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Edema (Symptoms, Types, Treatment, Pictures)

Thank you to Dr. Kwang's special guest Medical Author:

Ruchi Mathur, MD, FRCP(C)

What Is Edema?

Edema (or Oedema) is the abnormal accumulation of fluid in certain tissues within the body. The accumulation of fluid may be under the skin - usually in dependent areas such as the legs (peripheral edema, or ankle edema), or it may accumulate in the lungs (pulmonary edema). The location of edema can provide the health care practitioner the first clues in regard to the underlying cause of the fluid accumulation.

What Are the Symptoms of Edema? What Does It Look Like?

Symptoms will depend on the cause of edema.

Peripheral edema

Symptoms of peripheral edema include swelling of the affected area(s), which causes the surrounding skin to "tighten." The swelling from peripheral edema is gravity-dependent (it will increase or decrease with changes in body position). For example, if a person is lying on their back (supine), the swelling will not appear in the legs, but will appear in the area around the sacrum. The skin over the swollen area appears tight and shiny, and often when pressure is applied to the area with a finger, an indentation appears. This is called pitting edema.

Pulmonary Edema

In the case of pulmonary edema, there is often no evidence of fluid retention or noticeable swelling on examination of the patient's extremities. This is because the fluid is backing up into the lungs. Signs and symptoms of pulmonary edema include:

  • shortness of breath,
  • difficulty breathing when lying flat,
  • waking up breathless, and
  • requiring multiple pillows to raise the head at night for a comfortable sleep.

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What Causes Edema?

The balance and regulation of fluid in the body is very complex. In short, the cause of edema as simply defined as possible, is that tiny blood vessels in the body (capillaries) leak fluid into the surrounding tissues. This excess fluid causes the tissues to swell.

The cause of fluid leaking into the surrounding tissues may be the result of several mechanisms, for example:

  1. too much force, or pressure inside the blood vessels;
  2. a force outside of the blood vessel causes the fluid to be drawn through it; or
  3. the wall of the blood vessel is compromised and cannot maintain equilibrium, leading to fluid loss.

Each of these three mechanisms may be associated with a variety of diseases or conditions. Examples include the following.

  • Pregnancy: Edema during pregnancy may occur because pregnant women have a greater volume of fluid circulating in the body, and because they also retain more fluid. A woman may also experience postpartum edema.
  • Medications: Edema may be caused by a variety of medications, for example, steroids, calcium channel blockers (CCBs), thiazolidinediones, nonsteroidal antiinflammatory drugs (NSAIDs), estrogens, etc.).
  • Liver disease and/or kidney disease: Both of these organs are vital in maintaining fluid balance in the body, and if severe disease is present in either of these organ systems, edema can develop. Examples include: cirrhosis of the liver, chronic kidney disease, and acute kidney failure.
  • Venous insufficiency: This is a common condition in which blood does not return to the heart efficiently from the peripheral areas of the body (for example, the ankles, legs, feet, hands), which results in edema. This typically results in edema in both legs.
  • Heart failure: If the heart is weak and cannot pump blood efficiently, blood will pool in particular areas of the body, which will cause fluid to leak from the blood vessels into the surrounding tissues.
    • If the right side of the heart is weak, pressure will build in the peripheral tissues in the body (hands, ankles, feet, legs). This is referred to as peripheral edema.
    • If the left side of the heart is weak, pressure will build in the lungs, causing pulmonary edema.
  • Idiopathic edema: Accumulation of fluid in surrounding tissues with no identifiable cause is referred to as idiopathic edema.

Pulmonary Edema Symptoms and Signs

 

Pulmonary edema is a condition in which an abnormal amount of fluid builds up in the lungs. Symptoms an signs of pulmonary edema include shortness of breath while lying flat, decrease in exercise tolerance, wheezing, and difficulty doing activities that were once routine.

Click for more signs, symptoms, and causes of pulmonary edema »

 

How Is the Cause of Edema Diagnosed?

Depending on the details of the patient's history, the health care practitioner will perform a thorough examination. The health care practitioner may order tests, for example:

  • chest X-ray,
  • abdominal ultrasound,
  • ultrasound of the legs,
  • blood tests of liver function
  • urinalysis, and
  • evaluation of the patient's kidney and liver function.

It is important to understand that while the edema itself can be physically limiting, ascertaining the underlying cause is important so that treatment can be targeted specifically to the condition causing edema. Sudden swelling of one or both legs may be a sign of a serious medical problem. If this occurs, see a health care practitioner immediately.

What Home Remedies Treat and Help Relieve Edema?

