema and ascites. Without timely treatment, this disease leads to the death of the fetus.
• Genetic diseases. The human genetic apparatus consists of 46 chromosomes, formed as a result of the fusion of 23 maternal and 23 paternal chromosomes. Damage to one or more of them can be manifested by various diseases that can be transmitted to offspring. Ascites in the prenatal period can be a manifestation of Down's syndrome (in which an extra chromosome appears in pair 21), Turner's syndrome (which is characterized by a defect in the sex X chromosome) and other hereditary diseases.
• Intrauterine anomalies of development. Intrauterine anomalies can be caused by infection, radiation, or trauma. Ascites in this case can occur due to a violation of the normal development of the liver, cardiovascular or lymphatic system, with underdevelopment of the biliary system and other malformations.
• Damage to the placenta. The placenta is an organ that appears in the body of a pregnant woman and provides vital activity (delivery of oxygen and nutrients) to the fetus during the entire intrauterine period of development. Violation of the outflow of blood from the placenta or the umbilical cord can increase the pressure in the circulatory system of the fetus, thereby creating prerequisites for the development of edema and ascites.

Ascites in children

The cause of ascites in children can be:

• Malformations of the heart. In this case, abnormalities in the development of the heart muscle are implied, which lead to a violation of the pumping function of the heart (valve defects, defects in the interventricular and interatrial septa). In the prenatal period, these anomalies may not manifest themselves in any way, however, after birth (when the load on the heart increases), edema, ascites, and other signs of heart failure may develop.
• Kidney malformations. In the prenatal period, the excretory function is carried out by the placenta, therefore, even with severe anomalies in the development of the renal system, signs of renal failure in the fetus may be absent. After the birth of a child, toxic substances and metabolic products accumulate in the blood and tissues of the baby, which can lead to the development of edema and ascites.
• Infectious diseases. Infection of the fetus with various viruses (rubella virus, herpes, cytomegalovirus, enterovirus) or bacteria (for example, with syphilis) can lead to damage to internal organs and the development of multiple organ failure. This can be manifested by ascites, which will appear in the prenatal period or immediately after the birth of the child.
• Tumors. Neoplasms in newborns are extremely rare, since it takes time for the development of the tumor process and tumor growth. However, the appearance of a tumor (malignant or benign) in the prenatal period or in early childhood is possible. A growing tumor can compress the child's blood or lymphatic vessels, damage various organs and tissues (liver, spleen), which can lead to the development of ascites from the first days of life.
• congenital anemia. Anemia is a general name for conditions characterized by a decrease in the concentration of red blood cells (red blood cells) and hemoglobin (the respiratory pigment found in red blood cells) in the blood. Some types of anemia (sickle cell anemia, hemoglobinopathies, anemia with enzyme deficiency, and so on) are characterized by deformation and destruction of red blood cells. They are destroyed mainly in the liver and spleen, which can eventually lead to damage to these organs and the development of edema and ascites.

Ascites during pregnancy

The growth and development of the fetus itself requires more intensive work from all organs and systems of the female body. Accumulation of fluid in the abdominal cavity and an increase in intra-abdominal pressure further increase the load on the organs, which can lead to decompensation of chronic diseases and the development of multiple organ failure that threatens the health or even the life of the mother and fetus.

The most formidable manifestations of ascites in pregnant women can be:

• Respiratory failure. Enlargement of the uterus in late pregnancy causes the diaphragm (the main respiratory muscle that separates the abdominal cavity from the chest) to move upward, resulting in a decrease in the respiratory volume of the lungs. The appearance of a large amount of fluid in the abdominal cavity further exacerbates this process, which leads to a lack of oxygen in the blood of the mother and fetus.
• Heart failure. As already mentioned, the growth and development of the fetus leads to an increase in pressure in the abdominal cavity. As a result, blood pressure rises in the blood vessels located there. To overcome this pressure, the heart has to work harder. The appearance of ascites in late pregnancy further increases the load on the heart, which can cause a violation of its function. This, in turn, can lead to insufficient blood flow to the placenta and cause intrauterine fetal death.
• Squeezing the growing fetus. With ascites, the amount of fluid accumulating in the abdominal cavity can reach several tens of liters. This will lead to a pronounced increase in intra-abdominal pressure and compression of all internal organs, including the uterus with a developing fetus. As a rule, this condition makes it impossible for the further development of pregnancy.

Hemorrhagic ascites

The cause of hemorrhagic ascites can be:

• liver injury;
• spleen injury;
• bleeding during the collapse of the tumor;
• thrombosis (blockage of a blood clot) of the hepatic veins;
• perforation (perforation) of the intestinal wall (for example, with an ulcer).

tuberculous ascites

The defeat of the peritoneum by tuberculosis leads to the development of a specific inflammatory process (peritonitis), which is manifested by the expansion of blood vessels and the leakage of a large amount of fluid, lymph and proteins into the abdominal cavity.

Ascites in endometriosis

Initially, endometrial cells go beyond the uterine mucosa and penetrate into its muscular layer, starting to divide there. During the menstrual cycle, they (like the normal endometrium) undergo certain changes, which can lead to the development of bleeding. In the later stages of the disease, endometrial cells extend beyond the uterus and can affect any organs and tissues, including the peritoneum. Among other symptoms (abdominal pain, urination disorders, and so on), this can be manifested by the accumulation of fluid in the abdominal cavity.

Ascites and pleurisy

Pleurisy is an inflammation of the layers of the lung pleura, which is usually accompanied by leakage of fluid into the pleural cavity. Ascites and pleurisy can simultaneously be observed in systemic inflammatory diseases of an autoimmune nature (when the immune system attacks the cells and tissues of one's own body) - with rheumatic fever, systemic lupus erythematosus, rheumatoid arthritis, and so on. It is worth noting that with these diseases, accumulation of fluid in the pericardial cavity (heart sac) can also be noted.

Symptoms of ascites

However, regardless of the cause, the accumulation of fluid in the abdominal cavity will always be manifested by certain symptoms, the identification of which will make it possible to suspect the diagnosis in the early stages of the disease.

Ascites may be accompanied by:

• edema;
• an increase in body temperature;
• pain in the abdomen;
• an increase in the size of the abdomen;
• enlargement of the liver;
• enlargement of the spleen;
• "medusa head";
• jaundice;

Edema with ascites

Edema with ascites may be due to:

• renal failure (renal edema);
• heart failure (heart edema);
• liver failure (protein-free edema).

Cardiac edema
Cardiac edema develops because the heart cannot pump blood from the veins to the arteries. They occur mainly in the evening, first localized in the feet and legs, and then rise to the thighs and torso. This is explained by the fact that during the day a person is in an upright position for a long time, as a result of which the hydrostatic pressure in the veins of the lower extremities increases significantly and blood stagnation develops in them. This leads to the release of fluid from the vessels into the intercellular space.

The skin in the area of ​​cardiac edema is bluish in color, cold to the touch. With prolonged pressure, the resulting depression disappears slowly.

Protein-free edema
With a deficiency of proteins, the liquid part of the blood enters the intercellular space, which is manifested by extremely pronounced, generalized (observed in all parts of the body) edema. The skin in the area of ​​edematous extremities is stretched, tense, pale and dry, its temperature is reduced. When pressing on the edematous tissue, the dent disappears within a few seconds.

Temperature with ascites

With ascites, an increase in body temperature can be a manifestation of:

• Peritonitis. The defeat of the peritoneum by foreign microorganisms leads to the activation of the immune system and an increase in body temperature. The highest numbers (up to 40 degrees or more) are observed with bacterial peritonitis, when pathogenic bacteria and the toxins they release are absorbed into the bloodstream and spread throughout the body. With peritonitis of tuberculous etiology, the temperature usually keeps within 37 - 39 degrees.
• pancreatitis. With pancreatitis, a non-infectious inflammatory process develops in the pancreas, which is accompanied by an increase in temperature to 38 degrees. The transition of inflammation to the peritoneum and the development of peritonitis may be accompanied by a more pronounced temperature reaction (up to 39 - 40 degrees).
• Cirrhosis of the liver. In the early stages of the development of cirrhosis, all patients have subfebrile condition (increase in body temperature up to 37 - 37.5 degrees). If cirrhosis is the result of hepatitis B or C viruses, an increase in temperature to 37 - 39 degrees will be a natural protective reaction of the body that occurs in response to the introduction of foreign agents. An increase in body temperature above 39 degrees is usually a consequence of the development of bacterial complications and requires urgent medical intervention.
• Tumors. With all malignant neoplastic diseases, the patient has subfebrile condition for several weeks or months, which is usually accompanied by a feeling of weakness and weight loss. When cancer metastasizes to the peritoneum, there may be an increase in body temperature up to 39-40 degrees, which is explained by the development of an inflammatory reaction in response to the introduction of "foreign" (tumor) cells.

Pain with ascites

Pain in ascites may be due to:

• Cirrhosis of the liver. Liver cirrhosis develops gradually and is usually preceded by inflammatory liver disease (hepatitis). The liver itself does not contain pain receptors, but the capsule surrounding the organ is rich in them. An increase in the size of the liver in various diseases leads to overstretching of the capsule, which is manifested by pains of varying intensity. In the initial stages of cirrhosis, patients may complain of discomfort or mild pain in the right hypochondrium, which may worsen over time. Also, patients may complain of heaviness or pain in other parts of the abdomen. This is due to the indigestion that occurs in the later stages of cirrhosis.
• Syndrome (disease) Budd-Chiari. With this pathology, there is a blockage of the veins through which blood flows from the liver. As a result, there is an overflow of intrahepatic blood vessels, an increase in the size of the organ and stretching of the hepatic capsule, which is accompanied by sharp, stabbing pains in the right hypochondrium, radiating to the right back.
• Inflammation of the peritoneum. The sheets of the peritoneum contain a large number of pain receptors, so its inflammation is accompanied by severe cutting or stabbing pains in the abdomen, which are aggravated by pressure on the anterior abdominal wall.
• pancreatitis. The development of the inflammatory process in the pancreas is manifested by acute girdle pains, which are most pronounced in the upper abdomen. Pain can be given to the region of the right or left hypochondrium, in the back, in the heart.
• Tumor. Pain in a tumor is rarely severe, which greatly complicates the early diagnosis of malignant neoplasms. Patients may experience dull, pulling or aching pain in the abdomen for several weeks or months. The intensity of pain in this case can spontaneously increase or decrease.
• Endometriosis. Pain in this pathology is localized mainly in the lower abdomen, however, when endometrial cells metastasize to other organs, they can have any localization. Typically, women complain of increased pain during intercourse, during menstruation, pain during urination or defecation. The pain is sharp, cutting, not relieved by taking conventional painkillers.

Abdominal enlargement with ascites

With further progression of the disease, the amount of ascitic fluid increases, as a result of which the protrusion of the anterior abdominal wall becomes noticeable even in the supine position. With severe ascites (when more than 10-12 liters of fluid accumulate in the abdominal cavity), the skin of the abdomen becomes tense, tense, shiny.

