The first symptoms of ascites in stomach cancer and methods of its treatment

Ascites is the most common complication of stomach cancer. The accumulation of fluid in the abdominal cavity may be the first sign of cancer, allowing you to pay attention to problems in the body. But most often, ascites develops in the metastatic stage of cancer.

Most patients with metastases have ascites of varying severity.

• Why does ascites appear?
• How does ascites manifest in stomach cancer?
• How to deal with ascites?
• Protein deficiency problem
• Is radical treatment of ascites possible?
• Chemotherapy for ascites
• Prices at the European Oncology Clinic for evacuation of ascites (laparocentesis)

General rules

Ascites , often referred to as “abdominal hydrops,” is an abnormal accumulation of fluid (transudate/exudate) in the abdominal cavity. In the vast majority of cases, ascites is not an independent disease, but is part of a symptom complex of other diseases, the most common of which are liver cirrhosis , cancer, nephrotic syndrome , heart failure, pancreatic diseases, tuberculosis . The main complaints of patients with ascites are: increase in abdominal volume, weight gain, abdominal fluctuation, feeling of fullness in the abdominal cavity, shortness of breath , swelling of the lower extremities, difficulty digestion/urination, heartburn , belching , pain in the pelvis and abdomen.
Treatment of ascites consists of treating the underlying disease that causes the development of ascites. However, regardless of the cause, such patients undergo conservative treatment aimed at relieving ascites - diuretic therapy and diet therapy. In severe cases, when conservative treatment is ineffective, an abdominal puncture ( laparocentesis ) is performed to remove fluid.

Treatment of ascites with diuretics is carried out under the control of diuresis and the dynamics of the patient’s weight. The therapy is effective with positive diuresis (excreted fluid exceeds consumed fluid) with a difference of more than 500 ml - for patients who do not have peripheral edema, and for patients with peripheral edema - 1000 ml.

A diet for abdominal ascites involves limiting fluid intake to 750-1000 ml/day, sharply limiting table salt or completely refusing its use, including a sufficient amount of protein in the diet, as well as natural foods that have a diuretic effect/limiting foods that delay fluid in the body.

The diet should contain sufficient quantities (1.0-1.2 g/kg/day) of easily digestible protein products (cottage cheese, lean poultry/lean fish, rabbit meat), legumes, nuts, soy milk, brown rice, seafood, seeds, vegetable oils, oatmeal, dairy products. The content of table salt in the diet ranges from 0.5 to 2 grams/day.

All salty foods are also excluded - pickles, marinades, canned food, smoked meats, sausages, salted fish. Preference should be given to salt-free products. In order to improve the taste, food can be prepared using different seasonings/spices: orange zest, parsley, lemon juice, pepper, onion, garlic, mustard, cumin, bay leaf, marjoram, sage, cloves. Any vegetables, fresh or cooked, are useful.

It is mandatory to include in the diet foods with a diuretic effect: watermelon, radish, cucumbers, melon, beets, carrots, pumpkin, radishes, onions, asparagus, watercress, spinach, artichoke, rose hips, cranberries, viburnum, strawberries, lingonberries , lemon juice, garden herbs (dill, cumin, parsley), some cereals (buckwheat, oats), green tea, apple cider vinegar, ginger or freshly prepared juices from them, which can be combined in different proportions. Such products act gently and remove fluid without noticeable discomfort and do not have a significant effect on the balance of potassium and sodium. Rosehip decoction, herbal teas, freshly squeezed juices, dried fruit compotes, and still mineral water are recommended as free liquids.

Easily digestible carbohydrates contained in honey, sugar, syrups, jams, preserves, as well as foods that retain fluid in the body - fatty meats, yeast, eggs, fried foods, fatty white/red fish, mayonnaise, etc. are also subject to dietary restrictions. fatty desserts, potato chips, sharp cheeses, margarine, processed meats, canned fish/meat, milk, gravy, mayonnaise, sauces, animal fats, pastries, chocolate, ice cream, cakes, products containing artificial additives, alcoholic beverages, baked goods.

The diet for ascites includes, as mandatory components of nutritional support for patients with ascites, water- and fat-soluble vitamins and minerals, which are recommended in the form of vitamin-mineral complexes for daily use. You can also add herbal decoctions with a diuretic effect to your diet - bearberry, horsetail, nettle, chamomile, rose hips.

The purpose of the diet for dropsy in the peritoneum

Therapy for the main diagnosis assumes that the patient will have a salt-free diet. With ascites, nutrition is aimed at maintaining stable functioning of the digestive tract and stopping complications of the disease and internal bleeding.

Those suffering from ascites must agree to dietary restrictions. The diet is aimed at erasing the clinical signs of the disease. Proper nutrition optimizes hematopoiesis and metabolic activity in the body, reduces intra-abdominal pressure and improves digestion. It is recommended to switch to a limited menu in the near future.

Authorized Products

Dietary nutrition for ascites includes the inclusion in the diet of vegetarian soups, dietary red meat, lean white fish, rabbit meat, poultry (without skin), cottage cheese, seeds, nuts, soy products, vegetables/fruits that have a diuretic effect - ripe watermelon, melon , radishes, cucumbers, radishes, carrots, beets, pumpkin, watercress, onions, spinach, rose hips, artichoke, asparagus, cranberries, viburnum, strawberries, lingonberries, ginger, herbs (dill, parsley, cumin).

