Fluid in the Abdomen or Ascites

Approved by the Cancer.Net Editorial Board, 08/2017

Ascites is the buildup of fluid in the space surrounding the organs in the abdomen. When ascites is caused by cancer, it is called 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 often causes a lot of discomfort. People with ascites may experience the following symptoms:

  • Weight gain

  • Shortness of breath, also called dyspnea

  • Abdominal swelling

  • Sense of fullness or bloating

  • Sense of heaviness

  • Indigestion

  • Nausea or vomiting

  • Changes to the belly button

  • Hemorrhoids, which causes 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 3-dimensional picture of the inside of the body using x-rays.

  • Paracentesis, which is the removal and analysis of fluid from the abdomen with a needle. This test can be used 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 palliative care or supportive care. Talk with your health care team about any symptoms of ascites that you experience, including any new symptoms or a change in symptoms.

The goal of treatment for ascites is to relieve the symptoms that are causing you 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.

Options to help relieve ascites include:

  • Reducing the amount of salt you eat and drinking less water and other liquids. However, many people find this regimen unpleasant and difficult to follow.

  • Taking diuretics, which help reduce the amount of water in the body. Diuretics are effective and don’t cause side effects for most people. But they may cause the following side effects in some people:

    • Loss of sleep

    • Skin problems

    • Fatigue

    • Low blood pressure

    • Problems with self-esteem

  • Paracentesis, if ascites is causing breathing problems or diuretics stop working. If you need paracentesis often, you may need a special tube called a catheter placed in the abdomen. This catheter will help make fluid removal easier, even while you are at home.

  • Chemotherapy for people with certain cancers, such as lymphoma, breast, or ovarian cancers. However, chemotherapy is rarely used to manage ascites.

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

Related Resources

Fluid Retention or Edema

Side Effects

Fear of Treatment-Related Side Effects