how can someone physically tell about ... - British Liver Trust

British Liver Trust
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how can someone physically tell about having ascites?


Hi can anyone please help me with it. How would I know if my father is having fluid accumulation? I mean are there any physical symptoms, or any clue which points ascites?

22 Replies

Ascites/oedema is when fluid begins to gather under the skin and yes there are signs and symptoms. Swollen/puffy ankles and legs might indicate oedema, ascites can cause the stomach to become distended and full of fluid - in advanced stages the patient will appear as if they are very late stage in a pregnancy with a very rounded and bloated tummy.

It is a medical emergency and the fluid will need to be drained or else it will push on other internal organs such as the lungs and heart and can cause major breathing difficulties. Where it compresses the stomach the appetite will be very much affected and IF the fluid were to become infected (which it can) then the patient would become very poorly indeed.

This is always something that my husband is monitored for at his clinic appointments with doctors always checking his tummy and ankles.


in reply to AyrshireK

Can you feel it by touching you GUT? Like if you are not at the clinical how will you it's an emergency?

in reply to ZABohra

Is it necessary that foot swelling be accompanied with stomach swelling?

in reply to ZABohra

Does his tummy look more puffy/bloated than usual? Or his ankles? Even (I hate to say it his scrotum) may appear more bloated. If any of these look or feel more enlarged than usual they should be checked out. A lay person touching the tummy might not pick up the difference which a medic would. An ultrasound scan would pick up the presence of fluid or doctor palpating the tummy as they do in a physical exam.

Can any one else who has suffered ASCITES in the past give ZABohra a patients perspective on how it actually feels to the patient as the fluid builds up and they she can perhaps ask her father if he experiencing similar. My hubby has never had it (thankfully) so can only speak from experience of the negative tests he's had and from seeing others with it.

If in doubt ZABohra get it checked out medically.

Katie x

Here is something I found on the Internet about Ascites ...........

Grading of ascites and suggested treatment.

Grade of ascitesDefinitionTreatment

Grade 1 ascitesMild ascites only detectable by ultrasoundNo treatment

Grade 2 ascitesModerate ascites evident by moderate symmetrical distension of abdomenRestriction of sodium intake and diuretics

Grade 3 ascitesLarge or gross ascites with marked abdominal distensionLarge-volume paracentesis followed by restriction of sodium intake and diuretics (unless patients have refractory ascites)

D'abord, if your Dad just has swollen ankles this is not ascites but it is called oedema .

Ascites will generally i think develop AFTER periods of oedema

Ascites will make the abdomen feel bloated and uncomfortable when it gets to grade 3 - It's difficult to know when it's mild - and only the doctor who has the training can detect a moderate level but if tummy looks a bit big then it's possibly ascites

Don't wait to get ascites but restrict salt intake is best advice also if your Dads ankles are swollen then he Needs to see a doctor for dieuretics

Hi, I have had ascites. I did find that I had very little appertite, but mostly found that I was out of breath very easily. Simply walking left me breathless and stopping to gasp for air. My ankles and legs became swollen as well as my tummy. I put on a lot of weight suddenly. My shoes size went up to enable me to get footwear on.

If in doubt, go straight to the doctor to get him examined! X


Hello. I am similar to sweet Janey. I looked pregnant, severe difficulty walking, getting comfortable, intense itching, veins could be seen through my skin on my stomach. It felt as though my diaphragm was being wrenched upwards. Ate and drank really tiny amounts. Ended up drinking tiny amounts through a straw. It came on so rapidly. I am on diuretics 150mg daily since Sept. Swelling gone down a lot. Been left with some wrinkly skin in places! Had to take wedding ring off, since then I've had to have it reduced in size. I can still feel when my fluid starts to build. I watch my diet so carefully and plan my meals.

Please keep a very close eye.

Hope this helps

X x

in reply to Hidden

I agree, Mellow1 I had very bad ascites looked 9 months pregnant and it was so painful. I couldn't say more than 3 words at a time without having to take a breath that all gone now after drain and continued spironolactone but like you said it has left me with wrinkly skin on my tummy which I hate as it was so smooth before. But I am paranoid about keeping checking my stomach to see early signs of it returning. As AyshireK suggested ZABohra try tapping your dads tummy to hear if it sounds like a drum from fluid inside.

