The potential benefit managing ascites due to cirrhosis using an integrative medicine approach

While ascites are the most common complication of cirrhosis, and can be easily upon first appearance managed by simple clinical (i.e.diuretics) and behavioral (i.e.low-salt diet) interventions, the persistent cirrhotic state and treatment resistance makes recurrent ascites a long-term challenge to the patient's quality of life and prognosis.Such "refractory" ascites due to cirrhosis have been associated with increased risk of intra-abdominal infections, kidney failure, and progressive cirrhosis.The shortcomings of Western medicine to appropriately manage ascites due to cirrhosis has led to a research interest in whether an integrated approach with traditional Chinese medicine (TCM) will benefit these patients.In this article, we summarize the current reports and outcomes of integrated approaches to treat ascites due to cirrhosis.Specifically, we first discuss the pathophysiological process of the disease.The standard Western treatments and their mechanisms, including the various modulated strategies that have been designed according to the putative etiologies of refractory ascites, such as delivery of antibiotics and vasoactives, are then introduced.Finally, the patterns of Qi associated with refractory ascites and cirrhosis are detailed, along with the various promising TCM-specific applications to address each.The use of a Western medicine and TCM integrative approach for managing refractory ascites due to cirrhosis should continue to be researched and developed.