Edema and heart failure

Edema is swelling caused by the abnormal buildup of fluid in the body. The fluid collects under the skin within the tissues that are outside of the circulatory system. The circulatory system carries blood through the body.

Edema is most common in the feet and legs. It can also occur in the hands, arms, face, and abdomen. When edema occurs in the abdomen, doctors call it ascites. When it occurs around the lungs, doctors call it pleural effusion.

Causes of edema

The following factors may cause edema:

  • Cancer, especially kidney, liver, or ovarian cancers

  • Some types of chemotherapy, including cisplatin (available as a generic drug) and docetaxel (Taxotere)

  • Other medications, including the following:

    • Corticosteroids, which are drugs that reduce swelling

    • Hormone replacement medications

    • Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (multiple brand names) or naproxen (multiple brand names)

    • Some blood pressure drugs

  • Low levels of protein in the blood, caused by poor nutrition

  • Inactivity, which can cause fluid to collect in the feet and legs

  • Problems with kidney, liver, or heart function

Symptoms of edema

People with edema may have the following symptoms:

  • Puffiness, swelling, or a heavy feeling

  • Feeling that clothes, shoes, rings, or watches are too tight

  • Less flexibility of the joints in the arms and legs, such as the ankles, wrists, and fingers

  • Shiny, tight, or stiff skin

  • Indentation when pressing on the skin. This does not happen when edema is severe.

  • Sudden or rapid weight gain

  • Decreased amount of urine

Diagnosing edema

To diagnose edema, your doctor may check whether the skin over the swollen area indents when pressed. He or she will likely ask you questions about recent weight gain, tightness of clothes or jewelry, and other symptoms. You may also need to have blood and urine tests and x-rays.

Managing edema

Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any symptoms you experience, including any new symptoms or a change in symptoms.

Managing edema focuses on treating the underlying cause of fluid buildup. Edema caused by drugs or poor nutrition can be fixed in some people. Edema caused by cancer or by kidney, heart, or liver problems may be more difficult to treat. In these situations, edema may be permanent. The following suggestions may help reduce swelling and relieve symptoms:

  • Ask your doctor about prescription diuretics. These medicines help get rid of extra fluid from the body by increasing urination.

  • Eat a well-balanced diet.

  • Lower the amount of salt in your diet.

  • Walk or do other exercises, which helps pump fluids back to your heart.

  • Raise the affected area when sitting or lying down.

  • Avoid standing for long periods or sitting with your legs crossed.

  • Wear compression stockings or elastic sleeves to help push fluids back into your circulation system.

  • Do not reduce the amount of water or other fluids you drink without talking to your doctor.

  • Talk with your doctor about whether physical therapy or occupational therapy may be helpful.

Related Resources

Lymphedema

Leg Swelling After Cancer Treatment

Fear of Treatment-Related Side Effects

Causes of Edema

Things like a twisted ankle, a bee sting, or a skin infection will cause edema. In some cases, like an infection, this may be helpful. More fluid from your blood vessels puts more infection-fighting white blood cells in the swollen area.

Edema can also come from other conditions or from when the balance of substances in your blood is off. For example:

Low albumin. Your doctor may call this hypoalbuminemia. Albumin and other proteins in the blood act like sponges to keep fluid in your blood vessels. Low albumin may contribute to edema, but it’s not usually the only cause.

Allergic reactions. Edema is a part of most allergic reactions. In response to the allergen, nearby blood vessels leak fluid into the affected area.

Obstruction of flow. If drainage of fluid from a part of your body is blocked, fluid can back up. A blood clot in the deep veins of your leg can cause leg edema. A tumor blocking the flow of blood or another fluid called lymph can cause edema.

Critical illness. Burns, life-threatening infections, or other critical illnesses can cause a reaction that allows fluid to leak into tissues almost everywhere. This can cause edema all over your body.

Congestive heart failure . When the heart weakens and pumps blood less effectively, fluid can slowly build up, creating leg edema. If fluid builds up quickly, you can get fluid in the lungs. If your heart failure is on the right side of your heart, edema can develop in the abdomen.

Liver disease. Severe liver disease, such as cirrhosis, causes you to retain fluid. Cirrhosis also leads to low levels of albumin and other proteins in your blood. Fluid leaks into the abdomen and can also cause leg edema.

