Ascites is fluid build-up in the abdomen usually caused by portal hypertension and is such a critical event in the progression of cirrhosis that some experts refer to the phases of cirrhosis as preascitic and ascitic. Once ascites occurs, only half of patients survive after two years. Some physicians even believe that ascites signals the need for liver transplantation, particularly in patients whose cirrhosis is not due to alcohol. Swelling can also occur in the arms and legs and in the spleen. Ascites itself is not fatal, but it is uncomfortable and can reduce breathing function and urination.
Aldosterone is a steroid hormone produced in the adrenal gland that regulates sodium and potassium.
These abnormal blood vessels are thin-walled, often twisted, and are subject to high pressure. Recurrence is common within two weeks of the first episode, but after six weeks, the risk for recurrence is the same as for patients who have not had a bleeding event. Factors that predict bleeding include ascites, encephalopathy, large veins, and marked liver cell abnormalities. It should be noted that moderate to severe exercise may also increase the risk for variceal bleeding. Some researchers believe that bacterial infection may be a primary factor in triggering a bleeding episode.