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The challenge of the medical community: What are the complex causes behind ascites?
Ascites, a term translated from the Greek word "askos," meaning "bag" or "sac," is a medical term for an abnormal accumulation of fluid in the abdomen. When the fluid in the abdominal cavity exceeds 25 ml, it will be diagnosed as ascites, and its volume can sometimes reach more than ten liters. This situation not only affects the patient's quality of life, but may also cause a series of complications, such as spontaneous bacterial peritonitis.
Symptoms of ascites may include abdominal swelling, weight gain, abdominal discomfort, and shortness of breath. Severe ascites can cause a distended abdomen and increase the risk of breathing difficulties, primarily because the fluid presses on the diaphragm.
Causes of Ascites
In medical research, the cause of ascites can be traced back to a variety of diseases, the most common of which is cirrhosis of the liver. According to medical data, more than half of patients with cirrhosis will develop ascites within ten years of diagnosis. From a mortality perspective, half of those patients who develop ascites will die within three years. Other causes of ascites include cancer, heart failure, tuberculosis, and pancreatitis.
Diagnostic Methods
The process of diagnosing ascites usually includes a physical exam, ultrasound, or CT scan. Doctors will confirm the presence of ascites based on your medical history and symptoms and then do the necessary tests. If new-onset ascites is diagnosed, a paracentesis is often recommended to analyze the fluid, which can help determine the underlying cause.
The serum-ascites albumin gradient (SAAG) test can clarify the nature of ascites. If it is higher than 1.1 g/dL, it usually indicates ascites caused by portal hypertension. Otherwise, it is non-portal hypertension ascites.
Common treatment methods
The first step in treating ascites is to identify and treat its underlying cause. In cases of mild ascites, treatment is usually with a low-sodium diet and diuretics, with the goal of achieving daily weight loss, and the patient's electrolyte levels should be monitored to prevent complications.
If ascites is severe, hospitalization and abdominal paracentesis may be required. This is a way to reduce pressure in the patient's abdomen by removing excess fluid.
Challenges Ahead
Despite advances in current diagnostic and therapeutic approaches, the management of ascites remains challenging. For patients whose disease is ineffective or difficult to control with drugs, the medical community is seeking more effective surgical treatment options, such as liver transplantation or transjugular intrahepatic portal shunt (TIPS), but these treatments are still accompanied by potential complications.
In addition to finding effective clinical treatments, how to improve the allocation of medical resources to deal with various complications caused by ascites is still an important issue that the medical community needs to solve in the future.
Questions for consideration
When we face the complex disease of ascites, should we consider the patient's overall health and lifestyle in order to more effectively manage this condition?