Kidney disease. A kidney condition called nephrotic syndrome can cause severe leg edema and sometimes whole-body edema.

Pregnancy. Mild leg edema is common during pregnancy. But serious complications of pregnancy like deep vein thrombosis and preeclampsia can also cause edema.

Head trauma , low blood sodium (called hyponatremia), high altitudes, brain tumors, and a block in fluid drainage in the brain (known as hydrocephalus) can cause cerebral edema. So can headaches, confusion, unconsciousness, and coma.

Medications. Many medicines can cause edema, including:

  • NSAIDs (such as ibuprofen and naproxen)
  • Calcium channel blockers
  • Corticosteroids (like prednisone and methylprednisolone)
  • Pioglitazone and rosiglitazone
  • Pramipexole

When they cause swelling, usually it’s mild leg edema.

Tag Archives: lower leg indent

Last night I made a discovery.

It was Wednesday. The craziest day of the week for me. And the kids actually. I now get “I didn’t have any time to play today” from Tyler every Wednesday. It’s only partially my fault that their schedules are crazy that day. And no it’s not sports. Everyone always assumes that if a mom is running around with their kids it must be sports. It’s not. It’s Holiday Play practice and CCD (religious ed.) for 2 kids at 2 separate times. I also squeeze in homework and dinner. It’s fun.

But … Not the point. The point is that I finally got to sit down (not in my car). This is when I noticed that something was different.

I had changed into my PJs, grabbed my coffee, and sat down to watch S.H.I.E.L.D. I felt something on the back of my left leg. Somewhere between ankle and calf level. In hind site I can’t remember what I felt. Was it an itch? I don’t know. But when I pulled my legs up on the couch and ran my hand down my left calf that’s when I noticed it. A hole. Or indentation if you will. It was like I had been resting my leg on a bar and the bar left the indentation. Except there was no bar. I hadn’t been resting my leg on anything. Hell, I hadn’t been resting any part of me at all.

I tried to ignore it and watch the show. Which was pretty good. I didn’t realize that Rich, sitting next to me on the couch, was searching on the internet for the possible cause of the hole. He came up with ” I must have injured my Achilles Tendon.”. I was unsure of this answer. I had absolutely no pain. I don’t remember doing anything that could have possibly injured it. And I had no loss of strength or movement. So then I did a little searching. A lot of people have this happen to their thigh muscle. And that seemed to have reasonable explanations. But when it came to anything below the knee there was much less information. A lot of sights started talking about Edemas, which this is not. Or blood clots, which this is not. Otherwise they said that it could be in issue with your diabetes. They then said, begrudgingly it seemed, if you are not diabetic, which I am not, and it is not one of the above mentioned situations, then…. you may have MS.

REALLY?!?

I had no idea. Maybe I should check with a doctor. SMH!!!!

So I gave up and went to bed. I still wasn’t convinced that this was MS related. My brain is protected after all. Isn’t it?

Well now it’s morning. The area around said indentation is numb. Like a hand sized circle at the bottom of my left leg. Numb like my face was 3 years ago when I was on Copaxone (which wasn’t working). I noticed this in the shower. When water ran down my leg it felt like there was something covering that piece if my leg. Like if you felt water on your hand while wearing a glove. And now I’m thinking about it too much, so there is a constant fuzzy circle there now.

There is no impairment to my walking or anything. This is the same leg that has my other issues. The thumper situation, where my foot will bounce for no apparent reason, and the flipper crap, where I have a hard time flexing my foot when I’m tired. That last one does make walking more entertaining. So I guess a hole and now numbness is just par for the course.

I think that at this point it would be pretty hard to blame it on a non MS situation. But I welcome all thoughts. 🙂 because I am pretty sure that it would take another MRI for the hubby to believe that it is MS related. This feels like an Akum’s Razor type of situation.

Please share any knowledge that you might have about this.

Peripheral Edema: What You Should Know About Swollen Legs

The most common place to see edema, or swelling, is in your feet, ankles and lower legs. Edema is the result of fluid building up in your body. It can happen in any part of your body, but because of the effects of gravity, the fluid usually shows up as painless swelling in your lower extremities. Fluid in this area is called peripheral edema. The old name for edema was dropsy from the Greek word for water, hydrops. The word is no longer used in medicine, but descriptions of dropsy go back to the Ancient Egypt.

