Ascites in liver cirrhosis: what is it and how to treat? Ascites in liver cirrhosis: causes, symptoms, treatment

Ascites, which occurs with cirrhosis of the liver, is the accumulation of fluid in abdominal cavity and, as a consequence, stagnation of blood, as well as increased pressure in the veins, an increase in the volume of the abdomen. At the same time, ascites is not an independent pathology, but acts as a complication of cirrhosis, aggravating the course of the disease and significantly worsening the prognosis for recovery.

Ascites in liver cirrhosis is not such a rare occurrence. According to statistics, ascites occurs in 50% of patients over 10 years after confirmation of the diagnosis of liver cirrhosis.

Life expectancy in patients with dropsy with cirrhosis of the liver

You need to understand that ascites itself extremely rarely causes the death of a patient. Therefore, survival forecasts depend to a greater extent on the course of the main process.

So, there is the following data:

You should also consider:

• what lifestyle does the patient lead;
• how adequate is the prescribed therapy;
• timely puncture abdominal wall;
• correct use of diuretics, and so on.

Sometimes fulfilling these conditions helps patients live for more than 10 years. But more often, ascites is considered an unfavorable prognostic sign, as a result of which half of the patients die within 2 years.

Causes of ascites in liver cirrhosis

The main cause of ascites is cirrhosis. Why does this complication develop?

And this happens due to the following processes:

Clinical manifestations of ascites

In cases where a small amount of fluid accumulates in the abdomen, patients almost never complain.

But with further development of the disease, following signs ascites:

First clinical manifestations are detected when the volume of liquid reaches 1 liter, and maximum amount accumulated liquid can be 25 liters. However, before the first signs of ascites appear, patients are concerned about the symptoms of the underlying pathology (i.e. cirrhosis): painful sensations in the area of ​​the right hypochondrium, fatigue, weakness.

How to cure ascites in liver cirrhosis

After the diagnosis of “ascites” is confirmed, doctors begin its treatment, however, given that this nosology is a complication of cirrhosis, treatment is aimed primarily at eliminating the underlying pathology.

Drug therapy includes the following medications:

In addition, the patient must follow a diet (table No. 5). In this case, the amount of liquid consumed should be reduced to 1.5 liters per day. You should also follow bed rest, because in a horizontal position, blood filtration increases due to increased kidney function.

In cases where conservative treatment doesn't bring desired effect, patients are indicated for surgical intervention - laparocentesis, which involves removing excess fluid from the abdominal cavity using a special needle. As a rule, no more than 5 liters of liquid are removed in one procedure, since there is a likely risk of collapse. Laparocentesis significantly reduces painful sensations and improves the general well-being of the patient, but during its implementation there is high probability complications.

Diet for ascites

Successful treatment of ascites in liver cirrhosis is impossible without following a diet.

Changes in liver tissue are characterized by massive proliferation and subsequent replacement of normal tissues with connective tissue formations. Deformation and wrinkling of an organ entails a violation of its functions. The survival rate of patients in this case depends on the amount of connective tissue (scars), as well as the manifestations liver failure.

With this pathology, the liver is unable to fully neutralize allergens and neutralize toxins, as well as maintain normal exchange substances and provide the body sufficient quantity energy (that is, maintain an optimal balance of microelements and vitamins).

With ascites, the liver is unable to support normal level phospholipids, hormones, bile, which entails many disorders in the body. Therefore, in order to adequately cure patients, correction of disturbed processes is necessary.

Diet specifics

As mentioned above, the success of treating ascites largely depends on adherence to a special diet (diet No. 5):

With this pathology, the patient is prescribed vegetarian soups with vegetables, cereals, pasta, lean fish, dried bread, semi-viscous porridges made from oatmeal, semolina, buckwheat, rice groats, beef, rabbit meat, cookies, chicken.

Dairy products are also allowed, but they must be low-fat. Reception should be limited whole milk. Amount consumed butter should not exceed 30 grams per day, and vegetable - no more than 15 grams.

Cauliflower, zucchini, pumpkin, potatoes, and beets can only be consumed boiled or stewed. The only fruits allowed are:

• baked apples;
• compotes (fruit and berries);
• mousses;
• bananas (fresh);
• jelly.

