Fluid restrictions ASCITES

[Male47]

My serum sodium is 137 mmol/L. Completely in normal range (133-146). I am taking spironolactone 300mg and furosemide 80mg. My question is how much do I need to restrict fluid intake for ascites due to cirrhosis?

[AyrshireK]

That should be a question you ask your own specialist. Don't go off what others have been told since drinking too little can cause issues - this is an individual thing best getting advice off your own doctor as per what is required in your own circumstances.

Katie

[Kristian]

What Katie said, lol.

Fluid intake that is right for you we cannot advise on. We may cause more harm than good and it may not even affect the amount of ascites anyway. Only restrict it if you are advised to do so by your doctor.

[BumbleCat]

Hi! I take 200mg if Spiro and 80mg if Furosimide and I don't reduce intake if water. They both have an important job to do. Spiro stops the build up, Furosimide flushes it away.

If I dint drink enough the tablets dint actually work properly and I feel worse.

You should be aiming for 1.5litres min of water. I try and hit 2 liters and find that's when I am my best.

Restricting your body of fluid will actually make your organs work harder. Kindneys have to be monitored with this level of meds and water is really important. 😁

[Male47 in reply to BumbleCat]

Thank you. I'm taking for ascites but so far I'm still gaining fluid. Maybe I'm taking in too little fluid, I've cut right back. Bloods all ok on then, was last checked Thursday.

[BumbleCat in reply to Male47]

I really wouldn't be cutting back. When I was carrying about 13 litres of fluid I was constantly nagged to drink. It's a hard mindset get around but the fluid you have is caused by pressure build up and so your body naturally holds onto fluid. It's not because you're drinking. 😁

[Male47 in reply to BumbleCat]

I know the more I can flush my liver the better and the ascites is the pressure from portal vein that the liver is causing. At first my albumin levels were ridiculous low but already up to 40. Only been sober just over 4 wks

[BumbleCat in reply to Male47]

It will take time. I was really impatient with how slow the ascities went, but it does happen. Do you weigh everyday? I was asked to weigh daily and record it in kg so you can see it is dropping.

[Male47 in reply to BumbleCat]

I do, but I'm on a 3500 calories a day diet to gain weight. Hard to tell which is fluid gained. I have to just look and feel

[BumbleCat in reply to Male47]

I get that. The eating more part of really hard when you've got ascities. 😪 Do ypu have a dietitian? There was a mantra that everyone said to me - The Liver Loves Food! I learnt how to eat little and often. Full sized meals were hard, so I had everything over about 6 meal times a day. Bet you need a lot of protein too?

[Male47 in reply to BumbleCat]

I'm on 6/7 small meals aday. I've been referred to a dietitian, they called me to book an appointment but it isn't for weeks. I'm learning all I can from the Internet

[BumbleCat in reply to Male47]

A good amount of protein and carbs with every meal, and a low/zero salt diet. I used and still do use My Fitness Pal (it's free) to track my protein, calorie and salt intake. By salt, it means zero processed foods, no added salt and any foods that has high salt in. This will help with fluid retention and salt natually holds fluid. Do you have ensure drinks? I see to drink 1 as a snack.

Protein yogurts are fab. Mini cheeses, fish, chicken, etc. I was told no pork and if I did, make sure it's cooked very well.

The liver stores your energy, and when it isn't working well, it can't release the energy so your Iver naturally works harder. The more good foods you eat, the more it stores and the easier it is for it to release. When it doesn't get the right nutrition, the liver will uses its reserves or itself to release energy, which isn't good if it's already damaged.

P.s.. I just want to say well done on being 4 weeks sober.

I don't have a liver Condition linked to alcohol but I admire you doing this.

[Male47 in reply to BumbleCat]

Thank you so that's great advice. I've downloaded my fitness pal. I buy protein yoghurt and drinks

[Male47 in reply to BumbleCat]

Does body weight size impact the amout of fluid. I'm 6'4" normally around 17stone currently 15stone. Surely someone 5'5 and 8 stone for example would need the same fluid???

[down-but-not-out]

I agree that this should be a question you ask your own specialist. I identify with what people have said insofar as I was told by my nurse to drink lots of water as the more you drink the more you flush through and that worked for me. I lost a lot of weight and went down to 20mg from 80mg of Furosemide. Congrats too on the 4 weeks - always a joy to hear of such success 🙏😀

[Tizzwas]

1.5 litres. I was told categorically not to drink more than that as it dilutes the sodium further and makes the liver work harder to flush the fluid out when it's already overloaded. It did work but I also had two paracentesis during that time. When I was first admitted the nurses kept saying you must drink more, you must drink more. As soon as I met my specialist nurse she said NO, you have enough fluid there without making it worse.

Best to ask your hepatologist or liver nurse as others have said.

[Male47 in reply to Tizzwas]

It appears we all get different information advice from our professionals on the fluid intake. Waiting on a call for blood sodium levels, they were taken yesterday . So far have always been spot on