What causes ascites? 18 possible conditions

When fluid builds up inside the abdomen, it is known as ascites. Ascites usually occurs when the liver stops working properly. Fluid fills the space between the lining of the abdomen and the organs.

People with cirrhotic ascites have a two-year survival rate of approximately 50 percent. If you experience ascites symptoms, talk to your doctor as soon as possible.

Ascites Causes and Risk Factors

Ascites is most often caused by liver scarring. This increases pressure inside the liver’s blood vessels. The increased pressure can force fluid into the abdominal cavity, causing ascites.

Liver damage is the single biggest risk factor for ascites. Some causes of liver damage include:

  • cirrhosis
  • hepatitis B or C
  • a history of alcohol use 

Other conditions that may increase your risk of ascites include:

  • ovarian, pancreatic, liver, or endometrial cancer
  • heart or kidney failure
  • pancreatitis
  • tuberculosis
  • hypothyroidism

Symptoms of Ascites

Symptoms of ascites can appear either slowly or suddenly, depending on the cause of the fluid buildup. 

Symptoms don’t always signal an emergency, but you should talk to your doctor if you experience the following:

  • sudden weight gain
  • a distended (swollen) abdomen
  • difficulty breathing when lying down
  • diminished appetite
  • abdominal pain
  • bloating
  • nausea and vomiting
  • heartburn

Keep in mind that ascites symptoms may be caused by other conditions.

Diagnosing Ascites

Diagnosing ascites takes multiple steps. Your doctor will first check for swelling in your abdomen. Then they’ll probably use imaging or another testing method to look for fluid, including:

  • ultrasound
  • CT scan
  • MRI
  • blood tests
  • laparoscopy
  • angiography

Treatment for Ascites

Treatment for ascites depends on what’s causing your condition.


Diuretics are commonly used to treat this condition. They increase the amount of salt and water leaving your body to reduce pressure within the veins around the liver. 

While you’re on diuretics, your doctor may want to monitor your blood chemistry. You’ll probably need to reduce your alcohol use and salt intake.


This procedure uses a thin, long needle to remove the excess fluid. It’s inserted through the skin and into the abdominal cavity. There is risk of infection, so people who undergo paracentesis may be prescribed antibiotics.

This treatment is used most commonly when the ascites is severe or recurrent. Diuretics don’t work as well in such late-stage cases.


In extreme cases, a permanent tube called a shunt is implanted in the body. It reroutes blood flow around the liver.

Your doctor may recommend liver transplant if ascites does not respond to treatment. This is generally used for end-stage liver disease.

Preventing Ascites

Ascites can’t be prevented. However, you can lower your risk by protecting your liver with these healthy habits:

  • Drink alcohol in moderation. This can help prevent cirrhosis (scarring of the liver).
  • Get vaccinated for hepatitis B.
  • Practice safe sex. Hepatitis can be spread sexually.
  • Avoid intravenous drug use. Hepatitis can be transmitted through shared needles.
  • Be aware of the potential side effects of your medications. If liver damage is a risk, talk to your doctor about whether your liver function should be tested.

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See a list of possible causes in order from the most common to the least.



This condition is considered a medical emergency. Urgent care may be required.

Peritonitis is the inflammation of a thin layer of tissue inside the abdomen. Caused by bacteria or fungus, it causes tenderness, bloating, fatigue, greying of the skin, and other problems.

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Alcoholic Liver Cirrhosis

Drinking too much alcohol can harm the liver. It can result in a serious disease known as ALC (ALC). The liver in the organ in your body that is responsible for the breakdown of harmful toxins like alcohol. It als...

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Liver Cancer

Liver cancer causes destruction of liver cells and interferes with the ability of the liver to function normally. Cancer that originates in the liver can spread from the liver to other parts of the body.

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Chronic Pancreatitis

The pancreas is vital to digestion and blood sugar regulation. Chronic pancreatitis is long-lasting inflammation that causes nausea and pain in the abdomen, and may eventually lead to scarring.

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Congestive Heart Failure (CHF)

Congestive heart failure is a chronic condition that affects the four chambers of the heart. Early symptoms include fatigue and weight gain. Irregular heart beat and wheezing indicate a worsening.

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Hepatitis is swelling and inflammation of the liver. It's usually caused by a viral infection. There are several types of hepatitis, including: A, B, C, D, and E. Symptoms may not occur until liver damage occurs.

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Cirrhosis is severe scarring and poor function of the liver caused by long-term exposure to toxins such as alcohol or viral infections. Certain medications and disorder can also cause cirrhosis.

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Pancreatic Cancer

Pancreatic cancer is cancer of the pancreas, an organ that secretes an enzyme that breaks down fats, carbs, and proteins. Pancreatic cancer can obstruct the outflow of bile from the liver and causes yellow skin.

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Hepatic Vein Thrombosis (Budd-Chiari Syndrome)

Hepatic vein thrombosis (HVT) is an obstruction in the veins of the liver caused by a blood clot. This condition blocks blood flow from the liver to the heart. Without proper blood flow, the liver stops getting th...

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Non-Hodgkin’s Lymphoma

Non-Hodgkin's lymphoma is a lymphatic system cancer. Symptoms may include swollen lymph nodes, chest pain, fatigue, and fever.

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Ovarian Cancer

The ovaries are small, almond-shaped organs located on either side of the uterus that produce eggs. As the disease progresses, symptoms include back pain and indigestion.

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Pericarditis is the inflammation of the sac that surrounds your heart. The sac is a double-layered membrane called the pericardium. The pericardium protects your heart and helps it function properly.Pericarditis can b...

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Burkitt's Lymphoma

Burkitt's lymphoma is a relatively rare and aggressive form of non-Hodgkin's lymphoma, a type of cancer of the lymphatic system. It's most common in children living in sub-Saharan Africa.

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Hepatitis B

Hepatitis B is liver inflammation caused by the hepatitis B virus (HBV). It can be chronic or acute, but most cases are chronic. This disease is easily spread through blood, saliva, and other body fluids.

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Hepatitis C

Hepatitis C is a disease that causes inflammation and infection in the liver. Symptoms of chronic cases may not be obvious at first, whereas acute hepatitis C sets in quickly after exposure to the virus.

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Alcoholic Liver Disease

Damage to the liver from excessive drinking can lead to ALD. Years of alcohol abuse cause the liver to become inflamed and swollen. This damage can also cause scarring known as cirrhosis. Cirrhosis is the final stage o...

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Hepatitis E

The hepatitis E virus is spread most often by contaminated drinking water. It is different from the hep-A virus but the symptoms are similar. Most cases clear up on their own after a few weeks. In other cases, the viru...

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Hepatitis D

Hepatitis D is an infection of the hepatitis D virus that causes your liver to swell and is uncommon in the United States. It is almost always contracted by people with hepatitis B.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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