Compression stockings can be helpful by increasing the resistance to fluid leaking out of the vessels. These can be purchased in any medical supply store, and are particularly useful for peripheral edema. Body positioning can also be helpful for both peripheral and pulmonary edema to ease symptoms. For example, elevating the head with pillows in bed may benefit someone with pulmonary edema, while elevating the legs may minimize ankle and/or leg edema.

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What Is the Medical Treatment for Edema?

Once again, the treatment depends on the condition causing edema. In general, the treating principle is to reverse the forces that are not working properly:

  1. Increase the forces that keep fluid inside the blood vessels
  2. Reduce the forces that cause fluid to leak out of the blood vessels
  3. Identify the cause of the leaking blood vessel walls

For example, increasing the blood protein (albumin) level in a patient with a nutritional deficiency can help retain fluid in the blood vessels. Healing tissues exposed to trauma, (for example, swelling from a sprained ankle) assists in preventing fluid leaking from blood vessels.

The ultimate goal with edema treatment is to rid the excess fluid that has accumulated in the surrounding tissues in the body. The most common treatment is a diuretic. Diuretics make the kidneys excrete excess fluid from the body; which reduces the general fluid volume in the body. Diuretics should be used with caution as dehydration can be a side effect. There are many different types of diuretics that have different mechanisms of action and different potencies.

Depending on the cause of edema, follow-up may be as easy as wearing support hose when standing for prolonged periods, or it may require the input of cardiologists, nephrologists, and/or other subspecialists. It is important to keep the primary physician abreast of any treatment.

How Can Edema Be Prevented?

Prevention of further episodes of edema can be achieved by the treatments mentioned above. The ultimate goal is to address and treat any underlying cause of edema.

Can Edema Be Cured?

With appropriate follow-up edema can be treated successfully. The degree of response can vary depending on the severity of the cause and the patient's underlying medical condition.

Edema is swelling that occurs when too much fluid becomes trapped in the tissues of the body, particularly the skin.

There are different causes and types of edema. Pulmonary edema, for example, affects the lungs, while pedal edema causes swelling in the feet.

Edema usually starts slowly, but onset can be sudden. It is a common problem, but it can also be the sign of a serious condition.

This MNT Knowledge Center article will explain what edema is and how to recognize it, as as the different types and treatments of edema. The article will also look at possible complications of the condition.

Fast facts on edema

Here are some key points about edema. More detail is in the main article.

  • Edema happens when excess fluid stays within the body's tissues.
  • There is usually an underlying disease or condition.
  • Symptoms depend on the cause, and they normally develop gradually.
  • Medications are available to treat edema.

What is edema?

Edema, or water retention, causes swelling in the affected part of the body.

Edema refers to swelling and puffiness in different areas of the body.

It most often occurs in the skin, especially on the hands, arms, ankles, legs, and feet. However, it can also affect the muscles, bowels, lungs, eyes, and brain.

The condition mainly occurs in older adults and women who are pregnant, but anyone can experience edema.

Symptoms

Symptoms depend on the underlying cause, but swelling, tightness, and pain are common.

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A person with edema may notice:

  • swollen, stretched, and shiny skin
  • skin that retains a dimple after being pressed for a few seconds
  • puffiness of the ankles, face, or eyes
  • aching body parts and stiff joints
  • weight gain or loss
  • fuller hand and neck veins
  • higher pulse rate and blood pressure
  • headache
  • abdominal pain
  • changes in bowel habits
  • nausea and vomiting
  • confusion and lethargy
  • visual abnormalities

Symptoms depend on the underlying cause, the type of edema, and where the edema is located.

Treatment

Treatment will depend on the cause of edema.

Diuretics are a type of medication. They help get rid of excess fluid by increasing the rate of urine production by the kidneys. Different types work in different ways.

A doctor will recommend a specific treatment for macular edema, pulmonary edema, and other types of edema.

Alternative remedies

Compression stockings can help reduce the swelling and discomfort of edema.

Some self-care techniques can help prevent or reduce edema.

These include:

  • cutting down salt consumption
  • losing weight, if appropriate
  • doing regular exercise
  • raising the legs when possible to improve circulation
  • wearing supporting stockings, which are available to purchase online
  • not sitting or standing still for too long
  • getting up and walking about regularly when traveling
  • avoiding extremes of temperature, such as hot baths, showers, and saunas
  • dressing warmly in cold weather

A masseuse or physical therapist may help remove the fluid by stroking firmly in the direction of the heart.

Oxygen may be used to treat some kinds of edema. An individual with cardiogenic pulmonary edema may need additional oxygen if they have difficulty taking in enough oxygen.

Oxygen delivered through the nose may improve poor vision caused by diabetic macular edema.

