Excess Abdominal Fluid
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Try one of these related symptoms.
Stomach is full of liquid
Fluid in the abdomen
About the Symptom
This condition is called ascites and occurs when fluid builds up within the belly.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Fluid retention in abdomen
Possible Causes
Generally, Excess abdominal fluid can be related to:
- Portal Hypertension
A condition observed in advanced liver disease. Liver scarring compresses the blood vessels running through it and reduces their blood flood.
- Liver Cirrhosis
Cirrhosis refers to scarring of the liver which results in abnormal liver function as a consequence of chronic (long-term) liver injury. There are many different causes including infections, alcohol abuse, inherited disorders, and fatty liver.
- Biliary Tract Cancer
Cancer of the bile ducts is also known as "cholangiocarcinoma." It is a cancer that arises in the bile ducts inside the liver or in the ducts that connect the liver to the gall bladder and intestines. Risk factors include genetic conditions, a condition called primary sclerosing cholangitis, chronic liver disease, infection with liver worms (flukes), smoking, diabetes, and age >50. Patients often come to their physicians with abdominal pain, jaundice (yellow skin and eyeballs), itchiness, and weight loss.
- Alcohol-related liver disease
- Malignant Melanoma (Including Nails)
Related Serious Diseases
Sometimes, Excess abdominal fluid may be related to these serious diseases:
- Hepatitis C
Hepatitis C is a viral infection that can cause liver inflammation. It can lead to serious liver damage. It spreads from person to person through contact with infected blood, sharing infected needles, using infected needles while tattooing, and blood transfusions using infected blood. Sexual transmission is rare and more common with men who have sex with men.
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Have you been diagnosed with ascites?
- How long have you had fluid in your abdomen?
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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FAQs
Q.
Still Swollen? Why Your Body Traps Fluid: Medically Approved Bumex Steps
A.
There are several factors to consider; persistent swelling often reflects heart, liver, or kidney disease, medication effects, or hormonal shifts, and Bumex, a potent loop diuretic, can help when used correctly. See below for medically approved Bumex steps including exact dosing, morning weight checks, regular electrolyte labs, tight sodium restriction, and when to add other medicines, plus reasons swelling can persist like dose needs, disease progression, diuretic resistance, high salt intake, or ascites requiring drainage. Seek urgent care for shortness of breath, chest pain, severe belly swelling, confusion, fainting, or very little urine.
References:
* Ritz E, Wanner C. Diagnosis and Treatment of Edema. J Clin Hypertens (Greenwich). 2017 Mar;19(3):214-222. doi: 10.1111/jch.12932. PMID: 28247940.
* Barraclough J, Chitty S, Ticehurst R. Diuretics: a practical review. Aust Prescr. 2019 Feb;42(1):15-22. doi: 10.18773/austprescr.2019.002. PMID: 30733614.
* Mutharasan RK, Shah SJ. Bumetanide and Furosemide in the Treatment of Acute Decompensated Heart Failure: A Systematic Review. J Cardiovasc Pharmacol Ther. 2019 Jul;24(4):323-332. doi: 10.1177/1074248419830509. PMID: 30803367.
* Costanzo MR, Guglin ME, Saltzberg RG, et al. Management of Edema Due to Congestive Heart Failure. Cardiorenal Med. 2019;9(2):106-116. doi: 10.1159/000499092. PMID: 31105234.
* Collins SP, Cozart MA, Volpe M, et al. Diuretic Use in Heart Failure. J Card Fail. 2021 May;27(5):590-602. doi: 10.1016/j.cardfail.2021.03.003. PMID: 33714652.
Q.
Stomach Swelling? Why You Need Paracentesis & Medically Approved Next Steps
A.
Persistent stomach swelling, tightness, or rapid weight gain may be ascites, a buildup of abdominal fluid most often from liver disease but also cancer, heart or kidney problems, or infection; paracentesis is a safe, medically approved procedure that both diagnoses the cause and quickly relieves pressure. There are several factors to consider for next steps, including when urgent evaluation is needed and options like salt restriction, diuretics, antibiotics, oncology care, repeat drainage, or TIPS; see the complete guidance below to decide what to do now.
References:
* Singh A, Alkhouri N. Paracentesis: A review of indications, contraindications, and complications. J Clin Gastroenterol. 2021 Jul 1;55(6):469-478. doi: 10.1097/MCG.0000000000001509. Epub 2021 Apr 1. PMID: 33797430.
* Singal A, Jain V, Sachdev P, Singal AK. Diagnosis and management of spontaneous bacterial peritonitis: an update. World J Hepatol. 2021 Feb 27;13(2):162-177. doi: 10.4254/wjh.v13.i2.162. PMID: 33692809; PMCID: PMC7931367.
* Gelfand JM, Rubenstein LZ, Friedman SM. Approach to the Patient with Abdominal Distension. Med Clin North Am. 2021 May;105(3):415-430. doi: 10.1016/j.mcna.2021.01.006. Epub 2021 Mar 5. PMID: 33896500.
* Biggins SW, Ganger D. Therapeutic Paracentesis for Patients with Cirrhotic Ascites: Best Practice and Management. Clin Liver Dis. 2020 Feb;24(1):15-28. doi: 10.1016/j.cld.2019.09.002. Epub 2019 Nov 13. PMID: 31735500.
* Ripoll C, Banares R. Management of Refractory Ascites: The Current Role of Paracentesis and Other Therapeutic Approaches. Dig Dis Sci. 2020 Jan;65(1):97-106. doi: 10.1007/s10620-019-05908-1. Epub 2019 Nov 11. PMID: 31712869.
