Ascites is the abnormal accumulation of fluid within the abdomen, between the two layers of the peritoneum, the membrane that lines the abdominal organs. It may be caused by certain cancers, particularly in advanced stages of disease, but can also result from other conditions such as liver cirrhosis or heart failure.

Ascites may develop when:

  • Cancer has spread to the peritoneum.
  • Cancer affects the liver or increases pressure within the liver's blood vessels.
  • The lymphatic system is unable to drain fluid properly because of cancer.
  • The liver is damaged and produces fewer proteins, promoting fluid accumulation.

Ascites may cause the abdomen to enlarge and can lead to:

  • A sensation of bloating or abdominal distension.
  • Abdominal pain or discomfort.
  • Nausea or a general feeling of discomfort.
  • Indigestion.
  • Loss of appetite or feeling full quickly after eating.
  • Fatigue or weakness.
  • Shortness of breath (dyspnoea).
  • Rapid weight gain due to fluid accumulation.

Treatment

The most common treatment involves draining the accumulated fluid using a procedure known as paracentesis.

During this procedure, a needle or a small tube (catheter) is inserted into the abdomen after local anaesthetic has been administered. This often provides rapid symptom relief. Depending on the individual situation, the procedure may be performed on an outpatient basis or may require short-term hospital observation.

The fluid may reaccumulate over time, making repeat drainage necessary. If fluid build-up occurs frequently, a long-term or indwelling catheter may be inserted to allow regular drainage more comfortably.

In some cases, the medical team may recommend diuretics (medications that help the body remove excess fluid) to reduce or delay fluid accumulation, although they are not effective for everyone.

When Should You Contact Your Healthcare Team?

Contact your healthcare team if you experience:

  • Rapidly increasing abdominal swelling.
  • Significant abdominal pain.
  • Difficulty breathing.
  • Fever or deterioration in your general condition.
  • Persistent nausea or vomiting.

Preventing Infections

The immune system protects the body against infections caused by bacteria, viruses, fungi and other microorganisms. Some types of cancer and certain cancer treatments can weaken the body's natural defences and increase the risk of infection.

This may occur because:

  • Some cancers, particularly leukaemias and lymphomas, can affect the bone marrow and interfere with the normal production of white blood cells, which help fight infection.
  • Chemotherapy and some forms of radiotherapy can temporarily reduce the number of white blood cells in the bloodstream (neutropenia), increasing the risk of infection.
  • Surgery, central venous catheters, PICC lines and other medical devices can provide a route for microorganisms to enter the body if they are not properly cared for.

If your immune system is weakened, the following measures may help reduce the risk of infection:

  • Avoid close contact with people who have an infection, cold, influenza or another contagious illness.
  • Wash your hands frequently, especially before eating, after using the toilet and when returning home. Family members and carers should also maintain good hand hygiene.
  • Maintain good personal hygiene, including daily skin care.
  • Maintain good oral hygiene and regularly check for mouth ulcers, white patches or signs of infection.
  • Follow food safety recommendations by eating thoroughly cooked foods, storing food correctly and avoiding spoiled or unsafe products.
  • Care for your central venous catheter or PICC line according to the instructions provided by your healthcare team.
  • Always consult your healthcare team before receiving any vaccination. Some vaccines may not be appropriate during certain cancer treatments.
  • Avoid crowded places or environments with a higher risk of infection exposure if your healthcare team specifically advises you to do so.