What causes ascites? How is ascites caused?

There are many reasons that can cause ascites, the most common are some diseases of the liver and kidneys, such as some digestive system, as well as some tumors of the peritoneum and genitourinary system, which may cause ascites.

In addition, there are some diseases such as intestinal tuberculosis, or tuberculous peritonitis, and tumors can cause some ascites.

It is recommended that once you find ascites, you should go to the hospital for a check-up in time to clarify ** and then treat the symptoms**.

If you usually have a low-grade fever or night sweats, bloating, abdominal pain, and your weight has been declining, you should go to the hospital for a check-up.

Be careful not to overwork, rest more, try not to stay up late at night, ensure adequate sleep, and improve your own immunity.

In addition, malignant tumors, heart failure, tuberculosis or other rare causes can also cause ascites, the most common of which is liver disease itself, the mechanism of different diseases causing ascites is different, including systemic factors and local factors, systemic factors: such as poor kidney function, sodium and water retention, liver cirrhosis, or poor heart function, or hormonal changes in the body, thereby causing ascites.

There are many types of ascites, and portal hypertension is the most important cause of ascites, accounting for 75% of all causes of ascites. Other causes include carcinomatous ascites due to malignancy, transudate due to heart failure, tuberculous peritonitis due to tuberculosis, pancreatitis, and other less common causes.

About 5% of patients have mixed factors, such as peritoneal tuberculosis with cirrhosis, in which case only exudates, tuberculous ascites, or alcoholic liver disease with alcoholic cardiomyopathy, which are two types of hepatic ascites and heart failure ascites**.

The pathogenesis of ascites can be divided into two categories: local and systemic. Local factors refer to increased pressure in the portal vein, increased pressure in the hepatic sinusoids and mesenteric capillaries, fluid leakage from these two sites, and exceeds the drainage capacity of the lymphatic and thoracic ducts, and excess body fluid, leaking from the hepatic capsule into the abdominal cavity, forming ascites. Systemic factors include abnormal renal sodium excretion, occult cardiac insufficiency, altered intra-abdominal osmolality, peritoneal chemical injury, increased peritoneal permeability, and lymphatic obstruction.

There are many causes of ascites, mainly in the following aspects. First of all, it comes from liver diseases, common cirrhosis, due to portal hypertension, hypoproteinemia, lymphatic reflux disorders, renin-angiotensin-aldosterone system dysfunction and other factors, can cause ascites. Secondly, it is seen in kidney diseases, nephrotic syndrome, nephritic syndrome, renal failure, etc., renal ascites can occur.

It is again seen in some neoplastic diseases, such as genitourinary tumors, intestinal tumors, ** tumors, peritoneal tumors, etc., which can cause cancerous ascites. Ascites can also be seen in infectious factors, such as intestinal tuberculosis, which can cause ascites, and heart failure, especially right-sided heart failure, can cause cardiogenic ascites. There are many reasons for ascites, and it is necessary to clarify the basic one, carry out the basic one, and strengthen diuretic treatment.

The following is said about the issue:

There is no single cause of ascites, and there are many causes of ascites, such as patients with liver cirrhosis, portal hypertension, hypoproteinemia, etc.

1. Cirrhosis of the liver with portal hypertension

When the blood in the portal vein does not flow smoothly through the liver to the heart, the portal pressure increases. Once the pressure rises, there will be resistance to hepatic blood flow, and the blood vessel wall will be stretched, and water will easily leak through the blood vessel wall to the outside of the blood vessel, thus forming ascites.

2. Hypoproteinemia

Patients with cirrhosis often have a combination of inadequate protein production. Patients with cirrhosis of the liver are prone to loss of appetite, which can lead to malnutrition and hypoproteinemia in the long run. This results in a decrease in plasma colloidal osmolality, resulting in increased ascites production.

3. Volume depletion

When cirrhosis of the liver occurs, the body's secretory system is disordered. At this time, sympathetic activity and activation of the renin aldosterone system cause abnormal expression of splanchnic blood vessels and certain hormones, resulting in circulating volume depletion and ascites.