Q.
Is it a seroma? Why your body is trapping fluid and medical steps to heal.
A.
There are several factors to consider: a seroma is a pocket of clear fluid that commonly appears 7 to 10 days after surgery or trauma because inflammation and temporary lymphatic damage let serous fluid collect in a soft, squishy lump that often reabsorbs over weeks. Seek care urgently for fever, spreading redness, warmth, severe pain, or foul drainage; otherwise treatment ranges from watchful waiting with activity limits and compression to needle aspiration, short term drains, sclerotherapy, or rarely surgery. For key decision points, risks to watch, and how to choose next steps with your clinician, see the complete details below.
References:
* Kim B, Kim WH, Lee JS. Seroma formation: Pathogenesis and prevention. Ann Surg Treat Res. 2020 Aug;99(2):65-71. doi: 10.4174/astr.2020.99.2.65. Epub 2020 Aug 31. PMID: 32885149; PMCID: PMC7468132.
* Singh P, Ranganathan A, Singh V. Management of postoperative seroma. Cureus. 2021 Nov 16;13(11):e19619. doi: 10.7759/cureus.19619. PMID: 34925769; PMCID: PMC8675402.
* Schwab FD, Prizzi MJ. Mechanisms, risk factors, and prevention of seroma formation after breast surgery. Gland Surg. 2018 Aug;7(4):325-331. doi: 10.21037/gs.2018.06.01. PMID: 30175005; PMCID: PMC6105374.
* Barrientos N, Garcia E, Patel R, Husted A, Thoma M, Lee E, Balledux J. Postoperative Seroma. Curr Probl Surg. 2023 Oct;60(10):101344. doi: 10.1016/j.cpsurg.2023.101344. Epub 2023 Jun 2. PMID: 37271424.
* Agrawal A, Jain P, Jain K, Jain A, Gupta N, Jain R. Understanding Seroma: From Etiology to Prevention. Cureus. 2021 Dec 22;13(12):e20600. doi: 10.7759/cureus.20600. PMID: 35070258; PMCID: PMC8778641.
Q.
Swelling on Bumetanide? Why Your Body Retains Fluid & Medical Next Steps
A.
If you are still swelling on bumetanide, common reasons include the underlying heart, liver, kidney, or venous disease getting worse, diuretic resistance, too much dietary sodium, reduced kidney function, low albumin, medication interactions, or fluid in the abdomen. There are several factors to consider, and red flags like rapid weight gain, shortness of breath, chest pain, or very little urine need urgent care; for tailored next steps including dose adjustments, adding a second diuretic, lab checks, sodium limits, and when procedures like paracentesis are appropriate, see the complete details below.
References:
* Voors AA, et al. Diuretic Resistance in Heart Failure: Mechanisms and Therapeutic Strategies. J Am Coll Cardiol. 2020 Nov 3;76(18):2158-2172.
* Metra M, et al. Pathophysiology of Edema in Heart Failure. J Am Coll Cardiol. 2019 Jan 22;73(2):162-177.
* Ellison DH, et al. The Renin-Angiotensin-Aldosterone System in Heart Failure and the Loop Diuretic Paradox. J Am Soc Nephrol. 2020 May;31(5):940-951.
* Costanzo MR, et al. Management of Diuretic Resistance in Patients With Heart Failure. J Am Coll Cardiol. 2022 Mar 15;79(10):1001-1014.
* Wargo KA, et al. Loop Diuretics: Pharmacology and Therapeutic Use. Am J Health Syst Pharm. 2016 Apr 15;73(8):548-61.
Q.
Sudden Belly Swelling? Why Your Abdomen Is Storing Fluid (Ascites) & Medical Next Steps
A.
Sudden belly swelling is often ascites, a buildup of abdominal fluid most commonly from advanced liver disease but also from cancer, heart failure, kidney disease, or infection, and red flags like fever, severe pain, confusion, black stools, vomiting blood, or trouble breathing need urgent care. Diagnosis usually involves an exam, ultrasound, and sometimes paracentesis, and treatment may include salt restriction, diuretics, fluid drainage, and in select cases TIPS, transplant, or cancer-directed therapy; see below for complete details that can affect your next steps.
References:
* Moore, K. P., & Wong, F. (2019). Ascites: Pathophysiology, Diagnosis, and Management. *Clinics in Liver Disease*, *23*(3), 447–461. doi:10.1016/j.cld.2019.04.004. PMID: 31279435.
* Gines, P., Cardenas, A., Wong, F., & Arroyo, V. (2018). Management of ascites in cirrhosis. *Journal of Hepatology*, *68*(4), 856–868. doi:10.1016/j.jhep.2017.11.023. PMID: 29203301.
* Sangro, B., et al. (2020). Malignant ascites: Pathophysiology, diagnosis, and treatment. *Gastroenterology Report*, *8*(3), 163–172. doi:10.1093/gastro/goaa018. PMID: 32547781.
* Gopinathannair, R., & Singh, J. P. (2019). Ascites in Heart Failure: Pathophysiology, Diagnostic Evaluation, and Management. *Current Heart Failure Reports*, *16*(3), 90–97. doi:10.1007/s11897-019-0435-9. PMID: 30847627.
* Rabe, A., & Cadel, K. (2020). Approach to the adult patient with ascites. *Canadian Journal of Gastroenterology and Hepatology*, *2020*, Article ID 8415717. doi:10.1155/2020/8415717. PMID: 33269490.
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Cleveland Clinic
https://my.clevelandclinic.org/health/diseases/14792-ascites