Understanding Edema in One Article

Author: Chen Zhou Shanghai Changhai Hospital

Cartoon: Chen Zhou Shanghai Changhai Hospital

Reviewer: Mei Xiaobin, Chief Physician, Shanghai Changhai Hospital

"Edema" is a common symptom in life, especially for many elderly people who are prone to leg or foot swelling after fatigue. What is going on? Is it caused by poor kidney function? In fact, many people come to the nephrology department for edema, but the final diagnosis is often not caused by kidney problems, but by many other diseases.

What is edema?

Edema refers to palpable swelling caused by the expansion of interstitial fluid volume. In layman's terms, it means that there is too much water in the human body, and it can be clearly seen that it is "swollen". The so-called palpable swelling means that if you press the edema area with your fingers for 5 seconds, an obvious small pit will appear on the skin of the edema area. This type of edema is also called "pitting edema."

Figure 1 Copyright image, no permission to reprint

There are two parts of the human body that are prone to edema: the first is the lower limbs, because water tends to flow to lower places, and during the day we usually stand or sit, so it is easy to get swollen legs or feet; the second is the eyelids, because the connective tissue under the eyelids is very loose and weak. When you sleep in a supine position at night, it is easy to find swollen eyelids or the whole face when you wake up in the morning. Of course, sometimes, when too much fluid accumulates in large quantities and widely, it can cause systemic edema, such as edema in the upper limbs, back, scrotum and other parts.

What are the causes of edema?

There are many reasons for edema in life. Edema is a non-specific symptom, which can be caused by many different situations.

• “Exertional” edema : When traveling, long periods of time in trains, cars and other means of transportation, or sitting for long periods of time can cause calf edema.

• Physiological edema : Women may experience edema in different parts of the body during pregnancy, before or during menstruation, which usually disappears after menstruation.

• Pathological edema: edema caused by disease. In hospitals, the most common diseases that cause edema are heart failure, liver cirrhosis, nephrotic syndrome, as well as thrombosis in leg blood vessels, varicose veins, and obstructed lymphatic return.

•Drug-induced edema : Edema may be an adverse reaction to certain drugs, such as certain hormones, antihypertensive drugs such as dihydropyridine, etc.

• Malnutrition-induced edema: Although times have improved and this type of edema is less common, some slim women may experience edema during periods of deliberate dieting.

What kind of edema requires urgent medical attention?

After understanding the common causes of edema, if you experience new unilateral lower limb edema, hand edema, abdominal or perineal edema, edema of the skin around the eyes, or leg swelling after travel that does not subside after resting for a few days, it is recommended that you see a doctor as soon as possible!

The department you visit may be internal medicine, cardiology, nephrology or vascular surgery.

How to treat and relieve edema?

If you want to better treat edema, you must first identify the cause. Only by finding the cause can the treatment of edema be more purposeful and effective. As the saying goes, professional matters should be left to professional doctors. In addition, the following methods can be used to relieve edema.

•Dietary adjustments: A low-salt diet can improve edema. Eating too much salt will promote water and sodium retention, which is the main mechanism of edema.

• Raise your calves: You can raise your legs appropriately when sleeping at night, such as putting a pillow under your legs, which can reduce edema in the legs, ankles and feet.

•Use "compression stockings ": These socks fit tightly around the ankles and legs and can reduce leg swelling. Compression stockings come in different sizes, so be careful when buying them.

•Use medication under the guidance of a doctor : Diuretics can reduce edema, but they also have adverse reactions. For example, they may cause electrolyte imbalance and may further aggravate edema, so don’t take medication randomly!

•Precautions for long-distance travel : Do not sit for long periods of time. Get up and walk around more often. When sitting, you can massage your legs, stretch your feet, or curl your toes. Bend your knees and move your legs and feet frequently.

It should be noted that not all types of edema require treatment, such as edema during pregnancy and menstruation.