Ascites is a condition characterized by fluid accumulation in the space between the internal organs and the wall of the abdomen, called the peritoneum or peritoneal cavity. Symptoms include a distended abdomen, difficulty breathing and a feeling of pressure or fullness in the belly. Ascites is rarely lifestyle threatening, according to MayoClinic.com, but it could be a sign of a more serious condition. Dietary management involving changes in sodium and protein intake can help alleviate symptoms.
Causes of Ascites
Ascites is frequently a complication of cirrhosis, which is a chronic and progressive liver disease. Cancer and heart failure increase the risk for developing ascites. Ascites occurs because the liver is unable to make certain proteins that circulate in the blood, such as albumin, which are needed to maintain the balance between fluids inside and outside of the blood vessels, or osmotic pressure. The reduction in circulating proteins in the blood leads to a leakage of fluid into the peritoneal cavity.
Increase Dietary Protein
Up to 4 gallons of fluid can leak into the peritoneal cavities. Protein also leak into the peritoneal cavity. In some cases, a minor surgical procedure, called a paracentesis, is necessary to remove the water; a lot of protein is lost during this procedure as well. Between 0.5 and 1 g of protein for every cup of water can be lost; hypothetically, a patient who has 4 gallons of fluid removed will lose between 32 g and 64 g of protein that will need to be replaced. Patients will require 0.54 to 0.68 g of dietary protein per pound of body weight; a 150-lb. person would need 81 to 102 g of protein per day
Restrict Sodium and Fluid
Ascites causes a decrease in the rate at which the kidneys filter sodium, resulting in sodium retention. Patients need to restrict sodium intake to less than 2 g per day. If blood tests show a sodium level far below normal, patients need to restrict fluid to 1,500 mL, or 6.3 cups, per day. Low blood sodium levels are an indication that the bloodstream is diluted with excess fluid; this could result in death. A doctor may prescribe diuretics to help increase blood sodium levels and remove excess water.
High-Protein, Low-Sodium Supplements
Protein supplements low in sodium in the form of powder or liquid should be used to increase protein intake. High-quality protein from meat sources may contain high amounts of sodium and compromise the necessary sodium restriction. Patients need to avoid the salt substitute potassium chloride. If diuretics are prescribed that conserve serum potassium, potassium levels could increase to dangerous levels and lead to heart arrhythmia or death.
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