Edema

At first, edema may not be very obvious. Perhaps you may notice your shoes fit a bit too tight, your wristwatch leaves an indentation on your skin, your rings are too tight, or your waistband is not comfortable.

Edema primarily causes swelling in the skin of the hands, legs, fingers and ankles. These are the most common sites, although edema can occur in all parts of the body.

Common symptoms of edema include:

• Abdominal bloating

• Dimples under the skin that remain after being pressed or pinched

• Increased dimensions of affected body parts (abdomen, extremities)

• Puffiness of the fingers, ankles or legs

• Shiny skin

• Skin discoloration

• Swelling under the skin

Common symptoms of pulmonary edema include:

• Chest pain or pressure

• Difficulty breathing or rapid breathing

Edema that develops in the lungs (pulmonary edema) can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Chest pain or pressure

• Difficulty breathing

• Inability to catch your breath

The swelling of edema can occur anywhere in the body, but is most commonly seen in the ankles, legs, hands and fingers.

Edema in the ankle and lower leg
Edema in the hand

Getty

Getty

Edema occurs as a result of excess fluid buildup in the tissues due to a number of different causes. Leakage of fluids into body spaces may occur because of increased pressure within the circulatory system, blockages in blood flow, decrease in albumin (protein) levels in the blood, or damage to tissues.

Edema may occur during pregnancy. It may also be caused by heart disease (congestive heart failure), kidney disease, cirrhosis (scarring of the liver), and tissue damage, such as burns. Excess sodium intake can also increase the amounts of fluid retained by the kidneys and increase fluid pressure, causing the leakage of fluid into the tissue spaces.

Edema in the lungs (pulmonary edema), which can be caused by heart failure, is a particularly serious form of edema.

Common causes of edema include:

• Burns

• Certain medications

• Cirrhosis (scarring of the liver)

• Congestive heart failure (deterioration of the heart’s ability to pump blood)

• Damage to lymph nodes due to surgery or radiation therapy, or swelling of lymph nodes due to infection or tumor

• Excessive salt consumption

• Parasitic infection such as lymphatic filariasis

• Pregnancy

A number of factors increase the risk of developing edema. Not all people with risk factors will get edema. Risk factors for edema include:

• Alcoholism (which can lead to cirrhosis and other liver disease)

• Cancer (primary or metastatic)

• Congestive heart failure

• High blood pressure

• Kidney disease

• Liver failure

• Past mastectomy or other surgeries that involve removal of surrounding lymph nodes

• Pregnancy

• Recent surgery

• Sedentary lifestyles (lifestyles that involve little or no physical activity)

• Smoking

Some causes of edema can be prevented, especially those that have a lifestyle component, such as lack of exercise, smoking, or salt intake.

You may be able to lower your risk of edema by:

• Avoiding alcohol if you have a history of liver disease

• Getting regular exercise, especially if your job involves sitting or standing for long periods of time

• Limiting salt intake

• Quitting smoking

Reducing salt intake can be an effective way to reduce the symptoms of edema. Talk to your doctor about ways to adjust your diet, including:

• Adding potassium-rich foods or supplements, particularly if you’re taking a diuretic

• Avoiding alcohol

• Avoiding red meat in favor of lean proteins, such as chicken, fish and tofu

• Consuming antioxidants, which can reduce inflammation, through such foods as blueberries, kale, tomatoes, and bell peppers

• Eating foods high in iron and B vitamins, including dark leafy greens and whole grains

• Eating natural food diuretics, such as asparagus, beets, grapes, pineapple, onion, garlic and leeks. However, talk to your doctor about foods that may interact with your diuretic medication.

• Reducing high-sodium foods, including canned vegetables, cured meats or cold cuts, frozen pizzas, and condiments, such as ketchup or barbecue sauce

• Reducing or eliminating trans fats, which are often found in processed foods, such as cookies, donuts, crackers or French fries.

Your doctor should be aware if you have any edema to determine the cause of your edema. If a serious illness or condition is causing edema, this must be treated to relieve the swelling and to reduce the risk of other complications.

Typically, your doctor will perform a physical exam and discuss your medical history. Based on your symptoms and risk factors, he or she can typically determine what is causing your edema. In some cases, further testing—such as X-rays, ultrasounds, magnetic resonance imaging (MRI), blood tests, or urinalysis—may be necessary to learn more about the cause of your edema.

If you take prescription medications, you can ask your pharmacist if any of them could cause edema. However, do not stop taking your medication if you suspect this is an issue. Speak to your doctor first, who may revise the dose or change your prescription altogether.

See your doctor if have edema and you:

• Are pregnant

• Have a fever

• Have a history of kidney, heart or liver disease

• See sores on or around the edematous (swollen) area

• See the skin on or around the edematous area is red and warm to touch

If you have chest pain or shortness of breath (pulmonary edema), or a change in your mental status (cerebral edema), these are medical emergencies. Call 911 immediately.

Treatment for edema includes medications, such as diuretics, which limit retention of water or increase urine output by the kidneys. Other medications may be necessary to treat the underlying cause of the condition.

If the edema is mild or if your doctor has said it is not associated with any serious conditions, you can try to manage the swelling at home with some of these tips:

• Elevate your legs when you sit or lie down.

• Except for support socks or stockings, avoid clothing that constricts your legs, up to your thighs.

• Keep a healthy weight.

• Move your legs. If you are standing for long periods, move your legs as much as possible. If sitting for extended periods, get up and walk. If you can’t, try to stretch your legs, move your feet, and wiggle your ankles and toes.

• Reduce the amount of salt you consume, including foods packaged with added salt.

• Talk to your doctor about seeing a massage therapist who specializes in lymphedema massage.

• Wear support socks or stockings. Check with your doctor first if you have health conditions like diabetes.

If home care doesn’t work to relieve edema, or the edema is moderate to severe, you should see your doctor. Your doctor will need to determine what is causing the edema and, by treating the cause, the edema will likely lessen, if not resolve altogether. You may be prescribed a diuretic, often called a water pill. Diuretics cause you to urinate frequently to eliminate fluid from your body. Examples include thiazide, furosemide (Lasix), and spironolactone (Aldactone).

If the edema is caused by heart, kidney or liver failure, your doctor will work to treat those underlying conditions.

Pregnancy-induced edema usually resolves after the baby’s birth, but edema could be a sign of a very serious pregnancy complication called preeclampsia. For this reason, pregnant women should always report edema. Most of the time the edema is normal, but it is best to be safe and seek your doctor’s advice.

Complications of untreated or poorly treated edema can be serious, even life-threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your healthcare professional design specifically for you.

Complications of edema include:

• Breathing problems

• Circulation problems

• Infection, especially around the area of the edema

• Reduced mobility

• Scarring

• Skin discoloration, itching or ulcers

• Stiffness