Edema is the excessive accumulation of fluid (swelling) in the
soft tissues of the body. If you have edema for a long period
of time, you may develop pigmentation, reddening, and/or hardening
of the skin.
You may have swelling
throughout your body. This is known as generalized edema or "anasarca".
You may have edema that is localized in your upper body and which
involves your face, arms and neck; or you may have "dependent"
edema which involves the swelling of your legs and ankles and
occurs most often at the end of the day. Finally, you may have
periorbital edema, which is swelling around your eyes, usually
upon awakening.
Although each type
of edema may be caused by a variety of conditions, the location
of the swelling sometimes gives your physician important information
that helps him to diagnose any underlying illness.
What
causes edema?
There are many causes of edema, but the most common ones are underlying
kidney, liver or heart diseases.
Edema
may be caused by diseases of the liver such as cirrhosis. Cirrhosis
is a condition which is characterized by irreversible scarring
of the liver. Edema may also be caused by a disease of the kidneys
known as nephrotic syndrome". Nephrotic syndrome is distinguished
by a large amount of protein in the urine, weight gain, high blood
pressure, and anorexia.
Edema
may be caused by diabetes or AIDS. It may be produced by the use
of steroids or by chemotherapy. Another cause of edema is superior
vena cava syndrome. This condition involves the narrowing of the
vein which returns blood from the upper body to the heart.
Swelling
may be caused by cardiac as well as other conditions. Congestive
heart failure is a major cause of edema of the legs. If you have
heart failure there may be a back up of blood returning to your
heart. This causes congestion (edema) in your body's tissues.
Edema
in various parts of the body may also be caused by rarer cardiac
conditions such as: constrictive pericarditis, valvular disease,
or a cardiac tumor.
Other
causes of edema include: fractures, skin infections, or prolonged
immobility.
Your
doctor will be particularly interested in determining the reason
for your edema so that he can devise a proper treatment plan.
The
history and physical examination are very important tools for
diagnosing edema.
During
the physical examination, your doctor will press gently on your
skin to determine if it pits. This is one method of diagnosing
the presence of edema. When outside pressure is applied, the edematous
fluid is temporarily displaced. The displacement causes a depression
or "pitting".
Your
doctor may order urine and blood tests which are also important
tools for diagnosing the cause of edema.
If
you have a history of edema of the legs after prolonged sitting,
and if you are older and confined to a wheelchair, your edema
may be unrelated to illness.
How is edema treated?
Therapy for edema involves treating the underlying cause(s).
If you have heart failure, for
example, your doctor will probably prescribe diuretics (water
pills). Diuretics may cause depletion of your body's potassium
which can lead to the following side effects: dizziness, severe
weakness, or severe leg cramping. If you experience any of these
symptoms, call your health care professional.
You doctor may prescribe other
medications for heart failure such as ACE inhibitors and Digoxin..
He may put you on a reduced sodium diet of no more than 3 grams
of salt daily. He may suggest bed rest and/or recommend that you
keep your feet elevated when you are sitting.