What foods should be excluded from the diet?

So, for this pathology the following are prohibited:

Sample menu for patients suffering from liver cirrhosis with ascites

Breakfast: steamed omelette with the addition of beef or lean fish, tea, biscuits or oatmeal, tea, cottage cheese, crackers.

Dinner: potato soup, pasta, cutlet and plum-apple compote or vegetarian soup, rice, chicken.

Afternoon snack: fresh banana, cottage cheese, baked apple.

Dinner: salad, boiled fish, kefir.

It should be remembered that therapeutic diet in this case, it provides for boiled or baked dishes, and therefore it is better for patients with a similar pathology to get a double boiler.

Attention, TODAY only!

Liver cirrhosis is a multifactorial disease that results pathological changes is the death of liver cells of hepatocytes and the growth in their place of rough connective tissue in the form of tubercles.

In the stage of decompensation, clinical manifestations no longer depend on the causes. It is possible to develop brain damage (encephalopathy), liver failure, and bleeding from the dilated veins of the esophagus and stomach. Ascites in liver cirrhosis (enlargement of the abdomen due to fluid accumulation) is formed due to stagnation and increased pressure in the liver. venous system abdominal cavity.

Why does ascites form?

To fully carry out its tasks, the liver is equipped with a mass of blood vessels, from the smallest capillaries to large regional ones. Through the venous system, “waste” blood, containing substances for processing and destruction, enters the lobules. Arteries collect everything from cells healthy foods, synthesized in the liver.

Both vessels are located together in the interlobular septa, forming the framework of the liver tissue. With cirrhosis, connective tissue cells begin to grow and compress the vessels passing between them.

As a result, the entire blood supply system collapses: compression of arterioles leads to ischemia and tissue necrosis, venules quickly thrombose, and the passage of venous blood through the hepatic vein.

Along the chain, stagnation and increased pressure spread to all underlying venous pathways that collect blood from the abdominal cavity and lower limbs.

Fluid from the bloodstream is able to penetrate the walls of the veins; it accumulates between the layers of the peritoneum. Protein deficiency and an increase in sodium in the blood aggravate the retention of the liquid part of the blood.

Lymphatic drainage is also disrupted, and up to 70% of the body's lymph accumulates in the liver. It begins to leak through the vessels into the abdominal cavity.

IN normal conditions there is up to 200 ml of liquid in the small pelvis. In liver cirrhosis, ascites accumulates several liters of content.

Signs of ascites

The manifestation of ascites does not occur suddenly, but as a result of prolonged chronic process. This is a mild symptom. It occurs when the patient has lost enough weight, there is yellowness of the skin and sclera, and the liver is significantly enlarged and painful.

Other signs appear before ascites venous stagnation: spider veins on the skin upper sections, bleeding from the veins of the esophagus, nose.

Fluid accumulation can be objectively judged by measuring abdominal circumference daily. The navel turns outward and stretches umbilical ring muscles. Veins become visible on the skin of the abdomen, they are located with branches around the navel, forming the symptom of the “head of Medusa”. At the same time, swelling in the legs increases.

The main symptom is a significantly enlarged abdomen, which causes an increase in intra-abdominal pressure, elevation of the diaphragm, and difficulty breathing (shortness of breath).

The load on the heart increases sharply, a rapid heart rate appears, arrhythmia and pain in the heart area occur. Impact on the diaphragm causes belching and heartburn.

When viewed in vertical position the stomach looks saggy; when lying down, it spreads out “like a frog.”

Types of ascites

Ascites in liver cirrhosis is determined by ultrasound or during diagnostic laparoscopy(examination of the peritoneum and liver special device through a skin incision) even in the initial stages, when there is no large belly.

Based on the amount of liquid, it is customary to distinguish three types:

• small - liquids up to three liters;
• medium - the fluid level increases, but the diaphragm does not react, there is no stretching of the muscles of the anterior abdominal wall;
• large - liquid volume more than 20 liters, violated motor function patient has difficulty breathing.

Depending on the response to therapeutic measures Ascites in liver cirrhosis can be:

• transient (transient), if it quickly disappears after treatment;
• inpatient, when, despite the improvement of the patient’s condition, it is not possible to completely get rid of excess fluid;
• progressive (tense) - treatment does not reduce the process of fluid accumulation, the abdomen increases.