Hepatomegaly and splenomegaly in ascites

The cause of hepatomegaly and splenomegaly can be:

• Cirrhosis of the liver. With cirrhosis of the liver, there is a violation of the structure of the liver tissue and its partial replacement with fibrous (scar) tissue. This creates an obstacle to the flow of blood, as a result of which it accumulates in the veins of the liver and in the portal vein, leading to an increase in the size of the organ. To reduce the pressure in the portal vein system, part of the blood is discharged into the venous vessels of the spleen, which also leads to its overflow with blood and an increase in size.
• Tumor. The reason for the enlargement of the liver may be an increase in the size of the intrahepatic tumor or the growth of metastases from tumors of another localization. When a malignant tumor metastasizes to the liver tissue, hepatic capillaries will also be blocked by tumor cells, which will lead to impaired blood flow in the organ and may cause it to increase in size.
• Budd-Chiari disease. With thrombosis of the hepatic veins, the hepatic tissue is overfilled with blood and the size of the liver is enlarged. The spleen at the same time increases only in severe cases of the disease (with the development and progression of portal hypertension).
• Heart failure. With heart failure, blood stagnates in the system of the inferior vena cava, increasing the pressure in it. Since the hepatic veins (carrying venous blood from the liver) also empty into the inferior vena cava, severe heart failure can interfere with the outflow of blood from the liver, leading to an increase in its size.

Nausea and vomiting with ascites

Squeezing the stomach can significantly reduce its volume and impair motility, causing a person to experience nausea even after eating a small amount of food. If vomiting occurs, the vomit will contain freshly eaten, undigested food. After vomiting, the stomach empties, which usually brings relief to the patient.

Compression of the intestine can also impair its motility. With severe ascites, intestinal loops can be compressed with such force that the movement of processed food (chyme) through them becomes impossible. As a result of this, the chyme will begin to accumulate above the place of compression, causing an increase in peristalsis in this section of the intestine. The patient will complain of paroxysmal pain in the abdomen, nausea. The vomit that occurs in this case will contain partially digested foods or feces, and will also have a characteristic unpleasant odor.

"Head of a jellyfish" with ascites

Jaundice with ascites

The mechanism of jaundice is as follows - when red blood cells (erythrocytes) are destroyed, a yellow pigment is released into the bloodstream - bilirubin. It is a rather toxic product, therefore, under normal conditions, it is immediately captured by liver cells, neutralized and excreted from the body as part of bile. If the liver functions are impaired, this process slows down or stops altogether, as a result of which the concentration of bilirubin in the blood begins to increase. Over time, it penetrates into various tissues and organs and settles in them, which is the direct cause of the appearance of icteric coloration of the skin and mucous membranes.

Shortness of breath with ascites

In the initial period of development of ascites, shortness of breath occurs only in the supine position, when the fluid shifts upward and presses on the diaphragm. In a standing position, the liquid swells into the lower abdomen and the person breathes freely. In the later stages of the disease (when the volume of ascitic fluid reaches 10 liters or more), shortness of breath is observed in the standing position and increases in the supine position, which is why patients usually rest and sleep half-sitting.

Dehydration with ascites

Dubinchak-Muler D.N. Doctor II category

Water in the abdomen is an alarming symptom that the doctor diagnoses on ultrasound. It is recommended to undergo such an examination if the patient notices an increase in the abdominal cavity. Such a complaint should not be left without the attention of a specialist, since with advanced clinical pictures, an oncological disease progresses with a fatal outcome.

• Abdominal ascites
• What is ascites
• How to treat ascites
• Diet for ascites
• How to treat abdominal ascites: patient experience
• Choosing the right diet for ascites and its treatment with traditional medicine
• The reasons
• Symptoms
• Diagnosis and treatment
• Diet
• Treatment with folk remedies
• Ascites in oncology
• Causes and mechanism of development
• Symptoms
• stages
• Diagnostics
• Surgical intervention
• Treatment of abdominal ascites with folk remedies
• Symptoms and Causes
• Diet
• How to treat ascites at home?
• The reasons
• Ascites - fluid in the abdomen
• Symptoms
• Medical treatment
• Folk remedies
• Nutrition Features
• Course and forecast
• Prevention

What is ascites

This is a dangerous diagnosis, which is characterized by an increased accumulation of fluid in the abdominal cavity. Other important organs of the body, such as the lungs and heart, can suffer from ascites. The problem is not inflammatory. The fluid accumulated in the peritoneal region can reach liters in volume. In the people, such a disease is called "frog belly", it is prone to a malignant course. For 75% of all clinical pictures, this is a complication of progressive cirrhosis, and the main goal of treatment is to suppress disturbing symptoms and prolong the period of remission.

Why does fluid accumulate in the abdominal cavity

The peritoneum lining the walls of the abdominal cavity secretes a small amount of fluid, which is similar in chemical composition to blood plasma. It is necessary for the normal functioning of the internal organs, otherwise they would stick together. The fluid is absorbed and excreted throughout the day, but under the influence of pathological factors, this natural process can be disrupted. With an imbalance, intra-abdominal pressure increases, the stomach increases in size. Urgent diagnostics with the subsequent complex therapy is necessary.

Causes of abdominal ascites

This disease is a complication of liver cirrhosis and not only. It progresses gradually in the body, at first it does not manifest itself in any way. Abdominal ascites is difficult to successfully treat. However, healing occurs if the main pathogenic factor is eliminated. The causes of ascitic disease are of an unexpected nature, the most common among them are presented below. It:

• heart failure;
• malignant neoplasms;
• disturbed pressure of the portal vein of the liver;
• abdominal tuberculosis;
• development of mesothelioma, pseudomyxoma;
• disruption of the endocrine system;
• female diseases (from the field of gynecology).

Why does dropsy of the abdomen occur in newborns

Abdominal ascites can progress at any age, and infants with a characteristic ailment are no exception. The pathological process is exacerbated even in the prenatal period, characterized by a congenital disorder of the hepatic function. Such a disease is caused at such a young age by infectious diseases of a pregnant woman. These include the following diagnoses:

The risk group included newborns whose mothers abused narcotic substances, medicines, alcoholic beverages, chemical reagents during pregnancy. In addition, ascites progresses in case of blood transfusion during pregnancy, obesity, type 2 diabetes mellitus. So that from the first days of life the child does not get sick with abdominal ascites, a pregnant woman is not recommended to do permanent makeup, tattoos.

What is the accumulation of fluid in the abdominal cavity

The main symptom of peritoneal ascites is free fluid in the abdominal cavity that collects and is not excreted naturally. Such a sign of the disease provokes an increase in the abdominal cavity in size, and over time this process only progresses. At first, the patient does not notice the characteristic changes in appearance, but then he cannot strain and relax the stomach. Additional symptoms of ascites are as follows:

• abdominal pain;
• signs of dyspepsia;
• weight gain;
• shortness of breath when walking;
• big belly;
• heartburn, belching;
• fluctuation;
• a state of general discomfort;
• increased swelling of the extremities.

How is fluid accumulation in the abdomen diagnosed?

It is very problematic to determine ascites by visual examination and palpation of the abdominal cavity. A description of the symptoms is necessary to collect anamnesis data, but such actions of a specialist are not enough to make a final diagnosis. It is necessary to undergo a clinical examination, visualize the foci of transudate, determine the nature, stage of the pathological process. Diagnostics includes the following methods:

1. ultrasound. Helps to assess the systemic blood flow of the portal vein, the presence of cirrhosis of the liver, tumors of the peritoneum. The method is non-invasive, painless, but at an early stage of ascites is uninformative.
2. Radiography. This diagnostic method visualizes foci of ascites, determines the volume of fluid, the boundaries of the abdominal cavity. On the screen, you can see cirrhosis of the liver and tuberculosis, suggest heart failure.
3. Laparocentesis. An invasive method that involves the collection and further study of ascitic fluid in the laboratory. Additionally, a liver biopsy (puncture) is performed to identify the etiology of the pathological process.
4. CT and MRI. Both methods accurately determine abnormal fluid effusion, and diagnose pathology in hard-to-reach parts of the abdominal cavity. Laparocentesis complements complex diagnostics.
5. Angiography. This is a type of radiography, when a contrast agent is injected into the vessels to determine the etiology of the pathological process. This method can determine cirrhosis even at an early stage.

How to treat ascites

Having performed radiography and angiography, the doctor can make a prognosis, determine an effective treatment regimen. The approach to the problem is complex, and for advanced clinical pictures, it does not exclude an operation to remove oncology, laparocentesis. It all depends on the signs and symptoms, the diagnosis, the recommendations of a specialist. First, doctors tend to remove the focus of the pathology conservatively, but if the fluid continues to accumulate in the abdominal cavity, you definitely cannot do without surgery. Otherwise, oncology only progresses.

How is abdominal dropsy treated therapeutically

The main goal of drug therapy for ascites is to remove the accumulation of fluid in the abdominal cavity in a non-invasive way. Treatment is appropriate at an early stage, when the peritoneum is not yet completely filled with transudate. With ascites, the doctor prescribes diuretics, calcium preparations. In the first case, we are talking about such medicines as Veroshpiron, Diakarb, Lasix, Torasemide, after which the water in the abdominal cavity disappears. In the second - calcium tablets, Panangin and Asparkam. In addition, it is recommended to use multivitamin complexes.

How to remove fluid in the abdomen with surgical methods

If ascites is diagnosed in an advanced stage, an operation to pump out the transudate is indispensable. In this way, you can temporarily remove the big belly, but if the cause of the disease is not eliminated, its symptoms will very soon remind of themselves again. It is important to understand that we are talking about oncology, and you cannot do without surgery. Surgical intervention for ascites involves the following actions:

1. Laparocentesis. A puncture of the abdominal cavity is performed to further divert ascitic fluid. The procedure can take several days and requires the patient to be hospitalized.
2. Transjugular intrahepatic shunting. The surgeon forms an artificial duct between the hepatic and portal veins to ensure water exchange and stabilize intra-abdominal pressure.
3. Liver transplant. The operation is appropriate for oncology, advanced degree of cirrhosis.

Diet for ascites

To exclude serious health complications, therapeutic nutrition is necessary. In addition, a properly selected diet for ascites reduces the accumulation of fluid in the abdominal cavity, prolongs the period of remission, and eliminates alarming symptoms. The main focus needs to be on food ingredients, which contain a large amount of potassium. It:

Video: dropsy of the abdominal cavity in humans

The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

Ascites of the abdominal cavity is a pathological condition in which fluid enters it and lingers there in excess. This process can develop rapidly or proceed in a chronic form. It is never independent and always accompanies severe concomitant diseases, such as cirrhosis, tuberculosis, or cancer with metastasis.