Hyperbaric oxygen therapy (HBOT) has been found to increase the risk of pulmonary edema.

Types

There are many types of edema. Each one can indicate a range of further health conditions. Here are some types.

Peripheral edema: This affects the feet ankles, legs, hands, and arms. Signs include swelling, puffiness, and difficulty moving a part of the body.

Pulmonary edema: Excess fluid collects in the lungs, making breathing difficult. This can result from either congestive heart failure or acute lung injury. It is a serious condition, it can be a medical emergency, and it can lead to respiratory failure and death.

Cerebral edema: This occurs in the brain. It can happen for a range of reasons, many of which are potentially life-threatening. Symptoms include headache, neck pain or stiffness, whole or partial vision loss, change in consciousness or mental state, nausea, vomiting, and dizziness.

Macular edema: This is a serious complication of diabetic retinopathy. Swelling occurs in the macula, the part of the eye that enables detailed, central vision. The person may notice changes to their central vision and how they see colors.

Edema can occur in other locations as well, but those mentioned above are the most common. It can indicate one of many serious health conditions. It is important to check with a doctor if you are concerned about any kind of swelling.

What is pulmonary edema?

Pulmonary edema is a potentially serious condition. Find out more

Causes

Edema can result from circulatory problems, infection, tissue death, malnutrition, kidney disease, total body fluid overload, and electrolyte problems.

There are many possible causes of edema, including:

Heart failure

If one or both of the lower chambers of the heart cannot pump blood properly, the blood can accumulate in the limbs, causing edema.

Kidney disease or kidney damage

A person with a kidney disorder may not be able to eliminate enough fluid and sodium from the blood. This puts pressure on the blood vessels, which causes some of the liquid to leak out. Swelling can occur around the legs and eyes.

Damage to the glomeruli, the capillaries in the kidneys that filter waste and excess fluids from the blood, can result in nephrotic syndrome. One symptom of this is a low level of the protein albumin in the blood. This can lead to edema.

Liver disease

Cirrhosis affects liver function. It can lead to changes in the secretion of hormones and fluid-regulating chemicals and reduced protein production. This causes fluid to leak out of blood vessels into surrounding tissue.

Cirrhosis also increases pressure within the portal vein, the large vein that carries blood from the intestines, spleen, and pancreas, into the liver. Edema can result in the legs and the abdominal cavity.

Certain medications

Some medications increase the risk:

  • vasodilators, or drugs that open blood vessels
  • calcium channel blockers
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • estrogens
  • some chemotherapy drugs
  • some diabetes drugs, such as thiazolidinediones (TZDs)

Pregnancy

During pregnancy, the body releases hormones that encourage fluid retention, and a woman tends to retain more sodium and water than usual. The face, hands, lower limbs, and feet may swell.

When a woman is resting in a reclined position during pregnancy, the enlarged uterus can press on a vein known as the inferior vena cava. This can obstruct the femoral veins, leading to edema.

During pregnancy, the blood clots more easily. This can increase the risk of deep venous thrombosis (DVT), another cause of edema.

Eclampsia, which results from pregnancy-induced hypertension, or high blood pressure, can also cause edema.

Dietary factors

A number of dietary factors impact the risk of edema, such as:

  • consuming too much salt, in people who are susceptible to developing edema
  • malnutrition, where edema can result from low protein levels in the blood
  • a low consumption of vitamin B 1, B 6, and B 5

Diabetes

Complications of diabetes include:

  • cardiovascular disease
  • acute renal failure
  • acute liver failure
  • protein-losing enteropathy, an intestinal condition that causes protein loss

These, and certain medications for diabetes, can result in edema.

Diabetic macular edema is the swelling of the retina in diabetes.

Conditions affecting the brain

Some causes of swelling in the brain include:

Head injury: A blow to the head may result in an accumulation of fluids in the brain.

Stroke: A major stroke can result in brain swelling.

Brain tumor: A brain tumor will accumulate water around itself, especially as it builds new blood vessels.

Allergies

Some foods and insect bites may cause edema of the face or skin in people who are allergic or sensitive to them. Severe swelling can be a sign of anaphylaxis. Swelling in the throat can close a person's airway, so they cannot breathe. This is a medical emergency.

Problems with the extremities

A blood clot: Any blockage, such as a clot in a vein, can prevent blood from flowing. As pressure increases in the vein, fluids start to leak into the surrounding tissue, causing edema.

Varicose veins: These usually occur because valves become damaged. Pressure increases in the veins, and they start to bulge. The pressure also increases the risk of fluids leaking into the surrounding tissue.