4. Abnormal food hormone content

If the level of food hormone is abnormal, the atrial natriuretic peptide will decrease, which can easily cause sodium and water retention, which will aggravate ascites.

When a small amount of ascites (300-500ml) is not noticeable, there is no obvious discomfort and it is not easy to be noticed;

In moderate amounts of ascites (500-3000 ml), abdominal distension may be felt, mainly in the form of a distended abdomen, and there may be mobile dullness on physical examination;

If there is a large amount of ascites (3000 ml or more), it is manifested as dyspnea and edema of the lower limbs.

Ascites **

Sodium and water restriction - Applicable: Type I ascites; The effect is not very good.

Diuretics – indications: ascites type II; Note: Electrolyte imbalances, reduction principle.

Expansion - mechanism: improve blood osmotic blood circulation, which is conducive to ascites fluid circulation. Increases renal blood flow and increases glomerular filtration rate. Indications: Patients with obvious hypoproteinemia and ascites. Note: High cost, renal function, cardiac function.

Dilate renal blood vessels and increase renal blood flow—Application: Patients with low blood pressure and good renal function.

Ascites - paracentesis; Application: Cirrhosis of the liver with ascites. It has not been used as the main measure of ascites.

ascites + albumin infusion—albumin infusion; Better than high-dose diuresis. Disadvantages: Albumin is in high demand and has high medical costs.

It can be seen that the best methods of ascites are still relatively extensive, and patients can choose the right drugs according to their own conditions under the guidance of doctors.

In general, ascites is the most common**:Liver disease, ascites is less common** including non-liver diseaseSuch as cancer, heart failure, kidney failure, inflammation of the pancreas (pancreatitis) and tuberculous peritonitis.

Ascites often occurs slowly over a long period of time (chronic) rather than as a result of short-term (acute) liver dysfunction. The most common causes are as follows:

Portal hypertension—abnormal pressure in the portal vein and its branches (large veins that collect blood from the intestine and carry it to the liver).

A common cause of portal hypertension is cirrhosis (severe scarring of the liver), which is usually caused by alcoholism, fatty liver disease, or chronic viral hepatitis.

Ascites can also be caused by other liver diseases, such as severe alcoholic hepatitis without cirrhosis, other types of chronic hepatitis, and hepatic vein occlusion (Budd-Chiari syndrome).

In patients with liver disease, ascites can leak from the surface of the liver and small intestine and accumulate in the abdominal cavity for a variety of reasons, including:

Portal hypertension.

Fluid retention in the kidneys.

Various hormonal and chemical changes that regulate body fluids.

In addition, albumin usually leaks from blood vessels into the abdominal cavity. Normally, albumin, the main protein in the blood, keeps fluid from leaking out of blood vessels. Once albumin leaks out of the blood vessels, fluid also flows out of the blood vessels.

According to the MSD Manual, small amounts of ascites are usually asymptomatic, moderate amounts can lead to waist circumference and weight gain; Large amounts of ascites can cause abdominal swelling (bloating) and discomfort, a feeling of tightness in the abdomen, a flattening of the belly button, or even a flipping out.

Pressure on the stomach due to a distended abdomen can lead to loss of appetite, and squeezing the lungs can sometimes lead to difficulty breathing.

Some people with ascites develop swelling of the ankle joint (resulting in edema) due to a buildup of too much fluid.

Comorbidities of ascites.

Spontaneous bacterial peritonitis (infection of ascites of unknown cause) occurs from time to time. This infection is common in people with ascites and cirrhosis, especially those who drink heavily.

People with spontaneous bacterial peritonitis usually experience abdominal discomfort and tenderness. People may have a fever and feel generally unwell. They may be drowsy and confused.

If left unchecked**, the infection can be fatal. Survival depends on early and rigorous antibiotic use**.

Causes of ascites:1Portal hypertension, such as cirrhosis, liver congestion, etc.

2.Hypoproteinemia, such as nephrotic syndrome, protein-loss enteropathy, malnutrition, etc. 3.

