Conversation: The conversation between human and AI assistant.
[|Human|] Im a liver patient with sarcoidosis and I keep getting fluid build up in my stomach. I would like to know how can this problem be solved. Im currently taking spiraclatone and bumex as fluid pills but it is on removing fluid elsewhere but my stomach.
[|AI|]  Hi there, Unfortunately, first line treatment for ascites (fluid in your abdomen) is exactly what you are taking - spironolactone (Gladstone) and lasix or bumex.  I would also recommend incorporating a low sodium diet. The other options for treatment are repeated paracentesis - removal of the fluid with a needle, however this is temporary and will likely be need to be repeated as the fluid tends to build up. Another option to decrease the amount of fluid in your abdomen is a TIPS procedure - a trans jugular intrahepatic portal shunt - where a shunt (connection) is made between the portal vein and the hepatic veins. This decompresses the portal system and ultimately causes less buildup of fluid in your liver, but a lot of your blood bypasses your liver and this can cause worsening mental status due to worsening encephalopathy. Risks of TIPS is also infection and bleeding, and the connection can clot off. I hope this answers your questions. Please feel free to contact me should you have any further questions.