“Bloodletting, either by venesection or by leaches, was a popular way to alleviate symptoms from dropsy… Its treatment options were scanty and were aimed to cause ’emptying of the system,’ or to relieve fluid retention.” —Journal of Cardiac Failure

View the Parentgiving Picks to help find the right products to help with peripheral edema.

Symptoms of Peripheral Edema

Today doctors no longer use the term dropsy, and they don’t relieve edema by the old practice of bloodletting. Mild to moderate swelling in the lower legs is common with age and does not always mean you need to be treated. Your legs may feel tight and heavy, and you may notice the skin over your lower legs becoming stretched and shiny. If you press gently on a swollen area for about 15 seconds and it leaves a dent, it is called “pitting edema,” and you should let your doctor know about it.

Common Causes of Peripheral Edema

As you get older you are more likely to collect edema fluid in your lower legs if you stand or sit too long. You may notice tightness and swelling after a long flight or car trip. You may notice “sock marks” when you take off shoes and socks after a long day. In most cases these symptoms are not anything to worry about but if edema is pitting and doesn’t clear up quickly, alert your doctor.

Here are some more serious causes of peripheral edema:

Venous insufficiency. This happens when the veins in your legs have become weakened and can’t return blood to your heart quickly enough.
Congestive heart failure. This is the most common cause of serious peripheral edema. Congestive heart failure occurs when your heart is not pumping well enough to keep blood moving through your system.
Other diseases. Diseases of the lungs, liver, kidney and thyroid can all cause a buildup of fluid that leads to peripheral edema.
Medications. Some types of antidepressant medications and blood pressure medications can cause edema. If you are taking any of these types of medications and you have edema, talk to your doctor about it.

What You Can Do About Peripheral Edema

For mild cases of edema there are several things you can do for yourself:

  • Avoid standing or sitting too long. Get up and move around to get a good blood flow going.
  • If you have to sit or stand, wear support stockings. These stockings are available in most drug stores and online.
  • Elevate your legs as much as possible. When lying down, put a knee wedge pillow under your legs to elevate them above your heart.
  • Avoid too much salt in your diet. Ask your doctor about salt restriction and following a low-salt diet like DASH.
  • If peripheral edema persists, see your doctor. Your doctor will treat any underlying conditions causing the edema. The most common medication used to treat edema is a diuretic, often called a “water pill.”

Warning Signs for Seniors and Caregivers

Edema fluid can also start to collect in your lungs, which is a dangerous stage of congestive heart failure. If you feel short of breath or have chest pain call your doctor immediately or call 911. Call your doctor right away if you have any of these warning signs:

  • Fever, redness, swelling, warmth or pain in your leg, which could be symptoms of a clot or infection
  • Any sudden increase in edema, decreased urine output or accumulation of edema fluid in your belly
  • Any injury to the skin over a swollen leg—these areas are easily infected and take longer to heal

Peripheral edema becomes more common with age, and in many cases you can control occasional edema with home care. But persistent peripheral edema can be a sign of a serious disease like congestive heart failure that needs to be treated. If in doubt, call your doctor. Complications from edema can often be avoided with early recognition and treatment.

What is Edema?

Edema is the noticeable swelling resulting from fluid accumulation in certain body tissues. It is most commonly found in the feet, ankles, and legs although it may also affect the face, hands and other parts of the body and body organs. Pregnant women and older adults are often affected by this condition, but it can happen to anyone.

The swelling also referred to as dependent edema, is brought about by the accumulation of excess fluid beneath the skin in the interstitial spaces or compartments within the body tissues that are outside of the blood vessels. Excess fluid accumulation in the lower regions of the body, such as the ankles, feet, and legs, is referred to as peripheral edema.

Types of Edema

Clinically there are two types of edema – pitting and non-pitting edema. Pitting edema is the term used to describe edema when pressure applied to the skin of the swollen area is released and an indentation is left behind (e.g. when the skin is pressed with a finger or when stockings or socks induce indentation). Non-pitting edema is the term used to describe edema when this pressure-induced indentation does not occur. Non-pitting edema usually occurs in the arms and legs.

Occasionally pitting edema and non-pitting edema can occur without an underlying disease and it is then known as idiopathic edema. This is most common in women who experience it in their legs and feet when they are pre-menstrual or pre-menopausal – it is then often known as cyclical edema.

