EDEMA

Edema is swelling caused by excess fluid trapped in your body's tissues. Although edema can affect any part of your body, it's most commonly noticed in your hands, arms, feet, ankles and legs.

Edema can be the result of medication, pregnancy or an underlying disease — often heart failure, kidney disease or cirrhosis of the liver.

Taking medication to remove excess fluid and reducing the amount of salt in your food usually relieves edema. When edema is a sign of an underlying disease, the disease itself requires separate treatment.

Symptoms

Signs and symptoms of edema include:

• Swelling or puffiness of the tissue directly under your skin
• Stretched or shiny skin
• Skin that retains a dimple after being pressed for several seconds
• Increased abdominal size

When to see a doctor
Make an appointment to see your doctor if you have swelling, stretched or shiny skin, or skin that retains a dimple after being pressed. Seek immediate medical attention if you experience:

• Shortness of breath
• Difficulty breathing
• Chest pain

Causes:

Edema occurs when tiny blood vessels in your body (capillaries) leak fluid and the fluid builds up in surrounding tissues, leading to swelling.

Mild cases of edema may result from:

• Sitting or staying in one position for too long
• Eating too much salty food
• Premenstrual signs and symptoms
• Pregnancy

Edema can be a side effect of some medications, including:

• Drugs that open blood vessels
• Calcium channel blockers
• Nonsteroidal anti-inflammatory drugs
• Estrogens
• Certain diabetes medications called thiazolidinediones

In some cases, however, edema may be a sign of a more serious underlying medical condition. Diseases and conditions that may cause edema include:

• Congestive heart failure. When one or both of your heart's lower chambers lose their ability to pump blood effectively — as happens in congestive heart failure — the blood can back up in your legs, ankles and feet, causing edema.
• Cirrhosis. Fluid may accumulate in your abdominal cavity (ascites) and in your legs as a result of cirrhosis, a liver disease often caused by alcoholism.
• Kidney disease. When you have kidney disease, extra fluid and sodium in your circulation may cause edema. The edema associated with kidney disease usually occurs in your legs and around your eyes.
• Kidney damage. Damage to the tiny, filtering blood vessels in your kidneys can result in nephrotic syndrome. In nephrotic syndrome, declining levels of protein (albumin) in your blood can lead to fluid accumulation and edema.
• Weak or damaged leg veins (chronic venous insufficiency). One-way valves keep the blood in your leg veins moving toward your heart. If the valves stop working properly, blood can pool in your lower legs and cause swelling.
• Inadequate lymphatic system. Your body's lymphatic system helps clear excess fluid from tissues. If this system is damaged — for example, by cancer surgery — the lymph nodes and lymph vessels draining an area may not work correctly and edema results.

Risk Factors

Due to the fluid needed by the fetus and placenta, a pregnant woman's body retains more sodium and water than usual, increasing the risk of edema.

Your risk of edema may be increased if you take certain medications, including:

• Drugs that open blood vessels
• Calcium channel blockers
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Estrogens
• Diabetes medications called thiazolidinediones

Complications:

If left untreated, edema can cause:

• Increasingly painful swelling
• Difficulty walking
• Stiffness
• Stretched skin, which can become itchy and uncomfortable
• Increased risk of infection in the swollen area
• Scarring between layers of tissue
• Decreased blood circulation
• Decreased elasticity of arteries, veins, joints and muscles
• Increased risk of skin ulcers