Edema: Symptoms, Causes & Treatment for Swelling Relief

Oedema refers to the presence of excess fluid in a particular area of the body. Fluid leaves the bloodstream and accumulates in the interstitial space; thus, the size increases. Anywhere in the body that fluid can accumulate may show signs of oedema. Many patients suffering from chronic diseases are prone to developing Oedema. Oedema itself is not typically considered a disease but an indicator of underlying problems.

In medicine, 'Oedema' is defined as a process that involves the accumulation of fluid in a region of the body. Normally, there is continuous movement of fluid in both directions between blood vessels and the interstitial space. When there is an issue with fluid movement (either fluid leaking into the interstitial space or not draining from the interstitial space back into the bloodstream), then swelling occurs in the area. Although generally non-painful, swelling due to fluid accumulation can be painful.

Oedema can be classified into two broad categories. Generalised oedema is characterised by widespread swelling throughout the body, while localised oedema occurs in one area. Examples of each type of swelling include localised swelling from a bruise or sprain versus generalised swelling in the arms and legs, which could indicate an underlying fluid imbalance.

Depending upon location, oedema can be classified in many different ways:

• Cerebral oedema is brain swelling.
• Pulmonary oedema is fluid buildup in the lungs.
• Pleural effusion refers to fluid building up around the lungs.
• Pericardial effusion is fluid buildup around the heart.
• Ascites is fluid buildup in the abdominal cavity.
• Periorbital oedema refers to swelling around the eye.
• Lymphoedema refers to swelling due to blockage of lymphatic vessels.

The most apparent sign of oedema is swelling.

Other symptoms include:

• redness of the affected area(s)
• warmth
• tenderness
• decreased mobility of the area affected

Patients with mild localised swelling may have difficulty fitting into clothing or shoes that were previously comfortable. Another sign of oedema is slow, unexplained weight gain from retained fluid. More severe swelling may impede daily activities (e.g., closing fists or walking).

Oedema can be caused by a variety of factors. The most common cause of localized edema is inflammation caused by trauma, infection or allergic reaction. During pregnancy, fluid volume and blood vessel compression result in swelling in the legs and feet. Long periods spent standing or sitting allow fluid to collect in the legs and feet.

Some medications produce fluid retention as a side effect. High levels of sodium in the diet, alcohol abuse and poor circulation (venous insufficiency) can all contribute to or exacerbate swelling due to fluid accumulation. Sleep apnoea has also been found to contribute to fluid accumulation.

Heart disease, liver disease, kidney disease, and pregnancy are among those conditions that place individuals at greatest risk for developing oedema. Physical activity reduces your risk of developing oedema. Spending time sitting or standing for extended periods increases your risk for developing oedema. A diet high in sodium, excessive use of alcohol and obesity also contribute to developing swelling due to fluid accumulation.

Your doctor will start by assessing your symptoms, medical history and your lifestyle habits. They may look at the affected area(s) and apply pressure to determine if you have pitting oedema (an indentation remaining after pressure is released). Additional testing will be done to diagnose any underlying condition(s) that may be causing your swelling. Blood work will be performed in certain situations to test your kidney, liver and thyroid function. Urine analysis may be completed along with imaging studies, such as an ultrasound/chest X-ray/electrocardiogram, based on suspicion of heart disease. Identifying any underlying condition is important to choosing effective treatment.

Treatment options depend on the underlying reason for your swelling. If you have swelling due to an existing condition like heart failure/kidney disease, treating that condition first is necessary. Dietary modifications will be recommended as needed (especially lowering sodium intake) to minimise additional fluid retention.

Medications that act as diuretics ("water pills") will help remove extra fluid from your body via urination and are commonly prescribed for generalised oedema. If your swelling was caused by an inflammatory response, then anti-inflammatory medications may be prescribed as well. Medications that contribute to your swelling may need to be adjusted by your physician. Cold compresses or ice help reduce localised swelling (from minor injuries).

While receiving medical treatment, there are many things that you can do at home to help manage your swelling.

• Elevating your affected limb(s) (particularly your legs and feet) will encourage fluid to flow back to your heart and alleviate pressure on blood vessels.
• Try to get up every so often during long periods of sitting or standing.
• Lowering your sodium intake is perhaps the simplest way you can modify your diet to aid in reducing swelling.
• Maintaining a healthy weight and avoiding alcohol will promote optimal circulation.
• Compression stockings and sleeves are useful in helping to control swelling in the legs, but should be approved by your physician prior to wearing them.

Managing conditions and lifestyles that can lead to oedema is an ideal method for preventing it from occurring. Regular checkups with your primary care physician provide an opportunity for detecting chronic conditions that could lead to significant fluid retention. Eating a low-sodium diet, engaging in physical activity regularly and minimising lengthy sedentary episodes will reduce your chance of developing oedema. Not smoking, limiting alcohol consumption, and maintaining a healthy body weight will protect your cardiovascular system and lymphatic system. Adhering strictly to your doctor's treatment plan is the most effective way to prevent future bouts of swelling.

Contact your doctor if you notice shortness of breath along with oedema, if it appears suddenly and without warning or if it does not seem related to an injury or surgery. Seek prompt medical attention if you have swelling with severe pain, trouble breathing, fever, coughing up blood and vomiting and yellow discolouration of the eyes. A spontaneously swollen foot and calf can be a sign of a blood clot, requiring immediate assessment.

Emergency services should be contacted immediately if swelling develops rapidly throughout your body due to an allergic reaction (such as facial or mouth swelling) since this indicates a medical emergency. Don't wait; seek assistance if you suspect you have a serious issue.