Ascites (pronounced ‘ah-sigh-tees’) is fluid that has built-up inside your abdomen (tummy). There are treatments for ascites that may help you feel better. Having the fluid drained off is one type of treatment − but it's not the right treatment for everyone.
What is ascites?
Ascites is when fluid builds-up in your abdomen (tummy). If it gets to a certain level it can be uncomfortable, make you feel sick or breathless, or it may affect your mobility.
Causes of ascites
Ascites can be caused by different conditions including some types of cancer. But there are other illnesses that can cause it too.
Conditions that may cause ascites include:
- cancers such as ovarian, breast, bowel, pancreas and lung cancer
- cancer that started in an unknown place
- cancer that has spread to the lining of the abdomen or liver
- diseases of the liver
- heart failure
- tuberculosis (TB).
Tests for ascites
Your doctor might arrange some tests to find out if you have ascites. This could include a blood test, an ultrasound scan or a CT scan.
They may also take a sample of fluid from your abdomen. This is done with a small needle (about the same size that is used to take blood). This allows them to work out the best way to treat your ascites.
Treatment of ascites
Treatment of ascites aims to stop the fluid building up − or to take away fluid that has collected.
Treatments for ascites include:
- treating the cause of ascites, if possible
- medication to manage any pain, nausea or vomiting
- medication to reduce the fluid – sometimes called water or diuretic tablets
- inserting a tube into your abdomen to drain the fluid (this is called ascitic drainage or paracentesis).
Ascitic drainage (also called paracentesis for ascites)
Draining of ascites is a way to remove the fluid from your abdomen. You may also hear it called paracentesis. It's not the right treatment for all cases of ascites.
A healthcare professional will explain to you how it works. Let them know if you have any worries about it or have any questions. They will ask you to complete a consent form before they go ahead. This is because although ascitic drainage is a simple and safe procedure, there can be complications or side effects for some people (see Ascitic drainage risks below).
What does ascitic drainage involve?
You will usually have ascitic drainage at a hospice or hospital. You might have a blood test a few days before. You will also need to have an ultrasound scan of your abdomen to decide the best place to have the drain.
Diagram showing how ascitic drainage happens.
While you lie back on a bed, the doctor will feel your abdomen and inject a local anaesthetic. The local anaesthetic numbs the area where the drainage needle goes in. They may also do an ultrasound scan of your abdomen during the procedure.
They will then use a needle to pass the drain (a thin plastic tube) through your skin and into your abdomen. The drain is connected to a drainage bag or collection container that will collect the fluid. It will stay in for around 6-8 hours. You may want to bring something to read or listen to that can help to pass the time. While it's happening, you will have your blood pressure, heart rate and temperature checked regularly.
Usually 4 to 6 litres of fluid is drained off, but it may be more. Let the doctor or nurse know if you feel uncomfortable or unwell at any time.
You might need to have a drip for fluids, or a protein (albumin) infusion when the drain is in. This will depend on the cause of your ascites.
When ascitic drainage is finished
Once the doctor or nurse has taken the drain out, you will stay in the hospice or hospital for a while so that they can check that you're well enough to go home. You might be able to go home that day, or you might stay in overnight. This could be because the drainage takes longer than expected. Or it could be because of how you're feeling and if the doctor or nurse has any concerns.
Ascitic drainage risks
Ascitic drainage is a simple and safe procedure. You will have a thorough assessment before you have it to reduce the risk of any complications. But there can be complications and side effects for some people.
Side effects or complications include:
- increased tiredness during, or in the days after, the procedure
- discomfort while it's happening
- leakage of fluid from where the drain had been
- low blood pressure
- bleeding inside your abdomen (tummy)
- a hole in the bowel when the drain goes in (called perforation of the bowel) infection.
Your healthcare professionals will look after you during the drainage so that any of these things can be treated quickly. If you have any worries, speak to the doctor or nurse supporting you.
Does ascites come and go?
Sometimes, ascites builds up again in the weeks and months after an ascitic drainage. Your doctor might recommend water (diuretic) tablets to try to help the fluid stay away for longer. Some people may need to have another ascitic drainage.
If the ascites keeps coming back, you might have a permanent, or long-term, drain put in. You may hear it called a PleurX drain or catheter. This procedure will usually be done in hospital. A specialist nurse or doctor can talk to you about what would be the best option for you.
Getting support
If you would like to speak to someone about how you're feeling or for practical information you can contact the Marie Curie Support Line for free on 0800 090 2309. Or you can email us at support@mariecurie.org.uk.
If you think it would help to speak to one of our Information and Support Nurses, please let the Support Line know and they can arrange a call back for you.