Should I Be Concerned That My Ascites Is Not Going

Question : Should I be concerned that my ascites is not going away?

It is in middle to severe fluid level. I had dropped to 174lbs. and then climbed back up to 196lbs. The weight is primarily fluid, and it is not falling as rapidly as it was. Currently at 183lbs on a 6' frame.

I am not diagnosed with cirrhotic liver. I did have elevated liver function, and my last liver panel in March 2019 was good. My doctor said, "amazingly normal." I was a moderate to heavy drinker for many years, and have lately quit altogether. There has been no sign of SBP, and I have no pain or discomfort, nor shortness of breath. I did reach Type II Diabetic level eating too much fast food, and have backed that down to pre-Diabetic with a change of diet.

I understand the implications of ascites, its markers for end-stage liver disease, and have mortality concerns. Considering my wife just had an emergency with esophageal varices bleeding (she is at home now, recovering), I am now very concerned. Should I be?

Is there anything else I can do at home to accelerate the decline in my ascites? I have another appointment with my doctor (cardiology/internal medicine) in XXXXXXX and any further information, actions, or even a second opinion is appreciated. Thank you.

Thank you Dr. Kini,

Yes, the earlier questions pertained to my wife. This question is about my ascites.

My doctor believes it is related to my elevated liver panels due to alcohol consumption over a long period of time. I am not cirrhotic, yet. I never developed jaundice or any bilial/bilarubin issues. I have done some damage to my liver, as I understand.

Liver function seems to be improving, back to normal. Unfortunately, I do not have lab results in hand, either previous or the latest. Those are at my doctor's office. I have not had an ascitic fluid analysis done, unless it can be done by drawing blood from my arm. Even then, I do not know that he ordered that test as it was never mentioned. So that is something I should ask my doctor for on the next visit? Will that only establish a baseline to monitor? Could it further define source cause or underlying issue?

One thing I did not mention in my medical history is that I have varicose veins in my legs. I have had them for a long time, and they are untreated. Could that be a factor?

Again, thank you,
Philip

Thank you Dr. Kini. I will ask about the fluid test on my next visit. In the meantime, I will continue with diuretics and restricted salt, while charting my progress over the next six weeks.