What are the types of ascites?
Traditionally, ascites is divided into 2 types; transudative or exudative.
This classification is based on the amount of protein found in the fluid.
A more useful system has been developed based on the
amount of albumin in the ascitic fluid compared to the serum albumin (albumin
measured in the blood). This is called the Serum Ascites Albumin Gradient or
SAAG.
- Ascites related to portal hypertension (cirrhosis, congestive
heart failure, Budd-Chiari) is generally greater than 1.1.
- Ascites caused by other reasons (malignant,
pancreatitis) is lower than 1.1.
What are the risk factors for ascites?
The most common cause of ascites is cirrhosis of the
liver. Many of the risk factors for developing ascites and cirrhosis are
similar. The most common risk factors include hepatitis B, hepatitis C, and long standing alcohol abuse. Other
potential risk factors are related to the other underlying conditions, such as
congestive heart failure, malignancy, and kidney disease.
What are the symptoms of ascites?
There may be no symptoms associated with ascites
especially if it is mild (usually less than about 100 – 400 ml in adults). As
more fluid accumulates, increased abdominal girth and size are commonly seen.
Abdominal pain, discomfort, and bloating are also frequently seen as ascites
becomes larger. Shortness of breath can also happen with large ascites due to
increased pressure on the diaphragm and the migration of the fluid across the
diaphragm causing pleural effusions (fluid around the lungs). A cosmetically
disfiguring large belly, due to ascites, is also a common concern of some patients.
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