Ascites is an abnormal accumulation of fluid in the space between the organs in the belly and the wall of the belly. In the United States, the most common cause of ascites is cirrhosis of the liver while belly fat refers to fat around the abdomen.
Ascites is a term used to describe the buildup of excess fluid in your peritoneal cavity, which lines your abdomen and abdominal organs, according to the U.S. National Library of Medicine’s Medline Plus. If you have a severe liver condition such as hepatitis or cirrhosis, ascites develop from the combination of low levels of a liver protein called albumin and abnormally high pressure in the blood vessels that supply your liver. Medline Plus lists additional potential causes of ascites that include congestive heart failure, pancreas inflammation, inflammation of the heart sac, kidney dialysis complications, and cancers of the pancreas, colon or ovaries.
Ascites and belly fat are two distinct conditions that can cause enlargement of your belly or abdomen. Ascites commonly indicate the presence of significant liver disease, but may also result from a number of other serious medical conditions. Excessive belly fat can increase your risks for disorders such as diabetes, high blood pressure, and certain forms of cancer.
Belly fat, also called abdominal fat, comes in two varieties, according to Harvard Medical School. Subcutaneous fat, which you can feel when you grab your belly, lies between your skin and your abdominal wall. Visceral fat directly surrounds your abdominal organs. The third type of fat, called retroperitoneal fat, sits behind your abdominal cavity and is typically classified as a subtype of visceral fat. Both age and genetic factors can contribute to the increased presence of belly fat, according to Michael Jensen, M.D., of the Mayo Clinic. However, for men, in particular, lifestyle choice and physical inactivity are more significant factors.
Belly fat refers to fat around the abdomen. There are two types of belly fat:
- Visceral: This fat surrounds a person’s organs.
- Subcutaneous: This is fat that sits under the skin.
Health complications from visceral fat are more harmful than having subcutaneous fat.
What’s behind belly fat?
Your weight is largely determined by three main factors:
How many calories do you consume during the day
How many calories do you burn off through daily exercise
If you eat too much and exercise too little, you’re likely to carry excess weight — including belly fat.
Also, your muscle mass might diminish slightly with age, while fat increases. Loss of muscle mass also decreases the rate at which your body uses calories, which can make it more challenging to maintain a healthy weight.
Many women also notice an increase in belly fat as they get older — even if they aren’t gaining weight. This is likely due to a decreasing level of estrogen, which appears to influence where fat is distributed in the body.
The tendency to gain or carry weight around the waist — and have an “apple” rather than a “pear” shape — might have a genetic component as well.
Why belly fat is more than skin deep
The trouble with belly fat is that it’s not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs.
Although subcutaneous fat poses cosmetic concerns, visceral fat is linked with far more dangerous health problems, including:
Type 2 diabetes
High blood pressure
Research also associates belly fat with an increased risk of premature death — regardless of overall weight. In fact, some studies have found that even when women were considered a normal weight based on standard body mass index (BMI) measurements, a large waistline increased the risk of dying of cardiovascular disease.
Measuring your middle
So how do you know if you have too much belly fat? Measure your waist:
Stand and place a tape measure around your bare stomach, just above your hipbone.
Pull the tape measure until it fits snugly around you, but doesn’t push into your skin. Make sure the tape measure is level all the way around.
Relax, exhale and measure your waist, resisting the urge to suck in your stomach.
For women, a waist measurement of more than 35 inches (89 centimeters) indicates an unhealthy concentration of belly fat and a greater risk of health problems.
Trimming the fat
You can tone abdominal muscles with crunches or other targeted abdominal exercises, but just doing these exercises won’t get rid of belly fat. However, visceral fat responds to the same diet and exercise strategies that help you shed excess pounds and lower your total body fat. To battle belly fat:
Eat a healthy diet. Focus on plant-based foods, such as fruits, vegetables, and whole grains, and choose lean sources of protein and low-fat dairy products. Limit added sugar and saturated fat, which is found in meat and high-fat dairy products, such as cheese and butter. Choose moderate amounts of monounsaturated and polyunsaturated fats — found in fish, nuts, and certain vegetable oils — instead.
Replace sugary beverages. Drink water or beverages with artificial sweeteners instead.
Keep portion sizes in check. Even when you’re making healthy choices, calories add up. At home, slim down your portion sizes. In restaurants, share meals — or eat half your meal and take the rest home.
