ascites---types and risks and symptoms

What are the types of ascites?

Traditionally, ascites is divided into 2types; transudative or exudative. This classification is based on the amount ofprotein found in the fluid.

A more useful system has been developedbased on the amount of albumin in the ascitic fluid compared to the serumalbumin (albumin measured in the blood). This is called the Serum AscitesAlbumin Gradient or SAAG.四川省第四人民医院消化内科常玉英

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 iscirrhosis of the liver. Many of the risk factors for developing ascites andcirrhosis are similar. The most common risk factors include hepatitis B,hepatitis C, and long standing alcohol abuse. Other potential risk factors arerelated 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 withascites especially if it is mild (usually less than about 100 – 400 ml inadults).

As more fluid accumulates, increased abdominal girth and size arecommonly seen. Abdominal pain, discomfort, and bloating are also frequentlyseen as ascites becomes larger. Shortness of breath can also happen with largeascites due to increased pressure on the diaphragm and the migration of thefluid across the diaphragm causing pleural effusions (fluid around the lungs).A cosmetically disfiguring large belly, due to ascites, is also a commonconcern of some patients.