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Management of ascites in chronic liver disease

The management of ascites in chronic liver disease involves a multifaceted approach addressing the underlying liver dysfunction, fluid retention, and associated complications. Sodium restriction is a fundamental dietary intervention to manage ascites, aiming to decrease fluid accumulation by limiting water retention. Diuretics, such as spironolactone and furosemide, are commonly prescribed to promote diuresis and reduce ascitic fluid buildup by increasing urine output. Regular monitoring of weight, blood pressure, and renal function is essential to adjust diuretic dosages and prevent electrolyte imbalances. Paracentesis, a procedure involving the removal of excess ascitic fluid through a needle, may be performed for therapeutic and diagnostic purposes in cases of severe ascites. Transjugular intrahepatic portosystemic shunt (TIPS) is an interventional radiology procedure that can be considered in refractory cases to redirect blood flow and reduce portal hypertension. Antibiotic prophylaxis is often recommended to prevent spontaneous bacterial peritonitis (SBP), a serious complication associated with ascites. Liver transplantation is the ultimate therapeutic option for chronic liver disease with refractory ascites, offering a chance for long-term resolution.

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Dr. Uday Sanglodkar

Senior Consultant  Hepatology and Liver Transplant Global Hospital, Mumbai Co Founder Func Dent- Functional Dentistry, Mumbai

Dr. Uday Sanglodkar is currently working as Senior Consultant - Hepatology and Liver Transplant Clinical Lead Liver intensive care. Dr Uday has worked at Rela Institute and Medical centre (RIMC) as a Consultant Hepatologist and Liver Transplant physician for 3 years. Dr Uday is a Senior Consultant with vast experience in hepatology/ transplant Hepatology. His areas of interest include Hepatobiliary diseases, liver intensive care and transplant Hepatology.

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The management of ascites in chronic liver disease involves a multifaceted approach addressing the underlying liver dysfunction, fluid retention, and associated complications. Sodium restriction is a fundamental dietary intervention to manage ascites, aiming to decrease fluid accumulation by limiting water retention. Diuretics, such as spironolactone and furosemide, are commonly prescribed to promote diuresis and reduce ascitic fluid buildup by increasing urine output. Regular monitoring of weight, blood pressure, and renal function is essential to adjust diuretic dosages and prevent electrolyte imbalances. Paracentesis, a procedure involving the removal of excess ascitic fluid through a needle, may be performed for therapeutic and diagnostic purposes in cases of severe ascites. Transjugular intrahepatic portosystemic shunt (TIPS) is an interventional radiology procedure that can be considered in refractory cases to redirect blood flow and reduce portal hypertension. Antibiotic prophylaxis is often recommended to prevent spontaneous bacterial peritonitis (SBP), a serious complication associated with ascites. Liver transplantation is the ultimate therapeutic option for chronic liver disease with refractory ascites, offering a chance for long-term resolution.