Water in the stomach - causes, symptoms and therapy

Ascites; ascites

Will your waistline continue to tighten without you consuming more calories than before? Do you feel unpleasant pressure from the inside of the abdomen and suffer from abdominal pain? Are you constantly bloating without having eaten flattening foods like beans or onions? Are there even respiratory problems and circulatory problems? Then it is possible that you are plagued by dropsy, in technical jargon ascites. It is a pathological accumulation of fluid in the abdomen.

contents

• Ascites; ascites
• The balance of body fluid
• Why does water accumulate in the stomach??
• What role does the kidney play??
• Many dropsies
• Possible diseases
• Medusenhaupt and Leberstauung
• Liver coma and kidney failure
• Right heart failure
• protein deficiency
• hungry belly
• kidney disease
• tumors
• When is the doctor??
• diagnosis
• treatment
• What can you do yourself?

Cause is in 80% of the cases a liver damage, especially the liver cirrhosis. We then speak of a portal ascites. Other causes include tumors, inflammation of the internal organs or a disturbed discharge of lymphatic fluid. These are almost always serious health problems. Diseases that can cause abdominal dropsy include heart failure, liver failure, liver cirrhosis, liver cancer, liver metastases, stomach cancer, pancreas inflammation, peritonitis, and ovarian cancer.

The ascites is noticeable in an advanced stage by an extremely bloated belly. Cause can be in addition to liver disease, for example, a heart failure, peritonitis or the use of certain medicines. (Image: fizkes / fotolia.com)

The balance of body fluid

The largest part of our body consists of water that spreads to the cells, the spaces between the organs and the blood vessels. Only a small part of the fluid enters the tissue in a functioning organism, this absorbs the lymph channels and brings the water back into the veins.

Water that collects in the abdomen or other body tissue shows that the balance is disturbed. For example, more fluid pushes into the surrounding tissue when the wires are pressed. In addition to a dropsy in the abdomen, edema may also form in the legs or face. The latter, most people also perceive as particularly unaesthetic.

Why does water accumulate in the stomach??

A common cause of abnormal accumulation of water is increased pressure within the blood vessels, especially in cirrhosis, but also in heart failure.

A second cause is protein deficiency. When hungry it comes to the notorious Wasserbauch, as he is known from documentations about famine in Ethiopia or India. This is not primarily due to lack of calories, but an extraordinary lack of proteins. Thus, the water belly also forms in people who take enough calories or are even overweight, whose one-sided diet but contains too little protein. Examples of these are the people of Asia, who feed almost exclusively on rice, or Indians on the Amazon, who consume almost only manioc.

A third cause is weak cell walls. These become permeable, and the fluid enters the surrounding tissue. This happens especially with inflammations, which damage the cell structure, above all by viruses and bacteria.

The fourth cause is a lymphatic drainage disorder. This is especially due to scarring or tumors blocking the lymphatics.

What role does the kidney play??

An aquatic abdomen often increases due to misinformation that takes the kidney. If fluid enters the abdomen, the receptors in the vessels report that there is a lack of fluid, because the level within the vessels drops due to the water penetrating the abdomen. This also reduces the blood pressure. The kidney responds by excreting less urine and releasing hormones that raise blood pressure. This then causes even more fluid to enter the abdomen.

Many dropsies

Dropsy has different forms. We differentiate them depending on how the fluid that penetrates into the abdomen is composed.

1) Non-Inflammatory Ascites: If blood flow does not work, for example, in cirrhosis of the liver or in a weakness of the right ventricle, fluid enters the abdomen without cells being inflamed. This also applies to protein deficiency or tumors. However, such a non-inflammatory dropsy can irritate the peritoneum and thus lead to an inflammation of the peritoneum in an emergency. In turn, such inflammation can be fatal.

2) The inflammatory ascites: Here, the inflammation is not a consequence, but the cause of the accumulation of fluid. If the abdominal cavity has become inflamed, the organs and vessels become permeable and fluid can pass. The accumulation of fluid here is cloudy, and the doctor can prove in her pathogen.

3) The chylous ascites: In a disturbed lymph drainage, a milky fluid accumulates in the abdominal cavity.

4) Hemorrhagic ascites: Accumulation is not actually an accumulation of water but of blood. Internal injuries, bleeding to internal organs, small wounds in the abdomen, which do not close because of anticoagulants, lead to a swelling of the abdomen. In this case you must necessarily go to a doctor, or immediately to the hospital. There is danger to life due to bleeding. Ascites are an indication of a tumor cause.

For example, if liver function is compromised due to liver cancer or liver cirrhosis, increased accumulation of fluid in the abdomen is a typical consequence. (Image: magicmine / fotolia.com)

Possible diseases

Diseases of the liver are the most common cause of non-inflammatory dropsy in the abdomen. Thus, the portal vein collects the spent blood and brings it to the liver, where it is detoxified and brought back into the metabolism. Cirrhosis of the liver as well as thrombosis now cause extreme pressure on this vein.