How Olga, 62 years old, treated ascites with medication

My mother developed ascites at age 62. Health problems began about three years ago, when her legs began to swell, and a couple of years ago she was first admitted to the hospital, where they eliminated excess fluid with the help of diuretics. Then he was diagnosed with cirrhosis of the liver. After the diagnosis was made, she was sent to a hepatologist, but after a superficial examination, he did not find any serious pathologies and advised her to continue drinking diuretics.

The history of the treatment of ascites with folk remedies Grigory, 48 years old

I have chronic pancreatitis. In general, he did not give me any special problems with well-being. I just have to comply and drink certain medications from time to time. But a couple of years ago, my body scared me in earnest. After relaxing at sea under the scorching sun and, I confess, with some violations in the menu, my pancreatitis began to worsen. I decided, as usual, to take medicine and go to the doctor for an examination after returning home. But my condition worsened, my stomach began to appear.

• Decoction of bean pods. It is a good diuretic. For cooking, use the husk from 30 pods. They need to be filled with water in an amount of about a liter and put to boil. After 10 minutes, the broth is removed from the heat and infused for 20 minutes. The mixture is filtered and cooled. You need to take the drug 200 grams at a time. The first portion - at five in the morning, the second - half an hour before breakfast, the third - half an hour before dinner, the fourth - no later than eight o'clock in the evening.

After such treatment, I significantly improved my health, and I have not had any exacerbations for two years now. The main thing is to pass all examinations on time and monitor your well-being.

• Read the review of the complex remedy for hemorrhoids Proctonol
• How to lose weight by 20 kg - real reviews of Guarchibao

The history of the treatment of ascites with dietary nutrition Vyacheslav, 53 years old

At the beginning of the year, my gallbladder was removed. Almost immediately after the operation, my stomach began to “inflate”. As a result, I was given a concomitant diagnosis - ascites. In addition, a few years ago I had acute hepatitis (infected in the dentist's office).

How Nikolay cured ascites with herbal decoctions, 42 years old

Until I was 40, I drank a lot. Now, of course, I repent, but it seemed to me that this would not play a significant role in my life. And only when I had the first attack of liver failure against the background of alcohol intoxication and the doctors literally dragged me out of the other world, I realized that I needed to change something in my life.

Source: proper diet for ascites and its treatment with traditional medicine

Ascites is a rather unusual condition, but it can be recognized by the appearance of the patient. In this case, excess fluid accumulates in the abdominal cavity. To rid the body of excess fluid, you need to start treatment on time, as well as adhere to a diet, when the first symptoms appear, it is important to consult a doctor in time.

Ascites manifests itself as an accumulation of fluid in the abdominal cavity

Often, ascites can be provoked by increased pressure in the portal vein, which is typical for liver diseases, thrombosis, compression of the portal vein branches or trunk, and heart failure. Sometimes this condition can become an indicator of alimentary dystrophy, a general edematous syndrome in kidney diseases, and also result from damage to the abdominal cavity.

This pathology can provoke increased intra-abdominal pressure and push the diaphragm into the chest cavity. This leads to disruption of the activity of the abdominal organs, the movement of the lungs during breathing worsens, resistance to blood flow increases, and cardiac activity is disturbed.

In some cases, ascites progresses rapidly, for example, with cancer of the liver or peritoneum, with portal vein thrombosis, in others it proceeds imperceptibly, for example, with cirrhosis of the liver.

Often, ascites becomes a consequence of cirrhosis of the liver, because there is a delay in blood filtration, so there is a squeezing of part of the liquid fraction of blood into the abdominal cavity.

Ascites in cirrhosis of the liver appears due to insufficient work of the protein-synthesizing function. The lack of albumin affects the ability of blood to contain its liquid part in the vascular bed. The fluid, penetrating through the veins, enters the abdominal cavity. An increase in the sodium content in the body can also provoke fluid retention due to the fact that the liver cannot cope with the neutralization of certain substances.

Symptoms

The main symptom of ascites is bloating.

The main symptom of this disease is an increase in the abdomen, or rather, its swelling. The reason is that liquid accumulates in it, which practically does not come out. A person understands that he is unhealthy when he does not fit into clothes of the usual size. Usually this condition is accompanied by two more pathologies. Most often, this is a violation of the intestines and indigestion.

Moderate ascites usually manifests itself in the form of edema of the lower extremities, expansion of the chest, umbilical and inguinal hernia. The patient feels heaviness in the abdomen, heartburn, shortness of breath, problems with the stool. These are symptoms of a pathology that develops over weeks and months.

Tense abdominal ascites is characterized by the appearance of a round abdomen with shiny, tense, smooth skin. In this case, the skin of the hernial sac can thin and tear, which will lead to the release of ascitic fluid. The patient may develop respiratory and heart failure. The fluid can become infected and cause peritonitis, which can be fatal.

Diagnosis and treatment

Ascites is diagnosed by abdominal ultrasound.

Timely diagnosis will allow you to identify the cause and stage of the pathology, as well as determine the treatment. This requires a general examination with palpation and auscultation of the abdomen, ultrasound, x-ray of the abdominal cavity, computed tomography, as well as puncture and study of ascitic fluid.

Treatment of ascites should begin with restriction of sodium intake, no more than 1 g of sodium chloride should be consumed per day. The patient must comply with bed rest. If neither one nor the other helps, then diuretics are connected to the treatment process. Spironolactone, triamterene, amiloride, etc. are usually preferred. They are mild and do not cause side effects, so surgery can be avoided.

Surgical intervention is indicated in 5-10% of patients who are resistant to drug therapy. During the operation, peritoneovenous shunting is used, which can result in serious complications, such as fever, intravascular coagulation, or shunt occlusion. Shunting is not performed in those who suffer from infected ascites, with high serum bilirubin, with hemorrhoidal bleeding, hepatorenal syndrome.

Diet for ascites includes a ban on the use of pastries

Diet for ascites of the abdominal cavity plays a large role in the treatment. Fresh pastries, salt, pastry and puff pastry products should be excluded from the diet. If you don’t have the strength to give up bakery products, then you can afford yesterday’s bakery products. You should also exclude fried, fatty meat and poultry, stew, smoked meats, offal and sausages. At the same time, it is recommended to eat turkey, chicken or rabbit meat, dishes that include minced meat are also acceptable.

Broths should be prepared from chicken, after removing the skin. The first courses should be served in the form of pureed soups. With ascites, it is forbidden to use borscht, meat, fish and mushroom broths. It is permissible to add fish to the diet only in boiled or steamed form.

The use of fatty dairy products is undesirable, therefore whole milk is completely excluded, and low-fat sour cream is only acceptable as a dressing, the diet should also not contain fatty and salty sauces. Patients are allowed boiled cereals cooked in diluted milk. Under the ban are millet, legumes, sorrel, cabbage, garlic, mushrooms, rice, radish, onions, turnips.

From sweets, you can afford only marshmallows, jam or jelly. Dieters should not drink coffee and cold drinks.

Treatment with folk remedies

A decoction of bean pods is a well-known folk remedy for ascites.

Ascites can only be cured by treating the underlying cause. due primarily to the fact that excess fluid is removed from the bloodstream. In this case, the fluid from the abdominal cavity returns to the vessels to make up for losses. To do this, you need to use diuretic fees and decoctions. At the same time, it is necessary to replenish the loss of potassium by eating fruit and vegetable decoctions in a baked or boiled form.

• A decoction of bean pods is an excellent diuretic. Take the husk of 15 bean pods, pour 1 liter of water, boil for 10 minutes. Then insist 20 minutes, then strain. The first portion of the decoction (200 ml) should be taken at 5 o'clock in the morning, as early as possible. The second 200 ml - half an hour before breakfast, the third part - half an hour before dinner, the remaining 200 ml should be consumed before 8 pm. It is not recommended to drink any other liquid on this day. Use within three days, if it does not help, you need to change the medicine.
• A decoction of parsley. To do this, boil 300 g of fresh parsley in 1 liter of water. Then cool and strain the broth. You need to take it every hour in the morning, continue treatment for 3 days.
• Apricot decoction. Prepared from fresh or dried apricots. One glass of apricots pour 1 liter of water, cook for 40 minutes, then strain. A day you need to drink 250-400 ml of broth.
• Diuretic teas. Mix in equal parts the herb of bearberry and hernia. Half a glass of this mixture pour 300 g of water, boil for 15-20 minutes. Then cool and strain. Ready tea to drink before meals in the morning.
• If ascites in men has touched the testicles, then calendula and baby cream can be mixed in equal proportions. Lubricate the testicles with the finished mixture, put gauze on top, then put on the adjacent swimming trunks.
• Bathroom with birch infusion. To do this, you need 20 g of birch leaves or buds, pour 200 ml of boiling water, leave for 6 hours. Then add the infusion to the bath and take it for 30 minutes.
• Therapeutic massage is recommended to be done daily. In this case, you first need to rub the stomach with sunflower or linseed oil clockwise, and then against it.
• If possible, you can sit by the fire, that is, you need to evaporate the liquid by any available means.

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Source: in oncology

Ascites is a severe complication of various diseases in which a large volume of fluid accumulates in the abdominal cavity. Detected ascites in oncology seriously complicates the course and treatment of the underlying disease, worsens the prognosis. In patients with oncological diseases of the organs that have contact with the sheets of the peritoneum, the average probability of fluid effusion into the abdominal cavity is 10%.

Tumors of what organs are accompanied by ascites?

The process of accumulation of excess fluid in the abdominal cavity accompanies about half of all cases of ovarian cancer in women. It also complicates the course of neoplasms:

The severity of the patient's condition does not depend on whether the primary tumor caused the pathology or its metastasis. Signs of increased intra-abdominal pressure, elevation of the diaphragm, and reduction in respiratory movements of the lung tissue are added to the manifestations of cancer. As a result, conditions for the work of the heart and lungs worsen, heart and respiratory failure increases, which brings the lethal outcome of the disease closer.

Causes and mechanism of development

The abdominal cavity is formed by 2 leaves. One of them (parietal) lines the inner surface, and the other (visceral) surrounds the nearest organs. Both leaflets produce a small amount of liquid secretion from their glandular cells. With its help, a small local inflammation is eliminated, organs and intestines are protected from friction.

The fluid is constantly updated, as the excess is absorbed by the epithelium. Accumulation is possible if the balance of this state is disturbed. In 75% of cases, patients with ascites have cirrhosis of the liver. This disease has the maximum number of etiological factors leading to pathology.

These include an increase in hydrostatic pressure in the vessels under the influence of stagnation in the venous and lymphatic systems due to a violation of cardiac activity and a drop in oncotic pressure in the blood due to damage to the liver function and a decrease in the content of the albumin protein fraction.

Ascites of the abdominal cavity in oncology does not exclude these mechanisms as an addition to the main damaging factor - hyperfunction of the epithelium of the abdominal cavity with a tumor lesion of the peritoneum sheets. The growth of malignant cells causes irritation and non-specific inflammation.

