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Treatment
It is, again, important to understand that the original disease is the main focus of treatment of ascites. In liver disease, the ideal treatment is liver transplantation to control the condition and improve life expectancy. In additional, medical and surgical treatment is used to improve the quality of life and alleviate symptoms.
Medical treatment includes:
- Restriction of salt intake, since most patients with ascites have increased level of sodium, which damages the kidney and worsens the condition. Most patients are advised not to eat any table salt.
- Diuretics: Diuretics are medications that act on the kidney, increasing the excretion of water and improving ascites. Furosemide (Lasix) is usually the first diuretic used.
- Since diuretics allow electrolytes to be excreted along with water, they can, in turn, cause electrolyte disturbances. Therefore, more advanced diuretics are used known as aquaretics, which allows water only to be excreted.
- Paracentesis: Paracentesis basically means the physical removal of ascitic fluid. It is done using a special catheter inserted into the abdominal cavity. It can be done repeatedly and large volumes can be removed at once.
- Albumin infusion: Albumin is normally formed by the liver and can be severely deficient in patients with ascites due to liver cirrhosis. In addition, its infusion following paracentesis has been shown to decrease the incidence of hepatorenal syndrome.
- Antibiotics: Antibiotics for bacterial peritonitis is an essential part of management. It is a life-threatening condition that needs urgent treatment.
