Ascites or belly fat?: Is there a way to... - British Liver Trust

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Ascites or belly fat?

Mywildlove profile image

Is there a way to tell a difference in the two besides weighing yourself? My fiancé looks like he has put a bit of weight on in his belly and his face. His face was looking gaunt so I’m thankful for the weight but I’m worried it’s ascites coming back as he has stopped his diuretics a couple of weeks ago. His appetite is basically the same, he eats well and low sodium. Thank you in advance.

16 Replies

Being a potentially life threatening complication of liver disease ascites is too serious to be allowed to go unchecked. See if you can persuade your fiancé to see a doctor & if the doctor can't tell on examination if he has ascites then he should send him off for an ultrasound which ought to settle the matter. If your fiancé refuses to see a doctor then show him the following quote from hepatologist Dr Melissa Palmer's book. If he still refuses after reading it then ask him if he has a death wish.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"Ascites is the most common complication of portal hypertension. Once ascites has developed, the patient now has decompensated cirrhosis. The chances of this person living one year drops from greater than 90 percent to less than 50 percent. Thus, the development of ascites is a serious complication that requires prompt evaluation and treatment. Ascites is a disorder characterized by massive accumulation of fluid in the peritoneal cavity—the space between the abdominal organs and the skin. In addition, the kidneys tend to retain sodium and water in people with portal hypertension, leading to further fluid accumulation. This accumulation results in abdominal swelling and distention. In most cases, the disorder is readily apparent to the doctor on a physical exam. In cases where the diagnosis of ascites is suspected but not obvious, an abdominal sonogram can be used to detect whether small amounts of ascitic fluid, often as little as 100 ml, have accumulated."

You can grab hold of belly fat, whereas ascites is more akin to a pregnant belly - in that the fulness is behind the muscle wall.

I would make an appointment with your gp just to be sure. Tell them you need an urgent appointment not a routine one.

They should see fiancé pretty quickly considering his condition.

My ascites went after a short course of diuretics, thankfully it hasn't recurred since that first time, just over a year ago - so stay hopeful ☺

Best of wishes


Bihu profile image
Bihu in reply to Garyvh

Is rib cage pain & constipation cramps are symptoms of ascites

weight gain in the face means he may just be putting on some pounds or the liver is affecting other processes in the body that cause weight gain besides ascites. Hormones get out of balance and man may hold weight in his face and belly, the liver can also change thyroid function that can slow down or speed up metabolism. Why is he off the diuretic?

If he is gaining an abnormal amount of weight based on what he is eating I would find out the cause and get back on the diuretic if needed. How is his weight compared to before he got sick or a normal weight for him?

Thank you all for replying. He eats quite a bit most days and the weight gain in his face looks more like filling out, if that makes sense. He always had a little bit of a belly due to his job, he’s a UI designer and works from home so he doesn’t get much exercise. His doctor told him to go off the diuretics about 3 weeks ago. The same day, I swear that smell he has went away too and he started feeling even better. But also he eats a ton of garlic so it’s hard for me to tell if it was the garlic or something else. We are waiting to hear back from his GI about a referral to a hepatologist so hopefully it will be soon. I will keep an eye on him and also see if he can grab his belly fat today haha that sounds so funny to me for some reason. Maybe I’m finally losing my mind! 😉

in reply to Mywildlove

Get it checked out just incase. Especially because he has had it before.

Mywildlove profile image
Mywildlove in reply to

I’m going to try to talk him into going to the ER tomorrow since he doesn’t have a GP yet (still ugh) just to be safe. thank ya kindly Phoenix 😊

in reply to Mywildlove

Its a pain in the ass I know but its better to be safe than sorry love. You know id never get you to worry for no reason and im not suggesting its anything. But youll worry more if you dont find out.

Mywildlove profile image
Mywildlove in reply to

Oh I know you wouldn’t, you’ve been absolutely amazing with information, advice, and support. You know your shit! And you’re right, I will definitely worry more if he doesn’t get checked out. He doesn’t want to go of course, he doesn’t think it’s fluid. He knows his body more than I do so I’m trying to believe him haha but we made a deal. We will keep a close eye on him for a couple of days, I’m going to call his GI office Friday (they’re closed tomorrow) and if there are any changes we will go to the ER. Sorry this ended up being so long 😬

Mywildlove profile image
Mywildlove in reply to

Oh wait this is Thursday. What the heck, I thought it was Wednesday all day long haha

in reply to Mywildlove

I had the same problem yesterday thinking it was Thursday. Took the garbage out for Friday morning pick up and everything lol

Mywildlove profile image
Mywildlove in reply to

I did that last week! Haha

And he said he doesn’t feel any fullness like he did before when he had ascites.

I forgot to add, he will be 49 next month so maybe age could have something to do with weight? I’m not reaching here, just trying to make sense of everything. He was looking pretty sickly for a while but now he looks healthier and healthier.

Ascitic fluid is usually a great deal harder to the touch compared to the usual fat and stomach muscle density you find in stomach area.

Can u plz explain if someone have ascites causes frequent urination is it sighn of ascites

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