Bloating vs. Ascites: Symptoms, Causes, and Treatment (2024)

Bloating and ascites can both cause swelling and discomfort in your abdomen. Bloating is more common and usually goes away within hours to days. Ascites is more likely to be a sign of a serious medical condition.

Almost everyone experiences bloating at some point. It’s caused by the buildup of gas, food, or fluids in your abdomen or gastrointestinal (GI) tract. This buildup can stretch the lining of your intestines and cause pain or discomfort.

Ascites is the buildup of fluid in the spaces of your abdomen. The most common cause is cirrhosis. Other problems that can cause ascites include:

  • kidney failure
  • cancer
  • heart failure

Unlike bloating, which is usually related to excess gas inside the intestines, ascites is generally long lasting and progressively gets worse over time.

Read on to learn more about the difference between the two.

Here’s a look at the symptoms of bloating and ascites.

Bloating symptoms

Bloating can cause:

  • a tight, full, or swollen feeling in your abdomen
  • more buildup of gas in the digestive system (flatulence) than usual
  • stomach gurgling or rumbling
  • abdominal pain or discomfort
  • a feeling like your abdomen is bigger than usual

Bloating isn’t usually serious, but the discomfort can be bothersome.

Ascites symptoms

Ascites typically causes progressive swelling of your abdomen. This swelling may be painless at first but often causes discomfort if your abdomen grows very large.

Other symptoms may include:

  • weight gain
  • quick fullness
  • shortness of breath, especially when lying flat
  • fever
  • abdominal tenderness
  • loss of appetite
  • nausea or vomiting

Bloating is more common than ascites and usually has a less serious underlying cause. Here’s a look at the potential causes of both conditions.

Bloating causes

Trapped gas, food, or fluids in your gut can cause bloating. It’s often caused by excess gas produced from the digestion of your food.

Foods particularly prone to causing bloating include:

  • beans
  • lentils
  • fizzy drinks
  • broccoli
  • dairy

Learn more about foods that cause bloating.

Long periods of inactivity, such as during airline travel, can make bloating worse since trapped gas can’t work through your digestive tract.

In some cases, bloating is caused by underlying medical conditions like:

  • constipation
  • food intolerance
  • celiac disease
  • irritable bowel syndrome
  • inflammatory bowel disease

People with a uterus may have bloating around their period. Persistent bloating that doesn’t go away can be a sign of ovarian cancer.

Ascites causes

Ascites is most commonly caused by cirrhosis and is the most common complication of cirrhosis.

Less common causes include:

  • cancer
  • heart failure
  • tuberculosis
  • dialysis
  • pancreatic disease
  • type 2 diabetes
  • intravenous (IV) drug use
  • obesity
  • malnutrition

Bloating usually doesn’t require medical attention, but it’s a good idea to see a doctor if it becomes persistent or affects your daily life. It’s also a good idea to see a doctor if you have symptoms of ascites, such as:

  • vomiting
  • nausea
  • shortness of breath

If you have persistent bloating, a doctor will likely start the diagnostic process by asking about your symptoms. They may ask you questions like:

  • How long have you had symptoms?
  • How frequently do you have symptoms?
  • Do certain foods make your symptoms worse?

They may order tests to look for the underlying cause, such as:

  • complete blood count
  • abdominal X-rays
  • a small intestinal bacterial overgrowth test where you drink a sugary liquid and blow into a bag
  • colonoscopy
  • computed tomography (CT) scan

CT scans are usually the imaging test of choice for diagnosing ascites. Ultrasound may also be a reliable form of imaging.

Bloating often resolves itself once your body digests whatever food caused it. You may be able to resolve some discomfort by massaging your abdomen or moving around to release trapped gas. If it becomes an ongoing problem, a doctor may prescribe medications like muscle relaxers.

Learn more about relieving bloating.

Ascites treatment may include:

  • limiting salt intake
  • diuretics
  • paracentesis (also known as abdominal tap), a procedure where excess fluid is withdrawn with a needle
  • infusion of a protein called albumin after paracentesis
  • shunt to drain fluid

Here are some ways you can prevent bloating and ascites.

Bloating prevention

Habits you can adopt to minimize bloating include:

  • exercising regularly
  • chewing with your mouth closed
  • drinking plenty of fluids
  • eating plenty of fiber to avoid constipation
  • avoiding triggering foods like beans or cabbage
  • eating more frequent but smaller meals
  • minimizing spicy, fatty, and sugary foods

Ascites prevention

The ideal way to prevent ascites is to prevent the underlying diseases that cause it. You can adopt habits like:

  • eating a diet high in fresh fruits and vegetable
  • minimizing intake of processed foods
  • maintaining a body weight that’s healthy for you
  • exercising regularly
  • taking steps to prevent hepatitis, such as receiving vaccinations
  • avoiding too much alcohol consumption (if any)

Here are some frequently asked questions people have about bloating and ascites.

How can I tell if I have ascites?

Ascites tend to get worse over time. It’s also usually associated with underlying conditions like cirrhosis or heart failure.

What does an ascites belly feel like?

Ascites usually feels hard to the touch. Belly fat usually feels soft.

Does ascites come and go, like bloating?

Ascites generally causes progressive swelling of the abdomen, while bloating tends to come and go.

What’s the difference between ascites and belly fat?

Ascites is the buildup of fluid in your abdomen. Belly fat is the buildup of fat tissue from consuming excess calories.

How long can you live with ascites?

According to a 2023 study, people with ascites from cirrhosis have about 15% mortality rate within a year and about 44% within 5 years. Ascites from other causes have different outlooks depending on various factors.

Ascites and bloating can both cause swelling and discomfort in your abdomen. Bloating is usually short term and often doesn’t have a serious underlying cause.

Cirrhosis is the most common cause of ascites. In some cases, causes may also include potentially serious medical conditions. It’s important to see a doctor if you suspect that you may have ascites.

Bloating vs. Ascites: Symptoms, Causes, and Treatment (2024)
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