The most significant role of seeding with malignant cells in ovarian and uterine cancer in women. The complication in these cases aggravates the general condition of the patients so much that they die with an increase in abdominal ascites.

Cancer patients look accordingly

Of considerable importance is the direct compression of the hepatic tissue by the tumor and the creation of conditions for portal hypertension. With an increase in venous pressure, the aqueous part of the blood is discharged into the abdominal cavity.

Cancer intoxication is accompanied by a lack of oxygen in the cells (tissue hypoxia). Kidney tissue very acutely feels any changes and reacts with a decrease in filtration. This sets in motion the action of the pituitary antidiuretic hormone, which retains sodium and water.

Some authors distinguish hepatic and extrahepatic mechanisms in the pathogenesis of ascites. On the example of malignant growth, we see how these causes complement each other. The suction function of the peritoneum and lymphatic vessels is impaired.

An example of local changes would be abdominal lymphoma. This tumor is accompanied by impaired patency of the intra-abdominal lymphatic ducts. From them, the fluid passes directly into the abdominal cavity.

The provoking causes of ascites in oncological diseases can be such an anatomical feature as the close location of the peritoneal folds (fitting), the abundance of blood and lymphatic vessels, which causes the rapid spread of malignant growth to neighboring tissues.

Fluid leakage can be stimulated by the introduction of atypical cells into the peritoneal cavity during surgery, internal germination of the peritoneal walls by a malignant tumor, as well as a course of chemotherapy.

Symptoms

In cancer patients, ascites develops gradually over several weeks or months. Patients feel symptoms when a significant amount of fluid accumulates. Main symptoms:

• bursting heaviness in the abdomen;
• belching after eating;
• heartburn or nausea;
• dull pain in the abdomen;
• shortness of breath at rest, especially when lying down.

These signs are associated with the rise of the dome of the diaphragm, impaired peristalsis of the esophagus, intestines, reflux of acidic contents of the stomach into the esophagus. Some patients complain of attacks of cardiac arrhythmias. During observation, the attending physician reveals an enlarged abdomen. In a standing position, he falls down, the navel protrudes.

During examination on the couch, the abdomen spreads out to the sides

For patients with "hepatic" ascites, the picture of the "head of a jellyfish" is characteristic due to the formation of dense dilated veins around the navel. The accumulation of fluid makes it difficult to bend over and put on shoes.

Unfortunately, it is still not uncommon to find young women with an advanced ovarian tumor who were sure of their pregnancy for a long time, this was facilitated by the cessation of menstruation.

The accumulated fluid itself puts pressure on the tumor, causing decay. Metastasis through the venous system and heart failure is manifested by obstructed outflow of blood to the heart. This leads to swelling of the feet, legs, external genitalia.

All the described symptoms do not develop in isolation. In the first place there are signs of a malignant tumor. Ascites requires additional treatment, as it becomes more dangerous to live with its manifestations due to the possibility of other complications.

Regardless of the causes, 3 stages are distinguished during ascites. They are also typical for patients with oncological diseases:

• transient - the patient feels only bloating, the volume of accumulated fluid is not more than 400 ml;
• moderate - the amount of exudate in the peritoneum reaches 5 liters, all the described symptoms appear, various complications are possible;
• tense - ascites accumulates 20 liters or more, is considered stable (resistant), it is impossible to treat with diuretics, it is accompanied by a serious condition, disrupts the heart and breathing.

The transient stage is almost not felt by the patient

What complications can follow ascites?

The severity of the underlying disease in the event of ascites reduces the patient's chances of recovery. The risk of dangerous complications increases even more. These include:

• bacterial peritonitis - the attachment of an infection causes acute inflammation of the peritoneum;
• intestinal obstruction;
• the appearance of hernias in the area of ​​the white line of the abdomen, navel, in the groin with possible pinching;
• cardiac decompensation;
• accumulation of fluid between the pleural sheets - hydrothorax with acute respiratory failure;
• development of hepatorenal syndrome;
• hemorrhoidal bleeding, prolapse of the lower rectum.

Diagnostics

Such a complication as ascites is preliminarily assumed during an oncological disease. When monitoring the patient, the doctor is obliged to carry out weighing. Weight gain against the background of pronounced weight loss of the arms, legs, body raises suspicion of latent edema.

With an increase in the abdomen, the doctor conducts a percussion examination, a dull sound changes localization depending on the position of the body

If you make a jerky movement with your hand on one side of the abdomen, then in the presence of fluid, the second hand will feel a wave in the opposite side. Additional studies serve as objective confirmation:

• Ultrasound - allows you to identify 200 ml of fluid in the abdominal cavity, at the same time serves as a control over changes in the internal organs;
• survey radiography and tomography - will require good preparation of the patient before the study, reveals fluid when the position of the body changes;
• laparocentesis - a puncture of the anterior abdominal wall in order to pump out fluid and its laboratory analysis, the procedure is both therapeutic and diagnostic, it allows you to identify the degree of seeding of the peritoneum, the composition of the exudate, the presence of microflora.

Problems in the treatment of ascites in oncology

Therapy for ascites should theoretically primarily consist in suppressing the growth of malignant cells in the peritoneum. Then we can expect the removal of the irritating mechanism and the restoration of the function of fluid absorption.

But in practice, chemotherapy methods help to reduce ascites only with neoplasms in the intestines, and with localization in the liver, stomach, uterus, ovaries, they remain ineffective.

It remains to control the intake and excretion of fluid with food, to count on the optimal conditions for the action of diuretics (diuretics). You can remove excess water with a restrictive diet. The patient is prescribed a salt-free diet, all dishes are prepared without salt, in agreement with the doctor, it is possible to add salt to the plate.

Spicy seasonings, heavy fatty foods, everything cooked in fried form are excluded. The amount of fluid consumed is calculated by diuresis (the amount of urine excreted per day). At the same time, the menu should include foods that provide the body with protein and potassium. Therefore it is recommended:

• boiled lean meat and fish;
• cottage cheese, kefir with good tolerance;
• baked potato;
• compote of dried apricots, raisins;
• carrots, spinach;
• oatmeal.

How are diuretics treated?

In the appointment of diuretics should not be overzealous. The recommendation of doctors to drink more fluids is known for any intoxication. This also applies to cancer. The removal of a large volume of water from the body increases the overall intoxication with the decay products of malignant cells, therefore, weight loss while taking diuretics by 500 g per day is considered acceptable.

The choice of diuretics and dosage always remains with the doctor. You can not change drugs on your own, violate the regimen. The most effective is the combination of Furosemide, Veroshpiron and Diakarba.

After ingestion of one tablet, the action begins an hour later, lasts up to six hours

Furosemide (Lasix) belongs to the group of loop diuretics. The action is based on blocking the reverse absorption of sodium and chlorine in the tubules and the loop of Henle, the excretory apparatus of the kidneys. Simultaneously removes potassium. In order not to disturb the balance of electrolytes and not cause attacks of arrhythmia, potassium preparations are prescribed (Panangin, Asparkam).

Veroshpiron, unlike Furosemide, is a potassium-sparing drug. It contains spironolactone (adrenal hormone). It is with the help of the hormonal mechanism that it is possible to remove excess fluid without potassium. Tablets begin to act 2-5 days after the start of administration. The residual effect lasts 3 days after discontinuation of the drug.

Diakarb is a drug with a specific purpose. Especially indicated for the prevention of cerebral edema, less effective in the process of urine output. Its action begins 2 hours after ingestion. It is associated with blocking the enzyme carbonic anhydrase in the tissues of the kidneys and brain.

Surgical intervention

Most often, laparocentesis is used to remove accumulated fluid in the peritoneal cavity during the resistant stage of ascites. The method is considered surgical, although therapists in specialized departments own it.

The essence of the technique: the patient sits on a chair, the abdomen around the navel is treated with iodine. Novocain solution is injected into a point about 2 cm below the umbilical ring to provide local anesthesia. After that, a puncture of the abdominal wall is made with a special instrument (trocar). The appearance of fluid indicates entry into the peritoneal cavity. A tube is attached through which the liquid is pumped out by gravity.

Up to 10 liters of liquid are removed at a time. Against the background of a gradual decrease in the abdomen, the sheets are tightened to prevent the patient from collapsing. In some cases, if it is impossible to immediately withdraw a large volume of fluid into the peritoneal cavity, insert a drainage tube and block it until the next time. Thus, the procedure is repeated 2-3 days in a row.

During laparocentesis, it is necessary to monitor sterility, since the risk of infection of the peritoneum and peritonitis increases

Laparocentesis is not performed:

• with adhesive disease of the abdominal cavity;
• against the background of severe flatulence;
• in the recovery period after hernia repair.

Peritoneovenous shunting - consists in connecting a special tube of the abdominal cavity with the superior vena cava, through it, when the patient breathes, the fluid drains into the venous bed. Deperitonization - excision of areas of the peritoneum to provide additional ways to remove fluid.

Omentohepatophrenopexy - excision of the omentum fused with the anterior abdominal wall and suturing it to the diaphragm or liver, is necessary if the omentum interferes with laparocentesis.

Folk remedies in the treatment of ascites

In folk medicine, herbal tinctures are described that help reduce ascites in cancer. Doctors treat them extremely negatively, because often patients, believing in fabulous results, abandon the main treatment.

However, in the absence of real help from the ongoing therapy of a cancer patient, one can understand. Therefore, we provide a list of plants that, according to herbalists, can help:

• astragalus membranous;
• marsh calamus root;
• spurge;
• hoof grass root;
• herb prince Siberian;
• swamp saber.

Before purchasing herbal tea, it is better to consult a doctor and carefully read the composition

The overall survival rate of patients with ascites in oncological diseases gives disappointing figures - only half of the patients will live for two years. The final outcome is both better and worse than the expected time.

It depends on the patient's response to treatment, age, the presence of chronic diseases of the kidneys, liver, heart, and the nature of the tumor growth. Ascites in the initial stage with tumors is treated much more effectively. Therefore, in the treatment of malignant neoplasms, early diagnosis of complications should be provided.

Source: abdominal ascites with folk remedies

Ascites is an abnormal accumulation of fluid in the abdominal cavity. Normally, there is always a small amount of serous substance in the abdomen, which is necessary for the free placement of intestinal loops and their temporary movement during human movements. It also protects organs from friction and premature wear.

If serous fluid accumulates in large quantities, it becomes a threat to human life and health. In the initial stages of the disease, there is a real opportunity to remove excess fluid with the help of diuretics and a certain diet. Timely treatment of ascites with folk remedies is quite effective. In many cases, it avoids serious complications in the future.

Symptoms and Causes

Ascites, as a rule, does not occur on its own, but is a symptom of another (main) disease. The disease can be caused by:

• cirrhosis of the liver;
• disorders in the work of the cardiovascular system;
• malignant tumors.

