Edema. Edema can also be caused by certain medical conditions or medications. It is also common in pregnant women.

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1 Edema Introduction Edema is swelling caused by extra fluid in the tissue of the body. It usually happens in the feet, ankles and legs, but it can involve your entire body. There are many causes of edema, including certain health conditions or medications. Older adults and pregnant women are most likely to get edema, but it can happen to anyone. This reference summary discusses the signs, symptoms and causes of edema. It also explains how edema is confirmed and treated. What is Edema? Edema is a symptom of many diseases. It happens from the buildup of fluid in the tissues of the body. It can happen if blood flow to the heart is restricted. If this happens, blood and fluid can back up and leak into the surrounding tissues. Edema may also be the body s response to inflammation or injury. Inflammation or injury can cause small blood vessels in the body to leak. These small blood vessels are called capillaries. When capillaries leak, they release fluid into surrounding tissues. These tissues swell due to the extra fluid, causing edema. The extra fluid allows more white blood cells to enter the injured or inflamed area. White blood cells fight infections or disease. Edema can also be caused by certain medical conditions or medications. It is also common in pregnant women. 1

2 Signs Edema can happen anywhere in the body. However, it is most common in the feet, ankles and legs. Edema can be mild or severe. Signs of edema include: Swelling Skin that holds a dimple or pit after being pressed Skin that is shiny or stretched tight Enlarged abdomen Sudden weight gain Severe leg edema can cause the legs to feel heavy. Walking may become difficult. Ulcers may also develop on the skin of the leg since severe leg edema can interfere with blood flow. An ulcer forms when surface cells become inflamed, die, and are shed. When the skin breaks down, an ulcer develops. Ulcers can be very serious and may even become life threatening if left untreated. If fluid builds up in the air sacs of the lungs, it can cause pulmonary edema. Symptoms of pulmonary edema include: Shortness of breath Cough with bloody froth Gurgling or wheezing sounds when breathing Low blood oxygen levels Ulcer You should make an appointment with your healthcare provider if you notice any signs of edema. Seek immediate medical attention if you develop the symptoms of pulmonary edema suddenly. 2

3 Causes Mild edema may be caused by simply standing or sitting in one position for too long. Getting up and moving around every so often can prevent this from happening. A diet with too much salt Allergic reactions Premenstrual syndrome, or PMS Pregnancy, due to extra sodium and fluid in the body Sunburn Certain medications may also cause mild edema in some people. Medications that can cause edema include: Calcium channel blockers Corticosteroids, like prednisone or methylprednisolone Diabetes medications called thiazolidinediones Estrogens Medications that open blood vessels, such as those used to treat high blood pressure Nonsteroidal anti-inflammatory drugs, or NSAIDs Edema may also be a sign of a more serious medical condition. For example, congestive heart failure can cause edema. Congestive heart failure happens when your heart is less effective at pumping blood, which allows blood to back up in your legs, ankles, feet, and lungs. This causes edema. Edema caused by a more serious medical condition may come with other signs. For instance, the signs of heart failure include the following and you should seek emergency medical attention if you have any of them: Chest pain Difficulty breathing Shortness of breath Cirrhosis is another medical condition that can cause edema. Cirrhosis is a progressive liver disease in which liver cells are replaced by scar tissue. Drinking too much alcohol can cause liver cirrhosis. 3

4 Other common medical conditions that can also cause edema are kidney damage or kidney disease. The kidneys are responsible for removing extra sodium and fluid from the body. If they are damaged, extra fluid can build up in the body s tissues. Lung damage, such as from severe infection Major injury to the body Problems with the heart, such as leaking or narrowed valves Weak or damaged veins in the leg can cause edema in legs, ankles or feet. Valves in the veins of the leg help keep blood moving toward your heart. If they are damaged, blood can pool in the leg, ankle or foot and cause edema. Another possible cause of edema is problems with the lymphatic system. The lymphatic system helps clear extra fluid from the body. If the lymphatic system is weak and cannot remove extra fluid, edema may happen. Edema may also be caused by a blood clot or tumor preventing blood flow. When to See a Doctor You should talk to your healthcare provider if you have the signs of edema. Sometimes edema is the sign of a serious medical condition. To confirm edema, your healthcare provider will ask you questions about your symptoms and medical history. He or she will also perform a physical exam. Often a healthcare provider can diagnose edema with just this information. However, the underlying cause may need to be investigated further. In some cases, radiological exams such as x-rays, CAT scans, and ultrasounds may be needed to find an underlying cause of edema. Blood and urine tests may also be used. 4

5 More testing may be done if a medical condition is causing the edema. For example, if congestive heart failure is suspected to be the cause of the edema, special tests may be done to examine the heart. Treatment Treatment for edema depends on the cause. If the edema is mild, it may go away on its own. You can help mild leg, ankle or foot edema go away by elevating your legs higher than your heart while sitting. You should also avoid sitting or standing in one position for too long. Support stockings, sometimes called compression stockings, can also help treat some types of edema. Support stockings keep fluid from collecting in your legs, ankles, and feet by putting pressure on them. They are available at most drugstores. Limiting your salt intake can reduce the amount of extra fluid in your body and help prevent edema from happening again. Ask your healthcare provider about the amount of salt you should include in your diet. A medicine called a diuretic may also be prescribed to treat more severe edema. A diuretic is also called a water pill. It increases the production of urine to get rid of extra fluid in the body. A common diuretic used to treat edema is furosemide (Lasix ). If a blood clot or tumor is preventing blood flow in the legs, it must be treated to prevent edema. Often blood thinners are prescribed to dissolve a blood clot. A tumor may need to be surgically removed. Severe edema is usually the result of an underlying medical condition such as heart failure or kidney failure. Treating the underlying medical condition can prevent future problems with edema. Summary Edema is swelling caused by extra fluid in your body s tissues. It usually happens in the feet, ankles and legs, but it can involve your entire body. 5

6 Often, a healthcare provider can diagnose edema with a physical exam and information about your symptoms and medical history. However, the underlying cause may need to be investigated further. Treatment for edema depends on its cause and severity. It may involve support stockings, diuretics, and treating any underlying medical conditions. Moving around often and keeping your legs elevated above your heart while sitting can help. You should make an appointment with your healthcare provider if you notice any symptoms of edema. Sudden symptoms of pulmonary edema require immediate medical attention. Getting treatment early can help prevent edema from getting worse. It may also prevent serious complications and death. 6