The transient form is often small in volume. To determine the increase in ascitic fluid, the patient needs to weigh himself daily.

Therapeutic measures

Diet for ascites requires table correction No. 5: from food products Not only are all spicy and salty dishes excluded, but the appearance of edema requires salt-free preparation of dishes. You can consume no more than 5 g (teaspoon) per day. Cheeses, smoked and fried meats are not allowed.

The total volume of liquid is limited to 1–1.5 liters and is strictly controlled: the volume of urine excreted is measured daily, the allowed amount of liquid can be 200 ml less, and the calculation of liquid includes water for drinking and taking medications, tea, juice, soup.

To reduce ascites, it is necessary to improve the condition of the liver. For this purpose, it is carried out active treatment cirrhosis.

The patient is prescribed drugs that improve liver cell metabolism, vitamin complexes, bile thinners. In case of cardiac cirrhosis, the dosage of glycosides that have a positive effect on the heart muscle is selected.

Diuretics are prescribed under the control of daily urine output (diuresis). The difference of 200 ml must be observed. Increased urine output in one day will lead to increased weakness, loss of necessary electrolytes, and can provoke the development of encephalopathy. The specific choice of diuretic medication is a matter for the doctor. Apply complex treatment diuretics with different mechanisms of action.

Patients in the stage of decompensation are very sensitive to any infection. Therefore, it is necessary to use antibiotics if peritonitis is suspected.

Performing a puncture (laparocentesis)

Abdominal puncture is performed if there is no response to diuretics. The procedure is performed by a surgeon or trained therapists under sterile conditions.

The patient is offered to be released bladder, sit on a chair (in in serious condition placed on its side). After local anesthesia, a puncture is made with a thick needle (trocar) below the navel along the midline of the abdomen. Through it, it is possible to gradually remove the accumulated liquid. You cannot release more than 6 liters of fluid in one session. This is dangerous due to the development of a collaptoid state ( sharp drop blood pressure). After the procedure, the patient’s abdomen is tightly tied with a bandage.

Repeated laparocentesis may lead to local inflammation peritoneum, adhesive fusion of intestinal loops and anterior abdominal wall. This poses a risk of peritonitis for subsequent procedures.

The human liver is gradually destroyed under the influence of various aggressive factors, such as toxins, hepatitis virus, and alcohol. At this process sequential death of organ cells begins. They are replaced by connective tissue. But the latter cannot fully perform all the functions of the liver. As a result, a person develops cirrhosis. This is an extremely serious pathology. It is often accompanied by serious complications. The most severe of these is ascites; in cirrhosis, such a patient requires more responsibility, and the prognosis is significantly worse.

Characteristics of the pathology

Let's figure out what this pathology does not occur on its own. It develops against the background of liver cirrhosis or other pathologies. Ascites is a complication in which fluid accumulates in the abdominal cavity.

It should be noted that liver cells simply have unique ability to regeneration. But, unfortunately, under the influence negative factors, long-term or permanent impact on the organ, internal reserves are gradually depleted. Healthy cells die. They are replaced by connective tissue.

The death of the liver leads to a deterioration in blood purification. The human body accumulates a variety of harmful substances. The main filter is not able to produce the required number of enzymes and proteins. Namely, they ensure the occurrence of many important processes in the body.

As a result of the cessation of sufficient protein production, the leakage of fluid through the tissues and walls of blood vessels is disrupted. This leads to fluid gradually beginning to accumulate in the abdominal cavity. This is how ascites develops in liver cirrhosis. Treatment should begin immediately, since complications accompanying cirrhosis can progress quite quickly.

Reasons for the development of the disease

Why does ascites occur? The pathology is mainly the result of insufficient protein synthesis. Lack of albumin reduces the blood's ability to remain in vascular bed. In other words, this leads to the fact that fluid through the walls of the veins begins to easily penetrate into the abdominal cavity.

In addition, when considering liver cirrhosis, another factor should be mentioned. Such a complication can be caused by insufficiency lymphatic system. It is mainly the liver that produces lymph. Developing cirrhosis seriously violates this system. As a result, lymph pressure increases, and fluid penetrates into the peritoneum. Since the process of weakening the main filter does not end, fluid gradually accumulates in the body.

