Ascites vs. Beer Belly

Reviewed on 8/6/2020

What Are the Definitions of Ascites and Beer Belly?

A large, bloated belly can be a sign of either ascites or a beer belly.
A large, bloated belly can be a sign of either ascites or a beer belly.

The definition of ascites is an abnormal accumulation of fluid in the space between the organs in the belly and the wall of the belly. In the U.S., the most common cause of ascites is cirrhosis of the liver.

The definition of a beer belly is simply a large, protruding belly. It is also called a potbelly, a spare tire, or referred to as apple shaped. A beer belly is an accumulation of a large amount of visceral fat (the fat that surrounds your abdominal organs). Visceral fat pushes your abdomen outward as it builds up, but because it is underneath the muscle, the belly feels hard. This is in contrast to subcutaneous fat, which is located just under the skin's surface and results in a soft belly.

What Are the Main Differences Between Ascites and Beer Belly?

Both ascites and beer belly result in a large, protruding hard belly that can resemble that of a pregnant woman's belly. Ascites often results in a rapid weight gain in contrast to a more gradual gain with beer belly development. Some patients with ascites may develop spontaneous bacterial peritonitis, hernias, and fluid in the chest. Tests like ultrasound, CT, or paracentesis (test and/or treatment for ascites fluid or fluid removal) usually diagnose ascites in contrast to a clinical diagnosis of belly fat that does not produce detectable abdominal fluid.

However, the causes of the large belly are different for ascites and beer belly and are presented below.

What Are the Main Differences in the Symptoms and Signs of Ascites vs. Beer Belly?

Symptoms of ascites that are different from beer belly include

  • belly pain,
  • difficulty breathing, and a
  • feeling of fullness after eating only a small amount.

If the fluid in the belly becomes infected, symptoms may include

If you have been diagnosed with ascites and have these symptoms, see your doctor immediately.

What Are the Main Similarities Between the Symptoms and Signs of Ascites and Beer Belly?

Ascites and beer belly appear similar outwardly. Symptoms and signs of ascites and beer belly that are similar include a

  • large, distended belly/abdominal bloating,
  • hard belly, and
  • weight gain.

What Causes Ascites vs. Beer Belly?

The most common cause of ascites is cirrhosis of the liver, which is responsible for about 80% of cases.

Other conditions that can cause excess abdominal fluid buildup include the following:

Beer belly isn't generally caused by drinking too much beer but rather taking in too many calories. That said, a standard 12-ounce beer contains about 150 calories, so drinking a lot of beer can contribute to weight gain and a beer belly.

Causes of beer belly include

  • consuming excess calories and a
  • sedentary lifestyle

Males are more likely to develop beer belly because men tend to gain weight in their mid-section while females tend to gain weight in the hips, thighs, and buttocks.

Does Beer Cause Ascites?

Drinking beer (or other liquor) doesn't directly cause ascites, but excess consumption of beer may lead to ascites for the following reasons:

  • The most common cause of ascites is cirrhosis of the liver.
  • The most common cause of cirrhosis is alcoholic liver disease.
  • Alcoholic liver disease can result from alcohol abuse.
  • Thus, excessive consumption of beer may lead to ascites.


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What Procedures and Tests Diagnose Ascites vs. Beer Belly?

To diagnose ascites, tests to detect fluid in the belly include the following:

  • Ultrasound
  • CT scan
  • Paracentesis: A medical professional inserts a needle into the belly to remove a sample of fluid and then sends it to a lab. This can help diagnose the cause of the fluid buildup and if the fluid is infected.

Beer belly in itself is not a medical condition, but abdominal obesity increases the risk of certain conditions such as heart attack, stroke, diabetes, and erectile dysfunction.

For men, a waist circumference of 40 inches or greater, and for women, a waist measurement above 35 inches, increases the risk of health problems.

What Are the Treatment Guidelines for Ascites for Ascites vs. Beer Belly?

Treatment for ascites depends on the cause and severity.

If cirrhosis is the cause of ascites, treatment may include the following:

If symptoms of ascites are severe, treatment may include the following:

  • Drain fluid using paracentesis.
  • A doctor may implant a transjugular intrahepatic portosystemic shunt (TIPS) in the liver to help reduce fluid build-up.
  • Liver transplant, if liver disease is severe

Treatment for beer belly involves weight loss. This involves good old-fashioned diet and exercise.

Are Ascites or Beer Belly Serious?

The prognosis for ascites depends on the cause and severity. If ascites is due to heart failure, patients may live for many years if treated promptly and managed appropriately.

However, ascites due to cirrhosis usually indicates advanced liver disease, and the outlook is not as good.

If a patient has malignant ascites (ascites in patients with cancer), the prognosis is poor, and the mean survival time is between 20-58 weeks.

Beer belly in itself is not deadly, however, it can increase the risk for serious illnesses that can be deadly, such as diabetes, heart attack, and stroke.

How Can You Prevent Ascites vs. Beer Belly?

Preventing ascites involves preventing the conditions and risk factors that can lead to fluid buildup in the abdomen.

  • Avoiding alcohol or reducing alcohol intake may help prevent cirrhosis, the main cause of ascites.
  • Patients with existing liver disease should also avoid nonsteroidal anti-inflammatory drugs (NSAIDs) that can harm the liver.
  • Follow a low-salt diet as advised by your doctor or nutritionist.
  • Take diuretics (water pills) as advised by your doctor.

It's possible to prevent a beer belly by following a healthy diet and exercising regularly to keep your weight in check.

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Reviewed on 8/6/2020
Harvard T.H. Chan School of Public Health. "Waist Size Matters." <>.

Runyon, Bruce A. "Evaluation of adults with ascites." Apr. 9, 2019. <>.

Simon, MHarvey B. "Beer belly." Apr. 2, 2018. <>.

United States. National Institute of Diabetes and Digestive and Kidney Diseases. "Symptoms & Causes of Cirrhosis." March 2018. <>.