I was admitted to hospital and a drain was put into the side of my tummy to drain the fluid out, it was shocking how much was in there. I felt a lot of relief afterwards, and breathing returned to normal. I hope your father feels more comfortable soon.

Mellow, yeah my veins could all be seen as well. It is the quickest loss of weight I have ever had, I had put on over a stone in weight! I keep an eye on my weight now as I generally remain the same, as soon as I see it goes up suddenly I go to see the doctor. It is mostly under control now. I hope yours is as well Mellow x

For me the diagnosis of liver failure was made after my GP told me I had ascites and referred me to a gastroenterologist. Shortly after this I had what somebody has already mentioned - an infection in the fluid 'spontaneous bacterial peritonitis'. Ended up in resuscitation at A&E. that is as serious as it gets - can be fatal. Now I'm in the final stages of the assessment for a liver transplant. The bottom line is; if in doubt see the GP as a matter of urgency. (Jim - LAJs partner)

in reply to LAJ123

Dont give husband go for assessment transplant in march.push the nhs x

hi ive had odema for last 8 years gradually getting worse now i wake in the morning my feet are numb me legs get mis shaped if i rest one on the other and they hurt like hell now the leg bones and ankles hurt very much my weight is up and down but my consultant says i have not got ascites im on spirolactone 200mg a day and furosimide but if his legs and ankles start to swell then you need to get it all checked out


Two suggestions - have you tried sleeping with your legs raised ? Gravity helps to drain the fluid. Two or three pillows should be enough. Together with the diuretics it works for my oedema. Secondly, do not rest one leg on the other, never cross your legs - can cause a deep vein thrombosis.

I've just done a post as my husband is in hospital just now having his Ascites drained, although he has always had a bit of a "beer gut" as we would call it, suddenly when we were on holiday he said became really unwell and was struggling with walking any distance, having to stop to catch his breath, lost his appetite, and his stomach became much more bloated and was tight as a drum when you tapped it.

He's been in hospital since Tue, and the doctors were only giving him water tablets (which did not make much difference) and it was only once they got the liver specialist in did they put a drain on, and since yesterday at 2pm he has now had 18 Litres of fluid drained from his stomach.

I'm worried sick because his kidney function is really low and that needs to improve in order for him to have a tumour on his kidney removed (he only has 1 kidney)


Ascities,big tummy full of fluid,like pregnant,very uncomfortable

If it get like that need a drain,go gp or a and e

I have had it thrice. Its painful, I was uncomfortable, it affects sleeping because its impossible to sleep except for on my back. I have it in my abdomen. I have managed all 3 times to correct it but thats highly unusual. I get in the ocean to balance the fluid, there is something about water pressure outside the body having the ability to correct internal water pressure. I limit everything I eat and drink. I exercise a lot which helps move it out. I meditate instead of getting fearful about it but I have to admit its nothing to play around with. Its very dangerous and as I said earlier, its unheard of for anyone to restore the fluid balance. So far, so good, one day at a time or even one moment at a time. I wish you luck. If its bad enough, touch even hurts so much you can barely tolerate it. Its a tough disease.

in reply to Catfishjumpin

I've never heard of the water pressure thing before, will need to have a read up on that, anything I can find out to help him I will do.

in reply to Abhq

Even a tub of water filled to cover the belly helps balance the pressure which then causes me to urinate but whatever body of water, ocean, pool, tub one must stay covered in water over belly for almost an hour. I will see if I can find an article.

I thought I might have ascites so have done a lot of research. I know the ocean helps me a lot with fluid buildup as well. I am also a scuba instructor, and the phenomenon you are referring to is called immersion diuresis. I'll let you google it :)

Gently push two fingers on your tummy, If its spongy - little o no ascites... if its really hard - its probably Ascites, the breathing is the giveaway that it is. Draining or Diuretics If is less severe will solve it. I ave advanced cirrhosis - - I started on drain once a fortnight, now not needed at all as its under control although my feet and lower legs are bloated, but thats not necessarily related to liver disease - many other conditions can cause that = AIH. Lipodeama. heat disease etc etc

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