Thus, the development of ascites in cirrhosis is based on several factors:

1. Increased permeability
2. High education lymph.
3. Impaired kidney function, characteristic of cirrhosis. As a result, blood flow changes and sodium retention in the body is observed.
4. Increased pressure in the hepatic vessels. This leads to the penetration of liquid in large quantities into the tissue.

Symptoms of cirrhosis

First, let's look at what signs liver pathology signals. By the way, men often suffer from cirrhosis. The disease is diagnosed in them almost 3 times more often than in women. That is why we will analyze the symptoms that indicate the development of the disease in the stronger half.

If we consider early signs liver cirrhosis in men, the following should be highlighted:

1. Under the rib, in the right side, appears unpleasant feeling heaviness or pain. Discomfort increases after physical activity, eating spicy or fatty foods or alcohol.
2. Unpleasant taste in the mouth - dryness, bitterness.
3. The occurrence of nausea, often ending in vomiting.
4. Feeling of weakness, increased fatigue.
5. Frequent and loose stool. Such disorders are often accompanied by bloating.
6. Severe weight loss, sometimes reaching the point of exhaustion.
7. Appearance skin itching. Skin acquire a pale yellow tint.
8. Pathology in men manifests itself as sexual impotence.
9. An enlarged liver can be easily felt under the skin. Upon palpation, you can determine that the organ has become dense and lumpy. The patient experiences pain when touching the liver area.

Also, pay attention to visual livers in men:

1. The palms are painted a bright red hue. This occurs as a result of hyperthermia.
2. The tongue turns red. It is characterized by swelling and a certain “varnishing” (change in texture).
3. Availability spider veins. They can be localized near the nose, in the corner of the eyes. Sometimes they start to bleed.
4. Increase in size mammary glands. This symptomatology is typical exclusively for men. In this case, the patient’s genitals are significantly reduced.

In addition, cirrhosis is manifested by a number of specific symptoms:

1. Inadequate blood clotting leads to bruising and bleeding.
2. Urine takes on a cloudy, brown tint. The stool becomes lighter.
3. Fever appears periodically and body temperature rises.
4. Immunity decreases.
5. Sometimes hemorrhoids occur with bleeding. It is often accompanied by varicose veins.

Symptoms of ascites

Against the background of the symptoms described above, quite unpleasant complication, characterized by the accumulation of fluid in the peritoneum.

Symptoms of ascites are not immediately noticeable. Pathology can only be determined when at least 1 liter of fluid accumulates in the peritoneum. Subsequently, the number increases. Sometimes the patient accumulates up to 25 liters of fluid.

The pathology is characterized by the following symptoms:

• the stomach increases in size;
• the skin in this area is overly stretched;
• during movement, waves are felt inside the peritoneum;
• when tapping on the stomach, a dull sound is heard;
• veins become noticeable;
• Nausea and swelling may occur;
• the patient experiences stomach pain;
• the navel protrudes.

It is very important to take a responsible approach to such a pathology as ascites in liver cirrhosis. Treatment should begin as early as possible. Otherwise, the disease will progress rapidly.

Complications of the disease

Unfortunately, this pathology can lead to serious consequences. One of the most severe complications is peritonitis. It occurs against the background of the fact that the ascitic fluid becomes infected. Peritonitis without timely medical care may cause death.

The following symptoms indicate the development of this disease:

• weakening or absence of bowel sounds;
• worsening symptoms of encephalopathy;
• leukocytosis is observed in the blood;
• temperature rises in liver cirrhosis with ascites;
• chills occur.

Of course, peritonitis is not the only pathology that can develop against the background of this disease.

Sometimes observed the following complications ascites in liver cirrhosis:

• the occurrence of hemorrhoids as a result of increased intra-abdominal pressure;
• hydrothorax (this is an effusion of fluid into the pleura);
• esophageal reflux (stomach contents enter the esophagus);
• internal organs are displaced;
• Diaphragmatic hernias appear.

