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Ascites in liver cirrhosis

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What is ascites in liver cirrhosis?

Ascites in liver cirrhosis is the accumulation of fluid in the abdominal cavity and increase its volume, occurring due to blood stasis and increased pressure in the venous system. Ascites is not an independent disease but a complication of cirrhosis, which greatly aggravate the disease and worsens the prognosis for recovery.

Due to the fact that the underlying disease, causing ascites, has a wide distribution and occupies a leading position among causes of death from diseases of the gastrointestinal tract, and the ascites in liver cirrhosis is not uncommon. Statistics indicates that the ascites will occur 50% of patients within 10 years after they were diagnosed with "cirrhosis".

How I live with ascites in liver cirrhosis?

It should be understood that the ascites cause the death of a person is extremely rare. To give forecast for survival, it is necessary to have information on the process underlying disease.

However, there are the following data:

  • More than 10 years and can accommodate patients with a compensated form of cirrhosis and ascites, since the functions of the authority remain intact;
  • Less than 20% of patients live longer than five years with ascites in decompensated form of cirrhosis without a liver transplant surgery;
  • More than half of patients die within a year if they have resistant to treatment (refractory) form of ascites, with a tendency to relapse.

In addition, influenced by the lifestyle of the patient, whether he receives adequate treatment in a timely manner was made by puncture of the abdominal wall, whether he is taking diuretics for correctly drawn diagram, etc. In some cases, this helps patients to live 10 years or more. However, most often ascites is considered to be an adverse complication of cirrhosis and is the leading cause of mortality 50% of patients within two years.


Causes of ascites in liver cirrhosis

By itself, the liver cirrhosis is a major cause of development of ascites.

This is due to the following factors:

  • When illness occursthe death of hepatocytes (liver cells) that triggers excess recovery of the body tissues, resulting in the formation of regeneration nodes consisting of proliferating hepatocytes. The structure of these nodes differs from the structure of the normal liver tissue that leads to disruption of blood circulation and clamping of the portal vein. This leads to the accumulation of fluid in the abdominal cavity;
  • Another reason for the development of complications – the replacement of hepatocytes by fibrous tissue. The more extensive the process, the lower the functional ability of the liver. This provokes the development of its insufficiency and a decrease in the number of blood proteins. As a result of the fall in oncotic pressure of plasma and its connection to the abdominal cavity of the vessel;
  • Due to the loss of plasma total circulating blood volume is reduced. The body reacts to this violation by launching a number of processes, including increased release of the hormone aldosterone. He contributes to the retention of liquids and sodium. As a result, increased hydrostatic pressure and worsening of ascites;
  • With all this heart is under additional load, which causes the development of heart failure. There is a further increase in the volume of ascitic fluid.

Symptoms of ascites in liver cirrhosis

If in the abdomen accumulate small volumes of liquid, it does not cause anxiety in the patient.

However, as the progression of the disease a person starts to suffer from:

  • The increase of the abdomen volume. Within a few days it can become very large. The skin on it is smooth, sometimes there are pink stripes, there are dilated veins. When the patient standing, the abdomen a few droops down, and when lying, the side walls protrude, forming a "frog's belly";
  • The patient complains of discomfort and pain in the abdomen, gaining weight;
  • Symptom fluctuations or fluctuations in the abdominal cavity due to filling it with a liquid;

  • Violations of the respiratory system as a result of fluid pressure on diaphragm and reduced lung volume. This is manifested in the appearance of shortness of breath, rapid breathing, frustration oxygen. Especially keenly observed this symptom in a horizontal position. So the person tries to take a sitting or standing posture, with emphasis on the rise. Among other signs of respiratory distress may be noted bluish discoloration of the lips, cough.;

  • Disorders of the digestion. Pressure on the stomach leads to more rapid saturation during meals, and smaller amounts of food, causes a feeling of heaviness, heartburn, belching. Sometimes there is vomiting of undigested food, what happens when compression of a place of transition of food in the intestines. On the part of the intestine may occur intestinal obstruction, constipation, diarrhea, vomiting, intestinal contents or bile;

  • Violations of the bladder, resulting in frequent urination, cystitis and pyelonephritis;

  • Swelling in the lower extremities, due to obstructed lymph drainage;

  • The navel is stuck out forward, often the patient has a umbilical hernia.

