Ascites Cause Symptoms and Treatment
The first time I heard the word ascites, I had to google it. That was a few days after my diagnosis with end stage cirrhosis. A lot of new words were coming at me and this one is easy to remember because I know I was a SIGHT. Uh Sight Eeez is how it is pronounced. My big round belly was sticking out in front like that of a 7 months pregnant woman. My belly button was an outy. Ascites was the symptom that led to my MRI and how I discovered that I had Hepatitis C and end stage cirrhosis. That is one of the reasons it has taken me a while to write this blog. Post Traumatic Stress Disorder kicks in when I remember that day. Now that my ascites is under control, I am ready to talk about it. You may also be interested in a Low Sodium Shopping List or Varices article.
Let’s start by taking a look at ascites cause symptoms and treatment.
Definition – Ascites is when fluid is built up in the abdomen causing swelling. You may notice swelling in your feet and legs first, and then in your hands like I did. Within 48 hours of my feet swelling, I could not even put on my pants. The fluid filled my abdominal cavity until it was extremely uncomfortable. It really was similar to the stretching I felt during my pregnancy. But this time, I turned yellow.
Cause – Ascites is connected to high sodium levels that the kidney cannot process. It is also a result of portal hypertension. Honestly, that is the easiest way to describe it. Your low levels of protein albumin and high vein pressure together make your belly big. I really don’t understand exactly how it works. But with 1 kidney and portal hypertenion, I can tell you it is something I try to avoid. If you want more information, go to a health website like webmd or wikipedia.
Symptoms – The swelling becomes obvious as your stomach protrudes. In addition, you may feel a shortness of breath as the pressure from the fluid presses up against your diaphragm.
Treatment -There are 3 ways to treat ascites. They are preventative and also therapeutic.
Tap or Paracentesis – There are stages of treating ascites. Initially, if there is a lot of fluid built up, your doctor may perform paracentesis. It is commonly called a tap which I find funny cause they make a tap out of your stomach. This is done by inserting a tube into your abdomen. Gravity kind of does the work. No sedation is necessary.
I lay on the bed in the “tap room” chatting up the tech. He had done it for years and was very calming. I vaguely remember it because my little body was giving out. Fear was present for sure. I talk a lot when I’m scared and chatted the whole time. The tech reassured me and let me watch the fluid flow into the bottle. He said that it can be cloudy or milky in color. Sometimes blood may be mixed in. We caught it fast enough that mine was pretty clear!
Medications are also used to prevent more ascites from building up. A diuretic can be taken. It will send you running to the bathroom to get rid of excess fluid. Lasix, which is also called Furosemide is usually a first line of defense. In addition, you may take Spironolactone, which is also called Aldactone. The last one is great because it keeps your potassium levels in balance. It is referred to as a potassium sparing diuretic. I took them BOTH from the start. These powerful drugs are life savers when taken according to doctor’s orders. They did have side effects, the most obvious being that I was up and down all night going to the potty.
Spironolactone can also create larger breasts. Don’t ask me why or how. I can just tell you that it happened. Maybe a good side effect, right? For men – a friend of mine hated it for this reason. He got what he called Man Boobs. Don’t get scared. He was on high doses just before his transplant. A regular dose shouldn’t leave you looking like Dolly Parton, guys.
Low Sodium Diet – I truly believe this is one of the most important things that helped save my life. I was told that 2,000 mg of sodium was my daily maximum. I was so dad gummed scared that I went down to 1,500 at first. Even today, I can eat all day and stay under that. If I want a slice of pizza or some chips, there is always a little room to splurge.
If you take the low sodium diet seriously, the ascites can be controlled much easier. It can also reduce the amount of diuretics that you have to take. For example: I was on 40 mg of Lasix twice a day and 100 mg of Spironolactone from August until January. By then I had the diet down and asked my doctor to reduce. We cut it in half and I stayed there for several months.
I felt pretty good when we got the diuretics down to ½ of the original dose. I stayed with that for several months and then was accepted to treat with the new protease inhibitors! My body was so full of meds that I even tapered down further and went off of diuretics for a few months during treatment. But by the 15th week, my feet, hands, and even face were swelling so I went back on them. I stayed on until a few months after treatment was completed. I think the meds were just hard on an end stage liver and caused my portal hypertension to get worse.
Occasionally, if I go overboard on sodium, I will take ½ pill. It’s only happened a few times. For now, I want to be in control of my sodium level and not make the meds do it for me. I do not know how long I can do that. I just have to be flexible and admit that we need medications with liver disease.
About the salt reduction – I really believe this is one of the most important things that helped save my life. I was told that 2,000 mg daily was my maximum . I took it to 1,500 mg from day one. Today, I rarely go higher than that. I was on the diuretics from August until January and by then, I asked my doctor if we could taper back. I had met with a nutritionist and was an expert on low sodium cooking. Gosh it was boring in those early days. I basically survived on oatmeal, toast, and eggs. I have gotten much better at cooking low sodium and liver loving since then. You can too!
Check out my liver loving diet on the drop down menu across the top of the home page or the Best Restaurants for Low Sodium blog.
I just finished the webinar on Hepatic Encephalopathy. I have this ready to go up and edited while we watched. So glad some of you joined in!! I posted part one, but there is so much more to write. I love you all. You can beat ascites with a Tap, diuretics, or low salt diet. We’ve soo got this dear best friends! xoxo Karen:)
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