Stages of the disease

The question often arises: if ascites is diagnosed in liver cirrhosis, how long do such patients live? Of course, the prognosis depends on the stage of the disease. It is unlikely to recover from liver cirrhosis in which ascites occurs. But if noticed in a timely manner characteristic symptoms, then it is possible to slow down the progression of the complication. On last stage It is very difficult to recover from the disease. That is why it is important to identify the disease in a timely manner.

Ascites is characterized by 3 degrees:

1. The initial stage is characterized by a slight increase in the abdomen. With this degree, the patient accumulates about 3 liters of fluid in the peritoneum. The prognosis is quite favorable. Therapeutic measures allow you to delay progression and thereby prolong the patient’s life.
2. Further development of ascites is characterized by accumulation in the peritoneum more liquids (from 4 to 10 liters). The clinical manifestations of the disease are clearly visible. They cause serious discomfort to the patient. The shape of the abdomen is severely deformed. Many patients develop kidney failure.
3. At stage 3, more than 10 liters of fluid accumulates in the patient’s peritoneum. The patient's condition worsens. A person may experience difficulty breathing because big belly does not allow the lungs to expand normally. There is a disturbance in the functioning of the heart. Swelling appears throughout the body.

Pathology prognosis

No doctor can say with a 100% guarantee, if ascites is diagnosed in liver cirrhosis, how long patients with this disease will live. After all, each case is purely individual.

Unfortunately, the pathology often ends in death as a result of sequential intoxication with acetones. According to statistics, about 10% of patients with this complication live approximately one month.

However, very often doctors promptly compensate for the patient’s condition with diuretics, potassium and magnesium medications. This helps prevent the progression of the disease.

It is known that timely and competent manipulations can extend a person’s life, even in the presence of a complicated form of ascites, up to 10 years.

Treatment of pathology

Therapy gives excellent results if it is started at early stages. In this case, it is possible to combat quite effectively a pathology such as ascites in liver cirrhosis.

Treatment includes:

• drug therapy to control fluid accumulation in the body;
• dietary nutrition;
• special methods to ensure the evacuation of fluid from the peritoneum.

To combat liver cirrhosis and ascites, doctors recommend the following drugs:

1. Essential phospholipids. These medications ensure the restoration of damaged molecules of fat and carbohydrate layers cell membrane. Such drugs are “Essentiale”, “Phosphogliv”.
2. Antiviral medications. They are medications: Ribavirin, Adefovir. These medications are prescribed if the pathology occurs due to viral hepatitis.
3. Synthetic hepatoprotectors. They normalize cholesterol levels and also protect against exposure to bile acids hepatocytes. An excellent representative of this group is the drug “Ursodeoxycholic acid”.
4. Anti-inflammatory steroid drugs. They are recommended for patients who have been diagnosed autoimmune lesion liver. Such patients are prescribed the drug Prednisolone.
5. Diuretics. For ascites and cirrhosis of the liver, diuretics must be prescribed. The following drugs may be recommended: Lasix, Diacarb, Aldactone, Spirix.
6. Hepatoprotective amino acids. These medications improve metabolic processes, occurring in the body. However, they do not have a hepatoprotective effect. These medications include the following medications: Ornithine, Methionine.
7. To normalize colloid pressure, doctors prescribe the drug Albumin.

If drug treatment does not provide positive effect, is being undertaken surgery- laparocentesis. This manipulation involves removing fluid from the peritoneum using a special needle.

Diet food

It is very important for a patient suffering from this disease to adhere to a certain diet. As a rule, the patient is assigned table No. 5.

The diet for liver cirrhosis with ascites is based on the following features:

• caloric content of the diet varies between 2500-2900 kcal;
• exclude foods that stimulate the production of digestive enzymes in the body;
• consumption of fatty, spicy, fried, salty foods is limited;
• It is recommended to eat 4-5 times a day;
• allowed meat products, streaked with fat;
• vegetable fiber is useful;
• fluid volume during the day - 1.5 liters;
• in case of exacerbation of the disease, pureed vegetables are recommended;
• daily diet: protein - 100 g, fats - 70 g, carbohydrates - 400-450 g.

Folk remedies

Sometimes it is recommended not only medications and diet for a patient diagnosed with ascites due to liver cirrhosis. Treatment with folk remedies included in complex therapy, can bring quite noticeable relief. However, you should know that it is impossible to cure pathology solely with the recipes of healers.

