What causes hepatic ascites?

Aug 31, 2024 Source: Cainiu Health

Dr. Gao Jun

Introduction

Liver ascites may be associated with factors such as portal hypertension, hypoalbuminemia, spontaneous bacterial peritonitis, liver cancer, and heart failure. If discomfort occurs, it is recommended to seek medical attention promptly and receive symptomatic treatment under the guidance of a physician. Patients are advised to maintain healthy lifestyle habits, supplement necessary nutrients, ensure adequate nutrition intake, and avoid strenuous exercise, which may help promote recovery.

In general, hepatic ascites may be associated with factors such as portal hypertension, hypoalbuminemia, spontaneous bacterial peritonitis, heart failure, and liver cancer. If discomfort occurs, it is recommended to seek medical attention promptly and receive symptomatic treatment under the guidance of a physician. Specific analyses are as follows:

1. Portal Hypertension

Cirrhosis leads to increased resistance to blood flow within the liver, resulting in elevated pressure in the portal venous system. This increases vascular permeability, causing fluid to leak from blood vessels into the abdominal cavity, potentially leading to hepatic ascites. Interventional procedures such as endoscopic variceal ligation or transjugular intrahepatic portosystemic shunt (TIPS) may be required to alleviate symptoms.

2. Hypoalbuminemia

Impaired liver function reduces albumin synthesis, decreasing plasma oncotic pressure and promoting leakage of intravascular fluid into the abdominal cavity, thereby forming hepatic ascites. It is recommended to enhance nutritional support and maintain a high-protein diet.

3. Spontaneous Bacterial Peritonitis

Spontaneous bacterial peritonitis may be related to bacterial infection and inflammation. Patients with cirrhosis often have weakened immunity, and ascitic fluid provides a favorable environment for bacterial growth, leading to infection of the ascites and potentially worsening hepatic ascites. Symptoms may include fever, abdominal pain, and cloudy ascitic fluid. Treatment under medical supervision may include antibiotics such as levofloxacin hydrochloride capsules, cefuroxime axetil tablets, or azithromycin capsules.

4. Heart Failure

Heart failure, caused by myocardial damage or excessive cardiac load, results in reduced cardiac pumping function, which may lead to increased venous pressure in the abdominal cavity and subsequent accumulation of fluid, causing hepatic ascites. Symptoms may include dyspnea and lower limb edema. Medications such as hydrochlorothiazide tablets, enalapril maleate tablets, or valsartan capsules may be used as directed by a physician.

5. Liver Cancer

Liver cancer, caused by progression of hepatitis, genetic factors, and others, may compress or invade the portal venous system during tumor growth, leading to portal hypertension. Additionally, the tumor consumes body resources, contributing to hypoalbuminemia. These combined effects promote the development of hepatic ascites. Symptoms may include an upper abdominal mass and hepatic region pain. Patients are advised to receive treatment under medical guidance with medications such as sorafenib tosylate tablets, sunitinib malate capsules, or bevacizumab injection.

Patients are encouraged to maintain healthy lifestyle habits, ensure adequate intake of essential nutrients, and avoid strenuous physical activity to support recovery.

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What does it mean to have ascites in the late stage of liver cirrhosis, and what should be done?

In general, late-stage cirrhosis with ascites may be caused by factors such as aging, malnutrition, viral hepatitis, alcoholic liver disease, and cardiogenic cirrhosis. It is important to maintain a balanced diet in daily life, increase intake of high-quality proteins such as lean meats, fish, and eggs, and avoid consuming spicy, greasy, or irritating foods.

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Can ascites due to liver disease be cured?

In general, whether hepatic ascites can be cured depends on its underlying cause. Hepatic ascites mainly refers to fluid accumulation in the abdominal cavity caused by liver diseases, with common causes including hepatitis, cirrhosis, and liver tumors. Ascites due to hepatitis may be curable; early-stage cirrhosis may also be curable, while advanced-stage cirrhosis is often incurable; ascites caused by liver tumors is usually not curable.

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Can ascites be drained in patients with hepatic ascites?

Whether ascites in liver disease can be drained depends on the specific situation. If the amount of ascites is large, drainage is generally possible; however, if the volume is small, paracentesis is not recommended. Patients experiencing discomfort should seek medical attention promptly and receive treatment under a doctor's guidance. During treatment, patients should follow a low-salt diet, avoid high-salt foods such as preserved meats and sausages, and ensure adequate rest.

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What is hepatic ascites, and can it be cured?

Under normal circumstances, hepatic ascites may be caused by excessive alcohol consumption, hepatitis, portal vein thrombosis, cirrhosis, liver cancer, and other conditions. Generally speaking, it can be treated effectively. If symptoms of physical discomfort occur, timely medical attention is recommended. In daily life, patients with hepatic ascites should seek medical care as early as possible and undergo comprehensive examinations and treatment under the guidance of a physician. At the same time, patients should also maintain a positive mindset.