A cyst, growth, or tumor: Any lump can cause edema if it presses against a lymph duct or a vein. As pressure builds up, fluids can leak into surrounding tissue.

Lymphedema: The lymphatic system helps remove excess fluid from tissues. Any damage to this system, such as surgery, infection, or tumor, can result in edema.

Miscellaneous conditions

Prolonged immobility: People who are immobilized for a long time can develop edema in their skin. This can be due both to fluid pooling in gravity dependent areas and the release of antidiuretic hormone from the pituitary.

High altitude: This, combined with physical exertion, can increase the risk. Acute mountain sickness can lead to high-altitude pulmonary edema or high-altitude cerebral edema.

Burns and sunburn: The skin reacts to a burn by retaining fluid. This causes localized swelling.

Infection or inflammation: Any tissue that is infected or inflamed can become swollen. This is usually most noticeable in the skin.

Menstruation and pre-menstruation: Hormone levels fluctuate during the menstrual cycle. During the days before menstrual bleeding, levels of progesterone are lower, and this may cause fluid retention.

The contraceptive pill: Any medication that includes estrogen can cause fluid retention. It is not uncommon for women to put on weight when they first start using the pill.

Menopause: Around menopause, hormone fluctuations can cause fluid retention. Hormone replacement therapy (HRT) can also trigger edema.

Thyroid disease: Hormonal imbalances associated with thyroid problems can lead to edema.

Complications

Untreated edema can lead to:

  • painful swelling, with pain that gets worse
  • stiffness and difficulty walking
  • stretched and itchy skin
  • infection in the area of swelling
  • scarring between the layers of tissue
  • poor blood circulation
  • loss of elasticity in arteries, veins, and joints
  • ulcerats on the skin

Any underlying disease or condition needs treatment to prevent it from becoming more serious.

Lymphedema, or lymphatic obstruction, is a long-term condition where excess fluid collects in tissues causing swelling (edema).

The lymphatic system is a part of the circulatory system and vital for immune function. Lymphedema is caused by a blockage of this system.

Lymphedema commonly affects one of the arms or legs. In some cases, both arms or both legs may be affected. Some patients might experience swelling in the head, genitals, or chest.

Lymphedema is incurable, but with the right treatment, it can be controlled.

Fast facts on lymphedema

Here are some key points about lymphedema. More detail and supporting information is in the main article.

  • Experts believe primary lymphedema is caused by genetic mutation.
  • Secondary lymphedema can be caused by other conditions such as infections and inflammatory diseases.
  • In some cases, lymphedema can lead to skin infections and lymphangitis.
  • Protecting the skin can help reduce the risk of lymphedema.

Treatment

Swelling is a typical symptom of lymphedema and commonly affects legs and arms.

Compression stockings work to encourage the movement of lymph out of an affected limb.

Lymphedema is incurable. However, treatment can help reduce the swelling and pain.

Complex decongestive therapy (CDT): This starts with an intensive therapy phase, during which the patient receives daily treatment and training. This is followed by the maintenance phase when the patient is encouraged to take over their own care using techniques that they have been taught.

The four components of CDT are:

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  1. Remedial exercises: These are light exercises aimed at encouraging movement of the lymph fluid out of the limb.
  2. Skincare: Good skincare reduces the risks of skin infections, such as cellulitis.
  3. Manual lymphatic drainage (MLD): The lymphedema therapist uses special massage techniques to move fluid into working lymph nodes, where they are drained. The lymphedema therapist also teaches several massage techniques that can be used during the maintenance phase.
  4. Multilayer lymphedema bandaging (MLLB): Muscles surrounding lymph vessels and nodes move the fluid through the lymphatic system.

Unlike the circulation of blood, there is no central pump (heart). The aim is to use bandages and compression garments to support the muscles and encourage them to move fluid out of the affected body part. Patients will also be taught how to apply their own bandages and compression garments correctly so that MLLB can continue during the maintenance period.

Surgery has historically had disappointing results compared with non-surgical therapies for lymphedema. However, a new surgical technique using liposuction has proved more successful. It removes fat from the affected limb, resulting in less swelling.

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

  • What Is Edema?
  • What Are the Symptoms of Edema? What Does It Look Like?
  • What Causes Edema?
  • How Is the Cause of Edema Diagnosed?
  • What Home Remedies Treat and Help Relieve Edema?
  • What Is the Medical Treatment for Edema?
  • How Can Edema Be Prevented?
  • Can Edema Be Cured?
  • Edema (Symptoms, Types, Treatment, Pictures) Topic Guide

Edema (Symptoms, Types, Treatment, Pictures)

Medical Author:

Ruchi Mathur, MD, FRCP(C)

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

  • What Is Edema?
  • What Are the Symptoms of Edema? What Does It Look Like?
  • What Causes Edema?
  • How Is the Cause of Edema Diagnosed?
  • What Home Remedies Treat and Help Relieve Edema?
  • What Is the Medical Treatment for Edema?
  • How Can Edema Be Prevented?
  • Can Edema Be Cured?
  • Edema (Symptoms, Types, Treatment, Pictures) Topic Guide

What Is Edema?

