Treatment and Medications for Ascites

Ascites is painful and drains you of energy. Naturally, a person with ascites wants to minimize how much ascites affects them. In this video, I discuss how to get ascites under control. I explain a procedure called paracentesis, that drains ascites to provide relief and further evaluate the fluid. I then discuss how to prevent ascites reaccumulation. To effectively keep ascites away often requires both dietary changes and medications. When these therapies do not work, I discuss next steps to control ascites. These include liver transplant and a TIPS procedure which can essentially cure ascites.

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DISCLAIMER: While I am a Gastroenterologist, I am not acting as your Gastroenterologist. The information provided on this channel is intended to be general educational content and not directed towards any one individual. If you believe you have a medical condition that deserves attention please seek care from your healthcare provider. If you are experiencing a life threatening emergency, call 911.

[kiys]

My ascites stopped. My doctor recently lowed my dose of these medication’s. I survived alcoholic hepatitis.. I have liver disease /early cirrhosis. I feel great now. Staying positive.

[blastofo]

My belly was the size of a 7 months pregnant woman from Ascites a year ago. Caused by fatty liver disease. The junk I was eating and the quantity was unbelievable. The diagnosis scared me straight. I eliminated 90% of the salt and sugar from my diet. Joined a gym and exercised daily. Now my belly is slimmer than it was before these health issues. I weigh less than I have in 20 years. Didn't need a paracentesis or meds.

[StanSwan]

I am dealing with this and keep getting different advice from different doctors. One told me it is all about limiting fluids and the other said it was all about lowering sodium. When I first found out about this I went on what was as close as I could to a zero sodium diet and get very sick and ended up in the hospital. So I was told to go home and keep my sodium below 2000mg a day but "budget" for 1000ish but 2000 was okay. No one told me sodium stays in my tissues for up to a week so when I do go to 2000 my ascites sneaks up on me. It is very hard to get it back down through diet. No one said anything about sugar or protein being too high can be bad.

No question my past drinking is a factor in all this but I also was found to have some genetic issues holding onto too much iron I won't get into here. My point is all through this I get a hint of "well you did this to yourself" bedside manner. I can see it in the faces of a few of the doctors but for sure the nurses. I got the feeling ignoring me or just being 100% clinical while they were very helpful and kind to my roommates in the hospital for example. I self medicated being foolish but also had issues in my life were I might not have made it to my age now without a way to cope. In the end I am and will continue to pay a price for that. Not being able to just eat the foods I enjoyed anymore is hard to comes to grips with. When friends invite you out for pizza I load up on fruit and the good old stand by shredded wheat with no milk. Then I can just take a few bites of pizza and hid the rest under a napkin or something. I was never a shot or mixed drinker but drank beer. I can do without it really, that part is not been hard at all really.

I have been dealing with this for just over two months and it feels like forever. Belly pain and being tired a lot can really get you down and to withdraw from the world. I also live alone and this is making it very hard to earn a living. My savings has taken up the slack but hope to feel better and get back on my feet. Reading the stories here helps as is venting here even if I suspect no one will ever read this. :)

[Siggy]

Great, easy to understand video, very informative. Thank you!

I'm a stage 4 pancreatic cancer patient with metastatic liver cancer. Liver function is at a bare minimum at this point and I'm permanently jaundiced. I'm in home Hospice care, so going to the doctor or hospital is not allowed under Hospice rules because it is considered "seeking aggressive treatment" and it would require me getting off hospice.

I have recently developed edema in my feet (puffy/swollen) and ascites fluid build-up in my lower abdomen making me look pregnant. I feel heavy, sluggish, fatigued and itchy. A surgical scar from a hysterectomy over 20 years ago has suddenly popped up like the ridge on a Klingon's forehead and looks pink.

I was put on 20mgs of Lasix twice a day and a potassium supplement. I was told to reduce sodium intake as much as possible and to drink less water. I'm also on other medications that require me to do the exact opposite, to drink more fluids to help my kidneys and to flush out toxins and bilirubin.
So how do I balance the water issue? Before the ascites I was drinking four 16oz bottles of water daily plus herbal teas.

Reducing sodium is very difficult, just as with sugar for my type 2 diabetes. American food has so much sodium and sugar in almost everything. I was born and raised in Europe and this was something I immediately noticed when I came to the US in the 1980s.

[anthonypilla]

This is the first time I’ve seen your video, and I am on both the medication you discussed. I really enjoy the way you explained how it works and now I have a better understanding of why I’m taking it. Thank you very much for the information.

[Cnote]

Thanks very much Doctor Mark I appreciate the information.

