Q. What is the best treatment for ascites?

Ascites is a condition where fluid accumulates in the abdomen, causing swelling and discomfort. It's often associated with liver disease, heart failure, or certain cancers. Treating ascites involves managing the underlying cause and relieving symptoms. Here are some approaches:

1. Diuretics: These are medications that help your body get rid of excess fluid through urination. The most commonly prescribed diuretic for ascites is spironolactone, often in combination with furosemide. They work by increasing urine production and reducing fluid buildup.

2. Sodium restriction: Cutting down on sodium (salt) in your diet can help reduce fluid retention. Sodium causes your body to retain water, so limiting your intake can decrease the amount of fluid in your abdomen. Your doctor or a dietitian can advise you on how much sodium to consume daily.

3. Paracentesis: In severe cases of ascites where fluid buildup is causing significant discomfort or difficulty breathing, a procedure called paracentesis may be performed. During paracentesis, a thin needle is inserted into your abdomen to drain excess fluid. This can provide immediate relief and may need to be repeated periodically.

4. Albumin infusion: Sometimes, especially after large-volume paracentesis, a healthcare provider may administer albumin, a protein found in blood plasma, to help prevent a drop in blood pressure and maintain proper fluid balance.

5. Treating the underlying cause: Ascites is often a symptom of an underlying condition such as liver disease, heart failure, or cancer. Treating the root cause can help manage ascites more effectively. This may involve medications, lifestyle changes, or other treatments tailored to the specific condition.

6. Liver transplant: In cases where severe liver disease is the cause of ascites and other treatments are not effective, a liver transplant may be considered. This is a major surgical procedure that replaces a diseased liver with a healthy one from a donor.

7. Lifestyle modifications: In addition to sodium restriction, maintaining a healthy weight, limiting alcohol consumption, and managing other health conditions like diabetes and high blood pressure can help prevent or reduce ascites.

8. Regular follow-up: Ascites often requires ongoing management and monitoring. Regular check-ups with your healthcare provider are important to assess your condition, adjust treatments as needed, and monitor for any complications.

It's crucial to work closely with your healthcare team to develop a treatment plan that addresses your individual needs and circumstances. They can provide guidance on medications, dietary changes, and other strategies to help manage ascites effectively and improve your quality of life.