Ascites

Ascites is an accumulation of excess fluid in the abdominal cavity that has fallen out of the circulation processes of the life organization. The peritoneum is a “fluid-breathing” organ where fluid is constantly being formed and resorbed on its 2m² surface between the visceral and parietal peritoneum. The parietal peritoneum is very sensitive to pain and close to consciousness, which is noticed during punctures; it thus shows a relationship to the person’s capacity for sensation and consciousness (astral organization). The visceral peritoneum, which is directly adjacent to the abdominal organs, contains no pain fibers and is more related to the unconscious life organization. Just as each inhalation resembles a quiet awakening, and each exhalation a subtle tendency to fall asleep, in the abdominal cavity liquid secretion and resorption rhythmically oscillate between the two peritoneal layers and create the wafer-thin liquid film. It is through this process that the layers elastically adapt to the strongly changing volume of the abdomen.

In ascites formation, which most frequently occurs as a result of hardening processes (often in the context of peritoneal carcinosis or metastatic liver disease), there is a disturbance in the balance between production and reuptake of fluid. The accumulation of fluid indicates an insufficient activity of the life organization, which is no longer permeated by the “breathing” of the sentient organization. The liquid follows gravity and is deposited in a “third space”. It is no longer sufficiently integrated into the patient’s life processes.

The place of accumulation feels heavy and cool to the patient, which is also related to inadequate intervention by the “I”-organization. Ascites can exert enormous pressure on adjacent organs, resulting in loss of appetite, nausea, vomiting, reduced peristalsis, meteorism and constipation.

The treatment of ascites accordingly requires a multimodal approach, which, in addition to (not very promising) diuretic therapy and the possibly necessary relieving punctures, would aim to support the life organization, sentient organization and “I” activity.

Research news

Parental Confidence in Fever Management - Results from an App-Based Registry    
Parents' confidence regarding their children's fever is a key factor in its management and there is still unnecessary anxiety and associated antipyretic overuse. The FeverApp application collects naturalistic real-time data on febrile infections and educates parents on fever management. First entry data of 3721 children (mean age 21 months) was assessed. Antipyretics were used initially in 14.7% of children. Their use was mostly associated with febrile temperature, but also low well-being of the children. Thus, associations were partly in accordance with recent guidelines. All results are published open access: 
https://doi.org/10.3390/ijerph192114502.


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