Ascites is most commonly associated with advanced liver disease, and is due to the replacement of healthy liver tissue with fibrous or scar tissue, called cirrhosis, which may causes in some cases fluid to leak from the liver and accumulate in the abdominal cavity.
There are a wide variety of causing liver tissue damaged such as alcoholic cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), hepatocellular carcinoma to name a few. In its early stages, ascites can usually be treated with medication (diuretics) and/or a salt-restricted diet.
However, these treatments sometimes become ineffective or are no longer tolerated by the body. In such cases the ascites is described as being ‘refractory’ to medical therapy and it is removed by paracentesis or sometimes by the placement of a shunt called TIPS . If the above treatments are ineffective, liver transplantation may be required.