Fluid in the Abdomen or Ascites

Approved by the Cancer.Net Editorial Board, 10/2016

Ascites is the buildup of fluid in the space surrounding the organs in the abdomen. Cancer is one condition that causes ascites. Conditions other than cancer can also cause ascites. These include liver disease, blood clots, kidney disease, or heart failure.

When ascites is caused by cancer, doctors call it malignant ascites. Malignant ascites is most common in people with the following cancers:

  • Breast cancer

  • Colon cancer

  • Gastrointestinal tract cancers, such as stomach and intestinal cancers

  • Ovarian cancer

  • Pancreatic cancer

  • Uterine cancer

Symptoms of ascites

Ascites may cause discomfort because of the symptoms it causes. People with ascites may experience the following symptoms:

  • Weight gain

  • Shortness of breath

  • Abdominal swelling

  • Sense of fullness or bloating

  • Sense of heaviness

  • Indigestion

  • Nausea or vomiting

  • Changes to the belly button

  • Hemorrhoids, which cause painful swelling near the anus

  • Ankle swelling

  • Fatigue

  • Decreased appetite

Diagnosing ascites

To diagnose ascites, the doctor may examine your abdomen and ask you about any recent symptoms. The following tests may help diagnose ascites:

  • X-ray, which is a picture of the inside of the body

  • Ultrasound, which uses sound waves to create a picture of the inside of the body

  • Computerized tomography (CT or CAT) scan, which creates a three-dimensional picture of the inside of the body with an x-ray machine

  • Paracentesis, which is the removal and analysis of fluid from the abdomen with a needle. Your doctor can use this test to find out the cause of ascites.

Managing and treating ascites

Relieving side effects is an important part of cancer care and treatment. This is called symptom management or palliative care. Talk with your health care team about any new symptoms or changes in symptoms that you experience.

The goal of treatment for ascites is to relieve the symptoms of discomfort. You may not need treatment if the ascites is not causing discomfort. Ascites treatment may have unpleasant side effects. Talk with your doctor about the risks and benefits of each option before deciding on a treatment plan.

The following are options to help relieve ascites:

  • Salt and water intake. It’s controversial whether eating less salt and drinking less water can help with ascites. So, it’s important to talk with your doctor about what you eat and drink before making any changes.

  • Diuretics. These drugs help reduce the amount of water in the body. However, diuretics may not always help. In addition, these medications can cause significant side effects in some people:

    • Frequent urination

    • Imbalance of minerals in the blood

    • Loss of sleep

    • Skin problems

    • Fatigue

    • Low blood pressure

  • Paracentesis. This procedure can help if ascites is causing breathing problems or discomfort from abdominal fullness. If you need paracentesis often, your doctor may place a special tube called a catheter in your abdomen. This catheter will help make fluid removal easier, even while you are at home.

  • Chemotherapy. This may help people with certain types of cancer, such as lymphoma, breast cancer and ovarian cancer. However, chemotherapy is rarely used to manage ascites.

  • Shunt. Rarely, a person may need a device called a shunt to bypass or divert fluid from one place to another.

  • Treating other causes of ascites. If you have another condition causing ascites, such as heart or kidney disease, treating it may help with ascites.

More Information

Side Effects

Fear of Treatment-Related Side Effects