title: Medical management of ascites.
abstract: BACKGROUND
  Ascites is a common complication of advanced cirrhosis that has a significant negative impact on survival. This review updates the reader on the medical management of ascites.
  
  
  METHODS
  This review explores the pathophysiology of ascites formation in cirrhosis; the current mainstays of medical management (treating the underlying cause of cirrhosis, avoiding nephrotoxic agents, sodium restriction, and combination diuretic therapy); potential novel agents, such as vasoconstrictors and vaptans; and albumin infusions. The literature research covers all aspects of medical management of ascites from the English literature, concentrating on publications from the past 10 years. It provides a thorough understanding of how the correction of pathophysiology of ascites formation helps to improve ascites; knowledge on the monitoring of patients with cirrhosis and ascites receiving medical management, and on prophylaxis against potentially life-threatening complication such as spontaneous bacterial peritonitis; and potential new treatments for ascites.
  
  
  CONCLUSIONS
  Management of patients with cirrhosis and ascites requires careful attention to fluid and electrolyte balance and avoidance of complications. Recognition of refractory ascites allows for the use of second-line treatments. All patients with cirrhosis and ascites should be considered for liver transplantation.
authors.affiliation: University of Toronto, Toronto General Hospital, Department of Medicine, Ontario, Canada.
authors.forename: Wesley
authors.initials: W
authors.lastname: Leung
authors.forename: Florence
authors.initials: F
authors.lastname: Wong
mesh_terms: D001201:Ascites / Q000209:etiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D010538:Peritonitis / Q000382:microbiology / Q000628:therapy; D015996:Survival Rate