What is the recommended initial treatment for moderate ascites in a patient with cirrhosis?

The recommended initial treatment for moderate ascites in a patient with cirrhosis is spironolactone (Aldactone). Spironolactone is a potassium-sparing diuretic that helps in managing fluid retention associated with liver cirrhosis. It works by promoting the excretion of sodium while retaining potassium, which is crucial for patients with ascites due to portal hypertension. In essence, spironolactone helps reduce excess fluid in the body, alleviating the symptoms associated with ascites.

In moderate ascites cases, starting treatment with a diuretic like spironolactone is beneficial because it addresses the underlying issue of fluid overload effectively. It is typically used either alone or in combination with another diuretic, such as furosemide, if more potent diuresis is needed.

Other treatment options, while important in their respective contexts, are generally not the first-line approach for moderate ascites. Paracentesis is a procedure used to remove fluid accumulation but is usually reserved for cases where the patient presents with significant discomfort or tension from the ascites. Beta-blockers are utilized in cirrhosis management to prevent variceal bleeding rather than directly treating ascites. Antibiotics