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Ascites

Category: Illness or disabilities

Type

Involuntary

Introduction and description

 

Ascites describes an accumulation of fluid in the peritoneal cavity, in some medical definitions the amount is stated -  that it exceeds 25 mL – in other cases, the definition is just simply left as ‘abnormal accumulation’.  The term is from Greek askítes meaning "baglike".  Ascites is a form of localised oedema or anasarca, in the old days it was simply termed dropsy. 

Symptoms

The abdomen of a person with cirrhosis showing
'massive ascites' and prominent superficial veins

Mild ascites is hard to notice, but severe ascites leads to abdominal distension. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm.

Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient ("flank bulging"), "shifting dullness" (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).

Causes

Other organ damage

Ascites can be a sign of illness in one of the nearby organs – the liver, the stomach, the gall bladder, heart, pancreas and even the intestines.  Fluid may accumulate because the heart is too weak to enable the removal of the accumulating fluid or the fluid may be acting like a cushion to protect damaged or diseased organs.  In the latter case it may be very unwise to remove the fluid, as this protective layer is there for a purpose, it may be causing inconvenience, on the other hand, removal may end up causing the person a great deal more pain and distress, depending on which organ is damaged and by what.

Ascites is the most common complication of cirrhosis, with a prevalence of approximately 10%. Over a 10-year period, 50% of patients with previously compensated cirrhosis are expected to develop ascites. PMID:  22541699

The body does these things for a purpose.

Extreme emotion

 

Some false pregnancies are due to the absolutely overwhelming desire by a woman to have a baby; the body obliges with a pseudo baby – a big bundle of fluid. 

False pregnancy is termed pseudocyesis by doctors when women get it, couvade syndrome when men get it  and  pseudopregnancy when animals get it.   There is no underlying disease in true false pregnancy, as such it is not an illness but an odd condition. 

It can be a condition which occurs accidentally, it may be as a result of an emotional upset, but one can deliberately induce a false pregnancy in order to obtain a spiritual experience ranging from full kundalini type experiences to out of body, hallucinations, visions plus others.   Both men and women can get this – odd though it may sound.

Where the cause is not a false pregnancy, Ascites can be caused by extreme emotion such as shock or fright, or even frustration.  The following is an example

Illustrations Of The Influence Of The Mind Upon The Body In Health And Disease, Designed To Elucidate The Action Of The Imagination - Daniel Hack Tuke, M.D., M.R.C.P
Dr. Py, physician to the hospital at Narbonne, reported in the "Gazette de Sante".the case of a boy, set. 11, in whom ascites occurred under the following circumstances: Pierre Peyrel, having lost his father, imagined in a dream that he returned and embraced him, which gave him a great fright. He was a pupil at the "Hotel de la Charite," and the officers of the establishment were surprised next morning to find the abdomen distended (enfle du ventre comme un ballon), as the lad had played and taken his food as usual the preceding day. He was found by the doctor to be feverish, the pulse small and hard, and the abdomen painful and tender. Medicines having failed to remove the effusion, the surgeon to the hospital drew off ten pints (Paris measure) of clear fluid, the cure being completed by local frictions and diuretics.

Historically  the link between negative emotion and the appearance of ascites was well known.  It was believed to be a punishment from the gods for oath-breakers among the Proto-Indo-Europeans.  In other words, an indicator that oath-breaking had taken place.   “This proposal builds on the Hittite military oath as well as various Vedic hymns (RV 7.89, AVS 4.16.7).” Similar beliefs were held by the Kassites (12th century BC). The Jews even used it to weed out women with a guilty conscience about adultery.....

