ABSTRACT
Ascites is the pathological state in which fluid accumulates in the peritoneal cavity. Fluid accumulation may be due to infection and malignancy or due to other diseases like liver disease, heart failure, and renal disease. The ascitic fluid can be graded into Transuda-tive and Exudative fluid based on the serum ascites albumin gradient (SAAG). The prominent cause of ascites is found to be Liver Cirrhosis. The most common symptom of Ascites is recent weight gain, increased abdominal girth and dyspnea. The first line treatment of ascites includes education regarding dietary sodium restriction and oral diuretics. However, other mechanical methods can also be used if the patient is unresponsive to this approach. But, there are some limitations while using these mechanical methods. Ascites is also associated with certain complications like spontaneous bacterial perotinitis, hepatorenal syndrome and dilutional hyponatremia. Ascites itself is not fatal unless it becomes infected. So, early diagnosis and effective treatment should be ensured in order to avoid further complications. This review focuses on the grades, causes, symptoms, management and complica-tions of Ascites.
ABSTRACT
Ascites is the pathological accumulation of free fluid in peritoneal cavity. The aim of the present study was to observe the preva-lence, clinical management and the assessment of complications associated with ascites in hospitalized patients. A Descriptive Observational Study was conducted at two tertiary care hospitals of Lahore. The data was collected on a data collection form containing questions regarding basic patient information, presenting symptoms, clinical management and associated complications. Verbal informed consent was taken and confidentiality was maintained. Pilot study was performed prior to performance of a full-scale research project. The results are expressed in the form of frequency and percentages. A total of fifty (50) ascitic patients were evaluated during two months. It was slightly more common in females (58%) as compared to males (42%). Common causes of Ascites were Liver Cirrhosis (80%), Chronic Renal Failure (10%), Peritoneal Malignancy and Peritoneal Tuberculosis (4%) each and Cardiac Failure (2%). The mainstay for the first line treatment in patients with cirrhosis includes education regarding dietary sodium restriction and oral diuretics. The major complications associated with Ascites were Protein malnutrition (87%), Mental Confusion (73%), Hepatorenal Syndrome (21%) and Spontaneous Bacterial Perotinitis (8%). In most patients ascites was being managed successfully by limiting the salt intake and provision of a diuretic regimen. As, ascites is a starting point for more serious complica-tions; so, its early diagnosis should be ensured. Social media and NGOs should play their role in creating the awareness regarding this deadly disease.
ABSTRACT
Ascites is the pathological state in which fluid accumulates in the peritoneal cavity. Fluid accumulation may be due to infection and malignancy or due to other diseases like liver disease, heart failure, and renal disease. The ascitic fluid can be graded into Transuda-tive and Exudative fluid based on the serum ascites albumin gradient (SAAG). The prominent cause of ascites is found to be Liver Cirrhosis. The most common symptom of Ascites is recent weight gain, increased abdominal girth and dyspnea. The first line treatment of ascites includes education regarding dietary sodium restriction and oral diuretics. However, other mechanical methods can also be used if the patient is unresponsive to this approach. But, there are some limitations while using these mechanical methods. Ascites is also associated with certain complications like spontaneous bacterial perotinitis, hepatorenal syndrome and dilutional hyponatremia. Ascites itself is not fatal unless it becomes infected. So, early diagnosis and effective treatment should be ensured in order to avoid further complications. This review focuses on the grades, causes, symptoms, management and complica-tions of Ascites.
ABSTRACT
Ascites is the pathological accumulation of free fluid in peritoneal cavity. The aim of the present study was to observe the preva-lence, clinical management and the assessment of complications associated with ascites in hospitalized patients. A Descriptive Observational Study was conducted at two tertiary care hospitals of Lahore. The data was collected on a data collection form containing questions regarding basic patient information, presenting symptoms, clinical management and associated complications. Verbal informed consent was taken and confidentiality was maintained. Pilot study was performed prior to performance of a full-scale research project. The results are expressed in the form of frequency and percentages. A total of fifty (50) ascitic patients were evaluated during two months. It was slightly more common in females (58%) as compared to males (42%). Common causes of Ascites were Liver Cirrhosis (80%), Chronic Renal Failure (10%), Peritoneal Malignancy and Peritoneal Tuberculosis (4%) each and Cardiac Failure (2%). The mainstay for the first line treatment in patients with cirrhosis includes education regarding dietary sodium restriction and oral diuretics. The major complications associated with Ascites were Protein malnutrition (87%), Mental Confusion (73%), Hepatorenal Syndrome (21%) and Spontaneous Bacterial Perotinitis (8%). In most patients ascites was being managed successfully by limiting the salt intake and provision of a diuretic regimen. As, ascites is a starting point for more serious complica-tions; so, its early diagnosis should be ensured. Social media and NGOs should play their role in creating the awareness regarding this deadly disease.
ABSTRACT
To determine the efficacy of Rifaximin in prevention of repeated episodes of hepatic encephalopathy in patients with liver cirrhosis as compared to placebo. Triple-blind, randomized placebo-controlled trial. Department of Gastroenterology-Hepatology, Shaikh Zayed Hospital, Lahore, from October 2012 to April 2013. Patients in remission from recurrent hepatic encephalopathy resulting from cirrhosis were randomly assigned to receive either Rifaximin, at a dose of 550 mg twice daily [63 patients], or placebo [63 patients.] Patients were requested to take the drug orally twice daily for 6 months or until they developed a breakthrough episode of hepatic encephalopathy. Mean age of patients in treatment and control group was 40.21 +/- 2.33 years and 42.87 +/- 4.54 years respectively. The most common etiology of cirrhosis was hepatitis C followed by hepatitis B. Patients who remained free of hepatic encephalopathy during study period were 40 out of 63 patients in control group and 35 patients out of 63 patients [p = 0.56]. Most of the patients who developed breakthrough hepatic encephalopathy had a MELD score range of 21-25 in both groups. The number of deaths and adverse events was similar in both groups. Over a 6-month period, treatment with Rifaximin failed to maintain remission from hepatic encephalopathy more effectively than placebo in the studied group.