There is a “sac” in your abdomen called peritoneum. This sac houses all of your abdominal organs. It forms a cavity (peritoneal cavity), which usually contains a minimal amount of (peritoneal) fluid. The volume of peritoneal fluid in a woman usually varies with her menstrual cycle. It could be as much as 20 ml sometimes, and at other times, could be less than 1 ounce. When fluid accumulates in the peritoneal cavity for any reason, the volume of fluid there becomes abnormally high. This condition is called “ascites”. So what are the symptoms of ascites in a woman? How would you know that the high volume of peritoneal fluid is not because of your monthly cycle? Are there tell-tale signs that you may have ascites? We will talk about these and many more in this article.
Ascites is not a stand-alone condition. It usually indicates that there is an underlying disease. Any disease that could lead to fluid accumulation in the peritoneal cavity can cause ascites. Meanwhile, different diseases cause fluid accumulation for different reasons. Some conditions cause fluid to leak directly into the peritoneum, while some cause water retention with sodium. Liver disease can also cause ascites due to disruption in the production of certain proteins.
What Can Cause Ascites?
Since ascites is not a stand-alone condition, the symptoms you would feel if you have ascites would depend on what caused it in the first place.
The causes of ascites are quite many, but we would start with the ‘multitasking’ liver. It does not matter what causes liver failure, if the liver is not functioning properly, it would not be able to produce enough protein.
What do proteins have to do with ascites? Proteins help to sustain the oncotic pressure that keeps fluid in your circulatory system. When oncotic pressure drops, large amounts of fluids leave your circulatory system and lodge in body cavities such as the peritoneal cavity. This, in turn, causes ascites, edema, and a host of other symptoms.
Liver conditions that can cause ascites are as follows:
- Cirrhosis: A condition where scar tissues replace healthy tissues in the liver due to injury.
- Liver failure (Acute): Sudden injury to the liver cells caused by the side effects of drugs or as a result of substance abuse can also cause ascites.
- Budd-Chiari syndrome – When hepatic veins are blocked so that they cannot drain the liver. This can also cause ascites.
- Cancer: It could either be primary liver cancer or secondary due to metastasis. But once cancer spreads to the liver and damages it, ascites may develop.
Aside from these conditions, many other conditions may cause ascites. These conditions lead to accumulation of fluid in the peritoneum for diverse reasons. They are as follows:
- Heart failure
- Nephrotic syndrome
- Pancreatic disorders, including pancreatitis (both acute and chronic) and pancreatic cancer.
- Direct irritation on the peritoneum
- Diseases that affect the ovaries can also cause ascites. They include ovarian cancer and Meigs syndrome.
- Hypothyroidism (impairment in the function of the thyroid gland). This is quite uncommon. But if hypothyroidism is left untreated for a long time, it could cause ascites.
If you have any of the conditions we have mentioned above, you may have ascites. However, it would be accompanied by the typical symptoms of the underlying disease.
What Are The Symptoms of Ascites?
To identify the symptoms, you must know the difference between ascites that is caused by a liver problem and the ones caused by inflammation (which may be a complication of cancer). Ascites from a liver problem is usually almost painless, but if it is due to inflammation, there will be considerable pain.
Aside from pain, as the distinguishing factor, all other symptoms are usually similar. Firstly, the abdomen would swell to accommodate the buildup of fluid.
Accumulation of fluid in the abdomen causes it to be tense. That usually makes it easy to recognize. However, in some cases, the ascites may not be well pronounced initially. So it would be hard to detect.
By the time, the volume of fluid becomes so much, you may have a full feeling or experience heaviness in your abdomen. Abdominal swelling can also cause a few other symptoms.
For instance, a swollen abdomen may affect the function of the diaphragm in assisting with breathing. This can, in turn, shorten your breath.
These secondary symptoms of ascites are usually not the reason why people seek medical attention. Most times, symptoms of the underlying condition are the reasons why people go to the doctor.
So then, it is better to focus on the symptoms of the underlying condition, rather than the symptoms of ascites itself. For instance, aside from abdominal swelling, liver cirrhosis may also cause swelling in the legs.
Other symptoms that accompany ascites in cirrhosis include easy bruising, breast enlargement, and confusion – a complication of encephalopathy (brain disorder).
If the underlying condition is heart failure, you may also experience swelling in the legs, as well as shortness of breath, which worsens when you lie flat or with physical activity. You may also find that you wake up more often in the night with abnormal breathing.
Like we mentioned before, ascites due to cancer usually comes with pain. There would also be weight loss, fatigue, as well as abdominal distention.
Bacterial infection may also affect the peritoneum and cause inflammation. This causes fever and abdominal pain, alongside ascites.
Do You Need Medical Care Always?
Well, it may seem like you can manage some conditions at home. But then, the abdomen is a delicate region that contains many vital organs. So if you notice any abnormal swelling of your abdomen, you should immediately seek medical attention.
It does not matter what may have caused the swelling. So long as it is unexplainable, you should call the attention of your healthcare provider.
Even if you have confirmed ascites, other symptoms of ascites may point your attention to what the underlying condition is. And, that too needs proper treatment. If you experience, abdominal pain and fever, then you should know the fluid is probably infected already. That also requires prompt medical care.