Numbers 5

21 then the priest shall charge the woman with an oath of cursing, and the priest shall say unto the woman, The Lord make thee a curse and an oath among thy people, when the Lord doth make thy thigh to rot, and thy belly to swell;
 22 and this water that causeth the curse shall go into thy bowels, to make thy belly to swell, and thy thigh to rot: And the woman shall say, Amen, amen.
23 And the priest shall write these curses in a book, and he shall blot them out with the bitter water:
 24 and he shall cause the woman to drink the bitter water that causeth the curse: and the water that causeth the curse shall enter into her, and become bitter…………..
27 And when he hath made her to drink the water, then it shall come to pass, that, if she be defiled, and have done trespass against her husband, that the water that causeth the curse shall enter into her, and become bitter, and her belly shall swell, and her thigh shall rot: and the woman shall be a curse among her people.
28 And if the woman be not defiled, but be clean; then she shall be free, and shall conceive seed.

Pharmaceuticals

Doctor prescribed pharmaceuticals can cause ascites.  The mechanism is simply the damage they do to the various organs – kidneys, liver, heart and so on.  Pharmaceuticals cause inflammation and the ascites protects the inflamed organ.  The eHealthme site collects the Adverse Drug Reports submitted by doctors to the FDA and SEDA in the USA.  In October 2017, there were  24,815 reports from FDA and social media of ascites caused by pharmaceuticals.

This LINK should take you to the eHealthme website and the entry for ascites.  If you scroll down you will find the heading ‘drugs that could cause’, if you press the link it will take you to a list of all the drugs implicated and the number of people in the USA who have suffered.  This LINK may take you there directly, although we have had problems with broken links from this site, due to reorganisation. 

Nutritional deprivation

 

Ascites is a sign of specific types of nutritional deprivation and is associated with Kwashiorkor (childhood malnutrition).  It occurs in the nutritionally deprived in general, not just those who are starving:

We present the case of a woman aged 48 years, diagnosed with anorexia nervosa (AN) at the age of 12. She was admitted to a highly specialised eating disorder facility with distended abdomen, muscular atrophy, ulcerative dermatitis, electrolyte derangements and low serum albumin. Her weight was 53.1 kg, corresponding to a body mass index (BMI) of 17.9 kg/m2.   After initial stabilisation, a therapeutic ascites puncture relieved the patient from 6500 mL of ascites. After 6 weeks of nutritional and diuretic treatment, the patient was discharged with a weight of 46.8 kg (BMI 15.7 kg/m2), without ascites and with healed ulcerations. The condition was consistent with kwashiorkor, a complication to malnutrition rarely seen in AN.  PMID:  27852657

Ascites actually subsides once nutritional deprivation ceases, leading one to suspect that the presence of the ascites is again a protective measure – the fluid protects the shrunken stomach and intestines from damage, as well as any other organs that become exposed due to the lack of protective muscle and body fat.

Treatment

Find the cause from those above.  No pharmaceuticals are needed, you must treat the root cause not the symptoms.  We repeat, the body does these things for a purpose.  In the same way one would never burst a blister, because it is a protective cushion, one really needs to do nothing to ‘treat’ the ascites.  But one does need to find out why it is happening – heart problems or organ damage, emotional problems, nutritional deprivation or ill-advised pharmaceutical use.

  • Ultrasound investigation may reveal any disease in other organs and thus identify the source of the problem.
  • Blood tests – may help to find pathogens that may be the root cause of the problem
 

The procedure used to sample ascetic fluid is called Paracentesis (from Greek κεντάω, "to pierce"), it  is a form of body fluid sampling procedure, in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid.  Generally it is not a procedure one would perform if other less intrusive methods of diagnosis are available, as there are risks associated with the procedure, and the open wound, however small, is a means of entry for pathogens.

Removal of the fluid for diagnostic purposes, achieves very little, as it is usually surrounding organs that are diseased, the fluid is merely a protective cushion –like a blister. 

The main reason why one might wish to do this is if the pathogen causing the organ damage has leaked into the ascetic fluid, in which case taking fluid may have a diagnostic role.  If the organ disease is cancer, it may also help in diagnosing whether the cancerous cells have shed into the fluid, in other words it helps to identify whether Metastasis is taking place – metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body.

Related observations