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When a Big Stomach is More Than a Big Stomach

Posted Nov 02 2010 12:00am
When is a big stomach more than visible proof of eating way too much fatty food? When it is an accumulation of fluid, and not fat, that is causing the abdominal distension. It is called “ascites,” a medical condition for an accumulation of fluid in the peritoneal cavity, which is the gap between the wall of the abdomen and the organs that are contained within the abdomen.

“Ascites is a symptom of a disease. It is not a disease itself,” said H. Franklin Herlong, M.D. Dr. Herlong presented a talk on “Management of Ascites” at Sinai’s Grand Rounds last week.

Dr. Herlong, a visiting professor from Johns Hopkins, is a gastroenterologist. “Ascites is one of the most frustrating symptoms that can dramatically alter a patient’s life,” Dr. Herlong said. Ascites is usually a symptom when a patient has cirrhosis and severe liver disease. “Fluid leaks out of the liver and that is how ascites is formed,” he said. “Cirrhosis is the most common cause of ascites.” However, ascites may be a symptom of other serious illnesses including congestive heart failure.

Ascites can be managed but it is important to treat the underlying disease itself, he cautioned. Treatments include salt restriction and properly prescribed diuretics. People who can manage their ascites will be able to eat better, move around more easily and probably improve their self-image. “Patients feel better,” Dr. Herlong said. And that is the best reason for managing ascites.

-Sandra Crockett
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