Treating fluid in the abdomen

Advanced cancer can sometimes cause fluid to build up in the tummy (abdomen). The medical name for this is ascites. Treatments to remove the fluid or prevent it from building up include having a tube inserted, water tablets or having chemotherapy.

Having a tube to drain the fluid (paracentesis)

Your doctor can put a small tube into the abdomen to drain off the fluid. This reduces the swelling and makes you feel more comfortable. It’s called abdominal paracentesis (pronounced para-sen-tee-sis) or an ascitic tap (pronounced ass-it-ic tap).

Draining the fluid relieves symptoms in 90 out of 100 people (90%).

The fluid sometimes builds up again after a while so your doctor might suggest that you have medicines to try to slow the build up. They may suggest that you have a long term drain.

What happens?

You might have this treatment as an outpatient or you might need to stay in hospital for up to a few days.

You lie down on a bed and a nurse helps you get comfortable. Your doctor cleans the skin on your tummy and gives a local anaesthetic injection to numb the area. They make a small cut in your tummy and gently use a needle to put a small tube into the fluid. You might have an ultrasound scan at the same time. This helps them guide the tube into the right area.

Your doctor then attaches the tube to a drainage bag. They might make a couple of stitches in the skin to hold it in place. You have a dressing over the tube which also helps to keep it in position.

You might only need to have the tube in for a few hours. But if you have more than a couple of litres of fluid you might have it in for a few days. Some people might have a permanent drain that can stay in for a few months.

Possible problems

Low blood pressure

Your blood pressure may drop and make you feel ill if the fluid drains too quickly. Your nurses will check your blood pressure and pulse regularly.

Pain and discomfort

Your nurse can give you painkillers if you need them. They can also help you change your position to make you comfortable.

Fluid in separate areas of the abdomen

Your doctor might need to put the tube in more than one place if the fluid is in different areas. If the fluid is in lots of different pockets this is called loculated ascites. This may mean there are too many pockets of fluid for the doctors to be able to drain.

Infection (peritonitis)

Infections aren’t common. If you get one, you have antibiotics as tablets or through a drip.

Tube blockage

The tube might stop draining. Changing your position or sitting upright can sometimes get rid of the blockage. If not, your doctor might need to replace the tube.

Fluid leak after taking the tube out 

You have a dressing to absorb fluid. If there is a lot of fluid leaking from the drain site you may have a collection bag instead of a dressing. You might need to have stitches put in if the wound still leaks after a couple of days.

If fluid builds up again

You might be able to have the fluid drained again. Your doctor may suggest a shunt or a long term tube if the fluid builds up quickly or needs to be drained quite often.

Medicines to stop fluid building up

Some drug treatments can help to stop the fluid building up.

Water tablets

Water tablets make you pass urine more often. They are called diuretics (pronounced dye-yoo-ret-iks). Research shows that they help to stop fluid building up in about half the people who take them.

Chemotherapy or hormone therapy

These treatments can help to shrink or control a cancer. This stops fluid building up in the abdomen for some people. The type of chemotherapy or hormone therapy that might help you depends on the type of cancer you have.

Your doctor might suggest chemotherapy through a tube into your abdomen. This helps to control the build up of fluid for some people. But there isn’t much evidence at the moment to show that it works very well.