Ascites / Paracentesis : I have posted... - British Liver Trust

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Ascites / Paracentesis

Mls1973 profile image
13 Replies

I have posted before on how my husband has alcohol related cirrhosis. He stopped drinking the day he was admitted in the hospital, Aug 12, 2022. He remained there for 1 week. Since he has been released, his ascites has got worse. It has prevented him from eating and makes him very tired and hard to breath. He had an MRI on Oct 10, 2022. The findings were: Lungs: Trace bilateral pleural effusions, AORTA/IVC: Normal signal and contour. The celiac, superior mesenteric and inferior mesenteric arteries are patent. The portal veins are patent. Recanalized paraumbilical vein and small gastroesophageal varices. IMPRESSION: 1. Stable examination demonstrating cirrhosis and portal hypertension with large volume ascites. 2. No evidence of hepatic mass. His physician assistant wrote “Stable findings compared to previous imaging. Ascites. Cirrhosis of the liver. No liver masses.” I’m assuming the recanalized paraumbilical vein and portal hypertension have something to do with the ascites. The trace bilateral pleural effusions would explain why he is coughing constantly. And I think the ascites has something to do with this. He has a paracentesis scheduled on Thursday. For those of you who have gone through this, what can he expect afterwards? Will he be able to eat more? I’m sure he shouldn’t over do it but will his appetite increase. Will this help with his fatigue and breathing (he does not nor ever has smoked)? Does the umbilical hernia go away? We have also heard that the fluid usually comes back. Is there away to help keep it from coming back? Does it usually come back immediately? Any insight will help.

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Mls1973 profile image
Mls1973
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13 Replies
redpoint72 profile image
redpoint72

hello love.

I've experienced ascites,its not pleasent at all. It is so unbelievably uncomfortable.that was one of my first big signs of decompensated liver. I was hospitalized with it....I wasn't eating anything really,very little . I was being weighed every morning....fluid just kept increasing....so In the end,I had several paracentesis done...if I remember rightly,the first amount was 12 or 13 litres. The relief was tremendous. I could breathe properly again. Walk so much better,but over time fluid did increase again,so another drain,then another. I was put on spironolactone and furosemide, after that. Its kept the fluid at bay,until recently,but am now gaining fluid in lower legs.but not stomach. I also had a hernia,but I had to wait a year before it was operated on,as my bloods had to settle back down. It was to risky to operate until they had stabilized.My appetite did increase abit after that...but there was nothing of me,so was put on ensure plus protein shakes.

hope this helps.

Take care .my best Chris

Mls1973 profile image
Mls1973 in reply to redpoint72

Thank you. It does help. His doctor has put him on the same diuretics you are on. It has not done much for the fluid in his stomach but has helped with the swelling in his feet, ankles and legs. I’m hoping once he gets a drain, the diuretics will manage the fluid from coming back. I did buy him Ensure Protein Max and INLIFE Liver Care Hepstan Protein Powder. He drinks about 4 ounces at a time. I’m glad you are doing better. Do you still get fluid drained? Is this a life long thing?

redpoint72 profile image
redpoint72 in reply to Mls1973

well I think if the fluid reaches a certain level,diuretics dont work,that's what my consultant said to me.... but after the drains,the diuretics can keep the fluid at bay. I had to follow a no salt diet,as well as high protein. I'm classed as compensated at the moment. Although with the fluid in my legs and my last set of bloods being unsettled,I'm awaiting a consultation with my gastro consultant to see what's happening .Having the drains are ok.....its just the initial anesthetic needle,which isn't good!! I gripped the ward sisters hand that hard!!!

I hope your husband goes on ok with the paracentisis,and gets some relief.

take care love. Chris.

Lam1e profile image
Lam1e

hi

I had ascites pre transplant and required regular drains. Diuretics we’re not suitable for me. 3/4 months pre transplant I was draining 6/7 litres every 8 days.

It always made me feel better, able to eat, breathe, sleep and do more exercise. If your husband hasn’t seen a specialist dietitian, then it would be well worth him doing so. Their advice is so useful.

Hope the diuretics help, and that the paracentesis helps👍

Rshc profile image
Rshc

my partner had awful awful ascites and edema everywhere, legs, stomach, groin, back as for a while he wasn't able to take diuretics. He was hospitalised and put onto a diuretic drip and then sent home with oral diuretics (in May). The diuretics do take time to work, you may not see them working at first but try weighing regularly at the same time each morning and see if you notice a difference. So far my partner hasnt needed a drain since May

Jcm999 profile image
Jcm999

I have found that spironolactone keeps the fluid away/down for me. I also drink herbal tea and eat smaller lighter meals but often. I eat a very low salt diet and also have cut out or down on saturated fat and sugar. I had to research this myself but it seems to work for me. It is frightening when it happens. I hope you get the support and information you need. I do find that my hospital and GP just don't explain things to me - it's as if they expect me to know and understand! Good luck with everything.

