Everything you need to know about edema

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Edema is swelling, which happens when too much fluid is trapped in the body’s tissues, particularly the skin.

The causes and forms of edema are distinct. For example, pulmonary edema affects the lungs while pedal edema causes swelling in the feet.

Edema usually starts slowly but it can start suddenly. It’s a normal thing, but it can be a sign of a serious condition too.

This article from the Nccmed Knowledge Center will explain what edema is and how it can be treated as the various forms and treatments of edema. Even the article will discuss potential complications of the disease.

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?

What is edema?
Edema, or water retention, causes swelling in the affected part of the body.

Edema refers to swelling and puffiness in various parts of the body.

This most often occurs in the skin, particularly on the hands, arms, ankles, legs, and feet. But it may also affect the muscles, intestines, lungs, eyes and brain.

The disease occurs predominantly in pregnant older adults and women but anyone may experience edema.

Symptoms

Symptoms depend on the underlying cause but there is normal swelling, tightness, and pain.

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 the location of the edema.

Treatment

Treatment may depend on edema cause.

Diuretics is a type of medication. They aid by increasing the rate of urine output from the kidneys to get rid of excess fluid. Different types work in different ways.

A physician may prescribe a particular treatment for macular edema, pulmonary edema and other edema types.

Alternative remedies

Compression stockings can help reduce the swelling and discomfort of edema.
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 assist by stroking gently in the direction of the heart to absorb the fluid.

Oxygen can also be used to treat other forms of edema. An person with cardiogenic pulmonary edema can need additional oxygen if there is enough oxygen they have trouble taking.

Oxygen supplied through the nose may improve poor vision impaired by diabetic macular edema.

The risk of pulmonary edema has been found to increase with hyperbaric oxygen therapy (HBOT).

Types

There are several different forms of edema. Each may signify a range of additional health conditions. Below are a few examples.

Peripheral edema: It can affect knees, thighs, hands, and arms of the feet. Signs include swelling, puffiness, and difficulty of moving a body part.

Pulmonary edema: Excess fluid pools in the lungs, making it difficult to breathe. It may either be the product of congestive heart failure or acute lung injury. It’s a dangerous condition, it can be a medical emergency which can result in respiratory failure and death.

Cerebral edema: This happens within the brain. It can happen for a number of causes, many of which pose life-threats. Symptoms include headache, discomfort or stiffness of the neck, loss of vision in whole or in part, 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 which allows for a clear, central view. The person may notice changes in their central vision, and how colors are seen.

Edema may also occur in other locations but the most common are those listed above. It may point to one of several serious health conditions. If you’re worried about some kind of swelling, it’s best to consult with a doctor.

Causes

Edema can result from circulatory problems, infection, tissue death, malnutrition, kidney disease, overloading of the total body fluid, and problems with electrolytes.

There are several potential causes for edema, among them:

Heart failure

If one or both of the heart’s lower chambers can not properly pump blood, the blood may build up in the limbs, causing edema.

Kidney disease or kidney damage

An individual with a kidney disease may not be able to get enough sodium and fluid out of the blood. This puts pressure on the blood vessels, and some of the liquid spills out. Swelling may take place around the legs and the eyes.

Nephrotic syndrome may result in damage to the glomeruli, the capillaries in the kidneys that filter out waste and excess blood fluid. One symptom of this is low blood protein albumin concentration. That can result in edema.

Liver disease

Cirrhosis affects function of the liver. It can lead to changes in hormone secretion and fluid-regulating chemicals, and a reduction in protein production. This allows blood vessels to leak fluid into surrounding tissue.

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

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

The body releases hormones during pregnancy which stimulate fluid retention and a woman tends to retain more sodium and water than normal. The face, hands, lower extremities and feet can swell.

During pregnancy when a woman rests in a reclined position, the enlarged uterus can press on a vein known as the inferior vena cava. This can block the femoral veins, which can lead to edema.

The blood clotts more quickly during pregnancy. This can increase the risk of another cause of edema, deep venous thrombosis (DVT).

Eclampsia, which results from hypertension caused by pregnancy, 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 bites of insects in people who are allergic or susceptible to them can cause face or skin edema. Extreme swelling may be indicative of anaphylaxis. Swelling in the throat can close an airway for a person, so they can’t breathe. This is something of a medical emergency.

Problems with the extremities

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

Varicose veins: These typically occur because of damage to the valves. Pressure in the veins increases, and they begin to bulge. The strain also raises the risk of leakage of fluids into surrounding tissue.

A cyst, growth, or tumor: If it pushes against a lymph duct or a vein, any lump may cause edema. Liquids can leak into surrounding tissue as pressure builds up.

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 have long been immobilized may develop edema in their skin. It may be attributed to both the fluid pooling in gravity-dependent areas and the release of pituitary antidiuretic hormone.

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

Burns and sunburn: In retaining fluid, the skin reacts to a burn. This causes swelling localised.

Infection or inflammation: Any infected or inflamed tissue may become swollen. This is most generally visible in the face.

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

The contraceptive pill:Any medication that includes estrogen can cause fluid retention. People are not unusual to put on weight when they start taking the pill first.

Menopause: Hormone variations can cause fluid retention around the menopause. Edema can also be caused by hormone replacement therapy (HRT).

Thyroid disease: Thyroid-related hormonal imbalances 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

Every underlying illness or disorder needs treatment so that it does not get more serious.

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