Include physical activity in your daily routine. For most healthy adults, the Department of Health and Human Services recommends moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as running, for at least 75 minutes a week.
If you use a step counter, remember that it takes an average of 10,000 steps a day to prevent weight gain. Some studies indicate it might take 15,000 steps a day to prevent the regain of weight after significant weight loss.
Strength training exercises also are recommended at least twice a week. If you want to lose weight or meet specific fitness goals, you might need to exercise more. To lose excess fat and keep it from coming back, aim for slow and steady weight loss. Consult your doctor for help getting started and staying on track.
Being overweight is one of the leading causes of major diseases.
Excess belly fat can increase the risk of:
- heart disease
- heart attacks
- high blood pressure
- type 2 diabetes
- breast cancer
- colon cancer
The most common cause of ascites is cirrhosis of the liver. Drinking too much alcohol is one of the most common causes of cirrhosis of the liver.
Different types of cancer can also cause this condition. Ascites caused by cancer most often occur with advanced or recurrent cancer. Ascites may also be caused by other problems such as heart conditions, dialysis, low protein levels, and infection.
Ascites may develop if cancer affects the:
- lymphatic system
These are symptoms of ascites:
- Swelling in the abdomen
- Weight gain
- Sense of fullness
- Sense of heaviness
- Nausea or indigestion
- Swelling in the lower legs
- Shortness of breath
Your healthcare provider will do a physical exam and ask about your symptoms. You may also have tests such as:
- Fluid sample. A sample of fluid from your abdomen may be taken using a needle. This fluid will be checked for signs of disease, such as cancer or an infection. This test may help point to the cause of the ascites.
- Imaging. Your healthcare provider may request images of the inside of your abdomen using ultrasound, MRI, or a CT scan. An MRI creates images using a magnetic field and radiofrequency energy. A CT scan creates computerized images using X-rays.
A number of steps may help ease your ascites. Your healthcare provider may tell you to:
- Cut back on your salt intake. Your healthcare provider or a dietitian can show you how to follow a low-sodium diet. Avoid salt substitutes that contain potassium. This is because some medicines used in treating ascites can cause your potassium levels to rise.
- Cut back on the number of fluids you drink.
- Stop drinking alcohol.
- Take diuretic medicines to help reduce the fluid in your body.
- In certain cases, your doctor may need to remove large amounts of fluid from your abdomen through a needle. This may be done if you have trouble breathing or the diuretic is not working.
- In very complicated situations, you may need to have a special procedure in radiology called TIPS. In this procedure, a connection is made inside the liver between the blood vessels to ease the high pressure causing ascites.
Other treatments include:
In resistant cases, or if there is a significant amount of excess fluid, paracentesis can be an effective management technique. Paracentesis involves a doctor inserting a needle into the abdomen and draining off the excess liquid.
The aim of paracentesis is to relieve abdominal pressure, so the person feels less discomfort. In some instances, a person’s abdomen might contain about 5 liters of fluid, but in some extreme cases of ascites, doctors have drained more than 10 liters of fluid from the abdomen.
When ascites are caused by cancer, doctors may use a shunt (tube) to move the fluid from the abdomen into the bloodstream.
A doctor inserts a needle into a vein in the neck and places a shunt along the chest wall. The shunt connects the abdominal cavity to the neck, where it enters the vein. The fluid then moves along the tube into the bloodstream.
Ascites can make eating, drinking, and moving around difficult. It can also make it hard to breathe. Ascites can lead to abdominal infections, which may cause kidney failure. It can also cause umbilical or inguinal hernias.
Certain steps to help you avoid cirrhosis of the liver and cancer can prevent ascites. These include:
- Stop drinking alcohol.
- Maintain a healthy weight.
- Exercise regularly.
- Stop smoking.
- Limit salt in your diet.
- Practice safe sex to decrease your chance of getting hepatitis.
- Do not use recreational drugs to decrease your chance of getting hepatitis.
Living with ascites
Be sure to follow your healthcare provider’s advice for lowering your salt intake. You’ll need to do this even if you’re taking diuretic drugs to reduce fluid in your body. Also, weigh yourself daily and call your healthcare provider if you gain too much weight.
Fast facts about ascites
- Ascites are a symptom of another underlying cause.
- Abdominal swelling and associated weight gain are typical symptoms of ascites.
- Prognosis and outlook of ascites depend on the underlying condition.
