Treatment and Management of Advanced Cirrhosis with Ascites

In the later stages of cirrhosis, ascites becomes more difficult to manage and can lead to life-threatening complications. One of the most concerning signs is the development of refractory ascites, where fluid continues to build up in the abdominal cavity despite treatment. This can cause severe bloating and discomfort, and may even compress the diaphragm, leading to difficulty breathing.

Another serious complication is spontaneous bacterial peritonitis, which occurs when the accumulated abdominal fluid becomes infected. Patients may experience abdominal pain, fever, and tenderness upon physical examination. This condition requires immediate medical attention and antibiotic therapy to prevent sepsis and further deterioration.

A particularly dangerous progression is hepatorenal syndrome, a form of kidney failure that develops in people with advanced liver disease. This condition results in a significant decrease in urine output and does not respond well to standard diuretic treatments. In severe cases, patients may progress to complete renal shutdown, significantly increasing the risk of mortality.

Additionally, hepatic encephalopathy can develop as a result of advanced liver dysfunction. Patients may experience confusion, personality changes, and impaired orientation. If left untreated, this can progress from mild disorientation to deep coma and ultimately death.

These complications highlight the importance of early diagnosis and aggressive management of cirrhosis and ascites. Timely intervention can help reduce the risk of severe outcomes and improve quality of life for patients.