What Is Edema?
Edema - Definition and Discussion
Simply defined, edema is the abnormal pooling of fluid in tissues or the accumulation of excess interstitial fluids. It can be throughout the body which is referred to as generalized edema. It can also occur in a specific region, part or even spot, then it is called localized edema. The condition may be caused by increased pressure in the capillaries, blocking of vein, varicose veins, thrombophlebitis, venous obstruction, pressure from casts, tight bandages, congestive heart failure, kidney failure, liver cirrhosis, overactive adrenal glands, steroid therapy or inflammatory reactions.Edema may also occur because of loss of serum protein in burns, draining wounds, excessive bleeding, nephrotic syndrome or chronic diarrhea.
It is also seen in malnutrition, allergic reactions.But perhaps the most common edema experience by even millions of healthy individuals is inflammatory edema. This type of localized edema is a one of the body's most immediate reaction to trauma or injury to tissues. This can be caused by sprained muscles, torn ligaments, insect bites, cuts and abrasions. It is also caused by venous thrombosis or sudden vascular blockages. Joint swelling caused by arthritis is another common type of localized edema.The treatment of edema is directed at correcting or curing the underlying condition. Once this condition is resolved the edema dissipates. If this does not occur than it can be treated with diuretics and/or decongestive massage therapy. In the situation of edema caused by vascular anomalies, support compression hosiery may be worn. Treatment may also include dietary changes which focuses on a low sodium intake.
The symptoms of edema include unexplained weight gain, ring or shoe tightness, facial swelling or puffiness, swollen arms or legs and abdominal distention. Tissue changes in early edema are known as non pitting edema. When pressed with a finger, there is no indentation. Also, with edema the skin of the affected area may appear stretched and or shiny. In long standing edema, the tissue will experience (as with lymphedema) what is known as pitting edema.
Incidentally, all edemas used to be known as dropsy.
Infections can be a complication of both edema or lymphedema. It should be noted though, that edema may be caused by infection wheras in lymphedema infections are a direct complication of the condition itself. Also, with lymphedema, the affected limb is known as immuno-compromised and infections generally are much more severe and readily develop into cellulitis, or lymphangitis.Lymphedema however is a disorder where lymph collects in soft tissue (sub-cutaneous) because damage to the lymphatic system. This can be from a genetic malformation (hereditary); infection or injury in utero (congenital); a side effect to a developmental disorder of the lymphatics (also a type of hereditary lymphedema), or by removal of lymph nodes for cancer biopsy, injury, trauma or infection of the lymphatics, infection caused by a parasitic infection or damage done by the crushing of the lymphatics in morbid obesity.Since the destruction or injury to the lymphatics is the underlying cause, there is no cure for this swelling, only treatment and management. The preferred treatment for lymphedema is decongestive therapy. Other treatment modalities may include surgical management, and compression pumps. The use of diuretics should not be used and in fact may cause additional complications in lymphedema.
The general symptom of lymphedema is the swelling of an arm or leg unexpectedly and or without explanation or may suddenly appear after trauma, injury or lymph node removal for biopsy. In early lymphedema, when the limb is pressed with a finger, it will leave an indentation. This is known as pitting edema.
Edema or Lymphedema
(c) 2005 Pat O'Connor - Lymphedema People
Edema is swelling of both legs from an accumulation of excess fluid. Edema has many possible causes:
Prolonged standing or sitting, especially in hot weather, can cause excess fluid to accumulate in the feet, ankles and lower legs.
Venous insufficiency is a common problem caused by weakened valves in the veins of the legs. This makes it more difficult for the veins to pump blood back to the heart, and leads to varicose veins and buildup of fluid.
Severe chronic lung diseases, including emphysema and chronic bronchitis, increase the pressure in the blood vessels that lead from the heart to the lungs. This pressure backs up in the right side of the heart and the higher pressure causes swelling in the legs and feet.
Congestive heart failure, a condition in which the heart can no longer pump efficiently, causes fluid buildup in the lungs and other parts of the body. The swelling is often most visible in the feet and ankles.
Edema in the legs can occur during pregnancy because the pregnant uterus puts pressure on the vena cava, a major blood vessel that returns blood to the heart from the legs. Fluid retention during pregnancy also can be caused by a more serious condition called preeclampsia.
Low protein levels in the blood that can be seen in malnutrition, kidney and liver disease can cause edema. The proteins in the blood help to hold salt and water inside the blood vessels so fluid does not leak out into the tissues. If the most abundant blood protein, called albumin, gets too low, fluid is retained and edema occurs, especially in the feet, ankles and lower legs.
Symptoms vary according to the type of edema and its location. In general, skin covering the swollen area will be stretched and shiny.
To check for edema that is not obvious, you can gently press your thumb over the foot, ankle or leg with slow, steady pressure. If edema is present, an indentation will show on the skin. You should see a doctor to determine the cause of leg swelling. If both legs are swollen, your doctor will ask about other symptoms and do a physical examination. A urine test will show if you are losing protein from the kidneys. Blood tests, a chest X-ray and an electrocardiogram (EKG) also may be ordered.
Edema can be temporary or permanent. Also, it can come and go depending on the cause.
The only way to prevent edema is to prevent the cause. Smoking is the main cause of chronic lung disease. Congestive heart failure most often is caused by coronary artery disease, high blood pressure, or excessive alcohol use. To avoid leg swelling on long trips, stand up and walk around often. Ideally, you should get up once an hour. If that's not possible, then exercise your feet and lower legs while sitting. This will help the veins move blood back toward the heart.
Treatment of edema focuses on correcting the underlying cause of the fluid accumulation. In addition, a low-salt diet and avoiding excess fluid intake usually helps. If you are not short of breath, elevating your legs above the level of your heart also will keep swelling down. Your doctor might suggest that you take a low dose of a diuretic (water pill).
For swollen ankles and feet caused by pregnancy, you can elevate your legs and avoid lying on your back to help improve blood flow and decrease swelling.
If your have mild leg edema caused by venous insufficiency, you can elevate your legs periodically and wear support (compression) stockings. Sometimes surgery is needed to improve the flow of blood through the leg veins.
No matter what the cause of edema, any swollen area of the body should be protected from pressure, injury and extreme temperatures. The skin over swollen legs becomes more fragile over time. Cuts, scrapes and burns in areas that have edema take much longer to heal and are more prone to infection.
Call your doctor immediately if you have pain, redness or heat in a swollen area, an open sore, shortness of breath or swelling of only one limb.
The prognosis for edema of the legs depends on the cause. For most people with edema, the prognosis is excellent.
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