What is ascites, and why does it occur?

Ascites is a complication of portal hypertension and one of the most difficult complications to manage. As pressure builds in the portal vein, the body tries to reduce this pressure by leeching the liquid part of blood, called plasma, through the vessel walls into the abdomen. Although this transfer of plasma reduces portal pressure, it increases fluid accumulation in the body.

The management of ascites requires patience and close attention by both the physician and the patient. The initial treatment of ascites is restriction of dietary sodium to less than 2,000 milligrams per day and often fluid restriction to 2 liters per day. Diuretics can be added in a progressive, stepwise fashion.