  • Share Your Story

Edema (or Oedema) is the abnormal accumulation of fluid in certain tissues within the body. The accumulation of fluid may be under the skin - usually in dependent areas such as the legs (peripheral edema, or ankle edema), or it may accumulate in the lungs (pulmonary edema). The location of edema can provide the health care practitioner the first clues in regard to the underlying cause of the fluid accumulation.

What Are the Symptoms of Edema? What Does It Look Like?

Symptoms will depend on the cause of edema.

Peripheral edema

Symptoms of peripheral edema include swelling of the affected area(s), which causes the surrounding skin to "tighten." The swelling from peripheral edema is gravity-dependent (it will increase or decrease with changes in body position). For example, if a person is lying on their back (supine), the swelling will not appear in the legs, but will appear in the area around the sacrum. The skin over the swollen area appears tight and shiny, and often when pressure is applied to the area with a finger, an indentation appears. This is called pitting edema.

Pulmonary Edema

In the case of pulmonary edema, there is often no evidence of fluid retention or noticeable swelling on examination of the patient's extremities. This is because the fluid is backing up into the lungs. Signs and symptoms of pulmonary edema include:

  • shortness of breath,
  • difficulty breathing when lying flat,
  • waking up breathless, and
  • requiring multiple pillows to raise the head at night for a comfortable sleep.

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What Causes Edema?

  • Readers Comments 8
  • Share Your Story

The balance and regulation of fluid in the body is very complex. In short, the cause of edema as simply defined as possible, is that tiny blood vessels in the body (capillaries) leak fluid into the surrounding tissues. This excess fluid causes the tissues to swell.

The cause of fluid leaking into the surrounding tissues may be the result of several mechanisms, for example:

  1. too much force, or pressure inside the blood vessels;
  2. a force outside of the blood vessel causes the fluid to be drawn through it; or
  3. the wall of the blood vessel is compromised and cannot maintain equilibrium, leading to fluid loss.

Each of these three mechanisms may be associated with a variety of diseases or conditions. Examples include the following.

  • Pregnancy: Edema during pregnancy may occur because pregnant women have a greater volume of fluid circulating in the body, and because they also retain more fluid. A woman may also experience postpartum edema.
  • Medications: Edema may be caused by a variety of medications, for example, steroids, calcium channel blockers (CCBs), thiazolidinediones, nonsteroidal antiinflammatory drugs (NSAIDs), estrogens, etc.).
  • Liver disease and/or kidney disease: Both of these organs are vital in maintaining fluid balance in the body, and if severe disease is present in either of these organ systems, edema can develop. Examples include: cirrhosis of the liver, chronic kidney disease, and acute kidney failure.
  • Venous insufficiency: This is a common condition in which blood does not return to the heart efficiently from the peripheral areas of the body (for example, the ankles, legs, feet, hands), which results in edema. This typically results in edema in both legs.
  • Heart failure: If the heart is weak and cannot pump blood efficiently, blood will pool in particular areas of the body, which will cause fluid to leak from the blood vessels into the surrounding tissues.
    • If the right side of the heart is weak, pressure will build in the peripheral tissues in the body (hands, ankles, feet, legs). This is referred to as peripheral edema.
    • If the left side of the heart is weak, pressure will build in the lungs, causing pulmonary edema.
  • Idiopathic edema: Accumulation of fluid in surrounding tissues with no identifiable cause is referred to as idiopathic edema.

Pulmonary Edema Symptoms and Signs

Pulmonary edema is a condition in which an abnormal amount of fluid builds up in the lungs. Symptoms an signs of pulmonary edema include shortness of breath while lying flat, decrease in exercise tolerance, wheezing, and difficulty doing activities that were once routine.

Click for more signs, symptoms, and causes of pulmonary edema »

How Is the Cause of Edema Diagnosed?

  • Readers Comments 6
  • Share Your Story

Depending on the details of the patient's history, the health care practitioner will perform a thorough examination. The health care practitioner may order tests, for example:

  • chest X-ray,
  • abdominal ultrasound,
  • ultrasound of the legs,
  • blood tests of liver function
  • urinalysis, and
  • evaluation of the patient's kidney and liver function.

