What does it mean - fluid in the abdominal cavity? This is a common question. We will understand it in more detail.
Ascites is a secondary condition when exudate or transudate accumulates in the abdominal cavity. Symptoms of the disease manifest themselves in the form of an increase in the size of the patient’s abdomen, shortness of breath, pain, a feeling of heaviness, and other signs.
Abdominal dropsy
In medicine, the accumulation of fluid in the abdominal cavity is also called abdominal dropsy, which can accompany many urological, oncological, gynecological, cardiological, gastroenterological, lymphological and other diseases. Ascites is not an independent disease. It acts as an indicator of any severe defect in the human body. Ascites of the peritoneal cavity does not appear with mild diseases, but always accompanies pathologies that threaten the patient's life.
What does the statistics say?
Statistical information indicates that fluid in the abdominal cavity is formed mainly due to liver diseases (more than 70% of patients). Tumors that affect internal organs cause pathology in 10% of situations, and the cause of 5% is heart failure and other diseases. In young patients, ascites predominantly signals kidney disease.
It was revealed that the largest volume of fluid that accumulates in the patient in the abdominal cavity can be equal to twenty-five liters.
What causes ascites?
Fluid in the abdominal cavity occurs due to various reasons, which in all cases are caused by a significant violation in the human body. The abdominal cavity is an enclosed space where no excess fluid should appear. This place exists for the placement of internal organs - it is here that the liver, spleen, stomach, part of the intestine, gall bladder and pancreas are located.
The abdominal cavity is lined with two layers: the inner, surrounding organs and adjacent to them, and the outer, attached to the wall of the abdomen. Normally, there is always a small volume of fluid between them, which is the result of the functioning of the lymphatic and blood vessels that are in the peritoneal cavity. However, this liquid does not accumulate, because almost immediately after the discharge it is absorbed by the lymphatic capillaries. The small part that remains is required for free movement in the abdominal cavity of the intestinal loops and internal organs so that they do not stick to each other.
In case of violations of the resorptive, excretory and barrier functions, the exudate is no longer able to be absorbed normally, it accumulates in the abdomen, which results in ascites.
The causes of fluid in the abdominal cavity in women are presented below.
Perhaps the most common cause of fluid in small quantities is ovulation. In women of reproductive age, it occurs monthly. Torn, the follicle pours its contents into the abdominal cavity. Such water dissolves on its own, without posing a threat to health.
In addition, the causes of water inside the abdomen in women can be pathological processes requiring urgent treatment:
- Very often, fluid in the abdominal cavity in women is formed due to inflammatory processes of the reproductive system. For example, inflammation of the ovary, even its rupture. This condition is accompanied by sharp pain, it can not go unnoticed.
- Ectopic pregnancy. The embryo must attach to the wall of the uterus, and attaches to the wall of the fallopian tube. As it grows, the pipe does not withstand and bursts. Internal bleeding causes fluid to accumulate.
- Other internal bleeding, for example, due to trauma, after surgery, cesarean section.
- Intraperitoneal tumors provoke the development of complications - ascites - the accumulation of large amounts of water inside the abdomen.
- Endometriosis is another cause of abdominal fluid in women. The special tissue lining the uterine cavity from the inside can grow uncontrollably, go beyond its borders. The disease is characteristic of women of reproductive age, often appears after previous infections of the reproductive system.
This pathology appears as a result of the influence of many factors.
Liver disease
These primarily include cirrhosis, Budd-Chiari syndrome and cancer. Cirrhosis can occur against the background of the use of toxic drugs, with hepatitis, alcoholism, steatosis and other signs, but hepatocytes do not die in all cases. As a result, normal liver cells are replaced by scar tissue, an increase in organ size occurs, the portal vein is pinched, and ascites occurs. In addition, the release of excess fluid is possible due to a decrease in the oncotic pressure indices, since the liver itself can no longer synthesize plasma proteins and albumin. The pathological process also exacerbates a whole list of reflex reactions that are triggered by the patient's body in response to liver failure. What else causes fluid to build up in the abdomen?
Heart disease
Such a pathology as ascites can occur due to heart failure, as well as due to constrictive pericarditis. The insufficiency of the main human organ can be the result of almost all diseases of the cardiological sphere. The mechanism of ascites in this case will be due to the fact that the hypertrophied muscle of the heart can no longer pump blood in the necessary volumes that accumulate in the blood vessels, including the vena cava inferior system. Due to the high pressure, in the end, the liquid will begin to leave the bloodstream, causing ascites. The mechanism of its development with pericarditis is almost the same, only in this situation there is inflammation of the outer heart membrane, and this, in turn, leads to the fact that the organ cannot normally be filled with blood. This further affects the activity of the vein system. In addition, there are other reasons for detecting free fluid in the abdominal cavity by ultrasound.
Kidney disease
Ascites can be affected by chronic renal failure due to various diseases (urolithiasis, glomerulonephritis, pyelonephritis, etc.). Renal diseases lead to an increase in blood pressure, along with fluid in the body, sodium is retained, and as a result, ascites occurs. A decrease in plasma oncotic pressure can also be observed with nephrotic syndrome.
Other reasons
The occurrence of ascites can be affected by a violation of the integrity of the lymphatic vessels, which occurs as a result of trauma or the presence of a tumor in the patient's body, which gives metastases, as well as due to infection by worms such as filaria (they lay their eggs in large lymphatic vessels).
- Numerous abdominal lesions can also cause ascites, including fungal, tuberculous and diffuse peritonitis, cancer of the colon, breast, endometrium, ovaries, stomach, peritoneal carcinosis. Mesothelioma and pseudomyxoma of the abdominal cavity also belong to this group. The causes of fluid in the abdominal cavity are very diverse.
