Medical Treatment
Excess fluid in the abdominal cavity can cause significant discomfort and shortness of breath. The method of treatment depends upon the reason for the ascites accumulation, how quickly the fluid has accumulated, whether it is a first occurrence or a repeated event, and how significantly the symptoms affect the patient.
Lifestyle Changes and Medication
For patients with cirrhosis, the initial therapy for ascites begins with dietary salt restriction and medications to assist the body in ridding itself of excess salt and fluid. Spironolactone (Aldactone) is a first line diuretic medication that helps block the chemical aldosterone which is responsible for salt retention in the body. Furosemide (Lasix) and metolazone (Zaroxolyn) may also be added. This treatment is effective in controlling ascites fluid in the vast majority of patients.Body weight is used as a measurement of ascites control. The goal for diuretic therapy is to lose between one to two pounds of weight per day depending upon underlying medical conditions. Once most of the ascites fluid is gone, medication dosing will be individualized to the patient's needs.
Water restriction may be considered if hyponatremia, (low serum sodium) is present.