It is important to understand that while the edema itself can be physically limiting, ascertaining the underlying cause is important so that treatment can be targeted specifically to the condition causing edema. Sudden swelling of one or both legs may be a sign of a serious medical problem. If this occurs, see a health care practitioner immediately.

What Home Remedies Treat and Help Relieve Edema?

Compression stockings can be helpful by increasing the resistance to fluid leaking out of the vessels. These can be purchased in any medical supply store, and are particularly useful for peripheral edema. Body positioning can also be helpful for both peripheral and pulmonary edema to ease symptoms. For example, elevating the head with pillows in bed may benefit someone with pulmonary edema, while elevating the legs may minimize ankle and/or leg edema.

Heart Disease (Coronary Artery Disease) Slideshow Pictures

Slideshow: Atrial Fibrillation Causes, Tests, and Treatment

Take the Heart Disease Quiz!

What Is the Medical Treatment for Edema?

  • Readers Comments 1
  • Share Your Story

Once again, the treatment depends on the condition causing edema. In general, the treating principle is to reverse the forces that are not working properly:

  1. Increase the forces that keep fluid inside the blood vessels
  2. Reduce the forces that cause fluid to leak out of the blood vessels
  3. Identify the cause of the leaking blood vessel walls

For example, increasing the blood protein (albumin) level in a patient with a nutritional deficiency can help retain fluid in the blood vessels. Healing tissues exposed to trauma, (for example, swelling from a sprained ankle) assists in preventing fluid leaking from blood vessels.

The ultimate goal with edema treatment is to rid the excess fluid that has accumulated in the surrounding tissues in the body. The most common treatment is a diuretic. Diuretics make the kidneys excrete excess fluid from the body; which reduces the general fluid volume in the body. Diuretics should be used with caution as dehydration can be a side effect. There are many different types of diuretics that have different mechanisms of action and different potencies.

Depending on the cause of edema, follow-up may be as easy as wearing support hose when standing for prolonged periods, or it may require the input of cardiologists, nephrologists, and/or other subspecialists. It is important to keep the primary physician abreast of any treatment.

How Can Edema Be Prevented?

Prevention of further episodes of edema can be achieved by the treatments mentioned above. The ultimate goal is to address and treat any underlying cause of edema.

Can Edema Be Cured?

With appropriate follow-up edema can be treated successfully. The degree of response can vary depending on the severity of the cause and the patient's underlying medical condition.

Edema is swelling that occurs when too much fluid becomes trapped in the tissues of the body, particularly the skin.

There are different causes and types of edema. Pulmonary edema, for example, affects the lungs, while pedal edema causes swelling in the feet.

Edema usually starts slowly, but onset can be sudden. It is a common problem, but it can also be the sign of a serious condition.

This MNT Knowledge Center article will explain what edema is and how to recognize it, as as the different types and treatments of edema. The article will also look at possible complications of the condition.

Fast facts on edema

Here are some key points about edema. More detail is in the main article.

  • Edema happens when excess fluid stays within the body's tissues.
  • There is usually an underlying disease or condition.
  • Symptoms depend on the cause, and they normally develop gradually.
  • Medications are available to treat edema.

What is edema?

Edema, or water retention, causes swelling in the affected part of the body.

Edema refers to swelling and puffiness in different areas of the body.

It most often occurs in the skin, especially on the hands, arms, ankles, legs, and feet. However, it can also affect the muscles, bowels, lungs, eyes, and brain.

The condition mainly occurs in older adults and women who are pregnant, but anyone can experience edema.

Symptoms

Symptoms depend on the underlying cause, but swelling, tightness, and pain are common.

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www.ratreatment.com

A person with edema may notice:

  • swollen, stretched, and shiny skin
  • skin that retains a dimple after being pressed for a few seconds
  • puffiness of the ankles, face, or eyes
  • aching body parts and stiff joints
  • weight gain or loss
  • fuller hand and neck veins
  • higher pulse rate and blood pressure
  • headache
  • abdominal pain
  • changes in bowel habits
  • nausea and vomiting
  • confusion and lethargy
  • visual abnormalities

Symptoms depend on the underlying cause, the type of edema, and where the edema is located.

Treatment

Treatment will depend on the cause of edema.

Diuretics are a type of medication. They help get rid of excess fluid by increasing the rate of urine production by the kidneys. Different types work in different ways.

A doctor will recommend a specific treatment for macular edema, pulmonary edema, and other types of edema.

Alternative remedies

Compression stockings can help reduce the swelling and discomfort of edema.

Some self-care techniques can help prevent or reduce edema.

