"It is not as if I have eaten a lot, but my belly just keeps swelling." This is something people whose livers have gone bad often bring up in the clinic. The trouser button will not fasten, lying down leaves them short of breath, and bending at the waist to put on shoes is a struggle. Ascites is the phenomenon of water pooling inside the abdomen when cirrhosis or liver cancer has progressed to a certain degree. It sounds frightening, but once you actually understand it, there is quite a lot you can control in daily life. So today, instead of medication, I want to talk about how to spend your day at home so your belly swells less.
The first thing to address is salt. When you eat salty food, your body clings to that salt and holds on to water, and a person with a weak liver lacks the power to drain this water, so it pools in the belly. The usual recommendation is to keep daily sodium within 2g (about 5g as salt), but honestly, habit matters more than the number. Leaving half the broth, cutting down on kimchi, salted seafood, ramen seasoning packets, and processed foods, and simply removing the salt shaker from the table altogether — even these make a felt difference. Surprisingly, sodium hides in foods that do not look salty, like bread or cereal, so it is good to glance at the label now and then.
Water, on the other hand, should not be cut off blindly. Some people refuse to drink any water at all just because they have ascites, but unless the sodium concentration in your blood has dropped too low, you may drink as much as your thirst calls for. Unless your attending doctor has separately told you to "limit it to 1 to 1.5 liters a day," there is no need to hold back to the point of becoming dehydrated. This part differs by person's prescription, so it is right to check with your own physician.
The habit of weighing yourself every morning under the same conditions is a bigger weapon than you might think. After using the toilet, in the same clothing, on the same scale. If you are taking a diuretic, losing around 0.5kg a day is appropriate, and if you suddenly gain more than 2kg over a few days, it may be a sign that water is building up again. Measuring your waist circumference with a tape and noting it down is good too. With such records, at your next appointment you can show numbers instead of answering vaguely to "how have you been lately?", which makes adjusting the medication far more accurate.
Besides managing your body, there are other things to attend to. When your legs are swollen and your belly is taut, lying down and propping a pillow under your feet to raise your legs slightly makes it much more comfortable. When the belly swells, the stomach gets pressed, so you cannot eat much at once; rather than forcing down three full meals, it is better to eat a little, often, in divided portions. Protein is needed to protect your muscles, so do not cut out tofu, fish, or eggs. And some painkillers (especially anti-inflammatory ones) burden the kidneys and can make water pool more, so before buying just anything at the pharmacy, it is safer to ask first.
Finally, memorize the signs that mean you must contact the hospital right away from home. If your belly suddenly swells more along with a fever, or it hurts when you press on it, inflammation may have developed in the ascites — and this is an emergency. Becoming dazed, hands trembling, or slurred speech, as well as vomiting or stools turning jet black, must not be brushed off either. Ascites is a problem you can live with stably for a long time if managed well. Do not be too frightened, but do not take the signals your body sends lightly. What is written here is only a general management story, so be sure to discuss your actual food intake and medication with your own physician.