What you may notice
Ascites is fluid collecting in the abdomen. It may cause a tight enlarging belly, rapid weight gain, early fullness with food or breathlessness. A larger abdomen is not always fluid, and repeated drainage does not explain why it keeps returning.
Fluid around abdominal organs
What could cause it?
Advanced liver disease and high portal-vein pressure are common causes, but heart or kidney disease, cancer, infection such as tuberculosis and pancreatic disease are also possible. Examination, ultrasound, blood tests and often a sample of the fluid help identify the cause and exclude infection.
When to contact a doctor
New or increasing abdominal swelling needs medical assessment. Fever, new abdominal tenderness, vomiting, confusion, reduced urine or worsening breathlessness with ascites needs urgent hospital review. Vomiting blood, collapse or severe breathing difficulty is an emergency: call 108. Do not independently increase diuretics or restrict fluids drastically.
How interventional radiology may help
Treatment targets the cause and may include a clinician-directed salt and medicine plan. Image-guided drainage may relieve tense fluid. For selected patients with recurrent ascites from portal hypertension, IR may create a TIPS channel within the liver. Heart function, liver function and the risk of confusion must be assessed; TIPS is not suitable for every patient.
Further reading: detailed assessment and treatment options
Patient information sources
References are in English.
Educational information, not a diagnosis. The causes listed are examples, not a complete list. Tests and treatment depend on your individual assessment.