The first symptoms can be seen when the amount of liquid is exceeded 1 liter. The maximum content of it in the abdomen when ascites can reach 25 liters. In addition, before the first symptoms of ascites, the patient would be bothered by the signs of the underlying disease, i.e. cirrhosis. Among them, increased weakness and fatigue, pain localized in the right hypochondrium.

How to treat ascites in liver cirrhosis

After confirmation of the diagnosis, the doctors begin treatment of ascites. But as it is a consequence of liver disease, the therapy primarily aimed at addressing the cirrhosis.

Drug treatment is reduced to accept the following groups of drugs:

  • Synthetic hepatoprotectors, for example ursodeoxycholic acid, which protects the body from the destructive action of bile acids, lowers cholesterol, improves blood flow and prevents destruction of hepatocytes;

  • Hepatoprotectors of plant origin, for example, Kars and Allohol, which give a choleretic effect, promote intestinal motility;
  • Phospholipids essential, for example, Essentiale and Phosphogliv to restore the damaged phospholipids normalize fat and carbohydrate metabolism, relieve toxicity, stimulate the growth of hepatocytes;
  • Hepatoprotective amino acids, e.g. Ornithine and Methionine. Theyhave a protective effect, stimulates metabolic processes in the body;

  • Antiviral agents, including Pegasys (increases immune forces of an organism struggling with hepatitis C and b), Ribavirin (helps in the fight against the hepatitis C virus), Adefovir (destroys the cells of hepatitis b);

  • Steroid anti-inflammatory drugs, such as Prednisone. It is recommended to accept with cirrhosis caused by autoimmune processes;
  • Albumin, belonging to the group of protein drugs, which contributes to the normalization of colloidal pressure, fills the shortage of protein in the blood;
  • Diuretics different groups, for example, Aldactone, Spirits, Lasix, Diakarb and other. They are, first and foremost, the prevention of ascites.

In addition, the patient must adhere to a diet. Doctors recommend the table at number five. The amount of fluid intake should be reduced to 1.5 liters per day.

The patient must stay in bed, as in horizontal position improves the filtration of blood thanks to the hard work of the kidneys.

If conservative therapy has not had the desired effect, the patient is assigned a surgical intervention. It is called "laparocentesis" when using a special needle from the peritoneal cavity displayed a surplus of liquid. As a rule, doctors do not remove more than 5 liters at a time, as there is a risk of development of collaptoid state. Such manipulations can significantly reduce pain and improve the health of the patient, however, there is a high risk of complications.

In the most severe cases require transplantation of the damaged organ.

Topic: Treatment of liver cirrhosis folk remedies


Diet in liver cirrhosis with ascites

The diet is to limit not only water, but also salt. Under the ban, fresh products, fried and smoked foods, sweets, canned food, mushrooms, fatty meats, margarine, mayonnaise, coffee and of course alcohol.

In this patient, allowed to oat, buckwheat and rice porridge, fresh vegetables, yogurt and cheese, lean meat, broth hips, rye bread, egg white and some other products.

Sample menu

Sample menu of a patient with ascites might look like the following:

  • For Breakfast you can eat an egg white omelet, a slice of rye bread, and drink a decoction of rose hips;
  • As the first bite allowed cookies from nesdobnoe test and weak tea with milk;

  • At lunch you can make a salad of cucumbers, cabbage and green peas with olive oil, soup pasta and Turkey balls made of hake, cherry jelly;

  • As a second snack is allowed to eat the cracker with honey and tea with lemon;

  • For dinner you can cook rice soup and Turkey meatballs with mashed potatoes, drink compote of dried fruits;
  • To end your day with a small Cup of yogurt.

It is important to calculate the volume of liquid so that during the day it did not exceed 1.5 liters, including soups and other liquid dishes. Diet may vary somewhat, depending on the severity of the underlying disease and degree of ascites. Read more what you can eat and what is not cirrhosis of the liver?