Therapeutic target
- Flushing out ascites
Therapy recommendations
- Basic therapy: maximum 3-6 g of table salt per day and fluid restriction (750-1,000 ml/d) – see under “Further therapy/nutritional medicine).
- Preferred use of spironolactone (aldosterone antagonists; first-line agent)[1]), if necessary in combination with loop diuretics or thiazide diuretics (draining drugs)This benefits patients with portal vein hypertension (high pressure of the portal veins) due to hepatic metastases (daughter tumors in the liver); if necessary, also intraperitoneal chemotherapy.
- Malignant ascites: Anti-VEGF antibody bevacizumab (BEV) (preclinical approach); also intraperitoneal chemotherapy if necessary.
- Therapeutic ascites puncture in the absence of response to diuretics.
- See also under “Surgical therapy” and “Other therapy.”
Further notes
- Spironolactone: first-line agent for ascites, also for malignant ascites.