- Polyserositis is a disease in which ascites manifests itself simultaneously with other signs, including pericarditis and pleurisy.
- Systemic diseases can also lead to accumulation of fluid in the peritoneum. These include lupus erythematosus, rheumatoid arthritis, rheumatism, etc.
- In newborns, ascites is also found, it mainly occurs due to a hemolytic disease of the fetus, which develops in the presence of an immunological conflict inside the womb, when the blood of the mother and child are not combined for some antigens.
- Protein deficiency is one of the factors that predisposes to the appearance of ascites.
- Digestive diseases can cause excessive accumulation of fluid in the peritoneal cavity. It can be Crohn's disease, pancreatitis, chronic diarrhea. This also includes various processes that occur in the abdominal cavity and create obstacles to lymphatic outflow.
- Myxedema can lead to ascites. This disease is characterized by swelling of the mucous membranes and soft tissues, which indicates defects in the synthesis of triiodothyronine and thyroxine, that is, thyroid hormones.
- Serious flaws in the diet can also cause ascites in the peritoneal cavity. In this regard, strict diets and starvation are especially dangerous, which lead to a waste of protein reserves in the body, a decrease in its concentration in the blood, which results in a pronounced decrease in oncotic pressure. The liquid part of the blood eventually leaves the bloodstream, and ascites occurs.
- Ascites at an early age accompanies congenital nephrotic syndrome, malnutrition and exudative enteropathy.
Symptoms of the disease
The formation of fluid in the abdominal cavity is mainly characterized by gradual development, over many months, in connection with which most patients do not even focus on this for a very long time. People often think that they are simply gaining weight. It is really difficult to see ascites in the early stages: it is necessary that at least three liters of fluid are collected in the abdominal cavity. On ultrasound it is easiest to see.
Only after that the typical signs of this pathology are expressed: flatulence, heartburn, abdominal pain, belching, swelling of the lower extremities, difficulty breathing. As the amount of fluid increases, the stomach also becomes larger and larger, and it soon becomes difficult for the patient to even bend over. A spherical shape appears in the abdomen, dilated veins and stretch marks may appear. Sometimes with ascites, the fluid can squeeze the vessels under the liver, and the patient will eventually develop jaundice, accompanied by vomiting and nausea. However, for a final clarification of the picture of external signs is not enough - specialist advice is required.
How to get rid of free fluid in the abdominal cavity?
Therapeutic principles
In order to cure ascites, it is necessary to begin treatment of the main disease, which caused the accumulation of fluid. If ascites is caused by heart pathologies, drugs that dilate blood vessels, glycosides and diuretics are prescribed. For kidney disease, fluid intake and a low-salt diet are required. If there are disturbances in protein metabolism, a diet is prescribed in which the protein is contained in the optimal amount, as well as albumin transfusion. During cirrhosis, hepatoprotectors are prescribed. They are supplemented by symptomatic treatment: a diet with a low salt content (not more than two grams per day), in some cases - a diet without salt at all. In the presence of cirrhosis, fluid intake should also be limited, as well as taking diuretic drugs and potassium preparations. During therapy, the specialist monitors all changes in the patient's body, and especially his body weight. If the treatment methods used help, then weight loss should be about 500 grams per day.
Surgical intervention
In the absence of the expected effect of conservative methods, the patient requires the intervention of a surgeon. Often with ascites, fluid from the abdominal cavity is removed through gradual drainage (when its amount is significant). The doctor makes a small puncture in the peritoneal cavity and inserts laparocentesis (drainage tube) there. The alternative to such a painful method and associated with great risks to the state of health is the installation of permanent ports under the skin and catheters. Ascitic fluid is eventually removed gradually, as it accumulates. This approach greatly facilitates patients' lives, eliminating the need for new punctures and thereby reducing the likelihood of inflammation and organ damage.
In some cases, intrahepatic bypass surgery is necessary when the specialist creates a message between the portal and hepatic veins. In a particularly difficult situation, a liver transplant may be necessary.
Of course, this depends on the causes of fluid in the abdominal cavity in women and men.
Food
The patient's diet should be balanced, which will allow the body to provide all its needs for the necessary trace elements. It is very important to limit the use of salt and generally exclude it from its menu in its purest form.
The amount of fluid drunk also requires a downward adjustment. It is undesirable for patients to drink more than one liter per day (not including soups).
It is very important that the patient’s daily diet is enriched with products containing protein, but their quantity should also not be excessive. It is necessary to reduce fat intake, which is especially true for those people who have ascites as a result of pancreatitis.
What is the prognosis for abdominal fluid in men and women?
Therapeutic prognosis
The sooner ascites is diagnosed and the therapeutic course is started, the greater are the chances of a successful resolution of the situation. In the early stages, ascites is much easier to eliminate. However, there are a number of factors that adversely affect the effectiveness of treatment - diabetes, old age, oncological pathologies (especially liver cancer), hypotension, peritonitis and a reduced degree of albumin. A disease such as ascites is deadly to humans. In approximately half of all cases, in the absence of the effectiveness of diuretics, ascites gets a tragic outcome. Especially dangerous is the free fluid in the abdominal cavity in cancer, since death can occur in 60% of all cases.
Alleged complications and the likelihood of relapse
It must be remembered that ascites in all situations negatively affects the course of the main disease, causing hernias, respiratory failure, intestinal obstruction, hydrothorax and a number of other complications. Even if ascites is cured, you need to carefully monitor your health, since there is a risk of relapse. That is why, after completing treatment, adhere to dietary principles in nutrition.
We examined the fluid in the abdominal cavity, what this means is now clear.