What are the Symptoms of Edema?

Symptoms of edema may include:

  • Persistent indentation of the skin (Pitting)
  • Swelling
  • Swollen feet, ankles and legs
  • Painful skin sensations such as burning, soreness, tingling
  • Numbness
  • Cramps
  • Water retention or interstitial fluid
  • Puffiness
  • Abdominal bloating
  • Night sweats
  • Skin that is warm or hot to the touch

Pictures of Edema

What Causes Edema?

There are many factors that can contribute to the causes of edema. Since it is often related to an underlying condition, it’s important to get a proper diagnosis to be sure of the cause.

Possible Causes of Edema

  • Pregnancy can cause edema in the legs as the uterus puts pressure on the vena cava, a major blood vessel that returns blood to the heart from the legs, and progesterone relaxes the walls of the blood vessels. Fluid retention during pregnancy also can be caused by a more serious condition called pre-eclampsia.
  • High blood pressure (Hypertension), liver, kidney and thyroid diseases can cause edema
  • Injuries
  • Being largely overweight or obese. Excess weight can put added pressure on the knee and ankle joints and the lower limbs.
  • Standing or sitting for long periods of time particularly in hot weather can cause excess fluid to accumulate in feet, ankles and lower legs.
  • Diabetes
  • Low protein levels in the blood caused by malnutrition, kidney and liver disease can also cause edema. The proteins help to hold water inside the blood vessels so fluid does not leak out into the tissues. If a blood protein, called albumin, gets too low, fluid leaks out the blood vessels and edema occurs, especially in the feet, ankles and lower legs.
  • Dehydration
  • Flying (Air Travel)
  • Menopause
  • Low Blood Pressure
  • Menstruation
  • Overeating
  • Poor Circulation
  • Eating food with high salt content.
  • Spider & Insect Bites
  • Congestive heart failure is a condition in which the heart can no longer pump efficiently, and causes fluid buildup in the lungs and other parts of the body. Swelling is often most visible in the feet and ankles.
  • Severe chronic (long-term) lung diseases, including emphysema and chronic bronchitis, increase pressure in the blood vessels that lead from the heart to the lungs. This pressure backs up in the heart and the higher pressure causes swelling in the legs and feet.
  • Tiny valves inside the veins of the legs can become weakened, causing a common problem called venous insufficiency. This makes it more difficult for the veins to pump blood back to the heart and leads to varicose veins and a buildup of fluid.

Edema in Children & Infants

Most incidences of edema in children and infants are related to serious health conditions, so changes in your child should be monitored to avoid complications.

Children with acute or chronic upper airway obstruction are at risk for negative-pressure pulmonary edema, associated with upper airway obstruction. This condition may also occur after head injury, seizure, or accidental chemical ingestion or inhalation.

While quite rare, Nephrotic Syndrome (NS), a disorder of the kidneys, can cause edema in children. As the main symptom of NS, edema is commonly seen around one or both of the eyes, also referred to as periorbital edema, but may be found in other parts of the body such as the legs. Children with NS typically experience weight gain as a result of fluid accumulation. A urine test can confirm the diagnosis.

Periorbital edema should be closely monitored, as it may be the result of a more serious condition, such as congestive heart failure and liver diseases. Other causes of periorbital edema in children and infants may include allergies or infections, such as conjunctivitis.

Children and infants with diabetes may also experience edema as a side effect of insulin treatment. However, children with diabetes should report this to their pediatrician, as it may be a symptom of cerebral edema (brain swelling), a rare but serious complication of diabetes.

Diagnosing Edema

The diagnosis of pitting and non-pitting edema is determined by the symptoms upon physical examination. The doctor will examine the skin over the swollen area to check whether it may be stretched or shiny. By pushing gently on the swollen area for approximately 15 seconds, a dimple or indentation may be caused. Additional tests such as a urine test, blood test, a chest X-ray and electrocardiogram (ECG) may also be performed to confirm the cause of the edema.

Edema itself is usually a symptom of an underlying condition and can be noticed as swelling or puffiness of your face, hands, feet, legs, or around your eyes. Amongst others, edema can indicate disease of the heart, liver, thyroid, lymphatic system or kidneys (causing salt retention).