- Assessment of the progress of ascites may be made by regularly measuring the abdominal girth and by monitoring weight.
What Are the Main Differences Between Ascites and Fat Belly?
Both ascites and belly fat result in a large, protruding hard belly that can resemble that of a pregnant woman’s belly. Ascites often results in a rapid weight gain in contrast to a more gradual gain with beer belly development. Some patients with ascites may develop spontaneous bacterial peritonitis, hernias, and fluid in the chest. Tests like ultrasound, CT, or paracentesis (test and/or treatment for ascites fluid or fluid removal) usually diagnose ascites in contrast to a clinical diagnosis of belly fat that does not produce detectable abdominal fluid.
Does Beer Cause Ascites?
Drinking beer (or other liquor) doesn’t directly cause ascites, but excess consumption of beer may lead to ascites for the following reasons:
- The most common cause of ascites is cirrhosis of the liver.
- The most common cause of cirrhosis is alcoholic liver disease.
- Alcoholic liver disease can result from alcohol abuse.
- Thus, excessive consumption of beer may lead to ascites.
What Procedures and Tests Diagnose Ascites vs. Fat Belly?
To diagnose ascites, tests to detect fluid in the belly include the following:
Paracentesis: A medical professional inserts a needle into the belly to remove a sample of fluid and then sends it to a lab. This can help diagnose the cause of the fluid buildup and if the fluid is infected.
Fat belly in itself is not a medical condition, but abdominal obesity increases the risk of certain conditions such as heart attack, stroke, diabetes, and erectile dysfunction.
The prognosis for ascites depends on the cause and severity. If ascites are due to heart failure, patients may live for many years if treated promptly and managed appropriately.
However, ascites due to cirrhosis usually indicate advanced liver disease, and the outlook is not as good.
If a patient has malignant ascites (ascites in patients with cancer), the prognosis is poor, and the mean survival time is between 20-58 weeks.
Fat belly in itself is not deadly, however, it can increase the risk for serious illnesses that can be deadly, such as diabetes, heart attack, and stroke.
Tests like ultrasound, CT, or paracentesis (test and/or treatment for ascites fluid or fluid removal) usually diagnose ascites in contrast to a clinical diagnosis of belly fat that does not produce detectable abdominal fluid.
Ascites is a condition in which fluid collects in spaces within your abdomen. As fluid collects in the abdomen, it can affect your lungs, kidneys, and other organs. Ascites causes abdominal pain, swelling, nausea, vomiting, and other difficulties.
Signs and symptoms
Mild ascites is hard to notice, but severe ascites leads to abdominal distension. People with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm.
Techniques: Liver & Ascites
Inspection. Look for gross asymmetries across the abdomen.
Auscultation. Follow the inspection of the liver, as with the rest of the abdominal exam, with auscultation.
In general, the prognosis of malignant ascites is poor. Most cases have a mean survival time between 20 to 58 weeks, depending on the type of malignancy as shown by a group of investigators. Ascites due to cirrhosis usually is a sign of advanced liver disease and it usually has a fair prognosis.
Options to help relieve ascites include: Eating less salt and drinking less water and other liquids. However, many people find this unpleasant and hard to follow. Taking diuretics, which help reduce the amount of water in the body.
If ascites are left untreated, peritonitis, blood sepsis, kidney failure could occur. The fluid could migrate into your lung cavities. Treatment is necessary to prevent these bad outcomes.
Most people do not have any serious problems from having an ascitic drain. As the fluid drains, it can cause some people’s blood pressure to drop and their heart rate to increase. Your nurse will check your blood pressure, heart rate (pulse) and breathing regularly so they can treat this problem if it happens.
Initially, the swelling may go down overnight. As the condition worsens, however, the swelling may spread up the leg and be present day and night. As more fluid builds up, it may spread up to the chest and cause difficulty breathing.
The average life expectancy of a person having ascites usually depends upon the underlying cause and intensity of the symptoms. Overall, the prognosis of ascites is very poor. The survival rate varies from 20-58 weeks.
Ascites is a term used to describe the buildup of excess fluid in your peritoneal cavity, which lines your abdomen and abdominal organs. Belly fat, also called abdominal fat, comes in two varieties, according to Harvard Medical School. Subcutaneous fat, which you can feel when you grab your belly, lies between your skin and your abdominal wall. Visceral fat directly surrounds your abdominal