Ascites or Belly Fat? How to Differentiate and Treat?

A protruded belly is not only because of fat deposition. It may have many other causes. Ascites are one of those causes. What does an ascites belly feel like, and how does it differ from belly fat? Well, a physician can better make a diagnosis but there are certain methods to differentiate ascites from belly fat by yourself.

So, how to know whether it is ascites or belly fat?

Ascites is a Latin word that means bag-like. So, a person having ascites has a bag-like lly pouched forward. It seems like there is a lot of fluid in the belly. If you touch the belly, the ripples appear on the surface of the skin, as the fluid is displaced. Fatty belly, however, is tender to touch.

The detailed analysis, causes, symptoms, and treatment of ascites are described in this article.

Ascites or Belly Fat? How to Diagnose?

There are many ways to differentiate ascites from belly fat. If you are suspicious about having ascites, the following methods of diagnosis can help.

Visual Examination

Belly fat is different from ascites in the way that it is evenly distributed on your belly whereas ascites belly is just like a bag, where there is no fat on your flanks. 

Moreover, it feels like there is water in your belly if you have ascites, and your belly feels soft to touch. However, if it is belly fat, it feels hard to touch.

Neck Veins

If you are having ascites, the veins of your neck become very prominent. This is because of the underlying cause that is restrictive pericarditis.


If you have ascites, a minimum of 100 ml of fluid can be detected through an ultrasound. This confirms that you have more than the normal amount of fluid in your belly.

Fluid Thrill

When the examiner elicits fluid thrill on a patient with ascites, 1000 ml of fluid can be detected, which confirms ascites.

Shifting Dullness

This is another test to differentiate ascites from belly fat. By this method, a minimum of 500 ml of abnormal fluid can be found in the patient’s belly.

Apart from all these methods of diagnosis, certain symptoms also help to differentiate whether you have ascites or belly fat.


This is the collection of fluid from the abdominal cavity and examining whether it is normal or not. If this is an abnormal fluid, it means the person is having Ascites.

Effect of Exercises

You can reduce belly fat by doing abdominal exercises. The percentage of fat reduces gradually when you start exercising. But exercise does not affect your belly if it is because of ascites.

Ascites – Basics You Need to Know

The basic information about ascites will help you understand what ascites actually are. Even if you are not sure, the symptoms mentioned in this segment might give you doubt. And that’s when you will rush to the doctor for a perfect diagnosis. 

So, take a look at the following pieces of information. 

What are Ascites? 

Ascites is the medical term for fluid accumulation in the abdomen. This can happen to people with scarring in the liver called cirrhosis.

People with cirrhosis have a lot of scar tissue, which makes it hard for blood to move easily through the liver. Because blood can not move through the liver easily, it leads to high pressure in the liver, and some fluids leak into the belly.

Two out of three people with cirrhosis develop ascites. Ascites build-up is also associated with high salt in the diet. The more salt you will consume, the more fluid will accumulate in your belly.

So, ascites are the result of portal hypertension in patients with cirrhosis. 

Causes of Ascites

Ascites may have many different causes. Following are the common causes of ascites seen in several people.

  • Increased portal venous pressure
  • Low plasma proteins
  • Chronic peritoneal irritation
  • Leakage of peritoneal fluid into the peritoneal cavity
  • Fluid overload
  • Cirrhosis
  • Tuberculosis
  • Pancreatitis

All of these can be the cause of the accumulation of abnormal amounts of fluid in the peritoneal cavity.

Symptoms of Ascites

 Belly fat does not have any kind of specific symptoms. However, a person is referred to as having ascites, if he has the following symptoms. 

  • Sudden weight gain
  • A distended abdomen
  • Difficulty breathing when lying down
  • Diminished appetite
  • Abdominal pain
  • Bloating
  • Nausea and vomiting
  • Heartburn
  • Portal hypertension
  • Edema in lower legs

These symptoms only appear if the patient is suffering from ascites and do not appear merely in the case of normal belly fat.

Treatment of Ascites

There are different types of treatments for different amounts of fluid present in the abdominal cavity. Following are the common treatments for Ascites.

Fluid Drainage

This is one of the methods to remove the abnormal amount of fluid from a patient’s belly. It is done with the help of a syringe. The abnormal amount of fluid is drained out of the patient’s belly.


After confirming the diagnosis, the doctors prescribe medicines to the ascites patient. These medicines are mainly diuretics. They help to flush out the extra amount of fluids from your body.


When the patient sees no improvement after using medicines then surgery is the final treatment. In this method, a stent is implanted in the liver that diverts blood flow or the patient gets a liver transplant.

Lifestyle Changes to Manage Ascites

Although ascites can’t be treated without medical help, however, certain lifestyle changes reduce the severity of the disease. Following tips can work better to control ascites.

  • A person with ascites is advised to limit um intake. A low sodium diet can be helpful in this regard.
  • You need to limit the consumption of fluids and most importantly, stop alcohol consumption.
  • If you are a smoker, you have to quit smoking because it will cause more harm to you.
  • If you are diagnosed with ascites, immediately start intermittent fasting, because fasting can reduce liver enzyme levels.
  • Enhance your intake of Vitamin E, as vitamin E is a powerful antioxidant and reduces the damage caused by free radicals.

Following these tips consistently, you can reduce the severity of ascites and can make a speedy recovery.


Question: What is the effect of exercise on your belly if you have ascites?

Answer: If you are having ascites, there is no effect of exercise on your belly. As it is not fat but the d that is inside your belly. The percentage of belly fat on the other hand reduces with the help of exercise.

Question: what do ascites feel to touch?

Answer: If you are having ascites, the waves or ripples appear on your belly as you touch them. Moreover, it feels like a balloon filled with a lot of water. As your belly has fluid accumulated in it, it appears like a bag.

Question: Do ascites come and go?

Answer: Ascites reduce and increase depending upon your fluid and salt intake. If you are taking high fluid and salt in your diet, ascites become worse with time.

Question: How much water should I drink with ascites?

Answer: You shouldn’t drink a lot of water if you are having ascites because it can lead to more fluid buildup in your belly. It is advisable to drink less than one liter of water daily if you are suffering from ascites.

Question: When should you suspect ascites?

Answer: There are certain symptoms of ascites such as vomiting, diarrhea, abdominal swelling, and pain. If you’re experiencing these symptoms, visit your doctor for further diagnosis or confirmation.

Bottom Line

Ascites or belly fat? Sometimes, it is very hard to differentiate ascites from belly fat. But there are certain symptoms of ascites that make it different from belly fat. If you doubt that it is ascites, immediately consult your doctor.

A doctor can make the best diagnosis whether it is ascites or belly fat. If you are diagnosed with ascites, reduce your salt and fluid intake and add fruits and vegetables to your diet. Following your doctor’s guidelines to get the proper cure.

Haleema Sadia

Haleema Sadia

A physiotherapist by profession, a Nutritionist by passion, a literarian by soul, and a writer by heart! -a blog about Healthy Living