Edema is a swelling that occurs when excess fluid becomes trapped in tissues. Edema can occur in any part of the body, but it is most commonly seen in the legs and arms. The use of certain medications, infections, injuries and pregnancy can provoke the appearance of swelling (edema). It can also be the result of diseases, such as congestive heart failure, kidney disease, venous insufficiency or cirrhosis of the liver. Swelling of the legs, arms and other parts of the body can be relieved by reducing salt in the diet and wearing compressive socks. However, when edema is a symptom of the disease, treatment of the underlying disease is necessary.
What is edema?
Edema is a medical term for swelling that occurs due to the accumulation of fluid in the tissues, often in the feet, ankles, and legs, but also in other parts of the body such as the face, hands, and abdomen. Mild cases of edema usually resolve on their own, typically within a short period of time, while edema caused by underlying medical conditions requires long-term treatment and management.
Edema typically starts slowly but can also be sudden, which is often a sign of a serious condition.
Types of edema
Peripheral edema
It occurs in the legs, feet, ankles, and hands. It can be a sign of circulatory, lymphatic, or kidney problems.
Foot and ancle edema
It is caused by the accumulation of fluid in the feet and lower legs. It is more common in older people and pregnant women. It can make it difficult to move, as it leads to a partial loss of sensation in the legs.
Lymphatic edema – Lymphedema
This swelling on the hands and feet is most often caused by damage to the lymph nodes, tissues that help filter microorganisms and harmful substances from the body. The damage may be the result of cancer treatments such as surgery and radiation. Cancer itself can also block lymph nodes and lead to fluid buildup.
Pulmonary Edema
When fluid accumulates in the alveoli, pulmonary edema occurs. This makes breathing difficult, can cause rapid heartbeat, shortness of breath, and coughing up frothy sputum. Immediate medical assistance is necessary for these symptoms.
Cerebral edema
A very serious condition that occurs when fluid accumulates in the brain. It is often the result of a severe head injury, blocked blood vessel, or presence of a tumor.
Macular edema
It occurs when fluid accumulates in the macula, which is located in the center of the retina, a light-sensitive tissue in the back of the eye. It happens when damaged blood vessels in the retina leak fluid into that area.
Periorbital edema
Inflammation and swelling around the eyes. It is usually temporary.
Who is at a greater risk of developing edema?
Swelling of any body part can be experienced by anyone, but it is particularly common in individuals over the age of 65, pregnant women, and people with weakened immune system. Treatment involves making lifestyle changes, especially in diet and physical activity.
The impact of edema on the body
Edema occurs when tiny blood vessels, called capillaries, leak fluid. The fluid accumulates in the surrounding tissues, leading to swelling. Edema will cause an increase in the size of body parts (swelling), which often hinders movement and daily activities. Simple lifestyle changes, such as elevating the swollen body part or moving around after prolonged sitting or standing, can help reduce the swelling.
Causes of edema
Gravity
Prolonged sitting or standing in one place leads to fluid accumulation in the legs.
Weakened valves in the veins (venous insufficiency)
It becomes difficult for the veins to push blood back to the heart if the venous valves are weak, leading to enlarged veins and fluid buildup in the legs.
Diseases
Conditions such as heart failure and diseases of the lungs, liver, kidneys, and thyroid can have swelling or edema as a symptom.
Diabetes complications
Both diabetes-related complications and certain medications for diabetes can contribute to edema. Diabetic macular edema is the swelling of the retina in individuals with diabetes.
Side effects of medications
Edema can be an unwanted effect of certain medications, such as blood pressure medications or painkillers.
Poor nutrition
Consuming food high in salt content can lead to fluid accumulation in various parts of the body.
Pregnancy
Swelling of the legs during pregnancy occurs due to the pressure of the uterus on the blood vessels in the lower part of the body.
Compromised immune system
Allergic reaction, infection, burns, injuries or blood clots can lead to edema.
Symptoms of edema
The symptoms depend on the underlying cause and can include:
- Enlarged body part compared to before.
- The skin over the swollen area appears stretched and shiny.
- Difficulty walking if the legs, ankles, or feet are swollen.
- Coughing or breathing difficulties.
- Feeling of tightness in the swollen body part.
- Increase in the size of the abdomen.
- Mild or severe pain in the affected area.
- Swelling of the face or eyes.
- Indentations in the skin after pressing with a finger for a few seconds.
Diagnosing edema
The doctor will examine the patient, to examine the edema, followed by diagnostic tests to find out the cause of the swelling. The general practitioner will carefully look at the swelling especially on areas of the body where the skin is shiny or stretched. They will then assess the edema.