Medusenhaupt and Leberstauung

Such a congestion can also be recognized externally. The fluid not only accumulates in the abdomen, but the blood also seeks other drains. These can be recognized as "Medusenhaupt" on the abdominal surface.

A weakness in the right part of the heart causes the blood to back up into the liver and destroy the cells there. In addition to jaundice, this leads to a disruption of blood coagulation and also to ascites.

Alcoholism and viral hepatitis are the main causes of cirrhosis. In this disease, useless nodular tissue replaces healthy lung tissue. The liver feels hard and gets small.

Liver coma and kidney failure

If the liver can no longer fulfill its functions, high pressure develops in the vein. The end result is the liver coma. Through the water retention, the kidneys are in full swing, which incorrectly assess the water entering the abdomen as a lack of fluid and produce less urine. If the kidneys now fail in addition to the liver, the disease can no longer heal and almost certainly leads to death.

Right heart failure

In a right heart failure, the heart can no longer pass the used blood in the right ventricle and from there into the lungs. Instead of oxygenating the blood and bringing it back into the bloodstream, the blood builds up in the liver. In addition to a dropsy in the abdomen, the fluid now also accumulates in the legs.

The ascites can also be the result of a so-called right heart failure, which should urgently be clarified by a doctor. (Image: ag visual / fotolia.com)

protein deficiency

As the protein in the blood plasma decreases, the osmotic pressure in the vessels decreases, thereby preventing them from holding the fluid and exiting the tissue through the vessel walls. The cause is malnutrition, which is often associated with malnutrition. It comes to the "hunger belly", which is known from the slums of the Third World. In this country, anorexics are often affected.

hungry belly

However, not only underweight suffer from this protein deficiency. Even and especially overweight people who eat one-sidedly, take too little protein to themselves. For example, from India, water retention in the stomach is known in obese children, who consume many calories, but almost exclusively consist of carbohydrates.

kidney disease

If the kidney corpuscles get sick and therefore more proteins are excreted via the urine, this can also lead to dropsy. Again, the low osmotic pressure is the cause of the ascites. Sometimes the mucous membrane in the stomach and intestine also absorbs too much protein. Then it also comes to a dropsy, in addition to severe diarrhea and weight loss.

tumors

If cancerous tumors form in the abdomen, they often block the lymphatic drainage and cause water in the abdomen. Liver cancer triggers the dropsy caused by the damaged organ and can cause any kind of water retention: inflammatory, non-inflammatory, clear, bloody or lymphatic.

The following cancers are often associated with dropsy: gastric, colon and liver cancer, peritoneal metastases and ovarian carcinomas.

When is the doctor??

They usually have no dropsy when their belly circumference increases. Often, bloating or digestive problems are the cause. These usually go back by themselves after a few days. A true dropsy in the abdomen develop especially people who are already affected by diseases of the liver and heart. This also applies to people who develop ascites as a result of cancer or peritonitis. The accumulation of water is almost never the first noticeable symptom here.

Patients are usually aware of their underlying condition when they visit the doctor for their dropsy. However, they also notice the water in the abdomen only when the abdominal volume is steadily increasing - the small amounts of water at the beginning often go unnoticed. If you suspect you have a dropsy, be sure to visit a doctor. Ascites can cause the peritoneum to spontaneously inflame. If the volume of the fluid increases, the breath can be interrupted.

An ultrasound examination not only serves to determine the accumulation of fluid in the abdomen, but also possible causes of the discomfort can be determined with the help of this diagnostic method. (Image: Andrey Popov / fotolia.com)

diagnosis

The doctor often recognizes a larger accumulation of water at first glance. If you report a feeling of pressure in the stomach and the doctor knows about a history of heart and liver diseases, it would be almost a mistake not to investigate dropsy. The doctor knocks and now palpates the stomach. If larger accumulations of water are there, wave movements can be felt. The diagnosis is certain after an ultrasound analysis. This makes it possible to detect even small amounts of liquid of 50 milliliters. More importantly, the doctor also sees which organic disease is the cause of the dropsy, because he gets an accurate picture of the heart and liver.

A blood test will clarify what disorders of the heart, liver or pancreas. Sometimes the doctor also performs a puncture: he takes a sample of the liquid and excludes the color and consistency of the secretion, whether it is liver or heart problems (clear), disorders of the lymphatic flow (milky) or internal bleeding (bloody) is. He can also identify bacteria. He sets the course for the subsequent therapy.

treatment

The doctor mainly treats the underlying disease. In addition, he must reduce the volume of water in the stomach. In liver diseases, he treats those affected with dehydrating agents, diuretics, and patients must eat food without salt. Large amounts of water require a small operation, the liquid is discharged through a section here. However, infection or bleeding may occur. However, the complaints end immediately.

What can you do yourself?

If you are suffering from ascites, then reduce your salt intake to less than 4.5 grams a day until the problems have disappeared. Still, you should be getting enough calories, even though you feel full about the "full stomach". Lie down as much as possible. At rest, the vessels in the abdomen are pressed, and the kidney is thus given the sign to excrete fluid. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)