Ascites / water in the abdomen

Clearly explained!

SHORT & SHORT

Most common causes of ascites

Cancer (tumor, malignoma)
Liver cirrhosis
Heart (heart failure, cardiac insufficiency)

Symptoms of ascites

Feeling of pressure in the stomach
Shortness of breath (dyspnea)
Pain in the abdomen
Digestive difficulties
Weight gain and increase in abdominal girth
Gait instability (swaying)
Exhaustion (fatigue)

Synonyms for ascites

Abdominal fluid
Water belly
Dropsy

Treatment of ascites

Puncture
Implantable pump system
Peritoneal catheter for drainage

The peritoneum (peritoneum)

The peritoneum is a thin skin in the abdominal cavity (abdomen). The peritoneum parentale lies on the anterior and posterior abdominal wall from the inside and the peritoneum viscerale covers the organs lying within the abdominal cavity (intra-abdominal). In a healthy person, the peritoneal cavity contains a few milliliters of fluid so that the organs can move without pain.

The peritoneum has two functions. Firstly, it protects the organs in the abdominal cavity. Secondly, by producing a fluid, it ensures the necessary mobility of the organs.

Illustration des Bauchs mit Peritoneum (Bauchfell)

What is ascites?

Ascites (abdominal fluid) is the accumulation of excessive fluid in the abdominal cavity. This visibly increases the abdominal circumference and can lead to feelings of pressure, pain, breathing problems and loss of appetite.

What causes ascites?

The underlying diseases that trigger the symptoms of ascites can have very different causes. The most common causes include malignancies such as ovarian carcinoma (ovarian cancer), pancreatic carcinoma (pancreatic cancer) or liver carcinoma. Other underlying diseases such as advanced liver cirrhosis or cardiac insufficiency can also lead to excessive accumulation of water in the abdominal cavity.

Illustration des Bauchs bei Aszites

“

For me, the drainage system is a piece of quality of life that I have regained. I can connect the bag directly without much effort and remove it again after drainage.

– Mrs. B. T. / Ascites –

More patient experiences

How is an effusion treated?

It is important to treat the underlying disease. The appropriate treatment for ascites depends on the type of effusion. If, for example, a lot of fluid continues to accumulate in the abdomen despite optimal drug therapy, this is known as refractory, recurrent ascites.

In addition to treating the underlying disease, ascites can be treated with the following therapies, depending on the cause:

Ascites puncture

Refractory ascites can be treated with repeated ascites punctures (paracentesis) to reduce the symptoms caused by the effusion, such as shortness of breath, fatigue, nausea, loss of appetite, vomiting and pain.

An ascites puncture is an outpatient procedure that must be performed under local anesthesia in a hospital emergency room or outpatient clinic. The accumulated fluid is removed via a cannula using a syringe.

The following definitive therapies can be considered in order to spare the affected persons the time-consuming, recurring punctures in hospital or clinic.

Implantable pump

The implantable pump is inserted in a complex surgical procedure under general anesthesia and the fluid is then continuously pumped into the bladder via a catheter. The fluid is then excreted with the urine. If this method is considered, then mainly in the case of portal hypertensive ascites with the underlying disease of liver cirrhosis.

Transjugular intrahepatic portosystemic shunt (TIPS)

The catheter (shunt) is usually implanted by an interventional radiologist. This catheter then connects a hepatic vein (internal jugular vein) directly to a branch of the portal vein. The portal vein pressure is reduced by this measure, resulting in less ascites. However, it should be noted that the blood flow to the liver is then reduced. This method is only suitable for portal hypertensive ascites, e.g. in the case of underlying liver cirrhosis or oesophageal variceal bleeding.

Peritoneal indwelling catheter

A thin, soft silicone catheter is implanted once, under local anesthesia, on an outpatient basis or in conjunction with a short inpatient stay. This enables the person concerned to drain the fluid temporarily and independently at home as required. Repeated visits to the hospital, clinic or doctor are no longer necessary after implantation and the symptoms caused by fluid accumulation can be better controlled. Mobility and quality of life are improved and there is more time for the family.

Further advantages of an indwelling catheter are shorter hospital stays, a reduced risk of infection and a very low complication rate (proven by scientific studies).

Find out more about the catheter

Drainage eines Aszites mit einem drainova® Soft-Vakuumreservoir

The advantages of ewimed drainage systems at a glance:

Efficient symptom control
Fewer hospital stays
No recurring, painful puncture

Safe, simple and time-saving drainage at home
Information on the drainage procedure performed by a fenik employee at your home
Improving quality of life and mobility

Delivery of the sterile drainage sets prescribed by the doctor by post to your home
Reducing the risk of infection

The ewimed service and care concept