Liver Disease and Ascites: Do Women and Men Experience It Differently?
A new study from the North American Consortium for the Study of End-Stage Liver Disease reveals a surprising difference in how women and men deal with the challenge of living with ascites, a common complication of advanced liver disease.
Ascites, a buildup of fluid in the belly, can make daily life harder in many ways: people with ascites suffer bloating, nausea, pain, fatigue and sleep disturbances.
The study, published by the American Journal of Gastroenterology, found that women with cirrhosis and ascites experienced more severe symptoms. These symptoms were not linked to educational background, employment, frailty, or psychiatric history, which were similar across genders.
Instead, women’s heightened distress appeared to stem from their perception of the ascites burden, but importantly, despite these difficulties, their ability to engage in daily and leisure activities was comparable to men.
Led by Jasmohan Bajaj, M.D., of the institute and the Richmond VA Medical Center, the researchers followed 576 patients with cirrhosis and recurrent ascites that required frequent fluid drainage. They assessed how men and women perceived their symptoms and their impact on health-related quality of life. Despite similar physical and clinical profiles, including disease severity and frailty scores, women consistently reported feeling worse about their condition.
Despite similar physical and clinical profiles, including disease severity and frailty scores, women consistently reported feeling worse about their condition.
Women indicated more discomfort and were significantly more likely to report feeling depressed (35% of women vs. 22% of men). Mental health struggles were prominent, yet women maintained daily activities on par with men.
This research highlights an essential insight: while the physical challenges of ascites may not differ greatly between sexes, the emotional and mental toll can be much heavier for women. These findings emphasize the importance of integrating patient-reported outcomes into care, ensuring emotional well-being is prioritized alongside physical treatment.