Assessment and Diagnostic Evaluation
The presence and extent of ascites are assessed by percussion of the abdomen.
When fluid has accumulated in the peritoneal cavity, the flanks bulge when the
patient assumes a supine position. The presence of fluid can be confirmed either
by percussing for shifting dullness or by detecting a fluid wave. Daily
measurement and recording of abdominal girth and body weight are essential to
assess the progression of ascites and its response to treatment.Medical Management A) DIETARY MODIFICATION
The goal of treatment for the patient with ascites is a negative sodium balance
to reduce fluid retention. Table salt, salty foods, salted butter and margarine,
and all ordinary canned and frozen foods should be avoided. In the meantime, the taste of unsalted foods can be improved by using salt
substitutes such as lemon juice, oregano, and thyme.B) DIURETICS
Use of diuretics along with sodium restriction is successful in 90% of patients
with ascites. Spironolactone (Aldactone), an aldosterone blocking agent, is most