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Ascites or Belly Fat? How to Differentiate and Treat?

There can be several reasons why people have swelling of the abdomen. This protruded belly can not only be because of fat deposition. Rather, it may have many other causes. And ascites are one of those causes.

So, what does an ascites belly feel like, and how does it differ from belly fat? And how to know whether it is ascites or belly fat? Well, a physician can better make a diagnosis. However, there are certain methods you can use to guess if you have ascites or belly fat.

A person having ascites has a bag-like pouched forward. If you touch the belly, the ripples appear on the surface of the skin, as the fluid is displaced. A fatty belly, however, will not produce this same effect. By seeing the neck veins, shifting dullness, and visual examination, you can get a rough idea if you have ascites or belly fat.

That being said, let’s take a more in-depth look into the difference between ascites and belly fat. While we’re at it, let’s also check out the causes, symptoms, and treatment of ascites.

Table of Content

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. But, ascites belly is just like a bag. There’s a collection of fluid in the layers between your abdominal organs. This fluid can cause massive swelling. And this swelling will not fill up your flanks. However, in the case of belly fat, there’s generally 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 the touch. However, if it is belly fat, it feels hard to touch.

Neck Veins

If you are having ascites, the veins of your neck may become very prominent. This is because of the backing up of blood. You see, blood from your liver enters the right side of your heart. If there’s any abnormality in this right heart, then the blood collects in the liver. This increases the fluid pressure inside your liver.

The final result of this pressure buildup is fluid getting out into the abdomen in the form of ascites. Your neck veins also carry blood from your head to the right heart. So, any right heart abnormality cause backing up of blood in the neck veins as well along with ascites. Thus you might see prominent neck veins in some cases of ascites.

Fluid Thrill

This is a test that doctors perform to see if you have ascites. Here, the doctor will tell you to put the sides of your hand on your abdomen. They will then put one of their hands on one side. And they will push the side of the abdomen with the other hand on the other side.

In the case of ascites, there’s fluid inside the abdomen. So, the doctor can feel the rippling with the other hand. This is the fluid thrill test. 1000 ml of ascites fluid can be detected by the fluid thrill and this confirms ascites.

Shifting Dullness

This is another test to differentiate ascites from belly fat. Here the doctor will percuss your abdomen to check the presence of fluid. By this method, a minimum of 500 ml of abnormal fluid can be found in the patient’s belly.

Other symptoms

You’re likely to have other symptoms if you have ascites. Ascites are abnormal pathological conditions. So, you’ll notice other symptoms of the underlying disease. However, in the case of belly fat, there’s generally no pathology involved. So, you’ll not have other symptoms unless you have other diseases.

Other symptoms of ascites include nausea, vomiting, abdominal pain, bloating, heartburn, leg swelling, diminished appetite, etc. These can help determine if you have ascites or belly fat.

Effect of Exercises

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


This is the best diagnostic procedure to see 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.

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 a collection of fluid in the abdominal cavity. You see, the organs of your abdomen are wrapped in a two-layered membrane. You can think of this as the organs being wrapped in cellophane. This layer is called the peritoneum.
Normally, there’s a small amount of fluid in between the two layers of the peritoneum. However, there may be an excessive accumulation of fluid here which is ascites. There can be many causes of ascites. However, scarring of the liver or cirrhosis most often presents with ascites.

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.

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 cause 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 symptoms, like dilated veins in the abdomen, vomiting of blood, bloody stool, etc.
  • Edema in lower legs

These symptoms only appear if the patient is suffering from ascites. These 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. The 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. Because it is fluid 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. The degree of ascites also has to do with the specific disease which caused it.

Question: How much water should I drink with ascites?

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

Question: When should you suspect ascites?

Answer: If you notice a sudden protrusion and heaviness in your abdomen, you can keep ascites in mind. 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.

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