Ascites - CSD Student Contribution

Ascites

What is ascites? Ascites (AKA peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum, or abdominal dropsy) is an accumulation of fluid in the peritoneal cavity (space between the tissues lining the abdomen and abdominal organs). It is most commonly due to cirrhosis and severe liver disease, and can present other significant medical problems. It can be treated with medications (diuretics), paracentesis or other treatments directed at the particular cause. Mild ascites can be hard to notice, but severe ascites leads to abdominal distension. Fluid accumulation in the abdominal cavity can lead to additional fluid retention by the kidneys due to the stimulatory effects on blood pressure hormones (i.e. aldosterone). Ascites can also produce spontaneous bacterial peritonitis (SBP) due to the decreased antibacterial agents in the fluid. Patient complaints include progressive abdominal heaviness and pressure, and shortness of breath due to stress on the diaphragm. Other signs of ascites may be present due to its underlying etiology. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.

So what is ascites’ impact on speech? Ascites can affect respiratory support to due stress placed on the diaphragm which can lead many signs, such as: short breath groups, decreased loudness, reduced fluency (effect on prosody), inspiratory stridor, and difficulty coordinating breathing with swallowing due to reduced lung volumes on inhalation and expiration.

Encephalopathy may cause “mental” changes which can result in deficits in cognition, speech, and language, depending on which areas of the brain are affected.