Ascites and Alcoholic Liver Disease
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Ascites is a condition that refers to the accumulation of fluid in the peritoneal or abdominal cavity. Ascites is most commonly caused by liver damage and other medical terms for this condition include peritoneal cavity fluid, hydroperitoneum or abdominal dropsy.  Ascites that is caused by liver damage is referred to as cirrhotic ascites. Ascites in the abdomen can also be traced back to other sources such as heart failure, kidney failure, and cancer.

Ascites is traditionally divided into two types or categories – exudative and transudative ascites depending on the amount of protein found in the peritoneal fluid. Another method to categorize the type of ascites is by measuring the amount of albumin in the fluid and compare this to the serum albumin found in the blood. This is referred to as the SAAG or the Serum Ascites Albumin Gradient. Ascites caused by cirrhosis or heart failure generally has a SAAG score greater than 1.1 whereas the SAAG score of ascites caused by other reasons is generally lower than 1.1.

Causes of Ascites
-- The most common cause of ascites remains liver disease or Cirrhosis. Nearly eighty percent of all reported cases of ascites can be traced back to advanced liver damage. It is believed that the increase in pressure in the liver blood flow along with a decrease in the albumin content in the blood may be responsible for the development of abdominal ascites.
-- Salt and water retention can also contribute to the severity of ascites symptoms.
-- Congestive heart failure
-- Kidney failure / kidney damage
-- Obstruction of the portal vessel without cirrhosis such as tumors and blood clot formation
-- Certain cancers such as Colon Cancer, stomach cancer, Lung Cancer, pancreatic cancer, Ovarian Cancer, breast cancer and lymphoma can lead to malignant ascites
-- Chronic pancreatitis or inflammation of the pancreas caused by alcohol abuse can result in pancreatic ascites

Diet for Ascites
-- An ascites diet focuses on the reduction of your intake of sodium. Remedies and medication for ascites may have little or no effect if you have a high sodium intake. You will need to drastically reduce your salt intake – the maximum recommended intake of sodium per day should be 2000mg or 4 to 5 grams. Salt substitutes may be used but make sure they do not contain any potassium as potassium can react adversely with medications used to treat ascites.
-- You will need to avoid ready to eat meals and processed food items, especially products such as salad dressing, food mixes, and sauces as they tend to have a very high sodium content.
-- Eating a heart-healthy diet low in fatty and cholesterol rich foods is also recommended. The American Heart Association recommends meals high in fiber, vitamins, minerals, and whole grains but low in fats and refined sugars.
-- If there is too much fluid present in the abdomen, some alternative therapies suggest a milk-only diet for a few days or until the symptoms subside. Once the fluid levels in the abdomen are reduced, light meals such as vegetable soup and whole wheat bread can be slowly added back into the diet.
-- Foods that are recommended in the ascites diet include buttermilk, salads containing raw radish, honey, asafetida, and garlic.
-- Avoid starchy foods like rice, grains, and potatoes as far as possible.



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