Depending on the cause and severity of the disease, the abdomen may increase gradually or dramatically. The amount of accumulated fluid can be small, medium and very significant. In advanced cases, up to 25 liters of excess fluid can form in the abdominal cavity. The main symptoms of ascites:

• there is an increase in the size of the abdomen;
• there is a feeling of bloating and heaviness;
• in the prone position, the stomach becomes “flattened”, but at the same time it protrudes on the sides;
• there are periodic pulling pains in the stomach and intestines;
• swelling may occur in other parts of the body (usually they are concentrated on the legs);
• with a large abdomen, the navel protrudes;
• body weight due to the accumulation of excess fluid increases rapidly.

If left untreated, ascites may develop bacterial peritonitis, an infectious inflammation of the peritoneum that can only be treated surgically and can be fatal. To prevent this, you need to seek medical help in a timely manner when alarming symptoms appear. After the examination and diagnosis, you can agree with the doctor on the treatment options for ascites using folk remedies at home. In the initial stages of the disease, these methods are not inferior in effectiveness to pharmacy drugs. What is important, they have practically no side effects, that is, they are safe.

Diuretic folk remedies to eliminate edema

Folk remedies to eliminate edema are decoctions and infusions that have a diuretic effect. At home, you can use the following traditional medicine recipes:

1. Collection with bearberry. Dry and chop bearberry and hernia, mix in equal parts. 60 g of herbal mixture pour 0.3 liters of boiling water and cook over low heat for 30 minutes. After straining the decoction, it is recommended to take 300 ml in the morning on an empty stomach.
2. Parsley decoction. Pour 150 g of fresh parsley with 500 ml of hot water, bring to a boil and keep on low heat for 15 minutes. After that, the remedy must be filtered and taken 100 ml every hour in the morning (in total, you can drink up to 0.5 liters of broth per day).
3. Infusion of horsetail and birch leaves. These components must be mixed in equal parts and pour 500 g of the resulting collection of 0.5 liters of boiling water. Keep the remedy on low heat for 15 minutes, then strain and drink 200 ml in the morning.
4. Bean broth. For its preparation, it is necessary to rinse the husks from 15 pods of a legume plant and pour 1 liter of boiling water. Keep the product on low heat for 10 minutes, after which it should be infused for another 20 minutes under a closed lid. Drink the decoction in equal portions throughout the day.
5. Decoction of corn stigmas. To prepare this tool, you need 2 tbsp. l. vegetable raw materials pour 200 ml of boiling water and put in a water bath for 20 minutes. After filtering and cooling, the broth should be brought with boiled water to a total volume of 200 ml. It is recommended to take a healing agent 15 ml 3 times a day after meals.

Other treatments for ascites

Helps reduce the severity of edema in ascites bath with birch buds. First you need to prepare a concentrated solution. For this, 4 tsp. birch buds should be poured with a glass of boiling water and infused for 8 hours. Dilute the strained product with ordinary hot water and take a general bath for 15 minutes. This procedure stimulates sweating, helps to remove excess fluid from the body.

Apricots help to make up for the lack of potassium, which is washed out during ascites. Since the consumption of raw fruits is undesirable in this disease, a decoction must be prepared for therapeutic purposes. For 2 liters of water, you need to take 400 g of apricots, bring them to a boil and cook over low heat for 40 minutes. After cooling, the resulting drink should be consumed in small portions. You can drink up to 400 ml of apricot medicine per day.

It is useful for ascites to take tea from viburnum with honey. To do this, take 1 tsp in a glass of hot water. canned viburnum with sugar and mix well. After cooling, you can add a little honey to the product to improve the taste.

Onion juice gives a good effect, which you need to drink on an empty stomach in the morning. To do this, in the evening, the onion needs to be cut and sprinkled with sugar, during the night it will release the juice. You need to take it for 2 tbsp. l. every morning before breakfast. Cucumber juice has a diuretic effect. It can be squeezed from fresh vegetables and drunk 100 ml per day in small portions.

Diet

Compliance with a diet for ascites is necessary for successful treatment, since without it, not a single healing agent will have the desired effect. From the patient's diet, all semi-finished products, excessively fatty and spicy foods, bakery products and all dishes that increase gas formation should be completely excluded. Of the first courses, it is better to give preference to mashed soups cooked in vegetable or chicken broth. Be sure to remove the skin from the chicken before cooking. It is best to cook chicken broth from fillet or breast on the bone.

Fresh vegetables are undesirable. They need to be subjected to heat treatment (boil, steam). Fruits can be eaten only in dried form, cook compotes and jelly from them. Juices must be diluted 1:1 with water before drinking. The amount of liquid, including soups, in the diet should be limited to 2 liters per day (less, but not more). A very important point in the diet for ascites is the rejection of salt. It retains water in the body and leads to swelling, so it must be completely excluded from the diet for the duration of treatment. Salt can be replaced with natural mild seasonings (parsley, dill, dried herbs).

With ascites, you can eat fresh herbs, low-fat cottage cheese, cereals, boiled dietary meat and fish. For the duration of treatment, alcoholic beverages, strong coffee, tea, sauces and marinades should be completely excluded from the diet.

• Cover 61
• Respiratory 53
• Digestive 48
• Blood 45
• Reproductive 37
• Nervous 34
• Musculoskeletal 25
• excretory 21

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Source: treat ascites at home?

Ascites is an accumulation of excess fluid in the abdominal cavity.

Between the organs of the peritoneum and the loops of the intestine is a serous fluid, which ensures the free movement of organs. With the development of various pathologies, it can accumulate, which leads to the appearance of the disease.

Treatment of ascites at home is considered a very topical issue.

The reasons

The causes of the appearance of pathology are very diverse and are always associated with abnormal processes in the body. So what diseases cause ascites? The following disorders can lead to the development of the disease:

1. Diseases of the liver. Quite often, pathology develops with cirrhosis of the liver, malignant organ damage and the development of the Budd-Chiari syndrome. The development of cirrhosis can lead to hepatitis, the use of medications or alcohol. In any case, the disease provokes the death of hepatocytes. As a result, healthy liver cells are replaced by scar tissue, and the size of the organ increases. As a result, he pinches the portal vein, which leads to the development of ascites.
2. Heart diseases. Pathology can develop with heart failure or constrictive pericarditis. Ascites is due to the fact that the enlarged heart muscle cannot pump the required amount of blood. It accumulates in the vessels, and the inferior vena cava system is no exception. Under the influence of increased pressure, fluid exits the vessels and forms ascites.
3. Pathology of the kidneys. Chronic organ failure leads to the development of the disease, which can be the result of a variety of anomalies - pyelonephritis, urolithiasis, glomerulonephritis. All these pathologies provoke an increase in blood pressure, sodium with fluid is retained in the body, which causes ascites.
4. Damage to the lymphatic vessels. This may be the result of traumatic injury, the presence in the body of a tumor formation that gives metastases. Also, this condition occurs due to infection with filariae - worms that lay eggs in the lymphatic vessels.
5. Peritoneal lesions. These include tuberculous, fungal or diffuse peritonitis. Also, the cause can be a malignant lesion of the large intestine, breast, stomach, endometrium, ovaries. Often the cause is peritoneal carcinosis, mesothelioma and pseudomyxoma of the peritoneum.
6. Polyserositis. With the development of this disease, in addition to ascites, other symptoms appear - in particular, pericarditis, pleurisy.
7. Systemic diseases. Anomalies such as lupus erythematosus, rheumatism, rheumatoid arthritis can lead to the accumulation of fluid in the abdominal cavity.
8. Protein deficiency. This anomaly is one of the factors that creates the prerequisites for the development of the disease.
9. Pathologies of the digestive system. These include Crohn's disease, pancreatitis, chronic diarrhea. Also, the cause of the problem can be any processes that occur in the peritoneum and disrupt the outflow of lymph.
10. Myxedema. This anomaly is accompanied by swelling of soft tissues and mucous membranes. Its development is associated with a violation of the production of thyroid hormones - thyroxine and triiodothyronine.
11. Eating disorders. Strict diets and starvation are especially dangerous in this regard. This leads to the depletion of protein reserves, which provokes a serious decrease in oncotic pressure.

In some cases, pathology is diagnosed in newborns. It may be due to hemolytic disease of the fetus, which is associated with an immunological conflict.

Ascites - fluid in the abdomen

Symptoms

Before dealing with pathology, its clinical picture should be analyzed. Symptoms may come on gradually or appear suddenly over several days or hours.

The main manifestation of ascites is a significant increase in the size of the abdomen and a noticeable weight gain. At the same time, many people complain of the appearance of arching pains, nausea, heartburn, flatulence, and belching.

As the abdomen enlarges, the navel protrudes and the skin tightens. In the vertical position, the abdomen hangs down, while in the horizontal position it spreads out on the sides and protrudes in the area of ​​\u200b\u200bthe ribs.

With a significant increase in volume, pronounced shortness of breath, swelling of the limbs, impaired motor activity are observed. It can be difficult for a person to bend over.

Often patients complain of hernia and hemorrhoids. Many patients experience rectal prolapse and develop varicocele.

Depending on the cause of the disease, general symptoms may also occur:

• fever;
• expansion of veins in the abdomen;
• toxicosis;
• general weight loss against the background of an increase in the size of the abdomen;
• bluish tint of limbs.

In total, quite a lot of fluid can accumulate in the abdominal cavity. This indicator is 5-20 liters.

Medical treatment

How to treat ascites? This question worries many people. The main drugs that are used to remove excess fluid from the body are diuretics.

The use of such funds helps to ensure the transition of excess fluid from the peritoneum into the bloodstream. This allows you to significantly reduce the manifestations of pathology.

At the initial stage of therapy, the patient is prescribed a small amount of diuretics. This helps to minimize the risk of adverse reactions.

The key principle of diuretic therapy lies in the slow increase in diuresis. This will help prevent significant loss of potassium and other essential metabolites. In most cases, drugs such as Verospiron, Aldactone, Amiloride are used.

In addition to diuretics, your doctor may prescribe potassium supplements. Also, the treatment regimen must include hepatoprotectors.

During the treatment period, specialists carry out daily monitoring of the patient's diuresis. If the use of drugs does not give the desired effect, they are changed to stronger drugs. It can be Dichlothiazide or Triampur.

Also, during the period of therapy, medications are necessarily prescribed that help strengthen the walls of blood vessels. These include vitamins C and P, Diosmin.

It is useful to take drugs that prevent the removal of fluid from the vascular bed. These include Reopoliglyukin.

To normalize the metabolism of liver cells, protein preparations are administered. Usually, concentrated plasma or Albumin solution with a concentration of 20% is used for this. If the disease is of bacterial origin, antibiotics are indicated.

Many people wonder if ascites can be cured. Medications help get rid of excess fluid. To fully cope with the disease, you need to eliminate the provoking factor.

Folk remedies

Answering the question of how to get rid of pathology, one cannot fail to mention effective folk methods. Of course, they will not help to completely cure the disease, but they will significantly improve the human condition.

Treatment of ascites with folk remedies is carried out using the following products:

1. Infusion of cherry stalks. To do this, take a large spoonful of dried raw materials, add 500 ml of boiling water and leave to infuse for several hours. Strained means to use 200 ml 3-4 times a day. The course of therapy is 2 weeks. Then you need to take a break for a week.
2. Flax seeds. To prepare a healing agent, you need to take 4 small spoons of seeds, add 1 liter of water. Boil and put on a small fire for a quarter of an hour. Infuse for several hours and consume half a glass up to 7 times a day. This recipe is highly effective. Results will be available within 2 weeks. This composition helps with the appearance of internal edema. The course of therapy is 1 month. Then the treatment should be repeated after 10 days.
3. Collection of herbs. To ensure a normal water-salt balance and kidney function, you should mix the leaves of currant, wild rose, lingonberry and raspberry in equal parts. Pour half a glass of raw materials with 500 ml of water and cook for 10 minutes. Consume after meals instead of tea. This remedy has an excellent diuretic effect.
4. Decoction of parsley seeds. To make it, 1 large spoonful of seeds or the entire crushed plant should be mixed with 2 cups of boiling water, wrapped and left for 10 hours. Consume 1 tablespoon 3-4 times a day. The decoction should be taken with caution. At first, it should be drunk 2 days in a row, then interrupted for 3 days.
5. A decoction of birch leaves and buds. This tool will give good results if the cause of the pathology is a violation of the heart. Also in this situation it is useful to take an infusion of bedstraw and consume a large amount of parsley. In addition, it is useful to include pumpkin and juice of this vegetable in the menu.
6. A decoction of oatmeal. After the oats start to ripen, you need to collect fresh straw. Take 40 g of raw materials and add 1 liter of water. Drink half a glass 3-4 times a day. A decoction is useful to take with pathologies of various origins.
7. Diuretics. If puffiness is caused by disorders in the functioning of the kidneys, it is useful to use an infusion of stigmas of corn, horsetail, and bean pods. Diuretic fees and teas are no less effective. To prepare them, it is worth taking bearberry leaves and hernia grass in equal parts, dry thoroughly and grind. Place the resulting product in a glass container and take it like tea. Mix half a glass of raw materials with 2 glasses of water and cook over low heat for a quarter of an hour. Consume 30 minutes before meals.

Nutrition Features

Diet in ascites plays a key role, especially in the initial stages of the disease. To achieve good results, you must strictly observe all the prohibitions.

So, the following should not be eaten:

• fresh pastries from puff pastry or pastry;
• offal;
• sausages and smoked meats;
• stew;
• fatty, fried, spicy, salty foods;
• strong meat, mushroom and fish broths;
• fatty dairy products;
• some vegetables - cabbage, radish, garlic, onion, sorrel, radish, mushrooms.

At the same time, nutrition must be complete. The menu should contain a variety of products.

It is helpful to use the following:

• eggs in the form of a protein omelet;
• cereals - the exception is millet and legumes;
• mashed soups based on chicken, turkey and rabbit;
• minced meat dishes;
• fish in steam or boiled form;
• stale bread;
• warm drinks;
• jelly;
• marshmallow.

Course and forecast

Many people are interested in whether this ailment itself can pass.

Unfortunately, ascites does not disappear without adequate therapy, but is constantly progressing. This anomaly significantly worsens the prognosis of the underlying disease and is an unfavorable sign in terms of prognosis.

Ascites may be complicated by bleeding, peritonitis, spleen or liver failure.

There is also a threat of brain damage due to swelling. The average number of deaths within 2 years with severe ascites is 50%.

Prevention

To prevent the development of the disease, you need to engage in its prevention:

1. Correctly and timely treat pathologies that can provoke ascites. These include hepatitis, cirrhosis, and portal hypertension.
2. Follow a diet. Experts advise limiting the use of useless liquids that do not quench your thirst - coffee, carbonated drinks.
3. Avoid excessive physical and psychological stress.

Now you know how to remove this pathology. To do this, first of all, you need to deal with the treatment of the underlying ailment, which led to the appearance of ascites.

To do this, it is necessary to conduct a detailed diagnosis and strictly adhere to all medical recommendations.

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Ascites (abdominal dropsy) is an abnormal accumulation of fluid in the abdominal cavity. The amount of transudate in this condition can be up to 20-25 liters.

Treatment of ascites is carried out by eliminating the cause of the development of the disease, as well as reducing the amount of accumulated fluid with the help of a diet, in severe cases, they resort to a puncture of the peritoneum and outflow of transudate into the external environment. In addition, the problem of treating abdominal ascites with folk remedies is relevant.

What is the purpose of traditional medicine for ascites?

It is not very reasonable to use exclusively alternative methods of treatment to combat dropsy of the abdomen, since the pathological condition is fraught with a number of serious complications (for example, the appearance of bacterial peritonitis).

It is important to combine medical and surgical methods with the use of medicinal herbs and products that have a therapeutic effect. First of all, recipes are used, the components of which have a diuretic effect. The removal of excess fluid is the basis of symptomatic therapy.

However, one should not only remove fluid from the abdomen, but also eliminate the main cause of the pathological condition. Folk healers also advise taking infusions and decoctions based on medicinal plants, which will strengthen the patient's body's defenses and help activate metabolic processes.

Foods used in the treatment of dropsy

One of the well-known products that should be in the individual menu of a sick person is pumpkin. It enhances the excretion of salts from the body, which reduces the risk of retention of pathological fluid in the abdominal cavity and the appearance of swelling. Pumpkin reduces the load on the heart muscle, cleanses the patient's body of toxins and toxic substances.

The next important product is apricot. This is a source of potassium, which is necessary for the proper functioning of internal organs, subject to the use of diuretics and infusions based on medicinal plants.

Parsley is a representative of the beds, which has powerful antioxidant properties. Eating greens in food can enhance the effectiveness of other vegetables and fruits used in the treatment of ascitic pathology.

Enlargement of the abdomen, dull pain and excessive gas formation are the main symptoms of ascites.

Treatment of ascites with folk remedies

Treatment with folk remedies has always remained an urgent problem. After all, many people cannot withstand a strict diet or decide on a puncture of the abdominal cavity.

Recipe number 1. A decoction of bean pods

Peel the beans (about 20-25 g) and pour the resulting pods with 1 liter of clean water. Put everything on fire and bring to a boil. Boil for another 10 minutes on low heat and let stand and cool for 40 minutes.

Take the decoction orally 3 times a day, but no later than 8 pm. Due to the excellent diuretic effect, excess fluid will leave the body. In addition, you need to limit yourself in the amount of water consumed.

Recipe number 2. A decoction of parsley leaves or seeds

Pour parsley leaves or seeds (about 300 g) with 1 liter of water, bring to a boil and cook for about 15-20 minutes. After that, remove the broth from heat, cool and strain through cheesecloth. It is necessary to take the drug for 3 days every day from the very morning with an interval of 60 minutes. The total amount of liquid drunk should not exceed half a liter in 24 hours.

Recipe number 3. Horsetail and birch leaves

The components for the preparation of the medicinal product are mixed in equal proportions, and pour 0.5 liters of boiled water. Bring to a boil, cook for 20 minutes, cool and strain the broth. Take orally 200 ml every morning for 7-10 days.

Recipe number 4. Apricot fruit compote

Fresh or dried apricots (1 cup) are poured with 1 liter of water and compote is boiled for 40 minutes without adding sugar.

The resulting broth is separated from the fruit and filtered. Drink 1 glass of the drug every morning, with a positive effect, the dosage can be increased to 0.4 liters per day. The duration of treatment is several weeks.

Recipe number 5. A decoction of bearberry and hernia

In equal proportions, mix 2 plants and pour 300 ml of boiling water. Everything is cooked on low heat for 30-40 minutes, then cooled and carefully filtered. The resulting decoction is taken orally 300 ml daily for 2-3 weeks in the morning before meals.

Recipe number 6. Linden tea and coltsfoot

Linden flowers and coltsfoot flowers are mixed in equal proportions and immersed in 500 ml of pure water, brought to a boil and boiled for a quarter of an hour. The finished broth is removed from the heat, insisted for another 15 minutes, cooled and taken orally 4 times a day, 100 ml in a warm form. The duration of treatment is 10-14 days.

Linden tea with the addition of coltsfoot is an excellent option for the treatment of ascites

Recipe number 7. birch wraps

A clean cotton cloth is immersed in a prepared decoction of birch leaves (at the rate of 100 g per bucket of water), the patient is completely wrapped around, starting from the armpits and ending with the knees. As soon as possible, wind a second dry sheet on top and a third layer of a woolen scarf or blanket.

It is necessary to take a lying position, and cover with another blanket on top. The duration of the procedure is at least 1.5 hours. After the end of the procedure, everything is removed, but drafts or contact with cold air should not be allowed.

Recipe number 8. Oat straw infusion

One handful of fresh straw is taken per 1 liter of water. Infused for 2-3 days in a dark and cool place. It is recommended to take the drug 150 ml 3-4 times a day. The infusion is effective for any accumulation of fluid in organs and tissues.

Recipe number 9. Herbal collection: nettle, plantain, St. John's wort, rose hips and bearberry

One tablespoon of herbs is poured with cold boiled water and infused for 6-8 hours. After that, put the infusion on the fire and boil for 15-20 minutes over low heat. The broth is filtered, cooled and taken orally 50 ml 4 times a day.

Recipe number 10. Infusion of cherry stalks

One tablespoon of dried cherry stalks is poured with 1.5 liters of boiling water, covered and infused for 3-4 hours. The resulting liquid is filtered and taken orally in a glass 3-4 times a day. The duration of treatment should be at least 2 weeks. Then take a break for 7 days and repeat the course.

Remember! Before using any folk remedy, you should consult a specialist.

In addition, if during treatment with ascites an allergic reaction of the body or a deterioration in the condition was detected, the therapy should be stopped immediately!

Diet for ascites is an integral treatment option. It greatly facilitates the life of the patient. Food prohibitions are especially effective in the initial stages of the disease, since they largely determine the further development of the secondary condition. The diet is prescribed in combination with drug treatment to reduce the manifestation of ascites.

Medical treatment of ascites

The internal organs and the abdominal cavity of a person are shrouded in a thin tissue - the peritoneum. Her blood and lymphatic vessels secrete a small amount of fluid necessary for the free movement of intestinal loops and preventing the internal organs from sticking together. This fluid is absorbed by the peritoneum itself, so the body controls this process. In case of failures in the body, the process of absorption of the secreted fluid is disrupted, or a large amount of it is released. This pathology is called ascites of the abdominal cavity or dropsy of the abdomen.