If you experience shortness of breath, chest pain, redness or heat in a swollen edematous area, or a swelling of only one limb, consult a doctor immediately. Also, pregnant women who notice signs of edema should seek medical help. Because edema can be a symptom of a serious underlying disorder and can cause serious consequences itself, it is always important to seek medical advice.

Treatments for Edema

Depending on the causes of edema and whether it is temporary or permanent, treating edema usually focuses on treating the condition that is causing it. A low dose of a diuretic (water pill) may be prescribed to reduce the swelling and help you expel the excess fluid, but it is important to remember this just treats the symptom and is not necessarily addressing the cause.

If a blocked or damaged blood vessel is suspected as one of the causes of edema, surgery may be needed to improve the flow of blood. Blood thinners may also be prescribed to treat blood clots, which can cause edema. As the clot begins to break down, fluid drainage improves and thus swelling is reduced.

Treating edema should include protecting any swollen, edematous areas of the body from pressure, injury and extreme temperatures. The skin over swollen areas becomes more fragile over time. Cuts, scrapes, and burns in areas that have edema take much longer to heal and are open to infection.

Tips for the Prevention of Edema

  • Follow a low salt diet
  • Avoid drinking too many fluids
  • If you are overweight or obese, try to lose weight and reduce the pressure on your lower limbs and joints
  • Elevate your legs above the level of your heart to keep swelling down and improve blood flow
  • If your ankles and feet are swollen during pregnancy, keep your legs elevated and lie on your side rather than your back
  • When you do lie down, place a pillow under your legs
  • Wear support or compression stockings to improve the flow of blood through the veins
  • Avoid leg swelling on long trips by standing up and walking around often or get up every hour
  • Exercise your feet and lower legs while sitting as this will help the veins move blood back toward the heart
  • Avoid smoking and drinking alcohol
  • Try massage therapy, which stimulates blood flow and improves circulation

10 Home Remedies for Swollen Feet

Painless swelling of the feet or ankles is common and can happen for a variety of reasons. Causes of swollen feet can include:

  • staying on your feet too long
  • ill-fitting shoes
  • pregnancy
  • lifestyle factors
  • certain medical conditions

When fluid accumulates in tissues, it’s called edema. While edema usually resolves on its own, there are some home remedies that may reduce the swelling more quickly and increase your own comfort. Here are 10 to try.

1. Drink 8 to 10 glasses of water per day

Though it might seem counterintuitive, getting enough fluids actually helps reduce swelling. When your body isn’t hydrated enough, it holds onto the fluid it does have. This contributes to swelling.

2. Buy compression socks

Compression socks can be found at a drug or grocery store or even bought online. Start with compression socks that are between 12 to 15 mm or 15 to 20 mm of mercury.

They come in a variety of weights and compressions, so it might be best to start off with lighter-weight socks and then find the kind that provides the most relief.

3. Soak in a cool Epsom salt bath for about 15 to 20 minutes

Epsom salt (magnesium sulfate) may not only help with muscle pain. It may also reduce swelling and inflammation. The theory is that Epsom salt draws out toxins and increases relaxation.

Just make sure to get Epsom salts marked with the USP designation. This means that it meets standards set forth by the U.S. Food and Drug Administration and is safe to use.

4. Elevate your feet, preferably above your heart

Prop your feet on cushions, pillows, or even things like phone books, when you sleep. If you’re looking to reduce foot swelling while pregnant, try elevating your feet several times a day as well. Aim for about 20 minutes at a time, even on an ottoman or a chair.

Try to avoid standing for long periods of time and stay off your feet when you can.

5. Get moving!

If you sit or stand in one area for a long period of time (like at work), this can lead to swollen feet. Try to move a little bit each hour, even if it’s a walk to the break room, a walk around the block at lunch, flexing your knees and ankles, or a lap around the office.

6. Magnesium supplements can be helpful for some people

If you retain water, you might have a magnesium deficiency. Eating foods high in magnesium can help. Magnesium-rich foods to add to your diet include:

  • almonds
  • tofu
  • cashews
  • spinach
  • dark chocolate
  • broccoli
  • avocados

Taking 200 to 400 milligrams of magnesium daily might help with the swelling. But before you take any kind of supplement, ask your doctor. Magnesium supplements aren’t right for everyone, especially if you have a kidney or heart condition.

