Cirrhosis Ascites: Causes, Risks, and What You Need to Know

When the liver is badly damaged by cirrhosis, a late-stage scarring of the liver that blocks blood flow and impairs function. Also known as liver cirrhosis, it doesn’t just make you tired—it can trigger a dangerous buildup of fluid in your belly called ascites, an abnormal collection of fluid in the abdominal cavity, often the first visible sign of advanced liver disease. This isn’t just swelling. It’s your body signaling that the liver can no longer regulate fluids properly, and if left unchecked, it leads to infection, kidney failure, or worse.

Ascites happens because cirrhosis creates portal hypertension, high pressure in the vein that carries blood from the intestines to the liver. That pressure forces fluid out of blood vessels and into the belly. At the same time, the damaged liver stops making enough albumin—a protein that keeps fluid inside vessels. The result? Fluid leaks out and pools where it shouldn’t. About 50% of people with cirrhosis will develop ascites within 10 years. And once it shows up, your risk of hepatic encephalopathy, a brain disorder caused by toxins building up in the blood because the liver can’t filter them. goes up dramatically. You might feel confused, forgetful, or even drowsy—not because of aging, but because your liver is failing.

Managing cirrhosis ascites isn’t about quick fixes. It’s about stopping the cycle: cutting salt, taking diuretics like spironolactone, draining fluid when needed, and treating the root cause. Some people need a TIPS procedure—a tiny tube placed in the liver to redirect blood flow. Others need to stop drinking alcohol completely. A few may even need a transplant. But no matter the path, ignoring ascites is dangerous. It’s not a side effect—it’s a warning sign that your liver is running out of time.

The posts below cover real-world details you won’t get from a doctor’s one-page handout. You’ll find how to spot early signs of fluid buildup, what medications actually help (and which ones make it worse), why some people respond to treatment while others don’t, and how ascites connects to other liver complications like bleeding and confusion. These aren’t theory pieces—they’re practical, evidence-backed insights from people who’ve lived through this and the experts who treat it. What you learn here could change how you manage your health—or someone you care about.