Why does the abdomen become enlarged and hard in the late stages of heart failure?

The abdomen, commonly referred to as the belly, may become enlarged and hardened in the late stages of heart failure, usually due to ascites (abdominal fluid accumulation) and gastrointestinal congestion. The details are as follows:

1. Abdominal Fluid Accumulation (Ascites)

In the late stages of heart failure, patients often develop cardiogenic cirrhosis, accompanied by symptoms such as sodium and water retention and increased aldosterone levels. These conditions lead to the formation of significant amounts of ascites, causing the abdomen to enlarge and harden.

2. Gastrointestinal Congestion

When heart failure occurs, impaired cardiac function reduces the heart's ability to pump blood effectively. This commonly results in systemic and pulmonary circulation congestion, leading to poor venous return and congestion in the gastrointestinal tract. Due to localized congestion, patients typically experience symptoms such as abdominal distension and a hardened abdomen.

It is recommended that patients with heart failure seek timely medical evaluation to determine the underlying cause and receive prompt treatment. Under a doctor's guidance, patients may take medications such as furosemide tablets or spironolactone tablets to alleviate symptoms. During treatment, adequate rest is important, emotional extremes should be avoided, and a light diet is recommended—emphasizing fresh fruits and vegetables while reducing intake of fats and salt.