Ascites in the elderly may be due to hepatic ascites, but it can also be caused by other reasons, requiring examination to confirm the diagnosis and targeted treatment. Hepatic ascites is commonly seen in liver diseases such as cirrhosis and liver cancer, and treatment includes medication, dietary adjustments, and surgery. Non-hepatic ascites may be caused by heart failure, kidney disease, or infection, and appropriate measures should be taken based on the underlying cause.
1. The main causes of ascites include cirrhosis, liver cancer, and hepatitis. Cirrhosis leads to portal hypertension, causing fluid to leak into the abdominal cavity and form ascites; liver cancer and hepatitis can cause abnormal liver function, leading to ascites. Treatment methods include diuretics such as spironolactone and furosemide, sodium restriction, and paracentesis. In severe cases, liver transplantation or TIPS surgery may be considered.
2. Ascites caused by heart failure is related to decreased cardiac function. Treatment requires improving cardiac function, using diuretics such as torasemide and ACE inhibitors such as enalapril, while restricting fluid intake. Cardiac surgery or pacemaker implantation may be necessary in some cases.
3. Nephrotic syndrome or chronic kidney failure can also cause ascites. Treatment includes the use of diuretics such as bumetanide, protein intake control, and dialysis. In severe cases, kidney transplantation may be necessary.
4. Infectious ascites is usually caused by abdominal infections such as tuberculous peritonitis. Treatment requires the use of antibiotics such as isoniazid, rifampin or anti-tuberculosis drugs, and abdominal drainage may be necessary.
5. Malnutrition or hypoproteinemia can also cause ascites. Treatment includes protein supplementation such as whey protein powder, a balanced diet, and intravenous nutritional support.
The diagnosis and treatment of ascites in the elderly should be based on the specific cause. It is recommended to seek medical attention promptly for a comprehensive examination and adopt a personalized treatment plan according to the doctor's advice. At the same time, attention should be paid to dietary adjustments and lifestyle improvements to promote recovery.