Edema grading: Assessment of edema is a test used to identify the severity of edema and assess how much fluid has accumulated in the tissues. The doctor will gently press the swollen body part with their finger for five to 15 seconds (pitting test). After releasing the pressure, a small pit or indentation will remain on the skin, indicating the presence of fluid in the tissues.
The edema grading scale measures how quickly the indentation returns to normal (rebound) after the pitting test. The scale has the following ratings:
- Grade 1: Immediate rebound with a 2-millimeter (mm) indentation.
- Grade 2: Rebound within less than 15 seconds with a 3 to 4 mm indentation.
- Grade 3: Rebound longer than 15 seconds but shorter than 60 seconds with a 5 to 6 mm indentation.
- Grade 4: Rebound lasting 2 to 3 minutes with an 8 mm indentation.
Treatment of edema
The treatment of edema varies depending on the underlying cause, especially if the cause is related to an underlying health condition.
To treat edema, the underlying cause often needs to be addressed first. For example, allergy medications can help reduce swelling caused by an allergic reaction. A blood clot in the leg is treated with blood thinners. A tumor blocking the lymphatic system can sometimes be reduced or removed through surgery, chemotherapy, or radiation therapy.
Edema of the legs caused by congestive heart failure or liver disease can be treated with diuretics, medications that promote the removal of excess fluid in the body. Limiting the amount of sodium in the diet, as well as reducing the amount of alcohol can also help reduce edema. If edema is a side effect of the medication, the doctor may change the medication or adjust the dose to prevent swelling. The dosage of the medication or a change of therapy can only be determined by the doctor.
Prevention of edema
In addition to treating the underlying cause of edema, there are several steps you can take to prevent or reduce fluid buildup in the body:
- Elevate your legs above heart level by placing a pillow under them when sitting or lying down.
- Avoid sitting or standing for long periods without movement or taking short walks.
- Wear compression socks or sleeves that apply pressure to the affected areas to prevent fluid accumulation.
- Edema shoes are available for individuals with chronic edema as they require adjustable footwear for swelling.
- Reduce the amount of salt in your diet. Salt retains water, which can reach the tissues and cause swelling.
- Incorporate foods into your diet that promote fluid elimination, such as parsley, blueberries, dandelion greens, and cranberry juice.
- Follow your doctor’s instructions for taking medications. You may be prescribed a diuretic that helps eliminate excess fluid from the body.
- Moving and using the muscles in the affected area, especially in the legs, can help fluid return to the heart. Your doctor may suggest exercises that can reduce swelling.
- Gently massaging the affected area with edema using gentle movements can help move the fluid out of that area.
- Take diuretic teas (such as hawthorn or dandelion) that promote urine production (always consult your doctor beforehand).
- Keep the swollen area clean and free from injuries. Use lotion or cream. Dry, cracked skin is more open to scratches, cuts and infections.
Outcomes in the case of swollen arms or legs
Depending on the underlying cause, edema can be temporary or chronic. Swelling usually lasts for a few days. The swelling is typically greatest in the first two days and should begin to decrease by the third day. If the swelling does not subside after a few days of treatment, it is advisable to consult a doctor who can recommend a more effective treatment.
Complications of edema
If left untreated, edema can lead to:
- Increasingly painful swelling
- Difficulty walking
- Stiffness
- Stretched skin, which may itch
- Increased risk of infection in the swollen area
- Scarring between tissue layers
- Reduced blood flow
- Decreased ability of arteries, veins, joints, and muscles to stretch
- Increased risk of skin ulcers
When to seek medical help
Any swelling that does not improve after taking appropriate measures, becomes more painful, or spreads, requires a visit to the doctor. Individuals with heart, kidney, liver disease, cancer, or diabetes should pay special attention to edema. Any changes in color, size, or the appearance of new symptoms that were not present before are reasons to seek medical attention.
When to seek urgent medical help
Contact your doctor immediately if you have:
- Pain or a change in skin color in the swollen area
- An open wound in a swollen area
- Shortness of breath
- Swelling of only one extremity
- Difficulty walking or moving
Edema is a common phenomenon and varies in severity for each person, depending on the cause. If you are pregnant, it is normal to feel swelling as the due date approaches. Also, long standing or sitting can cause an island that slowly disappears when you start moving.
When edema does not resolve on its own, the doctor may prescribe medications and provide advice to effectively manage more severe cases. If you notice unexpected swelling in any part of your body, it is important to consult a doctor. Early diagnosis and treatment when edema is a symptom of an underlying condition can lead to the best prognosis for reducing or eliminating it.
