Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The list of causes of ascites begins with the liver. Regardless of the reason
for liver failure, a malfunctioning liver cannot make enough protein to maintain
oncotic pressure to keep fluid in the circulatory system.
Causes of ascites due to liver problems include:
Cirrhosis describes a form of liver failure in which
liver tissue that is damaged is replaced by scar tissue. As more liver tissue is
lost is progressive liver failure occurs. Alcoholic liver disease or alcoholic
(hepar=liver +itis=inflammation), viral hepatitis (B or
C), and fatty liver
disease are the most common causes for cirrhosis.
Acute liver failure can
result in ascites. This may be due to any acute injury to liver cells including
adverse reactions to medications or drug abuse (for example, liver failure is the major
consequence of acetaminophen overdose).
Cancer that has metastasized or spread to the liver can also be the source
Other causes of ascites include:
Heart failure is the inability of the
heart muscle to adequately pump the
fluid within the blood vessels. This can cause a variety of problems, but most
notably, fluid backs up into the lungs and other organs causing them to fail.
This water overload can cause leakage into the peritoneal cavity and the
formation of ascites.
Nephrotic syndrome, in which kidney damage causes
protein to leak into the urine, decreases oncotic pressure and may result in ascites.
Disorders of the pancreas can result in ascites in a
variety of ways. Acute pancreatitis (inflammation of the pancreas) can cause fluid accumulation as part
of the inflammatory response.
Chronic pancreatitis can result in malnutrition, leading to decreased total body
protein, loss of oncotic pressure, and ascites.
Pancreatic cancer can cause direct fluid loss.
Direct irritation of the peritoneum can cause it to leak fluid as part of the
inflammation process. This irritation may be due to a
malignancy (cancer) or
Diseases of the ovary can be associated with ascites.
Cancer of the ovary has no initial symptoms, and many women will have the
diagnosis made because they develop ascites. Meigs syndrome is a benign
tumor of the ovary called a fibroma that presents with ascites and
effusion (fluid in the cavities surrounding the lungs). The hard surface of an
ovarian tumor may cause
significant irritation of the peritoneum, causing it to leak fluid.
Ascites is found uncommonly in
thyroid function). Usually
the hypothyroidism has been untreated for a prolonged period of time, and the
ascites resolves when thyroid levels in the body return to normal.