Edema – Symptoms, Causes & treatment

Overview

Edema is a medical condition characterized by the abnormal buildup of fluids in the body's tissues. This fluid buildup can occur in various parts of the body, including the arms, legs, face and lungs.

Edema can be caused by various factors such as heart, liver or kidney disease, standing or sitting for long periods, injury or inflammation, pregnancy, hormonal changes, certain medications, and some underlying medical conditions.

Who does Edema affect?

Edema has no age limits, and it can affect anyone. But Edema is commonly seen in people aged 60 years or above and pregnant ladies.

Symptoms of Edema

The following are some of the symptoms of Edema.

• Swelling

Swelling of the tissue under your skin, particularly in your legs or arms, is observed. This swelling increase gradually and cause severe discomfort when left untreated.

• Stretchy skin

Stretchy skin Edema, also known as skin stretching or cutis laxa, is a condition in which the skin becomes loose and loses its elasticity. The skin may appear saggy, and wrinkles may form prematurely.

• Increased abdominal size

Edema may occur in any part of the body. If Edema affects the bowel, it will lead to stomach pain and an increase in abdominal size.

• Mild pain

Mild pain Edema is a condition characterized by the accumulation of fluid in the tissues, causing swelling and mild pain. The swelling is usually most prominent in the feet, ankles and legs but can also occur in the hands, arms, and face.

• Difficulty in walking or movement

Difficulty in walking is a condition characterised by the accumulation of fluid in the lower extremities, causing swelling and difficulty in walking or movement. A variety of factors, including injury, pregnancy, certain medications, heart or kidney problems and varicose veins, can cause this condition.

What is Edema grading?

A scale used to measure the severity of Edema is called Edema grading. This is used to diagnose Edema and to determine how much fluid accumulates in the tissues.

Your medical practitioner will test an area in your body for Edema. They will gently press the swollen area of your skin for a few seconds. This test is called the pitting test.

After releasing the pressure, a dimple (pit) will appear on your skin. The pit in your skin indicates the excess fluid retention in your body tissues.

The Edema grading scale measures the depth of the pit and shows how quickly the pit goes back to normal after the test. The Edema grading is classified into four stages.

• Grade 1

Once the pressure is released, the skin rebounds immediately from the 2-millimetre pit. This is considered the least severe type of Edema.

• Grade 2

A three to four-millimetre pit is formed after exerting pressure on the swollen area. The pit rebounds within 15 seconds. This is also considered the least severe type.

• Grade 3

A pit is formed after releasing the pressure applied gently on the skin. The depth of the formed pit will be 5 to 6 millimetres.

• Grade 4

The 8-millimetre pit will rebound between 2 to 3 minutes once the pressure is removed. This condition is considered a severe type of Edema.

The following list is the causes of Edema.

• Blood vessels leak fluid

Edema may occur due to the fluid leak in tiny blood vessels (capillaries). The leakage leads to fluid accumulation in the surrounding tissues resulting in swelling. 

• Sitting in a position for too long

NCBI states that staying inactive in the same position for an extended period is associated with lower limb Edema.

Sitting in the same position for too long will result in several health-related risk factors.

• Salty food

When the body ingests a large amount of salt, the kidneys respond by retaining more water to dilute the salt and maintain proper electrolyte balance in the body. This leads to an increase in blood volume, which in turn causes Edema.

• Pregnancy

NCBI says that total body water increases by 6 to 8 litres during pregnancy. Among them, 4 to 6 litres are extracellular, and 2 to 3 litres are intracellular.

Most pregnant women have temporary Edema without any health issues. Such Edemas are easily curable.

Medications

Edema is also caused by certain medication and it is known as drug induced Edema. Some of the medications that cause Edema include:

• Calcium channel blockers
• Steroids
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Hormone replacement therapy (HRT)

Risk factors of Edema

• High BP medications

Vasodilatory Edema is a common adverse effect of high blood pressure treatment with vasodilators. Here vasodilator means medications that dilate blood vessels.

According to NCBI, vasodilatory Edema is a frequently encountered side effect among hypertensive patients using high blood pressure medications. This side effect is dose-dependent, so low dosage is preferred in practice.