It is useful to include cereal products (oatmeal and buckwheat porridge), legumes, brown rice, and low-fat fermented milk products in your diet. As fats, preference is given to vegetable oils and butter in small quantities.

Recommended drinks include unsweetened green tea, still mineral water, freshly prepared juices, decoctions of vegetables, fruits/dried fruits.

Table of permitted products

What are metastases?

According to scientific data, every day hundreds and thousands of malignant cells are formed in the human body, which can lead to the development of a cancerous tumor. But the immune system prevents pathological division and destroys them. If for some reason the defense system was unable to intervene and “lost” sight of the cancer cell, it begins to rapidly and uncontrollably multiply, gradually forming a primary cancer focus in the body.

It is from it that subsequently, with the flow of lymph and blood, dissemination, or spread, of malignant elements will begin, which will penetrate into other organs and tissues, giving impetus to the formation of metastases. It turns out that metastatic cancer is a complication of cancer.

The human abdominal cavity is represented by a slit-like space, which contains a certain amount of serous fluid necessary for the natural hydration of the internal organs. The serous membrane covering the walls of the abdominal cavity is called the peritoneum. It can stretch during pregnancy, the growth of a benign or malignant neoplasm, inflammatory processes, for example, dropsy.

The serous membrane, moisturizing the abdominal organs, promotes their motor activity and prevents fusion with each other. Primary cancer practically does not develop in this area, with the exception of the female genital organs - the ovaries, or appendages. Metastases in the peritoneum have their own code according to the ICD-10 classification: C48.2 Malignant neoplasm of the abdominal cavity and retroperitoneal space of unspecified localization.

Fully or partially limited products

The diet for abdominal ascites includes the exclusion of fatty red meat, sausages, poultry meat (duck, goose), fatty varieties of white/red fish, smoked meats, pasta, canned foods, fresh baked goods, dumplings, dumplings.

The consumption of table salt, pickles and foods containing quickly digestible carbohydrates - sugar, honey, jam, jam - is limited. It is prohibited to consume cooking/animal fats, mayonnaise, cream, margarine, all types of sweets (cakes, cookies, candies, pastries, chocolate), chicken eggs, yeast, semolina, whole milk, cheeses.

Fatty desserts, canned fish, sauces, gravies, fried foods, spices, seasonings, fast food, foods with artificial additives, strong coffee, and alcohol-containing drinks are completely excluded from the diet.

Table of prohibited products

Principles of nutrition for ascites

Depending on the stage of development of the disease and the individual characteristics of the clinical case, the doctor selects a diet for the patient. For different people, the list of acceptable and not recommended foods differs slightly. However, the basic rules for organizing meals are the same for patients:

1. The number of meals per day is at least 6. Dishes are served warm. The intervals between meals are no more than 2-3 hours.
2. It is forbidden to eat hot or cold food to avoid spasms in the intestines.
3. The serving size should be 250 g. Prolonged fasting or overeating should not be allowed.
4. The balance in food recommended by the doctor is observed.
5. Fruits and vegetables should be boiled. Only sweet fruits are allowed uncooked.
6. It is recommended to remove salt (the permissible limit of salt consumption per day is 5 g).
7. Strict refusal of alcohol and cigarettes.

Patients need to follow a drinking regime: you can’t drink too much water! Daily fluid intake is 1 liter.

Principles of nutrition for ascites associated with oncology

Dropsy has a unique course if abdominal pathology is found in people with cancer. According to statistics, 50% of patients with dropsy are oncology clients. In such a clinic, the accumulation of a pathogenic substance in the abdomen is due to the involvement of the whole organism in the malignant process. As the pathology progresses, the metabolic problem also progresses. The patient experiences discomfort, he is tormented by bursting pain - there is an urgent need for nutritional adjustments:

1. A strict ban is imposed on fried and fatty foods.
2. Food should be baked in foil in the oven, cooked in a double boiler or boiled.
3. You are allowed to drink 1 liter of liquid per day.

Reviews and results

Most patients with ascites respond positively to the diet, believing that it is a properly selected diet that can reduce swelling and the accompanying symptoms.

• “... My husband is diagnosed with cirrhosis of the liver, accompanied by ascites. We take all medications prescribed by the doctor, including diuretics. I cook almost everything for him without salt, and try to follow a strict diet. I understand that without salt everything seems tasteless, but what can I do? In addition, I give him diuretic herbs. So we support him.”

Necessary treatment

Therapeutic measures for abdominal cancer must begin immediately after the diagnosis is made. The main method is surgical excision of the cancerous tumor. Before surgery, the following conservative treatment methods are prescribed:

• Irradiation. The treatment course is performed before and after surgery.
• Chemotherapy. It involves taking potent drugs, after which the cancer cells partially disappear.
• Immunotherapy. The patient is given special medications that strengthen the body's defense mechanisms.
• Washing the abdominal cavity. The affected area is treated with special solutions, which should not exceed 40 degrees Celsius. The manipulation is performed by a specialized physician, as it is highly complex.