Ascites

How Do I Know If I Have Ascites?

Ascites may be asymptomatic (having no symptoms) or a person may complain of increased abdominal width, becoming full quickly upon eating or breathing difficulty, depending upon the amount of fluid that has accumulated.

A physician may perform various physical tests. Upon physical examination a doctor may determine that a person has ascites if there is presence of the following:

  • If abdominal distention, or bloating of the belly, is present.
  • The sides of the abdomen, or flanks, are pushed outward.
  • When percussion is done over the abdomen and percussion note is tympanitic over the umbilicus (belly button) and dull over the lateral abdomen and flank areas (sides of the abdomen). This detection of tympany can be caused because the bowel floats to the top of the fluid in the abdomen.
  • If there is a shifting in dullness. When percussion is performed while the patient is laying on his/her back and then percussion is performed with the patient lying on his/her side, and the area of dullness shifts such that the area of tympany shifts to the top.
  • If a wave like motion is detected when the doctor places one hand on the flank and taps the opposite flank, fluid may be detected.

If a physical examination does not definitively show that the swelling is caused by excess fluid, a sonogram, ultrasound or CT (computerized tomography) scan may be performed.

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