1. Parsley decoction. For 1 liter of water you will need 300 g of fresh raw materials. Boil, let the product brew and strain. The decoction should be taken 0.5 tbsp. every hour during the first half of the day. Therapy lasts 3 days.
2. Bean pods. Boil the husks from 15 pods in 1 liter of water for 10 minutes. Then leave the product for 20 minutes. Strain. It is recommended to take the first dose (200 ml) at approximately 5 am. Drink the second serving 30 minutes before breakfast. The third - half an hour before lunch. The remainder should be consumed no later than 8 pm.

It should be recalled once again that ascites is serious pathology, which can very quickly lead to death. And most often, the death of patients is caused by late access to doctors. Therefore, be attentive to your condition and the health of your loved ones.

A large amount is vital important functions performed by our liver. She is the first to take the hit when toxins enter the body. Every day, the liver pumps about one hundred liters of blood, cleansing it. It is very important to monitor her health. Serious illness is ascites of this gland, which mainly occurs against the background of cirrhosis. Ascites is an accumulation of fluid in the abdominal cavity.

Causes of development of liver ascites

There are several reasons for the development of liver ascites. The main one is cirrhosis. Ascites in liver cirrhosis develops as a result of increased pressure in the portal vein. When dying large quantities liver cells, replacement with fatty and connective tissue, blood vessels are also overgrown. This leads to blockage, which significantly increases the pressure in still healthy vessels. Blood plasma gradually begins to leak through the walls of blood vessels and veins, filling the entire abdominal cavity.

In liver cirrhosis, the lymphatic vessels are also affected. Lymph stagnates, which also leads to its release into the abdominal cavity. These are the changes observed in people who drink alcohol. long time. During the stage of cirrhosis, the functions of all systems and organs change. Thus, ascites in liver cirrhosis may appear as a result of heart failure. Alcohol intoxication affects the heart muscle. The organ gradually begins to become overgrown with fat, which makes its work more difficult. Vascular blockages occur.

Cirrhosis also provokes a decrease in protein levels in the blood. Happening protein deficiency. The liver stops producing albumin, which is very important for the body. The retention of sodium and water in the body begins, which enter the abdominal cavity. The affected liver becomes unable to produce many vital hormones. Other causes of liver ascites include:

• Kidney diseases;
• Congenital edema;
• Diseases of the biliary tract;
• Loss of blood plasma;
• Congenital nephrotic syndrome;
• Malignant tumors;
• Tuberculosis of the abdominal organs.

Symptoms of ascites

Symptoms of ascites are associated with the rapid accumulation of fluid in the abdomen. This process is associated with thrombosis portal vein. But the disease may develop gradually over several months. In the latter case, the patient experiences flatulence and a slight increase in abdominal circumference. Also, the following main symptoms of liver ascites can be noted:

• Hemorrhoidal bleeding;
• Bleeding veins in the esophagus;
• Venous network on the surface of the abdomen;
• Nausea;
• Pain, heaviness in the abdomen;
• Memory loss.

Many patients experience swelling of the upper and lower extremities. There is a significant increase in body weight. Experts note that during palpation of the abdominal cavity, a dull sound is produced when tapping. Also, when pressed, you can feel the movement of the liquid in a wave-like manner.

In the case of severe ascites, symptoms such as dilated veins and a protruding navel occur. The increase in the abdomen occurs evenly. The formation of a hernia is often observed. Such visible symptoms it's hard not to notice. The amount of stagnant liquid can reach up to 25 liters. This liquid is considered sterile and does not contain bacteria.

Types of liver ascites

Ascites in cirrhosis can be divided into three degrees, according to the amount of accumulated fluid:

1. Less than three liters. Visible symptoms are rare. The disease can only be detected by ultrasound examination, laparoscopy. IN in this case the likelihood of a quick cure is highest.
2. More than three liters of liquid. The abdomen is visually enlarged, but the anterior wall of the peritoneum is not elongated. Violated brain activity sick. Symptoms of liver failure appear.
3. More than ten liters. As a result of a strong increase in the abdomen, breathing is impaired. Heart function deteriorates. Observed chronic fatigue, apathy, swelling of the whole body.