These include:

  • cutting down salt consumption
  • losing weight, if appropriate
  • doing regular exercise
  • raising the legs when possible to improve circulation
  • wearing supporting stockings, which are available to purchase online
  • not sitting or standing still for too long
  • getting up and walking about regularly when traveling
  • avoiding extremes of temperature, such as hot baths, showers, and saunas
  • dressing warmly in cold weather

A masseuse or physical therapist may help remove the fluid by stroking firmly in the direction of the heart.

Oxygen may be used to treat some kinds of edema. An individual with cardiogenic pulmonary edema may need additional oxygen if they have difficulty taking in enough oxygen.

Oxygen delivered through the nose may improve poor vision caused by diabetic macular edema.

Hyperbaric oxygen therapy (HBOT) has been found to increase the risk of pulmonary edema.

Types

There are many types of edema. Each one can indicate a range of further health conditions. Here are some types.

Peripheral edema: This affects the feet ankles, legs, hands, and arms. Signs include swelling, puffiness, and difficulty moving a part of the body.

Pulmonary edema: Excess fluid collects in the lungs, making breathing difficult. This can result from either congestive heart failure or acute lung injury. It is a serious condition, it can be a medical emergency, and it can lead to respiratory failure and death.

Cerebral edema: This occurs in the brain. It can happen for a range of reasons, many of which are potentially life-threatening. Symptoms include headache, neck pain or stiffness, whole or partial vision loss, change in consciousness or mental state, nausea, vomiting, and dizziness.

Macular edema: This is a serious complication of diabetic retinopathy. Swelling occurs in the macula, the part of the eye that enables detailed, central vision. The person may notice changes to their central vision and how they see colors.

Edema can occur in other locations as well, but those mentioned above are the most common. It can indicate one of many serious health conditions. It is important to check with a doctor if you are concerned about any kind of swelling.

What is pulmonary edema?

Pulmonary edema is a potentially serious condition. Find out more

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Causes

Edema can result from circulatory problems, infection, tissue death, malnutrition, kidney disease, total body fluid overload, and electrolyte problems.

There are many possible causes of edema, including:

Heart failure

If one or both of the lower chambers of the heart cannot pump blood properly, the blood can accumulate in the limbs, causing edema.

Kidney disease or kidney damage

A person with a kidney disorder may not be able to eliminate enough fluid and sodium from the blood. This puts pressure on the blood vessels, which causes some of the liquid to leak out. Swelling can occur around the legs and eyes.

Damage to the glomeruli, the capillaries in the kidneys that filter waste and excess fluids from the blood, can result in nephrotic syndrome. One symptom of this is a low level of the protein albumin in the blood. This can lead to edema.

Liver disease

Cirrhosis affects liver function. It can lead to changes in the secretion of hormones and fluid-regulating chemicals and reduced protein production. This causes fluid to leak out of blood vessels into surrounding tissue.

Cirrhosis also increases pressure within the portal vein, the large vein that carries blood from the intestines, spleen, and pancreas, into the liver. Edema can result in the legs and the abdominal cavity.

Certain medications

Some medications increase the risk:

  • vasodilators, or drugs that open blood vessels
  • calcium channel blockers
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • estrogens
  • some chemotherapy drugs
  • some diabetes drugs, such as thiazolidinediones (TZDs)

Pregnancy

During pregnancy, the body releases hormones that encourage fluid retention, and a woman tends to retain more sodium and water than usual. The face, hands, lower limbs, and feet may swell.

When a woman is resting in a reclined position during pregnancy, the enlarged uterus can press on a vein known as the inferior vena cava. This can obstruct the femoral veins, leading to edema.

During pregnancy, the blood clots more easily. This can increase the risk of deep venous thrombosis (DVT), another cause of edema.

Eclampsia, which results from pregnancy-induced hypertension, or high blood pressure, can also cause edema.

Dietary factors

A number of dietary factors impact the risk of edema, such as:

  • consuming too much salt, in people who are susceptible to developing edema
  • malnutrition, where edema can result from low protein levels in the blood
  • a low consumption of vitamin B 1, B 6, and B 5

Diabetes

Complications of diabetes include:

  • cardiovascular disease
  • acute renal failure
  • acute liver failure
  • protein-losing enteropathy, an intestinal condition that causes protein loss

These, and certain medications for diabetes, can result in edema.

Diabetic macular edema is the swelling of the retina in diabetes.

Conditions affecting the brain

Some causes of swelling in the brain include:

Head injury: A blow to the head may result in an accumulation of fluids in the brain.

Stroke: A major stroke can result in brain swelling.

Brain tumor: A brain tumor will accumulate water around itself, especially as it builds new blood vessels.

