Ascitis
The abdomen (belly) is surrounded by a membrane (lining) called the peritoneum. The peritoneum normally produces fluid called peritoneal fluid. When this fluid builds up in the belly, it鈥檚 called ascites. It can make the belly hard and swollen (distended). Ascites caused by cancer is called malignant ascites. 鈥�
What causes ascites?
In people with cancer, ascites can be caused by tumors in or around the abdomen. These tumors can trigger the peritoneum to create more ascitic fluid, leading to ascites.
Ascites is most common in these types of cancers because of their location near the peritoneum and abdomen:
- Peritoneal
- Liver
- Pancreatic
- Ovarian
- Bladder
- Gastric
- Colon
However, most ascites is not caused by cancer. The most common cause of ascites is cirrhosis (liver disease). Cirrhosis and other liver problems can lead to scarring, which slows down the liver鈥檚 ability to filter blood. Over time, this can cause fluid to back up in the liver and abdomen.
What are the symptoms of ascites?
Many symptoms are usually caused by the extra fluid pressing on nearby areas. The most common sign of ascites is a swollen and hard belly. Other signs and symptoms are:
- Belly pain or discomfort
- Nausea or vomiting
- Shortness of breath
- Weight gain that happens quickly or suddenly
- Loss of appetite or feeling full quickly
- Heartburn or indigestion
- Feeling the need to pee more often or urgently
If your doctor thinks you might have ascites, they often will test the ascitic fluid. A diagnostic paracentesis is a procedure that uses a needle to collect a small amount of fluid. Cytology testing is usually done to confirm malignant ascites. This means that cancer cells can be seen in the fluid under a microscope.
Call 911 or go to the emergency department if you:
- Have trouble breathing or chest pain
- Notice swelling that is red, warm, or leaking fluid
- Can鈥檛 eat for a day or more
- Can鈥檛 urinate (pee)
Treatment for ascites
If ascites is caused by cancer, treating the cancer will often relieve the buildup of fluid. (To learn more about different types of cancer treatment, see Treatment Types.)
If ascites is still a problem or the cancer can鈥檛 be treated, a procedure called a therapeutic paracentesis might be done to improve the symptoms. A needle is placed into the abdomen to drain and remove the extra fluid. Some people can have several liters of fluid removed at one time. However, if the underlying cause isn鈥檛 treated, the fluid will return, usually within a few weeks.
Some people might choose to have a peritoneal drain or catheter placed. It鈥檚 a small tube that stays in the belly for as long as a person needs it. The drain is connected to a bag and drained at home every few days or as needed. This means the person doesn鈥檛 have to go to an appointment or have a needle placed every time they need fluid removed.
Tips for managing ascites
Ascites can be very uncomfortable. Here are some things you can do to manage it:
- Limit or avoid salt, which can make you hold onto fluid and worsen swelling.
- Avoid alcohol, which can cause swelling and affect the liver.
- Ask your doctor before you take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These medicines can cause swelling and damage the liver.
Talk to your doctor or cancer care team
If you have ascites, it鈥檚 important to talk to your doctor about new or worsening symptoms. Tell them if you have:
- Swelling in your belly that is getting worse
- Gain more than ten pounds in one week
- Have fevers or signs of infection without a known cause
Ask your doctor or cancer care team what you should call right away for versus what can wait until office hours.
- Written by
- References
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
Bruera E & Dev R. Overview of managing common non-pain symptoms in palliative care. UpToDate. UpToDate Inc; 2023. Updated December 2021. Accessed December 18, 2023. https://www.uptodate.com/contents/overview-of-managing-common-non-pain-symptoms-in-palliative-care
Runyon BA. Evaluation of adults with ascites. UpToDate. UpToDate Inc; 2023. Updated March 2022. Accessed December 18, 2023. https://www.uptodate.com/contents/evaluation-of-adults-with-ascites
Runyon BA. Malignancy-related ascites. UpToDate. UpToDate Inc; 2023. Updated October 2022. Accessed December 18, 2023. https://www.uptodate.com/contents/malignancy-related-ascites
Smith CC. Clinical manifestations and evaluation of edema in adults. UpToDate. UpToDate Inc; 2023. Updated July 2023. Accessed December 18, 2023. https://www.uptodate.com/contents/clinical-manifestations-and-evaluation-of-edema-in-adults
Sterns RH. Pathophysiology and etiology of edema in adults. UpToDate. UpToDate Inc; 2023. Updated March 2022. Accessed December 18, 2023. https://www.uptodate.com/contents/pathophysiology-and-etiology-of-edema-in-adults
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