In medicine, ascites is also divided into three groups, depending on the nature of the behavior of the fluid in the abdominal cavity:

• Transient ascites - with timely detection easy to treat;
• Stationary ascites - conservative treatment does not give the desired result;
• Tense ascites - treatment does not bring results with a constant increase in fluid.

It is worth noting that ascites develops for at least ten years after the diagnosis of liver cirrhosis. To make a prognosis for ascites, it is worth identifying whether it is compensated or decompensated. In the first case, the patient will be able to live at least another 7-10 years from the moment the disease is diagnosed. The second case is difficult. Patients live no more than three years in the absence concomitant diseases from the central nervous system.

Treatment

Treatment of ascites in liver cirrhosis is aimed at eliminating fluid from the abdominal cavity. This requires local therapy, and surgical intervention. Diuretics will help eliminate the symptoms of ascites. Among them the following can be noted:

• Furosemide;
• Veroshpiron;
• Bumetonide;
• Torasemide;
• Nephropil.

Diuretics for ascites are prescribed in such a way that independent control of fluid output occurs. After all, if it is suddenly removed in large quantities, collapse can occur. The drug use regimen is prescribed only by the doctor, based on specific situation. If there is a visible increase in the abdomen, it is acceptable to remove one liter of fluid per day. If there are no visible symptoms of ascites, no more than 0.5 liters are excreted.

To reduce the level of sodium chloride in the body, diet No. 5 is required. Its essence is the complete elimination of salty foods, and table salt. In this case, the amount of liquid you drink should not exceed 1.5 liters per day. But the amount of protein in the body should be increased with the help of protein foods, but not dramatically. Required condition is complete failure from alcohol and other bad habits.

If a large amount of fluid accumulates, surgical intervention is required, in parallel with diet. The fluid is removed by puncture. The procedure is carried out in a hospital, observing all disinfection measures. The patient is given local anesthesia in the abdominal area, then a puncture. Liquid is slowly released through this puncture, no more than five liters at a time. After some time, the puncture is repeated. The more punctures, the higher the chances of developing abdominal infections. Adhesions of intestines and ducts may occur.

If ascites is accompanied by cardiac dysfunction, the patient should avoid stressful situations. In case of heart failure, restriction in water and salt intake is required. Drugs are prescribed to reduce the risk of myocardial infarction. Also, supportive therapy for the kidneys is required.

During the period of diagnosis and treatment, the behavior of the patient’s relatives plays a very important role. Under no circumstances should you put pressure or reproach a person. Any depression of his psyche will lead to complications. It is necessary to understand and accept the problem, to support in every possible way those suffering from cirrhosis and ascites. A dangerous complication is hemorrhage into the abdominal cavity. Therefore, it is necessary to protect the patient from heavy physical activity.

Relatives should observe any changes in the patient's behavior. An important aspect is regular stool, which leads to the systematic elimination of harmful toxins. It should be at least once a day. Blood impurities in stool are unacceptable. If any are found, be sure to inform your doctor. You can monitor the healing process by measuring your body weight and abdominal volume daily.

Principles of nutrition

In case of ascites caused by the presence of cirrhosis, it is necessary to replenish the missing vitamins and microelements. But, some of them are introduced very carefully. Thus, the disease is accompanied by a lack of protein in the body. It is not recommended to take it directly immediately. On initial stage you need to inject with albumin solution. Any food is prepared without the use of salt.

Restriction on the amount of carbohydrates consumed is required. But, if they are completely excluded, it is not possible (the patient has diabetes mellitus), are allowed complex carbohydrates: fruits, cereals, vegetables. In case of compensated cirrhosis, it is worth consuming dairy products, beef, lean fish, egg white, buckwheat, soy flour.

If liver cirrhosis is decompensated, the amount of protein consumed should be minimal (no more than 30 grams per day). It is important to eat more foods with potassium content: fruits, berries, cottage cheese, natural juices, dried fruits. It is necessary to compensate for the lack of zinc, phosphorus, and calcium. Also, in small quantities are introduced:

• B vitamins;
• Tocopherols;
• Calciferols;
• Ascorbic acid.