What is Edema?
By definition, an edema is accumulation of fluid in the extracellular space of the body. This condition happens because of fluid leaves the blood vessels and accumulates in the tissue or in certain cavities of the body such as the abdominal cavity.
“Heavy, swollen legs” in the afternoon and ankle edema are a typical kind of edema. But fluid accumulations can occur throughout the body and feel like a general feeling of swelling that affects several areas. Edema is characteristic of numerous diseases and disorders of metabolism. In some cases they are temporary and not so important as due to hormonal changes prior to menstruation. But fluid accumulation in the tissues may also be due to serious diseases such as heart failure or liver cirrhosis or less severe such as venous insufficiency or diabetes.
Edema is diagnosed by physical examination and with complete anamnesis where inflammation is present in specific circumstances. Edema can be due to menstrual cycle, outside temperature, drug intake, such as the contraceptive pill, diet, lifestyle, physical exercise, weight gain, pregnancy, menopause, staying at great heights, excessive consumption of salt, burns, having undergone a surgical operation. In addition, the practitioner may check analytical blood, urine and other complementary tests such as ultrasound, X-rays and renal or cardiological examinations.
The treatment of edema is focused on the cause that produces edema. If the edema responds to an inadequate lifestyle, the patient must be re-educated to practice healthy habits, in terms of food and physical exercise. It may also be necessary to institute a treatment that improves the venous return, for example by means of compression and guiding certain drugs to reverse the situation.
What Causes Edema?
Edema can be caused by numerous causes. Edema can appear because of the pressure inside the blood vessels which has increased (like when there are varicose veins), also because the number of proteins decrease which are the ones that keep the water in the intravascular compartment and do not let pass to the extracellular when there is cirrhosis.
Edema also appears when the blood vessels are more permeable than they should be (in cases of allergies and burns) and if there is an obstruction of the lymphatic vessels, as in lymphedema. All these causes can mix together and cause edema together.
In relation to the specific causes of edema, among others may be the following:
- Heart disease (eg, heart failure, valvular lesions, heart inflammation).
- Pulmonary diseases (such as COPD, asthma, chronic bronchitis and pulmonary emphysema)
- Problems of circulation and venous weakness.
- Renal diseases (renal inflammation, nephrotic syndrome).
- Liver diseases (inflammation of the liver, cirrhosis of the liver).
- Hormonal causes (hyperthyroidism, hypothyroidism, premenstrual syndrome (PMS), menopause, pregnancy)
- Diet poor in vitamin B1, B5 and B6 and albümin
- Weight gain
- Sedentary lifestyle (poor physical exercise) or spend much of the time sitting or standing without moving
- Post-operative period after an intervention
- Stay high which can lead to pulmonary edema
- Infections and inflammations
- Protein deficiency (hypoproteinemia)
- Neurological diseases
- Tumor Diseases
- Injuries (sports accident or head trauma)
- Excessive consumption of salt (especially in people with a tendency to edema formation and who are overweight and sedentary)
When a patient has accumulated fluid in the tissue (edema) it is necessary to make an examination that doctor can make the proper diagnosis. Causes of edema can be diseases that require treatment. For that reason it is important to medically clarify the cause of the edema.
To assure the diagnosis, the doctor first asks questions to patient. It is important to determine the physical condition of the patient, especially as regards cardiovascular symptoms in case of a medical emergency. To make a correct diagnosis of edema is also monitored if there has been a change in the diuretic patterns of the affected.
Some types of edema are genetic, so the clinician may also ask about family history. In addition, there is a type of edema called ‘’idiopathic cyclic edema’’ which is associated with certain circumstances like the menstrual cycle.
Thorough physical examination is performed which alterations of existing veins such as varicose veins are followed by blood and urine tests. In this case, the values of proteins and electrolytes (such as potassium) which are the ones that will inform whether here is a cardiac or renal overload. According to the supposed cause of edema, it is advisable to carry out other tests. These tests can be for example, ultrasounds, radiological exams, special blood tests, cardiac exams and many more.
The diagnosis of edema may require the participation of several medical specialists, such as a cardiologist, vascular surgeon, endocrinologist or digestive specialist.
To find the proper treatment of edema (fluid accumulation in the tissue), it is important to know and treat the primary disease. Movement and sport are fundamental as long-term treatment of edema, especially when the cause is circulatory disorders of the veins of the legs. The movement activates the pumping of the heart and causes the liquid to leave the tissue. The same can be achieved with a special venous gymnastics.
The affected limb should be raised to lower inflammation. In addition, for the edema of the legs may be convenient to apply a compressive therapy (compression bandage, compression stockings). A special massage (manual lymphatic drainage) can also help treat edemas and accelerate fluid out of the tissue. To quickly remove fluid from the body, your doctor prescribes liquid-eliminating medications called’’ diuretics’’.
If the cause of the edema is a slight muscle weakness, medicines for the veins with plant active substances such as calcium dobesilate, diosmin, escina (Horse Chestnut) or ruscus asculeatus may be helpful. These substances improve symptomatology with few side effects.