• Anti-inflammatory drugs

Anti-inflammatory drugs, also known as non-steroidal anti-inflammatory drugs (NSAIDs), can be a risk factor for Edema because of their effects on the body's fluid balance.

• Estrogens

Estrogens, a type of hormone typically found in females, can be a risk factor for Edema because of their effects on the body's fluid balance and blood vessels.

Estrogens can cause an increase in the body's retention of sodium and water, leading to an increase in blood volume and pressure in the blood vessels.

• Steroid drugs

Steroids are also called corticosteroids. They are anti-inflammatory medicines used to treat certain conditions.

NCBI says that an increased dose of corticosteroids may increase sleep disturbances, including skin and leg Edema. These effects may get worse with an increase in corticosteroid dosage.

• Diabetic medications

Edema caused due to diabetic medications is called insulin Edema syndrome.

This rare condition is noticed in patients with poor control over diabetes mellitus while starting the insulin treatment.

Diagnosing Edema

Diagnosis of Edema typically involves a physical examination and a review of the patient's medical history. In some cases, additional tests, such as blood tests or imaging studies, may be necessary to determine the underlying cause of the Edema. However, the following examinations may be carried out to diagnose Edema.

• Physical examination

The most common methods used to diagnose Edema are physical examination and measuring the circumference of the affected limb. The physician will look for signs of swelling, such as the skin appearing stretched or shiny, and may also press on the affected area to check for fluid buildup.

• Ultrasound test

An ultrasound test is an imaging technique that can be used to detect and pinpoint fluid buildup in particular organs, such as the heart or kidneys.

Treatment of Edema

The treatment of Edema depends on the underlying cause of the condition. Some common treatments for Edema include:

• Lifestyle changes: Making lifestyle changes such as losing weight, reducing salt intake and avoiding standing for long periods can help reduce Edema symptoms.

• Elevation: Elevating the affected limb can help reduce swelling by promoting fluid flow back to the heart.
• Compression stockings: Wearing compression stockings can help to reduce swelling by providing gentle compression to the affected area.
• Medications: Diuretics, also known as "water pills," can help to reduce Edema by increasing urine production and promoting the elimination of excess fluid from the body.
• Vasodilators: These medications can help to relax the blood vessels and reduce the pressure in the blood vessels, which can help to reduce Edema.
• Surgery: In severe cases, surgery may be necessary to remove excess fluid or repair the underlying condition that is causing the Edema.

It's important to consult a doctor if you are experiencing persistent or severe symptoms of Edema, as this condition can be a symptom of a more serious underlying condition.

A healthcare provider can perform diagnostic tests and develop a treatment plan based on the condition's underlying cause.

Can Edema be prevented?

Edema can be prevented in some cases by taking steps to maintain a healthy lifestyle and manage underlying medical conditions.

Some tips to prevent Edema include:

• Maintaining a healthy weight: Being overweight or obese can increase the risk of developing Edema, so it's important to maintain a healthy weight.
• Eating a low-salt diet: Consuming a high-salt diet can cause the body to retain more water, leading to Edema, so it's important to reduce your salt intake.
• Exercising regularly: Regular physical activity can help to improve circulation and reduce the risk of Edema.
• Managing underlying medical conditions: If you have a medical condition that increases your risk of developing Edema, such as heart failure, hypertension or kidney disease, it's important to manage these conditions to reduce the risk of Edema.

• Wearing compression stockings: Compression stockings can help reduce swelling by providing gentle compression to the affected area, especially for people with the condition that increases their risk of developing Edema.

When to see a doctor?

It's important to see a doctor if you suspect of having Edema, particularly if the swelling is severe or accompanied by other symptoms such as difficulty breathing or chest pain.

Conclusion

Edema can vary in severity depending on the underlying cause. For example, it is common to experience swelling during pregnancy, particularly as the due date approaches, and this is considered normal.

However, if you are not pregnant and experience sudden or unexpected swelling in a part of your body, it is important to consult a healthcare provider for an examination.

In many cases, mild Edema will resolve on its own. However, medication and treatment may be necessary if the case is more severe.

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