Use of Protein to Cure Ascites

Ascites is the most common symptom and one of the worst!

Simply put, ascites is the accumulation of fluid in the abdomen. This fluid leaks out of the veins due to two factors:

1. Low levels of Serum Albumin produced by the liver

2. Portal Hypertension brought about by the liver becoming denser and less permeable due to scarring.

Ascites can be a debilitating condition. Apart from the physical side effects of a swollen abdomen, the condition can also result in terrible pain, shortness of breath and a huge risk of infection. (spontaneous peritonitis).

Ascites, if left untreated, may also result in hernias, both umbilical and ‘scrotal’ which are awful to live with and may result in encapsulation or strangulation of gut within the hernia. This can be a life threatening condition!

The volumes of ascites fluid can be horrendous. At my worst, I has 22 pints of fluid drained from my abdomen. The procedure to do this (paracenticis) though not normally painful is uncomfortable, frightening and very tiring.

A patient with ascites needs to have regular drainings. Often these will need to be done at the ER due to the sudden onset of intense pain or shortness of breath. Should either of these conditions occur, they MUST be treated as an emergency and the patient taken to the ER. Should the fluid get infected (spontaneous peritonitis) the condition can be life threatening.

As the liver function worsens, so can the amount of fluid increase and draining may become more regular. This condition is known as refractory ascites. It has, in essence become uncontrollable.

If ascites fluid is allowed to accumulate, it may also invade the pleural cavity surrounding the lungs. Once this has occured, the fluid needs to be drained off via a needle through the back. This is NOT pleasant!!!

People who have ascites may also experience swelling of the feet and ankles. This condition is known as edema.

Ascites is normally treated tin three ways:

1. Restriction of fluid intake to less than 1.5L/day

2. Restriction of sodium(salt) intake to less that 1500mg/day

3. Diuretics

The diuretics most commonly used are Lasix and Spirolactone.

Lasix is extremely aggressive and long term use may damage the kidneys. Lasix also leaches Potassium from the body which can result in heavy bleeding.

Spironolactone is much milder but is also a Potassium sparing diuretic. Lasix and Spiro are normally taken in conjunction in a ratio of 1:3 or 1:4. eg 20mg Lasix to 60mg Spiro.

Continual or worsening ascites is indicative of worsening liver function and combined with the risks of infection means that the prognosis for people with ascites can be poor.

Ascites is a SERIOUS condition and should ALWAYS be treated a such!!

Ascites terrified me. When I was very ill,my ascites was awful, I developed an umbilical hernia which nearly killed me and due to my disease I was also losing weight at the rate of 5lbs body mass per month.

In desperation, I consulted my GI about my weight loss and sought his approval to go onto a protein-rich diet. My view was to eat as much meat (red) as possible in order to try and cram some pounds onto me.

My GI didn’t have an issue with this and I started eating meat, steak, ground beef, hamburgers etc at every opportunity.

Some people are meat intolerant. I’m not!! In addition I never had any issues with Hepatic Encephalopathy, which many docs (wrongly in my opinion) attribute to eating red meat.

My experiment with eating meat didn’t do anything much for my weight loss, that would require vitamins and minerals. But, it worked wonders on my ascites. Within 3 months of starting my high protein diet I was free of ascites. This became obvious when I needed emergency surgery on my hernia and the surgeon remarked on how well my ascites was being managed. He assumed it was my GI who was looking after my ascites. I told him it wasn’t.

My experiment with protein worked. I last got drained in May/June of 2009 and it has never come back.

Many people on this site have taken my advice and tried going onto a high protein diet and it has worked wonders for them.

So why does it work? Why do doctors not recommend this? Do doctors even know about this????

I have hunted high and low for an answer and the only explanation I can arrive at is as follows:

Eating high value protein encourages the liver to produce its own Albumin. In terms of red meat, red meat contains Iron and Iron (used by body builders) increases hemoglobin in the blood. This increase of hemoglobin has a side effect which is to spur the liver to produce more Albumin.

It is worth remembering that Cirrhosis is largely a disease of malnutrition. As is highlighted in Alcoholic Cirrhosis as a Syndrome, by treating the liver for malnutrition, the liver can and will start regenerating and recovering from damage.

This regeneration and recovery also impacts the porosity of the liver and greater porosity leads to reduced portal hypertension which in turn results in less fluid loss from the veins.

Therefore we have a two-pronged attack. The recovery of the liver and the increase in Serum Albumin.

Viola!! Ascites cured…..

Craig

January 3rd 2011