What does it mean - fluid in the abdominal cavity? This is a common question. Let's look into it in more detail.
Ascites is a secondary condition where exudate or transudate accumulates in the abdominal cavity. Symptoms of the disease are manifested 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 in mild diseases, but always accompanies pathologies that threaten the life of the patient.
What do the statistics say?
Statisticaldata indicate that fluid in the abdominal cavity is formed mainly due to liver diseases (more than 70% of patients). Tumors affecting the 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.
Revealed that the largest volume of fluid that accumulates in the patient's abdominal cavity can be equal to twenty-five liters.
What causes ascites?
Liquid in the abdominal cavity occurs due to various reasons, which in all cases are due to a significant violation in the human body. The abdominal cavity is a closed space where excess fluid should not appear. This place exists for the placement of internal organs - this is where the liver, spleen, stomach, part of the intestine, gallbladder and pancreas are located.
The abdominal cavity is lined with two layers: the inner, surrounding the organs and adjacent to them, and the outer, attached to the wall of the abdomen. Normally, there is always a small amount 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, since almost immediately after the release it is sucked up by the lymphatic capillaries. That insignificant part that remains is required for the free movement of intestinal loops and internal organs in the abdominal cavity so that theydid not stick to each other.
When the resorptive, excretory and barrier functions are disturbed, the exudate is no longer able to be absorbed normally, it accumulates in the abdomen, which eventually causes ascites.
Causes of fluid in the abdominal cavity in women are presented below.
Perhaps the most common reason for the appearance of a small amount of fluid is ovulation. In women of reproductive age, it occurs monthly. Bursting, the follicle pours out its contents into the abdominal cavity. Such water dissolves on its own, without posing a threat to he alth.
In addition, the causes of water inside the abdomen in women can be pathological processes that require urgent treatment:
- Very often, fluid in the abdominal cavity in women is formed due to inflammation of the reproductive system. For example, inflammation of the ovary, even its rupture. This condition is accompanied by a sharp pain, it cannot 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 fails and breaks. Internal bleeding causes fluid to build up.
- Other internal bleeding, eg due to trauma, surgery, caesarean section.
- Intra-abdominal tumors provoke the development of a complication - ascites - accumulation of large amounts of water inside the abdomen.
- Endometriosis is another cause of abdominal fluid in women. Special fabric liningthe uterine cavity from the inside, can grow uncontrollably, go beyond it. The disease is typical for women of reproductive age, often appears after 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 manifest itself 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 the size of the organ occurs, the portal vein is occluded, and ascites occurs. In addition, the release of excess fluid is possible due to a decrease in oncotic pressure, since the liver itself can no longer synthesize plasma proteins and albumins. The pathological process also exacerbates a whole list of reflex reactions that are triggered by the patient's body in response to insufficiency of the liver. What else causes fluid to accumulate in the abdomen?
Heart disease
Pathology such 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 occurrence of ascites in this case will be due to the fact that the hypertrophied muscle of the heart can no longer pump blood intothe required volumes accumulating in the blood vessels, including the inferior vena cava system. Due to the high pressure, as a result, the fluid will begin to leave the vascular bed, causing ascites. The mechanism of its development in pericarditis is almost the same, only in this situation inflammation of the outer heart membrane occurs, and this, in turn, leads to the fact that the organ cannot be filled with blood normally. This affects the activity of the venous system in the future. In addition, there are other reasons for the detection of free fluid in the abdominal cavity on ultrasound.
Kidney diseases
Ascites can be affected by chronic kidney failure due to various diseases (urolithiasis, glomerulonephritis, pyelonephritis, etc.). Kidney diseases lead to an increase in blood pressure, along with fluid, sodium is retained in the body, and as a result, ascites occurs. A decrease in plasma oncotic pressure can also be seen in nephrotic syndrome.
Other reasons
The occurrence of ascites can be affected by a violation of the integrity of the lymphatic vessels, which happens as a result of trauma or the presence of a tumor in the patient's body that metastasizes, and also due to infection with worms such as filariae (they lay their eggs in large lymphatic vessels).
- Many abdominal lesions can also cause ascites, including fungal, tuberculous and diffuse peritonitis, colon cancer, breast cancer,endometrium, ovaries, stomach, peritoneal carcinosis. This group also includes mesothelioma and pseudomyxoma of the abdominal cavity. The causes of fluid in the abdominal cavity are very diverse.