TummyGrumpy profile image
TummyGrumpy

I can relate to all the treatments discussed here. I'm a short (5'1") and skinny person by nature. I, too, had ascites. At first, I was put on furosemide (40 mg) and spironolactone (first 25 mg; later upped to 100 mg. Didn't really help with the ascites initially, and they couldn't do a paracentesis due to gas bloating (in the way), so told me to take Gas-X. Few months from then, I finally was able to get the drain done. Being small like I am and although nothing to the amount of others, they were able to get 2 liters drained, leaving 1 liter they couldn't get to due to the intestines in the way.

That's the only paracentesis I've had so far. And, though no thin waistline, it did feel so much better to do things. I did notice it was coming back to the point of being uncomfortable and hard to do things (like put on socks or cook on the stove top of my son's digital gas stove without always turning the baking power on with my belly. Ugh), but due to other factors, I was not able to make an appt to see the GI Dr. Also, my feet, ankles, AND legs were having the most edema I've had so far!

However! Two simple things I did start doing, well three when it came to the edema. On the edema, I found a couple of YouTube videos on simple movement exercises to open up for that flow back as well as put your feet up above your heart level. On the ascites (and possibly the edema as well), the two main things I have started doing is very simple. 1) Simple stretch exercises like toe touches, bending over from my waist as far down as I could side-to-side, big-step marching in place (lift those knees high!), and massages to my abdomen and colon (helps move the gas and BM, too). (Plus I wear an abdominal hernia belt daily now.) 2) This is my biggest surprise... I started drinking LOTS more water! (I put a little lemon juice in mine for taste). To my logic that almost sounds contradictory to the problem, but it does play into logic in drinking more water also "watering-down" the salt in the body.

I still do these simple things daily, and in one month's time, (from 9/13 to 10/13), since I take and record my weight every morning and my waist measurement also, I went from a weight of 123.8 to 110.0 (in pounds) and waist of 36 inches to 32 (in inches)! I'm still maintaining the 110 lbs, and today waist is measuring between 31 and 31 1/2 inches! So, bottom line for me is: Drink plenty of water! and MOVE, MOVE, MOVE!

Hope that is encouraging !

Lisa (from USA)

Mls1973 profile image
Mls1973 in reply to TummyGrumpy

Thank you. This is encouraging. I’ll have to look for some of those YouTube videos. He does need to move more. He just feels so fatigue with the ascites. I’ll be reading your comment to him. Thanks again.

TummyGrumpy profile image
TummyGrumpy in reply to Mls1973

Mls1973, this was one thing I really didn't want to consider, because really, though diabetic too, I like drinking sugar free drinks (Dr Pepper Zero Sugar, Sparkling Ice, and stuff like that). But, turns out my favorites usually were made using carbonated water (which also can cause gas/bloating).

All that said, and to get to my point I'm trying to reach, drinking plenty of water throughout the day can also help with fatigue (as well as many other things). I like to think of it this way: the negative symptoms our body feels are typically caused by toxins either induced or made by the body due to health-related conditions, so the toxins build up and cause many other issues as well. Water though, is the ONE thing that the body can use to help flush out those toxins.

Mls1973 profile image
Mls1973 in reply to TummyGrumpy

Lol! That makes sense. And thank you for the article.

TummyGrumpy profile image
TummyGrumpy

The online exercise videos I liked the best are the ones you can do lying or sitting. I understand the fatigue. I still have trouble sleeping past 4am and can often just doze off when sitting in this computer chair. Sleep is also important, but when I know I'm up for the day, I sometimes even have to set the computer alarm for things I need to accomplish and set my mind to just get up and do them. lol It can be tiring, and make you feel short of breath, but on a positive note (I live with my son and his family), it's okay to go at my own speed and take my time. I don't have to be spot-on quick like they are (whether they understand or not). lol (Besides, they eat too fast anyways. Haha! Not the best.)

Mls1973 profile image
Mls1973

I like the alarm idea. That will definitely help keep him on tasks. Because I can tell him to do something and he’ll tell me he forgot. Thank you.

TummyGrumpy profile image
TummyGrumpy in reply to Mls1973

If he's like me, don't forget to choose the time (15, 30 min or 1 hr) on the computer alarm's snooze, so when I lag, sure enough, it reminds me again. 😉⏰

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