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Ascites is an abnormal collection of fluid that gathers around the abdominal organs. It may be associated with oedema, which is swelling caused by the collection of fluid around the eyes, face and lower limbs.

What causes ascites?

Ascites can be caused by:

  • A fall in the production of albumin, which is a protein made by the liver. Albumin helps keep the fluid part of the blood within the blood vessels. If albumin levels are low, fluid leaks out and collects in body cavities and tissues.
  • Increased pressureportal hypertension raises the pressure in the veins around abdominal organs and this contributes to fluid leaking into the abdomen.
  • Salt being retained by the body, which can contribute to build-up of fluid.


All these are generally signs that liver disease has been present for a while.

How is ascites diagnosed?

Diagnosis may be made by physical examination or an ultrasound scan.

What are the signs and symptoms of ascites?

Some, but not necessarily all, may be present:

  • Protruding abdomen (tummy)
  • Shiny, tense skin over the protruding abdomen
  • Appearance of prominent veins just under the skin of the abdomen
  • Rapid weight gain not consistent with normal growth
  • Shortness of breath
  • Reduced appetite


Treatment options for ascites

Treatments aim to reduce the ascites and may be carried out in hospital or at home, depending on the treatment and the severity of the child’s overall condition.

  • Medication – A diuretic may be prescribed to help the body get rid of the excess fluid. Spironolactone is commonly used.
  • Nutrition/diet – The dietician may advise some changes, such as avoiding heavily salted foods and not adding salt to food.
  • Reduction of fluids – in some cases a reduction in the amount of fluid being drunk may be advised, but must not be done without medical advice.
  • Albumin replacement – If very low, this may be necessary and is done by intravenous infusion. Extra diuretics are often given during the procedure.
  • Drainage of excess fluid – a fine needle is passed into the abdominal cavity and attached either to a syringe or continuous drain. A local anaesthetic may be used.


Possible complications of ascites include:

  • Failure to thrive – the presence of ascites in the abdomen can cause children to feel full very easily, be poor feeders and have a tendency to vomit.
  • Infection – The ascetic fluid can become infected by bacteria. Any fever with pain or tenderness over the abdomen should be reported to your doctor immediately.
  • Restricted movement – developmental progress may be delayed in infants and toddlers due to restriction of movement by their enlarged abdomen.
  • Breathing difficulties – ascites may make full expansion of the lungs more difficult. If your child becomes breathless you must get in touch with your doctor.


Want to know more?

Download CLDF's leaflet on ascites.


The information on this site is for guidance only. It is not a substitute for professional medical care by a qualified doctor or other health care professional. ALWAYS check with your medical team if you have any concerns about your condition or treatment. CLDF is not responsible or liable, directly or indirectly, for any form of damages resulting from the use (or misuse) of information contained in or implied by the information on this site.