Diet in Ascites

DIET IN ASCITES & PEDAL EDEMA

Ascites is a condition in which fluids accumulate in the abdominal cavity. The stomach of the patient gets swollen; he has a feeling of heaviness and uneasiness. The legs also get swollen, breathing becomes difficult, and the palpitation becomes rapid.

Cause

The most common cause of ascites is liver disease. It is commonly seen in liver cirrhosis. One of the complications of liver cirrhosis is portal hypertension which contributes significantly to formation of ascites. The other important factor is decreased levels of albumin in the blood. Albumin is a protein that is produced by liver. The body then starts retaining salt (sodium) and water, leading to ascites.

Symptoms

  • Increase in abdominal girth and size, along with a feeling heaviness.
  • Pain in abdomen, discomfort and bloating.
  • Sever ascites can cause shortness of breath.
  • A large belly, due to ascites is also a common concern of some patients. Sometimes the umbilicus bulges and herniates out.

Diet

Diet plays an important role in patients with ascites. The patient should not be given salt as far as possible. He should be given diuretics (also call water pills, may also be used to treat ascites. They increase urine flow by which salt and water is excreted from the body). A regular diet contains approx 800mg-1g of sodium without any added salt for cooking.

  • To control fluid retention, reducing the amount of common salt in your food to 2-5gm/day.
  • Cut out foods with a high salt content like: pickles, chutneys, bhujia, salted crackers, processed cheese, all tinned and bottled foods, salted butter, bread and bakery items. Instead of salt try:lemon juice, black pepper, zeera powder, olive oil, vinegar.
  • Restrict fluids to around 1-2liters a day. Fluid includes water, milk, dal, fruit juices, tea/ coffee, soups etc.
  • Protein helps maintain the albumin store in the body, so it is important to take high protein food in the diet such as milk and milk product like curd, cottage cheese, All pulses especially soybean, Egg white and fish, Nuts like- almond, peanuts, cashew nuts.

Self monitoring of ascites

Daily monitoring of patient is required on the following basis

  1. Weight (in Kg)
  2. Total fluid intake (in ml)
  3. Output (measure of all the urine produced in 24hrs)in ml.
  4. Abdominal girth: measure the abdomen with a measuring tape in the lying position at the navel. A reduction in abdominal girth suggests reduction in ascites.

    

Ascites Management Monitoring chart

Name: Cr No:

Date How do you feel

(good=+,bad=-)

Weight (kg) Fluid Intake

water,juice,team(l)

Urine Output (ml) Fluid Balance

(ml)

Abdominal Girth Diuretics type and dose Investigations

Na /K/ Creat