Cirrhotic Ascites
Ascites due to cirrhosis refers to the accumulation of more than 200 mL of free fluid in the abdominal cavity secondary to chronic liver disease.
TCM Pattern Identification and Medication Reference
| Common Symptoms
Clinical description:
Marked abdominal distension and fullness with a firm abdomen that sounds drum-like when percussed; distension or pain in both flanks; pale-red tongue with a white, greasy coating.
In everyday terms:
- The abdomen is enlarged and firm, feels tight and hard to the touch, and appears noticeably distended.
- Lightly tapping the abdomen produces a hollow, resonant sound, like tapping a drum.
- There may be fullness or pain in both sides of the rib area, with greater discomfort during movement or when pressure is applied.
- The tongue is pale red in color, appearing red but not deeply so.
- The tongue coating is white and sticky-looking, appearing thick, greasy, and not clear.
| Treatment Approach
Clinical description:
Soothe the Liver and regulate qi; promote water movement and relieve distension.
In everyday terms:
- May help soothe Liver qi and regulate the flow of qi, easing discomfort such as fullness in the chest and flanks, emotional unease, or difficulty burping.
- May help promote the movement of fluids in the body, easing symptoms such as difficulty urinating, a heavy feeling in the body, or swelling in the legs.
- May help ease feelings of distension and fullness, abdominal discomfort, poor appetite, or a feeling of pressure in the abdomen.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Marked abdominal distension and fullness; on palpation, a fluid-filled, sac-like sensation; epigastric and abdominal bloating; relief with warmth; poor appetite and loose stools; a white, moist or greasy tongue coating.
In everyday terms:
- The abdomen is enlarged, distended, and visibly swollen.
- When pressed, it may feel as though a bag filled with water is moving inside.
- The upper abdomen and belly may feel bloated, heavy, or blocked.
- Warmth may bring some relief, easing the bloated or heavy feeling.
- Appetite may be poor, with reduced food intake and loose, unformed stools.
- The tongue coating may be white and moist, or white and greasy-looking.
| Treatment Approach
Clinical description:
Warm the Middle Jiao and strengthen the Spleen; regulate qi and promote urination.
In everyday terms:
- May help warm and support the digestive system, easing discomfort such as sensitivity to cold, abdominal pain, poor appetite, or loose stools.
- May help regulate qi, easing symptoms such as fullness in the chest and abdomen, difficulty burping, or pressure in the upper abdomen.
- May help promote fluid metabolism, easing symptoms such as difficulty urinating, a heavy feeling in the body, or swelling in the legs.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Marked abdominal distension and fullness with tightness in the epigastrium and abdomen, or abdominal pain with tenderness; yellowing of the eyes and skin; red tongue with a yellow, greasy coating.
In everyday terms:
- The abdomen is enlarged, firm, and full, feeling tight and distended; walking or turning may cause discomfort from the sense of pressure.
- The upper abdomen and belly may feel stretched, tight, and tense, as though something inside is pushing outward and cannot relax.
- Abdominal pain may also occur, with increased pain and discomfort when pressed or touched.
- The whites of the eyes and the skin may appear yellow, with a noticeable change in color.
- The tongue may be red, with a yellow, greasy-looking coating that appears to cover its surface.
| Treatment Approach
Clinical description:
Clear Heat and drain Dampness; use purgation to expel retained fluid.
In everyday terms:
- May help clear Damp-Heat in the body and ease symptoms such as scant, dark urine, a bitter or sticky taste in the mouth, and feeling hot or restless.
- Using a purgative approach may help promote bowel movements and dispel retained fluid, easing ascites, abdominal distension, or constipation.
- May help promote fluid elimination and reduce swelling, easing symptoms such as a heavy feeling in the body or swelling in the legs.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Abdominal distension as if swollen like a drum; prominent veins on the abdominal wall; fixed, stabbing pain in the flanks; a purplish-red tongue or purplish spots; a white, moist coating.
In everyday terms:
- The abdomen is distended like a drum, appearing taut and swollen, with a pronounced feeling of fullness when pressed.