Allergies

Some foods and insect bites may cause edema of the face or skin in people who are allergic or sensitive to them. Severe swelling can be a sign of anaphylaxis. Swelling in the throat can close a person's airway, so they cannot breathe. This is a medical emergency.

Problems with the extremities

A blood clot: Any blockage, such as a clot in a vein, can prevent blood from flowing. As pressure increases in the vein, fluids start to leak into the surrounding tissue, causing edema.

Varicose veins: These usually occur because valves become damaged. Pressure increases in the veins, and they start to bulge. The pressure also increases the risk of fluids leaking into the surrounding tissue.

A cyst, growth, or tumor: Any lump can cause edema if it presses against a lymph duct or a vein. As pressure builds up, fluids can leak into surrounding tissue.

Lymphedema: The lymphatic system helps remove excess fluid from tissues. Any damage to this system, such as surgery, infection, or tumor, can result in edema.

Miscellaneous conditions

Prolonged immobility: People who are immobilized for a long time can develop edema in their skin. This can be due both to fluid pooling in gravity dependent areas and the release of antidiuretic hormone from the pituitary.

High altitude: This, combined with physical exertion, can increase the risk. Acute mountain sickness can lead to high-altitude pulmonary edema or high-altitude cerebral edema.

Burns and sunburn: The skin reacts to a burn by retaining fluid. This causes localized swelling.

Infection or inflammation: Any tissue that is infected or inflamed can become swollen. This is usually most noticeable in the skin.

Menstruation and pre-menstruation: Hormone levels fluctuate during the menstrual cycle. During the days before menstrual bleeding, levels of progesterone are lower, and this may cause fluid retention.

The contraceptive pill: Any medication that includes estrogen can cause fluid retention. It is not uncommon for women to put on weight when they first start using the pill.

Menopause: Around menopause, hormone fluctuations can cause fluid retention. Hormone replacement therapy (HRT) can also trigger edema.

Thyroid disease: Hormonal imbalances associated with thyroid problems can lead to edema.

Complications

Untreated edema can lead to:

  • painful swelling, with pain that gets worse
  • stiffness and difficulty walking
  • stretched and itchy skin
  • infection in the area of swelling
  • scarring between the layers of tissue
  • poor blood circulation
  • loss of elasticity in arteries, veins, and joints
  • ulcerats on the skin

Any underlying disease or condition needs treatment to prevent it from becoming more serious.

Lymphedema, or lymphatic obstruction, is a long-term condition where excess fluid collects in tissues causing swelling (edema).

The lymphatic system is a part of the circulatory system and vital for immune function. Lymphedema is caused by a blockage of this system.

Lymphedema commonly affects one of the arms or legs. In some cases, both arms or both legs may be affected. Some patients might experience swelling in the head, genitals, or chest.

Lymphedema is incurable, but with the right treatment, it can be controlled.

Fast facts on lymphedema

Here are some key points about lymphedema. More detail and supporting information is in the main article.

  • Experts believe primary lymphedema is caused by genetic mutation.
  • Secondary lymphedema can be caused by other conditions such as infections and inflammatory diseases.
  • In some cases, lymphedema can lead to skin infections and lymphangitis.
  • Protecting the skin can help reduce the risk of lymphedema.

Treatment

Swelling is a typical symptom of lymphedema and commonly affects legs and arms.

Compression stockings work to encourage the movement of lymph out of an affected limb.

Lymphedema is incurable. However, treatment can help reduce the swelling and pain.

Complex decongestive therapy (CDT): This starts with an intensive therapy phase, during which the patient receives daily treatment and training. This is followed by the maintenance phase when the patient is encouraged to take over their own care using techniques that they have been taught.

The four components of CDT are:

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  1. Remedial exercises: These are light exercises aimed at encouraging movement of the lymph fluid out of the limb.
  2. Skincare: Good skincare reduces the risks of skin infections, such as cellulitis.
  3. Manual lymphatic drainage (MLD): The lymphedema therapist uses special massage techniques to move fluid into working lymph nodes, where they are drained. The lymphedema therapist also teaches several massage techniques that can be used during the maintenance phase.
  4. Multilayer lymphedema bandaging (MLLB): Muscles surrounding lymph vessels and nodes move the fluid through the lymphatic system.

Unlike the circulation of blood, there is no central pump (heart). The aim is to use bandages and compression garments to support the muscles and encourage them to move fluid out of the affected body part. Patients will also be taught how to apply their own bandages and compression garments correctly so that MLLB can continue during the maintenance period.

Surgery has historically had disappointing results compared with non-surgical therapies for lymphedema. However, a new surgical technique using liposuction has proved more successful. It removes fat from the affected limb, resulting in less swelling.

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