7. Make some dietary changes

Reducing your sodium intake can help decrease swelling in your body, including in your feet. Opt for low-sodium versions of your favorite foods, and try to refrain from adding salt to meals.

8. Lose weight if you’re overweight

Being overweight can cause reduced blood circulation, leading to swelling of the lower extremities. It can also lead to extra strain on the feet, causing pain when walking. This can result in being more sedentary — which can also cause fluid buildup in the feet.

Losing weight can help ease the strain on your feet and possibly reduce foot swelling as well. Talk with your doctor about whether you need to lose weight and healthy ways to go about doing so.

9. Massage your feet

Massage can be great for swollen feet and can also promote relaxation. Massage (or have someone massage them for you!) your feet toward your heart with firm strokes and some pressure. This can help move the fluid out of the area and reduce swelling.

10. Increase your intake of potassium-rich foods

A potassium deficiency can contribute to high blood pressure and water retention. If you have no dietary restrictions, consider eating foods containing potassium. Some potassium-rich foods include:

  • sweet potatoes
  • white beans
  • bananas
  • salmon
  • pistachios
  • chicken

Try drinking orange juice or low-fat milk instead of soda, too. If you have any medical conditions, especially kidney issues, talk with your doctor before adding lots of potassium to your diet.

When to see your doctor

Each person is different. Depending on what’s causing the swelling, some of these remedies might not be effective all of the time for everyone. If one doesn’t work, don’t hesitate to try another or use one in conjunction with another.

If none of these home remedies alleviate your swollen feet or you notice other symptoms that accompany your swollen feet, call your doctor. These symptoms could indicate an underlying health condition that needs to be treated. Your doctor may prescribe diuretics if they think that medical steps are necessary to reduce the fluid retention.

If you’re pregnant, ask your obstetrician before taking any supplements or before increasing your activity level. If you have any medical conditions or take any medications, check with your doctor before adding a supplement. Even natural supplements and vitamins can interfere with medications, so it’s always good to touch base first.

Edema (known as oedema in the UK) is a build up of fluid in the body (water retention) which causes swelling.

Edema commonly affects the legs, ankles, feet and wrist.

Water retention is often treatable, with treatment varying depending on the cause.

Symptoms of edema

The main symptom of edema is swelling of the affected area.

Other symptoms that may occur, along with swelling, include:

  • Weight gain
  • Aching limbs
  • Stiff joints
  • Discolouration of skin
  • Hypertension (high blood pressure)

What causes swelling in the legs, feet and ankles?

Swollen ankles and legs will often be brought o, or aggravated, by long periods of standing.

A number of medications can increase the risk of oedema. Such medications include corticosteroids , blood pressure medications and the contraceptive pill

Water retention may also be caused by a number of conditions including:

  • Kidney disease
  • Heart failure
  • Liver cirrhosis
  • Thyroid disease
  • Lymphoedema
  • Pregnancy

A high intake of salt can increase the problems of swelling in people with kidney disease.

Treatment for edema

Treatment for edema may vary depending on the cause. Water retention may be resolved if the underlying cause can be adequately treated.

Regular physical activity and preventing long periods of standing can help reduce water retention. A low dietary salt intake is advisable, particularly if fluid retention has been brought on by kidney disease. If you are overweight, weight loss can help with reducing fluid retention

Diuretics, also known as ‘water tablets’, help to remove fluid from the body and may be prescribed for some causes of oedema.

Prevention

You can reduce your risk of edema by taking steps to prevent kidney disease and heart failure from developing.

This can be achieved through good control of blood glucose levels , regular exercise and a healthy diet.
If you can avoid long periods of standing, this will also help to reduce the risk of water retention.

Edema

Normal versus swollen ankles.

What is edema?

Edema is swelling that is caused by fluid trapped in your body’s tissues. Edema happens most often in the feet, ankles, and legs, but can affect other parts of the body, such as the face, hands, and abdomen. It can also involve the entire body.

What causes edema?