Endocrine lesions, such as myxedema, ovarian diseases, etc. 4.Visceral leakage, such as pancreatic ascites, biliary ascites, chylous ascites, urinary ascites, and nephrogenic ascites.

5.Caused by infection, such as bacterial infection, tuberculosis infection, fungal infection, parasitic disease, etc. 6.

Caused by new organisms, such as primary malignant mesothelioma, mesothelial hyperplasia and benign mesothelioma, secondary malignant lesions, pseudomyxoma peritonei, etc. 7.Granulomatous peritonitis, including exogenous, endogenous, iatrogenic and other causes.

8.Sclerosing peritonitis, including toxic, indwelling foreign body, idiopathic, etc.

How is hepatic ascites caused? These triggers are the key, and they must be taken seriously.

**Classify. (1) Cardiovascular disease.

1. Chronic congestive right heart failure.

2. Pericarditis: such as exudative pericarditis and chronic constrictive pericarditis.

3. Thin Keshan disease.

b) Liver disease.

1. Viral hepatitis.

2. Liver cirrhosis.

3. Liver tumors.

4. Hepatic vascular disease.

1) Hepatic vein occlusion syndrome.

2) Portal vein thrombosis.

3) Inferior vena cava obstruction syndrome.

c) Peritoneal disease.

1. Peritonitis: such as exudative tuberculous peritonitis, acute pancreatitis complicated by peritonitis, pulmonary fluke peritonitis, disseminated lupus erythematosus peritonitis, cholesterol peritonitis, granulomatous peritonitis, sugar-coated liver.

2. Peritoneal tumors, peritoneal metastases, peritoneal mesothelioma.

d) Kidney disease.

1. Chronic nephritis nephropathy type.

2. Nephrotic syndrome.

5) Dystrophic ascites.

Hypoproteinemia.

6) Other reasons.

1. Sideline chyle ascites.

2. Hypothyroidism.

3. Meigs (MEIGS) comprehensive Tong Qi Xun Zheng.

These are all conditions that can cause ascites.

Generally, it is caused by the liver, and tumors in the abdominal cavity such as the kidneys can lead to the production of ascites Detailed abdomen and subdued fluid** deficiency can go to my space to see.

Ascites Free fluid that accumulates in the abdominal cavity. A normal person can have a small amount of fluid in the abdominal cavity, which acts as a lubrication for the internal organs. Ascites can be caused by heart disease, liver disease, kidney disease, tuberculosis, malignancy, etc., and is a common clinical sign.

According to its nature, it can be divided into exudate or exudate; According to its appearance, it can be divided into serous, bloody, purulent or chylous. Ascites occurs due to systemic or local factors that cause fluid to leak into or leak into the abdominal cavity from blood vessels and lymphatic vessels. Hypoproteinemia, sodium and water retention, decreased inactivation of antidiuretic hormone and aldosterone, portal hypertension, hepatic vein occlusion, peritoneal inflammation, and malignancy are all important factors causing ascites.

Experts from Guizhou Hospital of Traditional Chinese Medicine and Liver Disease said that the imbalance of protein ratio and liver cirrhosis are easy to cause liver ascites.

Normal people have a small amount of free ascites in the abdominal cavity, generally about 50 ml, which plays a role in maintaining lubrication between organs, and when there is too much free fluid in the abdominal cavity, it is called ascites. Cirrhosis of the liver with ascites is a chronic liver disease. Massive, nodul, diffuse hepatocytic degeneration, necrosis, and regeneration; Regeneration and necrosis promote tissue fibrous hyperplasia and scar contraction, resulting in hardening of the liver and forming cirrhosis.

Cirrhosis of the liver causes portal hypertension, which leads to splenomegaly, and the protein fluid leaks out due to the non-absorption of proteins and vitamins, resulting in ascites.

Portal hypertension, hypoproteinemia, renal drainage dysfunction, increased lymphatic effusion. These symptoms can be relieved with three meals a day.

Depending on what the disease is, if it is cirrhosis or liver cancer, it may be portal hypertension or low protein.