Ascites: Understanding Causes, Symptoms & Management for Canadians

Ascites refers to the abnormal buildup of fluid inside the abdominal cavity. It is most often associated with cirrhosis of the liver, making it a common complication for people living with advanced liver disease.

Symptoms

People with ascites may develop:

A noticeably enlarged abdomen
Rapid or unexplained weight gain
Swelling of the ankles or legs
Shortness of breath or discomfort

These changes may affect mobility, appetite, and daily activities.

Why Ascites Develops

Ascites typically occurs after a series of events related to liver injury. When cirrhosis develops, scar tissue blocks blood flow through the liver. This increases pressure in the major vein supplying blood from the digestive organs to the liver — a condition called portal hypertension.

With portal hypertension, the kidneys struggle to eliminate sodium effectively. Excess sodium encourages fluid retention, which then collects in the abdomen, leading to ascites.

Risk Factors

Ascites is most often linked to conditions that contribute to cirrhosis, including:

Chronic hepatitis B or hepatitis C
Alcohol-related liver disease
Long-term alcohol misuse

Other causes may include:

Kidney failure
Congestive heart failure
Certain abdominal cancers

Diagnosis

Healthcare providers may assess ascites using:

Physical examination
Medical history
Blood tests
Ultrasound or CT imaging
Paracentesis (removal of a small sample of abdominal fluid)

Paracentesis helps check for infection, cancer cells, or other underlying conditions.

Possible Complications

Complications depend on severity and underlying disease, and may include:

Infection (spontaneous bacterial peritonitis)
Fluid may become infected, causing fever, abdominal pain, or worsening illness. Treatment typically involves intravenous antibiotics, followed by oral medication to prevent recurrence.

Discomfort & breathing difficulty
Large volumes of fluid can interfere with mobility, eating, and daily tasks and may contribute to shortness of breath.

Fluid in the lungs (hepatic hydrothorax)
Abdominal fluid can move into the chest cavity, usually on the right side, causing cough, breathlessness, or chest discomfort.

Kidney dysfunction or failure
As liver disease progresses, kidney complications may worsen.

Treatment & Management Options

Management focuses on reducing fluid accumulation and supporting underlying liver health. Approaches may include:

Limiting dietary salt (often to 2,000 mg/day or less)
Consulting a registered dietitian for nutrition planning
Diuretics such as spironolactone or furosemide (as prescribed)
Paracentesis in select cases

Managing ascites requires medical oversight, especially when liver disease or kidney function is involved.

Awareness & Preparedness for Canadians

While ascites itself is not a first-aid condition, caregivers and family members may benefit from broader health awareness skills. Programs offered through St. Mark James Training — including first aid and CPR/AED — help Canadians feel confident responding to emergencies such as breathing distress or sudden collapse, which may occur in people with advanced chronic illness.

Workplace safety training can also support Canadian employers who aim to improve health literacy and response readiness in office, industrial, and community environments.

Educational Disclaimer

This article provides public education in a Canadian context and should not be used to diagnose or manage medical conditions. If symptoms worsen, new symptoms appear, or complications are suspected, seek medical evaluation or emergency services.