Edema has many possible causes:

  • Edema can occur as a result of gravity, especially from sitting or standing in one place for too long. Water naturally gets pulled down into your legs and feet.
  • Edema can happen from a weakening in the valves of the veins in the legs (a condition called venous insufficiency). This problem makes it hard for the veins to push blood back up to the heart, and leads to varicose veins and a buildup of fluid in the legs.
  • Certain diseases — such as congestive heart failure and lung, liver, kidney, and thyroid diseases — can cause edema or make it worse.
  • Some drugs, such as medications that you are taking for your blood pressure or to control pain, may cause or worsen edema.
  • An allergic reaction, severe inflammation, burns, trauma, clot(s), or poor nutrition can also cause edema.
  • Too much salt from your diet can make edema worse.
  • Being pregnant can cause edema in the legs as the uterus puts pressure on the blood vessels in the lower trunk of the body.

What are the symptoms of edema?

Signs that you might have edema include the following:

  • The affected area is swollen.
  • The skin over the swollen area might look stretched and shiny.
  • Pushing in gently on the swollen area with your finger for at least 5 seconds and then removing your finger will leave a dimple in the skin.
  • You may have trouble walking if your legs are swollen.
  • You may be coughing or have trouble breathing if you have edema in the lungs.

Share Facebook Twitter LinkedIn Email Get useful, helpful and relevant health + wellness information enews

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Causes

Edema is caused by extra fluid in your tissues. This can happen for many reasons. You may have been standing or sitting too long, for instance like during a plane flight. It could also be an allergic reaction to or side effect of a medicine.

Some drugs for diabetes and high blood pressure can cause pitting edema. So can estrogen pills and over-the-counter pain relievers like ibuprofen.

Women hold onto more fluid when they’re pregnant and can develop a pitting edema. This tends to happen toward the end of pregnancy. Talk with your doctor if you are pregnant and develop edema.

For some people, pitting edema can be a sign of a more serious health issue, such as:

  • Blood clot: One of these in a deep vein can cause edema in the region of the clot. This is called “deep vein thrombosis,”or DVT. If a DVT is present in one leg, edema may be present in just one leg.
  • Congestive heart failure: If your heart is too weak to pump blood around your body as it should, fluid will build up in your tissue. Many people with heart problems get swelling in their legs.
  • Kidney disease: It’s your kidneys’ job to get rid of extra salt and water from your body. If they aren’t working right, you can develop high blood pressure and pitting edema.
  • Liver disease: If blood isn’t flowing normally through your liver, edema can form in your lower legs.
  • Lung disease: If the pressure in your heart or lungs gets too high because of a disease like emphysema, pitting edema can show up in your legs or feet.
  • Vein problems: If your veins have trouble bringing blood back up from your feet to your heart, it can start to pool in your feet and ankles. Extra fluid leaks out of your blood vessels and into nearby tissue.

Returning/lasting Edema

Hi

So, I have been trying to recover from an ED for quite some time now. After 7 years of restriction and a few years with very slow weight gain, I have finally managed to really speed up things the last 7 – 8 months. i am now getting closer to the weight I was before and I must say that it is not that bad, despite not exercising.

However, there is this edema that keeps retuning. At the begining, the edema was unbearable. I did subside as I put on weight. Now it is mainly focused around my ankles. I have ruled out any serious condition, but my doctor cant give me a good explanation except circulation. I am still hoping that it is caused by the eating dissorder, but I must say that i am starting to loose motivation. My feet hurts and it is really not comfortable.
I have tried to find some kind of connection with every day activities, but there are no clear trends. I do work in an office but I try to vary sitting and standing. I can also get it on the days I am working around in the house, moving around a bit. Days when I am standing for a long period of time is the worst.
I get it in both feet, pitting edema. Thing is that I find it a bit strange that I still get is if it has to do with my eating dissorder. I have been recovering for so long and my weight is much higher than to start of with. i know it is not water weight as I have contiously weighed myself during the recovery.

Can anyone share some thoughts on what they think. Should I just hang in there? Will it go away as I put on even more weight? Or is this something that I have to accept and live with? To add, blood works have just started to become better. My resting puls has increased. Please, share some thoughts.

Edema

Edema, (alternate spelling: oedema) formerly referred to as dropsy or hydropsy, is the swelling of the body’s tissues due to excess interstitial fluid retention. Edema can occur locally, often affecting the extremities (peripheral edema), or generally, affecting the entire body (anasarca).