[Fallenlyrics]

Of 9 videos on ascitess this one I could understand and gave me assurance and knowledge. The others who explained had such thick foreign accents I couldn’t concentrate on the jnfo more on trying to understand thru such heavy accents. Thank you. I’m 38 and everything so far is narrowing down to non-alcoholic ascities likely from hepc. It’s so hard to breathe, walk, even laying down is uncomfortable, on top of barely gettin a deep. Breath. I’m a side sleeper so when I wake up all the fluid has amassed to the side I slept in and is firm and tender. Furosemide was prescribed, but I get really painful scary hamstring, shin, to of my foot cramps. It’s one thing or another. The leg, ankle&foot swelling wooo that’s another one I won’t even crack into. I hope I can find more informed info for when the time comes to redo bloodwork n all the fun stuff😏. Thank you 🙏🏼

[beegs]

I'm having a lot of abdominal distension. I had 3 CT scans within a couple months and they said " mild " distension. Yet I kept explaining to the doctors that I'm gaining weight while barely eating. Not gaining anywhere else except my protruding abdomen. I don't know what to do now. They found a fatty liver. Also some blood work was unusual for me such as glucose being very high, low levels of lymphocytes, high levels of monocytes. They never even called me about it. Frustrated and confused. Also had an endoscopy and colonoscopy which he said looked good.

[westfield]

My dad who has been recently diagnosed with CHF. He now gets water build up. The legs get swollen first. Then he gets GI issues where he gets constipation and extreme fatigue and extreme hunger where he feels he needs a meal immediately. After a yogurt or small snack he feels fine. His blood was tested before and after meals and was always fine so these episodes of fatigue and extreme hunger don’t seem related to his blood sugar but alway happens once his fluid builds up. Is this Ascities.? Once he takes Lasix and the fluid is drained the GI symptoms go away. Is is ok to take lasix everyday so he doesn’t have the fluid build up?

[rowenalunas-hf]

Hi dok..my belly get floated and my legs also. But when im hospital he didnt notice he notice gallblader only..he operated me but my ascites is still my body😢

[ZonyrahMakafui]

😊Hi doc, my brother was diagnosed of herpatitise b, liver cirrhosis and cholangiocarcinoma which has metastasized and there's ascites, was managed on stent but the stent has shifted and is now giving him infection every now and then, was also doing chemo but He's not responding to the tumor and now doctor's have given up on him, what do we do

[janaprasanna.g]

Can a stage V ckd patient take these two medicines for the treatment of ascites?

[gothafloxacin]

I have mild ascites right now from liver transplant rejection and theyre not draining it. They said it'll go away on its own. This rejection episode was brutal.

[zombiekush]

Would a sauna help expel excess fluid?

[slickdan]

Thank you for all of the amazing videos! I have a question that doesn’t go with this video. For the past 2 years I have had a foul odor coming out of my left nostril. I have bad pollen allergies that make my sinuses swell so I figured it was that. Went to a allergy doctor they did a CT scan to see if there was any polyps or fungal balls and there was nothing. I recently went on a 40 day water only fast and the foul odor completely disappeared even while still having pollen allergies throughout that duration of time. It has been almost 25 days off of the fast and sadly the foul odor has just now returned. I am starting to wonder if it is something from my diet causing this. Have you heard of any similar instances? Thank you so much!

[mrmrlee]

I have fluid retention in my legs and I believe in my belly as well. It is abnormally distended, yet my arms neck and face are very slim, no bodyfat noticeable at all. I eat extremely healthy (pescatarian) and go to the gym. I eat less then 2000 cals a day, yet I weigh 300 lbs and have gained 50 lbs in 2 years. My liver doctor just keeps saying my bloodwork and liver and thyroid function seem normal, yet my sonogram examiner says I have fatty liver (NAFLD). Do I need to see another doctor?

[herbiekruger]

I have ascites and was getting a drain approx every 4/6 weeks. Typical quantity of fluid was 10 to 12 litres each time, they increased my spironolactone to 100mg tablets X4 a day and my furosemide 40mg once a day.

My legs are not as swollen now as previously and my belly seems to be more in control, it has now been an over a good 2 months since my last drain.

They have spoken about getting a TIPS done but i don’t know when. I was really really struggling before with all the added weight, 14kg once. I struggle to do anything though as i am constantly going to the toilet

[melodymatteleonpolpol]

Please I hope you will answer my question it's really big help ..my son has a result of minimal ascites?? Is this dangerous?

[GDNebula_]

I’ve had this issue for many years where it feels like my stomach slightly pops forward under my lung when I breath occasionally, my stomach can sting in that area on occasion during episodes, under my lung and the lining of my stomach on my left side is slightly raised and higher than my right, and I can hear and feel fluid running in that area 24/7. Is it possible that this could be ascites? I’ve spend thousand at different doctors mostly non gi and none have recommended this or other possibilities. Any info would be greatly appreciated!

[charlastar]

How about INCREASING potassium, either through lots of potassium-rich foods (NOT sugary bananas) or potassium citrate to assist in balancing sodium.