- Polyserositis is a disease in which ascites manifests simultaneously with other signs, including pericarditis and pleurisy.
- Systemic diseases can also lead to the accumulation of fluid in the peritoneum. These include lupus erythematosus, rheumatoid arthritis, rheumatism, etc.
- In newborn babies, ascites also occurs, it mainly occurs due to 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 do not combine for some antigens.
- Protein deficiency is one of the factors that predisposes to ascites.
- Diseases of the digestive organs 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 the 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 drop in concentrationit in the blood, which causes a pronounced decrease in oncotic pressure. The liquid part of the blood eventually leaves the vascular bed, and ascites occurs.
- Ascites at an early age accompanies congenital nephrotic syndrome, malnutrition and exudative enteropathy.
Symptoms of disease
The formation of fluid in the abdominal cavity is predominantly characterized by gradual development, over many months, and therefore most of the patients do not even focus on it for a very long time. People often think that they are just gaining weight. It is really difficult to see ascites in the early stages: it is necessary that at least three liters of fluid be collected in the abdominal cavity. This is easiest to see on an ultrasound.
Only after that do the typical signs of this pathology get expressed: flatulence, heartburn, abdominal pain, belching, swelling of the lower extremities, difficulty breathing. As the amount of fluid increases, the abdomen also becomes larger and larger, and it soon becomes difficult for the patient to even bend over. The abdomen appears spherical, dilated veins and stretch marks may appear. Sometimes, with ascites, fluid can compress the vessels under the liver, and the patient will eventually quickly develop jaundice, accompanied by vomiting and nausea. However, for the final clarification of the picture, external signs are not enough - a specialist consultation is required.
How to get rid of free fluid in the abdomen?
Therapeuticprinciples
To cure ascites, it is necessary to begin treatment of the main disease that caused the accumulation of fluid. If ascites is caused by pathologies of the heart, drugs that dilate blood vessels, glycosides and diuretics are prescribed. Kidney disease requires fluid restriction and a low-s alt diet. If there are violations of 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 low in s alt (no more than two grams per day), in some cases - a diet without s alt at all. In the presence of cirrhosis, fluid intake should also be limited, as well as diuretic drugs and potassium supplements. 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 approximately 500 grams per day.
Surgery
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 the amount is significant). The doctor makes a small puncture in the peritoneal cavity and inserts a laparocentesis (drainage tube) there. An alternative to such a painful and high he alth risk method is the installation of permanent ports under the skin and catheters. Ascitic fluid is eventually removed gradually, as it accumulates. This approach makes life much easier for patients by eliminating the need for new punctures, thereby reducing the likelihood of inflammation and organ damage.
In some cases, intrahepatic shunting is necessary, when a specialist creates a connection between the portal vein and the hepatic vein. In a particularly severe situation, a liver transplant may be needed.
Of course, it depends on the causes of abdominal fluid in women and men.
Food
The patient's diet should be high-calorie balanced, which will allow the body to provide all its needs for essential trace elements. It is very important to limit the use of s alt and generally eliminate it from your menu in its pure form.
The amount of fluid you drink also needs to be adjusted downwards. It is undesirable for patients to drink more than one liter per day (excluding soups).
It is very important that the daily diet of the patient be enriched with foods containing protein, but their amount should also not be excessive. Reduce your fat intake, especially for people who have ascites as a result of pancreatitis.
What is the prognosis for abdominal fluid in men and women?
Therapeutic prognosis
The earlier the diagnosis of ascites is made and the therapeutic course is started, the greater the chances for a successful resolution of the situation. It is much easier to eliminate ascites in the early stages. However, therea number of factors that adversely affect the effectiveness of treatment - diabetes mellitus, advanced age, oncological pathologies (especially liver cancer), hypotension, peritonitis and a reduced degree of albumin. A disease such as ascites is deadly to humans. In about half of all cases, in the absence of the effectiveness of diuretics, ascites receives a tragic outcome. Especially dangerous is the free fluid in the abdominal cavity in cancer, since death can occur in 60% of all cases.
Expected complications and recurrence rates
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, it is necessary to closely monitor he alth, since the risk of relapse remains. That is why it is necessary to adhere to dietary principles in nutrition after completion of treatment.
We looked at the fluid in the abdominal cavity, what it means is now clear.