In the body, there are two main compartments between which fluid is exchanged: the intravascular and extravascular compartments. Intravascular compartments include the cardiac chambers and the vascular system itself, whereas the extravascular compartments include everywhere else. Fluid moves easily between these compartments, and the extent of this movement is determined primarily by the balance between hydrostatic and oncotic pressures.

Hydrostatic pressure refers to the pressure exerted by gravity on a fluid at equilibrium, and tends to cause fluid to filter out into the extravascular compartment. Oncotic pressure is a form of osmotic pressure in which proteins in the plasma pull fluid back into the intravascular compartment. Typically these pressures are balanced relatively equally, with a net filtration into the extravascular compartment of about 1% of the plasma. The lymphatic system then transports this extra fluid back into the intravascular compartment through the thoracic duct. Therefore, any change in the balance of these pressures that results in a net filtration greater than the lymphatic system can effectively transport can cause edema.

Symptoms of Edema

In addition to pronounced swelling, typically the overlying skin will have a stretched, shiny appearance. In cases of pitting edema, the skin over the affected area will retain a distinct dimple for 10 to 15 seconds after being depressed. In patients with peripheral edema, the swelling is often worst after extended periods of sitting or standing. Anasarca, or general edema, will present with swelling covering the entire body. Ascites refers specifically to fluid retention in the peritoneal cavity, and results in distinct swelling of the abdomen.

Etiology

An increase in hydrostatic pressure can occur as a result of heart failure, kidney failure, liver failure or venous obstruction. Decreased oncotic pressure occurs in patients with malnutrition resulting in an abnormally low level of blood proteins. In addition, any conditions affecting the permeability of vascular membranes, including inflammation or tissue trauma, can also cause more fluid to “leak” out of the intravascular compartment. When the body notices that this leaking is happening, the kidneys in turn retain more water and sodium to make up for the loss of fluid, causing more blood to circulate and more leakage to occur. Edema related specifically to the impairment of the lymphatic system in carrying away interstitial fluid is referred to as a lymphedema.

Risk Factors

Edema itself is not a disease, but a symptom. Less severe forms of edema can result from lifestyle and general health factors such as:

  • Staying in one position (sitting, standing or supine) for too long
  • Increased sodium intake
  • Hormonal changes due to menstruation
  • Pregnancy

Edema can also occur as a side effect of several different medications, including:

  • Vasodilators
  • Calcium channel blockers
  • Estrogen-based medication
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Certain diabetes medications

However, edema can also be a sign of severe underlying medical conditions, such as:

  • Congestive heart failure
  • Cirrhosis
  • Kidney disease
  • Chronic venous insufficiency
  • Chronic lung diseases (pulmonary edema only)
  • A damaged lymphatic system

Complications

If left unchecked, peripheral and general edema can result in the overlying skin becoming stretched, developing infections or ulcerating. Also, decreased blood circulation can lead to blood clots in the deep veins of the body, also known as deep vein thrombosis.

Diagnostic Studies

  • Ultrasound of heart, chest, peritoneum and extremities
  • Blood tests and urine analysis to evaluate renal and liver function, as well as albumin levels
  • X-rays including MRI, CT scan, lymphangiography

Treatments & Interventions for Edema

Depending on diagnosis, the following precautions may help minimize the risk of developing edema in at-risk patients and to minimize complications in patients already exhibiting symptoms:

  • Reduce daily sodium intake.
  • Avoid tight clothing and jewelry that could constrict the affected area
  • Avoid extreme temperatures.
  • Keep the affected limb above your heart when possible.
  • Lymphatic massage to the affected area can help move excess fluid. Find a qualified lymphedema therapist to properly perform this procedure.
  • During activity, monitor the affected limb for any change in size, shape, tissue, texture, soreness, heaviness, or firmness.
  • Pay particular attention to the limb during air travel, as the decrease in pressure and extended time seated can exacerbate existing symptoms of edema. Consider wearing a compression garment for such travel, except if you have open wounds or poor circulation in the affected limb

Treating edema should always begin with diagnosing and treating the underlying cause. Depending on the cause, diuretics may be prescribed to increase water output from the kidneys and combining these with a low-sodium diet can help to decrease fluid retention. Other medications and treatments may be prescribed as well. Peripheral edema can also be treated by wearing prescribed compression stockings or garments, which apply more pressure to the affected area and can help force fluid to be reabsorbed into the intravascular compartment.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *