What Causes Ascites?


When fluid builds up inside the abdomen, it is known as ascites. Ascites usually occurs when the liver stops working properly. Fluid fills the space between the lining of the abdomen and the organs.

People with cirrhotic ascites have a two-year survival rate of approximately 50 percent. If you experience ascites symptoms, talk to your doctor as soon as possible.

Ascites Causes and Risk Factors

Ascites is most often caused by liver scarring. This increases pressure inside the liver’s blood vessels. The increased pressure can force fluid into the abdominal cavity, causing ascites.

Liver damage is the single biggest risk factor for ascites. Some causes of liver damage include:

  • cirrhosis
  • hepatitis B or C
  • a history of alcohol use 

Other conditions that may increase your risk of ascites include:

  • ovarian, pancreatic, liver, or endometrial cancer
  • heart or kidney failure
  • pancreatitis
  • tuberculosis
  • hypothyroidism

Symptoms of Ascites

Symptoms of ascites can appear either slowly or suddenly, depending on the cause of the fluid buildup. 

Symptoms don’t always signal an emergency, but you should talk to your doctor if you experience the following:

  • sudden weight gain
  • a distended (swollen) abdomen
  • difficulty breathing when lying down
  • diminished appetite
  • abdominal pain
  • bloating
  • nausea and vomiting
  • heartburn

Keep in mind that ascites symptoms may be caused by other conditions.

Diagnosing Ascites

Diagnosing ascites takes multiple steps. Your doctor will first check for swelling in your abdomen. Then they’ll probably use imaging or another testing method to look for fluid, including:

  • ultrasound
  • CT scan
  • MRI
  • blood tests
  • laparoscopy
  • angiography

Treatment for Ascites

Treatment for ascites depends on what’s causing your condition.


Diuretics are commonly used to treat this condition. They increase the amount of salt and water leaving your body to reduce pressure within the veins around the liver. 

While you’re on diuretics, your doctor may want to monitor your blood chemistry. You’ll probably need to reduce your alcohol use and salt intake.


This procedure uses a thin, long needle to remove the excess fluid. It’s inserted through the skin and into the abdominal cavity. There is risk of infection, so people who undergo paracentesis may be prescribed antibiotics.

This treatment is used most commonly when the ascites is severe or recurrent. Diuretics don’t work as well in such late-stage cases.


In extreme cases, a permanent tube called a shunt is implanted in the body. It reroutes blood flow around the liver.

Your doctor may recommend liver transplant if ascites does not respond to treatment. This is generally used for end-stage liver disease.

Preventing Ascites

Ascites can’t be prevented. However, you can lower your risk by protecting your liver with these healthy habits:

  • Drink alcohol in moderation.This can help prevent cirrhosis (scarring of the liver).
  • Get vaccinated for hepatitis B.
  • Practice safe sex. Hepatitis can be spread sexually.
  • Avoid intravenous drug use. Hepatitis can be transmitted through shared needles.
  • Be aware of the potential side effects of your medications. If liver damage is a risk, talk to your doctor about whether your liver function should be tested.