- Prominent veins may be visible under the skin of the abdomen.
- There may be a stabbing pain in the flanks. The pain stays in one place rather than moving and may feel worse when pressed.
- The tongue may appear purplish red or dark purple, and may have bruise-like spots.
- The tongue coating may be white and somewhat moist, appearing damp rather than dry.
| Treatment Approach
Clinical description:
Invigorate the Blood and resolve stasis; regulate qi and promote urination.
In everyday terms:
- May help promote blood circulation and address stasis, easing symptoms such as painful bruising, localized swelling or hardness, or poor menstrual flow.
- May help regulate the flow of qi, easing discomfort such as fullness in the chest and flanks, abdominal distension or pain, or difficulty burping.
- May help promote urination and fluid elimination, easing symptoms such as difficulty urinating, swelling in the legs, or a heavy feeling in the body.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Abdominal distension resembling a frog’s belly, worse in the evening than in the morning; sallow complexion; sensitivity to cold and cold limbs; pale, enlarged tongue, sometimes with teeth marks; thin, white, moist coating.
In everyday terms:
- The abdomen is enlarged and distended, with a shape resembling a frog’s belly; it may feel uncomfortable when touched.
- Symptoms may be milder in the morning and worsen by evening; distension may become more noticeable after daytime activity.
- The face may look yellowish and dull, with a sallow complexion.
- There may be sensitivity to cold, with cold hands and feet that are slow to warm up.
- The tongue may be pale and enlarged, with tooth marks along its edges.
- The tongue coating may be thin, white, and moist, rather than dry.
| Treatment Approach
Clinical description:
Warm and tonify the Spleen and Kidney; promote qi transformation and urination.
In everyday terms:
- May help warm and support Spleen and Kidney yang, easing sensitivity to cold, soreness and weakness in the lower back and knees, or fatigue.
- May help support digestion and absorption, easing symptoms such as poor appetite, abdominal distension, or loose stools.
- May help promote qi transformation and fluid elimination, easing difficulty urinating, swelling, or a heavy feeling in the body.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Marked abdominal distension and tightness; bleeding gums and occasional nosebleeds; deep-red tongue with little moisture; scant or patchy tongue coating.
In everyday terms:
- The abdomen is enlarged, distended, and tight, and may feel increasingly uncomfortable with movement.
- The gums may bleed easily, such as when brushing the teeth or eating.
- Nosebleeds may occur from time to time and may recur after stopping.
- The tongue may be deep red or crimson and somewhat dry, with little moisture on its surface.
- The tongue coating may be scant or patchy, with an uneven, peeled appearance.
| Treatment Approach
Clinical description:
Nourish the Liver and Kidney; resolve stasis and promote urination.
In everyday terms:
- May help nourish the Liver and Kidneys and support the body’s vital substances, easing symptoms such as dizziness, blurred vision, soreness and weakness in the lower back and knees, or fatigue.
- May help address stagnation and promote blood circulation, easing symptoms such as fixed, stabbing pain, purplish bruising, or localized lumps.
- May help promote urination and fluid elimination, easing discomfort such as difficulty urinating, swelling in the legs, or a heavy feeling in the body.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
References
- European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritionits, and hepatorenal syndrome in cirrhosis[J]. J Hepatol，2010，53(3)：397-417.
- Liu Chenghai, Yao Shukun. Consensus recommendations on the integrated Chinese and Western medicine diagnosis and treatment of ascites due to cirrhosis[J]. Chinese Journal of Integrated Traditional and Western Medicine，2011，31(9)：1171-1174.
- Zhang Shengsheng, Wang Xianbo. Expert consensus on TCM diagnosis and treatment standards for ascites due to cirrhosis[J]. Beijing Journal of Traditional Chinese Medicine，2012，31(11)：868-872.
- Jin Yingpeng, Fu Qingchun. Advances in the diagnosis and treatment of ascites due to cirrhosis—an introduction to the 2012 AASLD practice guidelines for the diagnosis and treatment of ascites due to cirrhosis[J]. Chinese Journal of Liver Diseases，2013，18(9)：638-640.