Mechanisms Behind Ascites Formation in Cirrhosis

Ascites, the accumulation of fluid in the abdominal cavity, is a common complication in individuals with liver cirrhosis. The development of ascites is multifactorial and involves several interconnected physiological changes within the body.

Decreased Albumin Production

Albumin is primarily produced in the liver, and its synthesis is significantly reduced when liver function is impaired due to cirrhosis. Low albumin levels lead to decreased oncotic pressure in the blood vessels, causing fluid to leak into surrounding tissues and eventually accumulate in the abdominal cavity as ascites.

Fluid and Sodium Retention

Cirrhosis triggers a complex set of responses in the body that result in increased retention of sodium and water. This excess fluid tends to accumulate in the peritoneal cavity, further contributing to the formation of ascites.

Impaired Kidney Function

As cirrhosis progresses, it can negatively affect kidney function, reducing the excretion of sodium and water through urine. This diminished renal clearance exacerbates fluid retention and promotes the accumulation of ascitic fluid.

Lymphatic System Obstruction

In cirrhosis, the normal lymphatic drainage from the liver becomes obstructed. As a result, lymph fluid builds up and leaks into the abdominal cavity instead of being properly reabsorbed by the body, adding to the volume of ascites.

Managing ascites typically involves medical interventions such as albumin infusion to improve protein levels and diuretic therapy to reduce fluid buildup. In more advanced cases, other treatments like paracentesis or transjugular intrahepatic portosystemic shunt (TIPS) may be considered to alleviate symptoms and improve quality of life.