Ascites is not an independent disease - it is only a symptom of a severe disorder in the body. It always develops as a complication of other diseases.

Conservative therapy of ascites is based on the suppression of the underlying disease and depends on the cause of the primary pathology. For all types of dropsy, drugs are prescribed - diuretics to normalize water-salt metabolism and reduce the formation of fluid in the abdominal cavity.

The initial course of treatment includes such drugs as: Veroshpiron, Aldactone, Spironolactone. In case of ineffectiveness of therapy with these drugs, a more potent drug Furosemide or Torasemide is added.

Drugs such as Captopril, Enalapril may be prescribed. They increase the excretion of sodium from the body and at the same time retain potassium.

The attending physician prescribes doses of drugs individually, depending on the underlying disease and the patient's well-being. It is necessary to take into account the fact that the use of high dosages can lead to side effects.

Uncontrolled and excessive use of diuretics can put the body at risk of dehydration.

In the treatment of abdominal ascites, multivitamin complexes are prescribed that have a beneficial effect on the functioning of the body as a whole. It is recommended to administer them in the form of injection solutions, given the violation of the absorption of vitamins from the intestine.

Complicated ascites require the use of surgical methods of treatment. A widely used surgical procedure for ascites is laparocentesis - puncture (tissue puncture) removal of fluid from the abdominal cavity. In complicated ascites, a permanent catheter is installed for prolonged fluid withdrawal.

Treatment of ascites with folk remedies

Many people believe that you should not neglect the proven methods of treatment of traditional medicine, which has thousands of years of practical experience and is still relevant.

Treatment of ascites with folk remedies is dynamically used in complex therapy with drug treatment aimed at eliminating the main cause that provoked the development of this disease. Natural diuretics help to remove excess fluid from the abdominal cavity and thereby facilitate the work of internal organs.

Before treating ascites with traditional medicine, you should consult a doctor, as the consequences of this treatment can be significant.

Parsley with milk

To remove the unpleasant symptoms of dropsy of the abdomen, you can use parsley with milk. When taking this remedy, the fluid from the abdominal cavity leaves already on the 2nd day. For a decoction, you will need 0.5 liters of milk and a large bunch of parsley. Boil the milk, add the chopped parsley to the milk. Simmer the resulting mixture over low heat for at least 2 hours, then cool and strain. Drink the prepared drug every hour for 2 tbsp. l. Store the diuretic in a cool place.

Lemon and horseradish

An effective treatment for ascites is an infusion of lemon and horseradish. For infusion, you need to take 100 g of squeezed lemon and chopped horseradish, mix and let it brew for 1 night. Take 1 tsp. daily for 2 weeks. Store the tincture in the refrigerator.

Coltsfoot and sweet clover

With the accumulation of unnecessary fluid, a decoction of coltsfoot and sweet clover will help to cope. The coltsfoot grass and sweet clover flowers should be taken in equal proportions, crushed and mixed. For 1 tsp. you will need a glass of boiling water, stand for half an hour and use 2 tbsp. l. 3 times a day.

Red root

Treatment of dropsy with folk remedies, such as red root (tea kopek), is widely used in Tibetan folk medicine.

To prepare the infusion, you need 2 tbsp. l. finely chopped root, pour 0.5 liters of vodka and let it brew for 10 days. Take an infusion of 1 tsp. 3 times a day. The duration of treatment is not more than 30 days.

A popular remedy for eliminating abdominal ascites is an infusion of dried apricots. In addition to the main diuretic effect, it replenishes a significant part of the need for potassium in the body. It is necessary to pour 200 g of well-washed dried fruits with boiling water (0.5 l) and tightly close the container, and it is better to use a thermos to prepare the infusion. It must be insisted for at least 6 hours. You need to take the remedy 2 times a day, 150 ml.

diuretic tea

For the preparation of diuretic tea, you can use a collection of dried raspberries, lingonberries, currants and rose hips. You need to take 4 tbsp. l. mixture, pour 250 g of boiling water and boil for 20 minutes. Allow the broth to cool, strain and take 2 times a day instead of tea.

Nettle can become the basis for diuretic tea. The remedy helps if it is used at an early stage of ascites. Finely chop dried nettle roots, take 1 tsp. 1 cup boiling water, insist and drink 2 cups a day.

An effective remedy for dropsy is a decoction of the root of angelica forest. For its preparation, dried and crushed root is used. To obtain a medicine, it is necessary to use dried and crushed raw materials. To prepare the daily norm of decoction 1 tbsp. l. root pour a glass of water and simmer over low heat for 20 minutes. The resulting broth is divided into 3 doses.

Diet for ascites

Diet, that is, a specially designed nutrition system, is one of the main components of the treatment of many diseases.

The diet for ascites should be aimed at preventing fluid retention in the body. To do this, you need to minimize salt intake and reduce fluid intake. When following a diet, the patient should eat boiled or steamed food.

With this disease, a ban is imposed on sour, spicy and fatty foods.

From the diet it is necessary to remove meat delicacies that contain the so-called hidden fats (pork skin, lard, visceral fat) and smoked products. Pork and other fatty meats should be replaced with rabbit, turkey and chicken meat. It is not recommended to consume dairy products with high fat content.

Fresh bakery products are unacceptable for this disease. Some vegetables should be avoided:

• turnips;
• sorrel;
• radish;
• Luke;
• garlic;
• radish.

It is necessary to forget about coffee, cocoa and carbonated drinks. You can drink weakly brewed green tea, which is not only a treasure trove of many vitamins, but also has a pronounced diuretic effect. Fruits must be included in the diet in dried form or prepared from them compote. From sweets, you can afford only marshmallows or jam.

In the patient's diet, foods containing a large amount of potassium must be present, such as:

• spinach;
• grapefruits;
• eggplant;
• dried apricots;
• baked potato;
• asparagus;
• raisin;
• carrot;
• green pea.

Allowed cereals that do not contain millet and legumes. It is recommended to use nuts (walnuts, hazelnuts, peanuts), after mixing them with honey.

The diet must be strictly observed, and the patient must be aware of the seriousness of proper nutrition.

In the treatment of abdominal dropsy, therapeutic starvation is effective. It should be carried out systematically and from the very beginning of the disease. Fasting should be carried out 1 time in 2 months for a week, drinking only 2 cups of tea without sugar per day. It is recommended to do enemas every evening during fasting. After this procedure, the transition to regular food should be gradual.

Ascites of the abdominal cavity is a pathological process that is characterized by the accumulation of fluid in the abdomen, the volume of which can reach 25 liters. The cause of the pathology can be various diseases of the liver, gastrointestinal tract and other organs. The accumulated fluid may have impurities of pus, the so-called exudate, which indicates the development of inflammation in the body. With ascites of the abdominal cavity, treatment with folk remedies, along with taking medications, gives a positive result. But home therapy is possible only in cases where the disease is not caused by inflammatory processes, otherwise the patient's condition may worsen in the absence of necessary treatment in the clinic.

How pathology manifests itself

The clinical picture with ascites shows a high level of protein and leukocytes contained in the biomaterial taken from the abdomen by puncture. This phenomenon can serve as the beginning of the development of peritonitis - inflammation of all organs of the abdominal cavity.

The physical manifestations of ascites include:

• a sharp and unreasonable increase in the abdomen;
• protrusion of the navel, which is due to fluid pressure on the walls of the peritoneum;
• with a large amount of accumulated biomaterial, a hernia may occur;
• covering the skin of the abdomen with a venous mesh.

Patient complaints are often added:

• dyspnea;
• discomfort in the abdominal cavity;
• labored breathing.

The lungs are squeezed due to the large volume of fluid, while not allowing normal breathing. A person can also feel pressure on the diaphragm of varying intensity.

Factors causing the development of abdominal ascites

Ascites is not a primary disease, but a consequence of other pathologies present in the patient's body. The reasons for its occurrence include:

• high blood pressure in the portal vein;
• metastases affecting the abdominal organs during oncological processes (carcinomatosis);
• replacement of parenchymal liver tissue with fibrous tissue, which is called cirrhosis;
• inflammatory processes in the liver due to alcohol exposure and its insufficiency;
• abdominal tuberculosis;
• kidney diseases that have developed as a result of long fasting;
• heart failure;
• acute form of pancreatitis - inflammation of the pancreas.

It is necessary to treat abdominal ascites taking into account the underlying disease. But in order to establish the exact cause of the pathology, it is necessary to undergo an examination that will show what exactly caused the accumulation of fluid. The patient also needs to pay attention to accompanying symptoms that will help narrow down the range of possible diagnoses.

Diagnostics

The examination begins with a face-to-face examination of the patient by a doctor. The doctor collects a detailed history, which in the future will help to make the correct diagnosis. The patient is sent for an examination, which includes:

• x-ray of the peritoneum;
• laparocentesis - sampling of biomaterial from the abdomen for research.

The latter procedure not only helps to find out the cause of the pathology, but also improves the patient's condition, since the amount of fluid in the peritoneum decreases and the person can breathe and move normally again for some time.

Treatment in a medical setting

As mentioned earlier, before treating ascites, it is necessary to identify the cause that caused it and make every effort to eliminate it. But if the fluid accumulated in the abdomen threatens the health and life of the patient (when its volume exceeds 15 liters), then the attending physician prescribes its emergency removal. The patient is prescribed laparocentesis - a puncture of the abdominal cavity, due to which excess biological fluid is removed from the abdomen.

Surgical intervention can provoke bleeding, perforation of the intestine (getting its contents into the abdominal cavity), adhesions, infection of the body.

folk therapy

Prior to the diagnosis, during the examination by specialists, the patient can treat ascites with folk remedies. Their action is aimed at removing excess fluid from the abdomen and preventing its accumulation.

bean pods

Bean pods have a good diuretic effect. Excess fluid is excreted from the body, significantly facilitating the patient's condition.

To prepare the medicine at home, you need to peel 15 pods from the seed, place the remaining husk in a small saucepan, pour 1 liter of water and boil for 15 minutes. Let it brew for 30 minutes, strain. You need to drink a cooled medicine, so it can be prepared in the evening. Take 100 ml three times a day:

• in the morning after waking up;
• before breakfast;
• After dinner.

After three days, the result will be noticeable: the patient will breathe easier, shortness of breath will disappear and the stomach will decrease in volume.

Parsley

To prepare the medicine you need:

1. Rinse thoroughly with 300 g of parsley.
2. Pour greens with a liter of hot water.
3. Put on fire for a quarter of an hour.
4. Strain.

It is necessary to take the medicine for three days. You need to drink a decoction from the moment you wake up until late in the evening, the interval between doses is 1.5 hours.

Apricot

To prepare a medicinal decoction, you can use fresh or dried apricots. A glass of pitted fruits is boiled in a liter of water for 40–60 minutes, filtered and drunk daily, 200 ml each. The amount of compote consumed per day can be doubled if the patient's condition improves markedly.

Diuretic and diaphoretic teas

To get rid of excess fluid in the body is possible only through its intensive removal. For this, tea is perfect, which has an effective diuretic effect:

1. Mix 3 tablespoons of hernia and bearberry, pour 0.5 liters of water, bring to a boil and cook over low heat until the broth becomes dark and strong. Strain the remedy and cool. Take a glass on an empty stomach. The effect will be noticeable already on the second day.
2. Dilute a teaspoon of viburnum rubbed with sugar in 250 ml of warm water. Take a glass up to four times a day. Honey can be added to the product to improve its taste.
3. Not only diuretic tea will help to remove excess fluid. You can also use products that increase perspiration. Similarly to the first recipe, a mixture of coltsfoot and linden is brewed, drunk warm, 250 ml four times a day.

Patients should limit their daily fluid intake, so in addition to diaphoretic tea, you can drink no more than 0.5 liters of water so that the result is as effective as possible.

Onion

After waking up, you need to drink 2 tablespoons of onion juice. On the eve of the evening, the average onion is cut into cubes and plentifully covered with sugar. In the morning, drain the juice and store it in the refrigerator.

Cucumber

As you know, cucumber has an effective diuretic effect. Freshly squeezed cucumber juice drink 2 tablespoons six times a day. It is better not to prepare a lot of juice in advance, but to prepare fresh each time.

Corn silk

To remove the liquid, it is necessary to prepare a decoction of corn stigmas:

1. 2 tablespoons of dry ingredients pour a glass of boiling water.
2. Simmer the medicine in a water bath for half an hour.
3. The prepared product is filtered and cooled.
4. Dilute the decoction with a glass of water.

Drink the remedy should be a tablespoon after meals three times a day.

Birch infusion bath

You can treat ascites with folk remedies in combination with water procedures. A good effect is given by a bath with an infusion of birch leaves and buds.. It increases perspiration by removing excess fluid. Four tablespoons of the collection pour 250 ml of boiling water and leave to infuse overnight. You should get an infusion of high concentration, which can be understood by the characteristic smell. The resulting product is added to a warm bath and water procedures are taken for 20 minutes.

Food

An important role in the treatment is played by the diet, as well as the quality of the consumed products. With ascites, it is important to exclude from the diet:

• puff pastry and pastries;
• fast food, stew, canned food, smoked sausages, offal;
• meals high in fat;
• salt and hot spices;
• rich fatty foods;
• roast;
• fatty dairy products;
• vegetables that irritate the stomach: cabbage, onions, turnips, radishes and others.

The patient needs to adhere to a sparing diet, which will help to avoid the complications of pathological accumulation of fluid in the peritoneum. The menu must include products and dishes:

• protein omelettes (you can eat proteins from a maximum of three eggs per week);
• cereals, except millet;
• stewed or boiled diet poultry (turkey, chicken);
• soup-puree from rabbit meat;
• fish, steamed or boiled;
• two-day bread, crackers;
• marshmallow, jelly;
• weak tea.

Diet and traditional medicine recipes will help prevent an increase in accumulated fluid both during diagnosis and throughout the entire period of treatment of the underlying disease.

is a secondary condition characterized by the accumulation of exudate or transudate in the free abdominal cavity. Clinically manifested by an increase in the volume of the abdomen, heaviness, a feeling of fullness and pain in the abdominal cavity, shortness of breath. Diagnosis of ascites includes ultrasound, CT, ultrasound, diagnostic laparoscopy with the study of ascitic fluid. For pathogenetic treatment, it is necessary to establish the cause that caused the accumulation of fluid; symptomatic measures for ascites include the appointment of diuretics, puncture removal of fluid from the abdominal cavity.

General information

Ascites or abdominal dropsy can accompany the course of a wide range of diseases in gastroenterology, gynecology, oncology, urology, cardiology, endocrinology, rheumatology, lymphology. The accumulation of peritoneal fluid in ascites is accompanied by an increase in intra-abdominal pressure, pushing the dome of the diaphragm into the chest cavity. At the same time, the respiratory excursion of the lungs is significantly limited, cardiac activity, blood circulation and the functioning of the abdominal organs are disturbed. Massive ascites may be accompanied by significant protein loss and electrolyte disturbances. Thus, with ascites, respiratory and heart failure, pronounced metabolic disorders can develop, which worsens the prognosis of the underlying disease.

Causes of ascites

Common causes of ascites are diseases that occur with portal hypertension - an increase in pressure in the portal system of the liver (portal vein and its tributaries). Portal hypertension and ascites may develop due to cirrhosis of the liver, sarcoidosis, hepatosis, alcoholic hepatitis; hepatic vein thrombosis caused by liver cancer, hypernephroma, blood diseases, widespread thrombophlebitis, etc.; stenosis (thrombosis) of the portal or inferior vena cava; venous congestion in right ventricular failure.

Protein deficiency, kidney disease (nephrotic syndrome, chronic glomerulonephritis), heart failure, myxedema, gastrointestinal diseases (pancreatitis, Crohn's disease, chronic diarrhea), lymphostasis associated with compression of the thoracic lymphatic duct, lymphoangiectasia and difficulty in lymphatic drainage from the abdominal cavity predispose to the development of ascites .

Pathogenesis

Normally, the serous cover of the abdominal cavity - the peritoneum produces a small amount of fluid necessary for the free movement of intestinal loops and the prevention of gluing of organs. This exudate is sucked back by the very same peritoneum. In a number of diseases, the secretory, resorptive, and barrier functions of the peritoneum are impaired, which leads to ascites.

Thus, the pathogenesis of ascites may be based on a complex complex of inflammatory, hemodynamic, hydrostatic, water-electrolyte, metabolic disorders, resulting in interstitial fluid sweating and its accumulation in the abdominal cavity.

Symptoms of ascites

Depending on the causes, the pathology can develop suddenly or gradually, growing over several months. Usually the patient pays attention to the change in the size of clothes and the inability to fasten the belt, weight gain. Clinical manifestations of ascites are characterized by sensations of fullness in the abdomen, heaviness, abdominal pain, flatulence, heartburn and belching, nausea.

As the amount of fluid increases, the stomach increases in volume, the navel protrudes. At the same time, in the standing position, the stomach looks sagging, and in the prone position it becomes flattened, protruding in the lateral sections (“frog belly”). With a large volume of peritoneal effusion, shortness of breath, swelling in the legs appear, movements are difficult, especially turns and tilts of the body. A significant increase in intra-abdominal pressure with ascites can lead to the development of umbilical or femoral hernia, varicocele, hemorrhoids, rectal prolapse.

Ascites accompanying intrahepatic portal hypertension proceeds with muscular dystrophy, moderate hepatomegaly. At the same time, the expansion of the venous network in the form of a “jellyfish head” is clearly visible on the skin of the abdomen. In posthepatic portal hypertension, persistent ascites is associated with jaundice, severe hepatomegaly, nausea, and vomiting.

Ascites in protein deficiency is usually small; Peripheral hypostases, a pleural exudate are noted. Polyserositis in rheumatic diseases is manifested by specific skin symptoms, ascites, the presence of fluid in the cavity of the pericardium and pleura, glomerulopathy, arthralgia. With impaired lymphatic drainage (chylous ascites), the abdomen rapidly increases in size. Ascitic fluid has a milky color, pasty consistency; in a laboratory study, fats and lipoids are detected in it. The amount of fluid in the peritoneal cavity with ascites can reach 5-10, and sometimes 20 liters.

Diagnostics

During the examination by a gastroenterologist, other possible causes of an increase in the volume of the abdomen are excluded - obesity, ovarian cyst, pregnancy, tumors of the abdominal cavity, etc. To diagnose ascites and its causes, percussion and palpation of the abdomen, ultrasound of the abdominal cavity, ultrasound of venous and lymphatic vessels, MSCT are performed abdominal cavity, liver scintigraphy, diagnostic laparoscopy, examination of ascitic fluid.

Percussion of the abdomen with ascites is characterized by dullness of sound, a shift in the border of dullness with changes in body position. Applying the palm to the lateral surface of the abdomen allows you to feel jolts (a symptom of fluctuation) when you tap your fingers on the opposite wall of the abdomen. Plain radiography of the abdominal cavity allows to identify ascites with a free fluid volume of more than 0.5 liters.

From laboratory tests for ascites, a study of the coagulogram, biochemical liver tests, levels of IgA, IgM, IgG, and a general urine test is carried out. In patients with portal hypertension, endoscopy is indicated to detect varicose veins of the esophagus or stomach. Chest x-ray may reveal fluid in the pleural cavities, high standing of the bottom of the diaphragm, and limitation of respiratory excursion of the lungs.

During the ultrasound of the abdominal organs with ascites, the dimensions, condition of the tissues of the liver and spleen are studied, tumor processes and lesions of the peritoneum are excluded. Dopplerography allows you to assess blood flow in the vessels of the portal system. Hepatoscintigraphy is performed to determine the absorption-excretory function of the liver, its size and structure, and to assess the severity of cirrhotic changes. In order to assess the state of the splenoportal bed, selective angiography - portography (splenoportography) is performed.

All patients with ascites, identified for the first time, undergo a diagnostic laparocentesis to collect and study the nature of ascitic fluid: determine the density, cellular composition, amount of protein and bacteriological culture. In difficult to differentiate cases of ascites, diagnostic laparoscopy or laparotomy with targeted biopsy of the peritoneum is indicated.

Treatment of ascites

Pathogenetic treatment requires eliminating the cause of fluid accumulation, i.e., the primary pathology. To reduce the manifestations of ascites, a salt-free diet, restriction of fluid intake, diuretics (spironolactone, furosemide under the cover of potassium preparations) are prescribed, correction of water-electrolyte metabolism disorders and reduction of portal hypertension with the help of angiotensin II receptor antagonists and ACE inhibitors. At the same time, the use of hepatoprotectors, intravenous administration of protein preparations (native plasma, albumin solution) is indicated.

With ascites that is resistant to ongoing drug therapy, they resort to abdominal paracentesis (laparocentesis) - puncture removal of fluid from the abdominal cavity. For one puncture, it is recommended to evacuate no more than 4-6 liters of ascitic fluid due to the risk of collapse. Frequent repeated punctures create conditions for inflammation of the peritoneum, the formation of adhesions and increase the likelihood of complications in subsequent sessions of laparocentesis. Therefore, with massive ascites for long-term evacuation of fluid, a permanent peritoneal catheter is installed.

Interventions that provide conditions for the direct outflow of peritoneal fluid include a peritoneovenous shunt and partial deperitonization of the abdominal walls. Indirect interventions for ascites include operations that reduce pressure in the portal system. These include interventions with the imposition of various porto-caval anastomoses (porto-caval shunting, diabetes mellitus, liver cirrhosis, hepatocellular insufficiency, etc. According to experts in the field of clinical gastroenterology, the two-year survival rate for ascites is about 50%.