Guidelines

What is intractable ascites?

What is intractable ascites?

In 1988, the International Ascites Club divided refractory ascites into two categories: type 1, or diuretic-resistant ascites, which is defined as the inability to mobilize ascites fluid despite intensive medical therapy and salt restriction diet for at least 1 week; and type 2, or diuretic-intractable ascites, which …

What is meant by refractory ascites?

Refractory ascites, that is ascites which cannot be mobilized by low sodium diet and maximal doses of diuretics (up to 400 mg spironolactone or potassium canrenoate and 160 mg furosemide per day), occurs in 5% of cirrhotic patients with ascites.

What are the two types of ascites?

Traditionally, ascites is divided into 2 types; transudative or exudative. This classification is based on the amount of protein found in the fluid. A more useful system has been developed based on the amount of albumin in the ascitic fluid compared to the serum albumin (albumin measured in the blood).

What are the grades of ascites?

Grade 1 ascites is mild and can be detected only by an examination such as ultrasound. Grade 2 ascites is moderate and evidenced by moderate distension of the abdomen, and is therefore readily detectable on physical examination. Grade 3 ascites is large with marked distension of the abdomen.

What stage of liver disease is ascites?

Ascites is the main complication of cirrhosis,3 and the mean time period to its development is approximately 10 years. Ascites is a landmark in the progression into the decompensated phase of cirrhosis and is associated with a poor prognosis and quality of life; mortality is estimated to be 50% in 2 years.

What is the survival rate of ascites?

Patients with cirrhotic ascites have a 3-year mortality rate of approximately 50%. Refractory ascites carries a poor prognosis, with a 1-year survival rate of less than 50%.

Which is the best definition of refractory ascites?

Refractory ascites, that is ascites which cannot be mobilized by low sodium diet and maximal doses of diuretics (up to 400 mg spironolactone or potassium canrenoate and 160 mg furosemide per day), occurs in 5% of cirrhotic patients with ascites. The development of refractory ascites is mainly relate …

What are some of the complications of ascites?

What are the complications of ascites? Abdominal pain, discomfort and difficulty breathing: These problems may occur when too much fluid builds up in the abdominal cavity. This may limit a patient’s ability to eat, walk and perform daily activities.

How to reduce fluid in the abdomen with ascites?

Your healthcare provider may tell you to: 1 Cut back on your salt intake. 2 Cut back on the amount of fluids you drink. 3 Stop drinking alcohol. 4 Take diuretic medicines to help reduce the fluid in your body. 5 In certain cases, your doctor may need to remove large amounts of fluid from your abdomen through a needle.

How is ascites treated in patients with cirrhosis?

This is a common problem in patients with cirrhosis (scarring) of the liver. Ascites is treated by lowering salt in the diet and taking water pills.