What is the Difference Between Ascites and Edema

Ascites and edema are two conditions involving swelling. Swelling can occur in any part of the body and occurs when organs, skin, or other parts enlarge. It is caused by the increased movement of fluid and white blood cells into the injured area. Both ascites and edema are common problems in patients with terminal illnesses. However, they have different aetiologies.

The key difference between ascites and edema is their cause. Ascites is a condition that causes fluid build-up in the abdomen while edema is a condition that causes swelling and puffiness in the different parts of the body.

CONTENTS

1. Overview and Key Difference
2. What is Ascites 
3. What is Edema
4. Similarities – Ascites and Edema
5. Ascites vs Edema in Tabular Form
6. Summary – Ascites vs Edema
7. FAQ – Ascites and Edema

What is Ascites?

Ascites is the fluid build-up in the abdomen. This normally happens when the fluid in the circulatory system does not drain out properly. Ascites are caused by cancers such as ovarian cancer, kidney failure, heart failure, and liver failure. The symptoms of ascites are pain or discomfort in the abdomen, a swollen abdomen, difficulty sitting upright, nausea and vomiting, loss of appetite, acid reflux, constipation, and breathlessness.

Figure 01: Ascites

Ascites can be diagnosed through physical examination, ultrasound, and CT scan. Furthermore, ascites is treated by reducing the amount of salt in the patient’s diet, diuretics, medication to manage any pain, constipation, nausea or vomiting, paracentesis, transjugular intrahepatic shunt (TIPS), and liver transplant.

What is Edema?

Edema is the swelling in body parts. It can affect a small area or the entire body. Edema is caused by medications, pregnancy, infections, and many other medical problems. The symptoms of edema include swelling or puffiness of the tissue under the skin, such as in legs and arms, stretched or shiny skin, pitting, swelling of the belly, and feeling of leg heaviness.

Figure 02: Edema

Edema can be diagnosed through medical history, physical examination, ultrasound, and blood test. Furthermore, edema is treated by raising the affected arm or leg higher than the heart and wearing compression garments, changing the dose of medicine or looking for another medicine that doesn’t cause edema, and using diuretics (water pills) that help the body get rid of too much fluid through urine.

Similarities Between Ascites and Edema

1. Ascites and edema are two associated conditions.
2. Ascites and edema both involve swelling.
3. These are common problems in patients with terminal illness.
4. Both these can be diagnosed through physical examination, blood test, and ultrasound.
5. They can be treated through specific medications such as diuretics.

Difference Between Ascites and Edema

Definition

1. Ascites is a build-up of fluid in the abdomen.
2. Edema is swelling resulting from too much fluid trapped in the tissues of the body.

Cause

1. Cirrhosis, cancer, and heart failure.
2. Sitting or staying in one position for too long, being premenstrual, being pregnant, eating too much salty foods, high blood pressure medicines, NSAIDs, steroid medicines, estrogens, certain diabetes medicines called thiazolidinediones, and medicines used to treat nerve pain.

Symptoms

1. Shortness of breath, nausea, swelling in the legs and ankles, indigestion, vomiting, heartburn, loss of appetite, fever, and hernia.
2. Swollen, shiny, stretched skin, skin that retains a dimple after a few seconds of pressing, puffiness in ankles, face, or eyes, aching body parts, stiff joints, weight gain or loss, decreased urine production, fuller hands and neck veins, and visual abnormalities.

Diagnosis

1. Physical examination, blood test, X-ray, ultrasound, or CT scan, and serum ascites albumin gradient (SAAG) test.
2. Medical history, physical examination, ultrasound, and blood test.

Treatment

1. Sodium reduction and diuretics such as furosemide and spironolactone.
2. Positioning the affected body parts to improve drainage, usage of diuretics (water pills), and intermittent pneumatic compression.

The following table summarizes the difference between ascites and edema.

Summary – Ascites vs Edema

Ascites and edema are both swelling in the body. Ascites is the fluid build-up or accumulation in the abdomen while edema is the swelling in the different parts of the body which usually in the skin. This is the basic difference between ascites and edema.

FAQ: Ascites and Edema

1. What is the cause of ascites?

• Ascites result from high pressure in certain veins of the liver and low blood levels of a protein called albumin. Conditions such as cirrhosis that cause severe liver damage can lead to ascites. Ascites can also be caused by cancer, heart failure, and kidney failure.

2. How do I know if I have ascites?

• Symptoms of ascites may develop slowly or suddenly, depending on the cause. These symptoms may include swelling in the abdomen, weight gain, a sense of fullness, bloating, a sense of heaviness, nausea or indigestion, vomiting, and swelling in the lower legs.

3. Can ascites be cured?

• Treatments for ascites can help improve the symptoms and reduce complications, such as diuretic therapy with TIPS or liver transplant. Ascites associated with the liver may resolve with improvements in liver function.

4. What are the three main causes of edema?

• The main causes of edema are long periods of standing or sitting, venous insufficiency, chronic lung diseases, congestive failure, pregnancy, and low levels of protein.

5. How to treat edema?

• Treatment of edema includes treatment of the underlying cause, reducing the amount of salt (sodium) in the diet, using a medication called a diuretic to eliminate excess fluid, using compression stockings, and elevating the legs.

 Reference:

1. “Ascites: Causes, Symptoms, and Treatment.” WebMD.
2. “Edema: Types, Causes, Symptoms, and Treatment.” WebMD.

Image Courtesy:

1. “Diagram showing fluid (ascites) being drained from the abdomen CRUK 122” By Cancer Research UK – Original email from CRUK (CC BY-SA 4.0) via Commons Wikimedia

2. “Depiction of different types of Edema” By Myupchar.com (CC BY-SA 4.0) via Commons Wikimedia

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