Askiteshoitoon

Askiteshoitoon is the Finnish term for the medical management of ascites, the abnormal buildup of fluid in the peritoneal cavity. It commonly arises from cirrhosis but can be due to heart failure, cancer, nephrotic syndrome, or infection. The aim is to relieve symptoms, prevent complications, and treat the underlying cause.

Diagnosis starts with physical examination and imaging, and is confirmed with diagnostic paracentesis. Fluid analysis helps identify infection or malignancy. Baseline labs assess liver and kidney function, electrolytes, and overall prognosis.

Core treatments include dietary sodium restriction and diuretic therapy, typically spironolactone with or without furosemide. Dosing is titrated to response and tolerance, with regular monitoring. For symptomatic large-volume ascites, therapeutic paracentesis provides relief; albumin is given to prevent circulatory dysfunction after large-volume taps.

Refractory ascites may require advanced approaches such as transjugular intrahepatic portosystemic shunt (TIPS) or consideration of liver transplantation. Chronic paracentesis with albumin can be used in selected patients.

Complications include spontaneous bacterial peritonitis; prophylactic antibiotics may be used in high-risk cases. Ongoing monitoring includes weight, abdominal girth, renal function, electrolytes, and signs of infection. Nutrition and fluid balance are important.

The prognosis depends on the underlying disease. Askiteshoitoon is typically part of a multidisciplinary approach in hepatology, oncology, and palliative care, aiming to improve quality of life and survival where possible.