What should I do if I feel uncomfortable because of ascites in my stomach?

Ascites means there are many pages in the abdominal cavity. In fact, sometimes some diseases cannot be understood according to their literal meaning. Ascites is actually caused by excessive fluid accumulation in the abdominal cavity. In fact, it is a human physical characteristic and not a disease. The most important thing for abdominal ascites is to go to the hospital to find out the specific cause and then treat it. Now let me show you what ascites is.

1. Understanding of ascites

Ascites, the excessive accumulation of free fluid in the abdominal cavity, is a physical sign rather than a disease. Any pathological condition that causes the amount of fluid in the abdominal cavity to exceed 200 ml is called ascites. There are many causes of ascites, the more common ones include cardiovascular disease, liver disease, peritoneal disease, kidney disease, nutritional disorders, peritoneal metastasis of malignant tumors, ovarian tumors, connective tissue diseases, etc.

2. Examination of ascites

Routine abdominal puncture and the extraction of ascitic fluid for laboratory examination can determine whether it is exudate or transudate, and macroscopic examination can determine whether it is serous, bloody, purulent or chylous. Ultrasound examination may show a small amount of ascites or an abdominal mass. X-ray, radionuclide scanning, angiography, CT, MRI and other examinations have great diagnostic value for diseases that cause ascites.

3. Treatment principles of ascites

1. Cause and treatment of ascites

The treatment plan should be formulated according to the primary disease. For example, tuberculous peritonitis should be treated with anti-tuberculosis treatment, cirrhosis should be treated with liver protection treatment, nephrotic syndrome should be treated with hemodialysis, and tumor ascites should be treated with surgery, intraperitoneal perfusion of chemotherapy drugs, radiotherapy or interventional treatment according to the condition.

2. Limit sodium and supplement potassium

Limit sodium intake, increase water and sodium excretion, and pay attention to potassium supplementation when using diuretics.

3. Diuretic application

When urinary sodium excretion decreases, diuretics are added. Oral spironolactone accelerates diuresis, and the use of diuretics in this ratio can usually maintain normal serum potassium. Monitor body weight (weight loss < 0.5 kg/d), electrolytes, and renal function, and avoid NSAIDs.

4. Prevent and treat hypoproteinemia

Increase plasma colloidal osmotic pressure. Regularly infuse plasma, albumin or fresh blood to increase the concentration of plasma albumin and plasma osmotic pressure, promote the absorption of ascites, and increase renal blood flow and glomerular filtration rate.

5. A large amount of anti-ascites

For refractory ascites and tense ascites, large-volume paracentesis three times a week (4-6 L each time) and simultaneous intravenous infusion of 6-8 g/L (30-40 g) of albumin can quickly relieve the patient's symptoms. This is also applicable to patients with cirrhosis. After draining the ascites, use a belly bandage.

6. Surgical treatment

For patients with refractory ascites and poor liver function, transjugular intrahepatic portosystemic shunt (TIPS) can be used, which can significantly relieve ascites in the short term.