Ascites (ay-SITE-eez) is when too much fluid builds up in your abdomen (belly). This condition often happens in people who have cirrhosis (scarring) of the liver.
A sheet of tissue called the peritoneum covers the abdominal organs, including the stomach, bowels, liver and kidneys. The peritoneum has two layers. Ascites happens when fluid builds up between the two layers.
Having a condition that causes cirrhosis puts you at greater risk for developing ascites. These conditions include:
Non-alcohol associated fatty liver disease.
Hepatitis B.
Hepatitis C.
Alcohol use disorder.
Autoimmune hepatitis.
Genetic liver diseases like hemochromatosis, Wilson disease and alpha-1-antitrypsin deficiency.
Other conditions that can lead to ascites include:
Congestive heart failure.
Kidney failure.
Fluid buildup rarely occurs in otherwise healthy people. It develops as a result of other diseases, most often cirrhosis. Ascites is the most common complication of cirrhosis. About half of people with decompensated cirrhosis will develop ascites. Cirrhosis accounts for about 80% of the cases of ascites.
Cirrhosis is the most common cause of ascites. Other conditions that can cause it include heart failure, kidney failure, infection or cancer.
When you have cirrhosis, your liver doesn’t function as it should. The decrease in liver function combines with portal hypertension to cause ascites symptoms. Portal hypertension is high pressure in the portal vein that delivers blood to your liver. The high pressure causes fluid to leak out of your veins into your belly and collect there.
The main symptoms of ascites are a large belly and rapid weight gain.
Other symptoms include:
Swelling in your ankles.
Shortness of breath.
Digestive issues, such as bloating, abdominal pain, loss of appetite, indigestion and constipation.
Back pain.
Difficulty sitting.
Fatigue.
Your healthcare provider performs a physical exam and asks you about your symptoms and medical history. You will likely need blood tests or imaging tests as well.