Oedema

What is oedema?

Oedema refers to swelling that occurs when fluid is trapped in the tissues. It mostly affects the legs, feet, or ankles, but can also occur in other parts of the body, including the abdomen, face, and hands.

Who does oedema mostly affect?

While oedema can affect anyone, it primarily occurs in pregnant women and adults aged 65 or over.

How common is oedema?

Oedema is relatively common due to its wide range of potential causes. Mild oedema often resolves on its own, so the exact frequency of the condition is difficult to determine.

How does oedema impact the body?

Oedema causes certain areas of the body to swell, making it harder to carry out day-to-day activities. Simple adjustments, such as raising the swollen area or walking around after standing or sitting for an extended period, can ease swelling and improve comfort.

In some cases, oedema may indicate an underlying medical problem. It is important to consult a healthcare provider if you experience any symptoms.

Symptoms

The primary sign of oedema is swelling, where part of the body enlarges due to trapped fluid in the tissues. Although it can occur anywhere, it is most commonly seen in the feet, legs, and ankles.

Common symptoms include:

• A part of the body appears larger than it was the previous day.
• The skin over the swollen area looks tight and shiny.
• Difficulty walking, particularly when the legs, feet, or ankles are affected.
• Coughing or shortness of breath.
• A feeling of fullness or tightness in the swollen area.
• Mild discomfort or tenderness in the affected region.

Causes of oedema

After diagnosing oedema, your doctor will determine the cause of the fluid build-up. Possible causes include:

• Gravity: Prolonged standing or sitting can cause fluid to pool in the arms, feet, or legs, leading to dependent oedema.
• Venous insufficiency: Weak vein valves can prevent blood from flowing back to the heart, resulting in varicose veins and fluid accumulation in the legs.
• Underlying health conditions: Disorders such as heart failure, or conditions affecting the lungs, kidneys, liver, or thyroid may present oedema as a warning sign.
• Medication side effects: Oedema may result from certain medications, such as those used to manage pain or blood pressure.
• Poor nutrition: A poor or imbalanced diet, especially one high in sodium, can cause fluid retention.
• Pregnancy: Swelling in the legs during pregnancy occurs as the growing uterus puts pressure on the blood vessels.
• Compromised immunity: Infections, allergic reactions, trauma, burns, or blood clots may also contribute to oedema.

Diagnosis and Tests

How is oedema diagnosed?

To diagnose oedema, your healthcare provider will conduct a physical exam, checking for swelling in areas where the skin appears stretched or shiny. Additional tests may be performed to determine the underlying cause.

Oedema grading

Oedema grading is a scale used by medical professionals to assess the severity of oedema and estimate the amount of fluid in the tissues. The grading is based on how long it takes for a pit (or dimple) to disappear after pressure is applied to the swollen area.

The grading scale includes:

• Grade 1: Instant rebound with a 2-millimetre (mm) dimple.
• Grade 2: Rebound in less than 15 seconds with a 3-4 mm dimple.
• Grade 3: Rebound takes more than 15 seconds but less than 60 seconds with a 5-6 mm pit.
• Grade 4: Rebound takes 2 to 3 minutes with an 8 mm pit.

Management and Treatment

How is oedema treated?

Oedema treatment depends on its cause, particularly when associated with an underlying condition. Possible treatments include:

• Lung disease: If lung conditions such as chronic bronchitis or emphysema cause oedema, quitting smoking may be recommended.
• Chronic heart failure: If oedema is related to heart failure, lifestyle changes, such as monitoring weight, salt intake, and fluid consumption, may be advised. Limiting alcohol intake might also be necessary.
• Medication side effects: If a drug causes oedema, your doctor may adjust your dosage or recommend stopping the medication. However, always consult your doctor before discontinuing any prescribed medicine.

Treatments to ease swelling

In addition to addressing the underlying cause, the following steps can help prevent fluid accumulation:

• Elevate your legs above heart level by placing a pillow underneath them while lying down or sitting.
• Avoid prolonged sitting or standing; take short walks regularly.
• Wear compression stockings or sleeves to prevent fluid build-up. Special oedema shoes are available for those with chronic swelling.
• Reduce your salt intake.
• Follow your doctor's advice regarding medication dosages. Diuretics (water pills) may be prescribed to help eliminate excess fluid.

What foods should I avoid with oedema?

Oedema is often linked to excessive salt intake, as salt can lead to water retention, causing fluid to seep into the tissues. Reducing your intake of salty foods can help improve the condition.

How soon will I feel better after treatment?

Oedema can be either temporary or long-term, depending on the cause. In most cases, swelling lasts for a few days. The first two days may be the most painful, but symptoms should begin to subside by the third day. Adhering to your treatment plan will help reduce the swelling, but you should contact your doctor if it persists for several days.

Prevention

How can I prevent oedema?

While preventing oedema may be difficult if it results from underlying medical conditions like heart failure or kidney disease, your healthcare provider will help you manage your symptoms.

If oedema is related to high salt intake, reducing your consumption of salty foods can help. Moving around regularly and avoiding long periods of sitting or standing can also prevent fluid from accumulating in the tissues.

Outlook / Prognosis

What can I expect if I have oedema?

You should always seek medical advice if you experience swelling. Left untreated, oedema can worsen and lead to serious health complications. Depending on the underlying cause, oedema may be temporary or permanent, but treatments are available to manage the condition.

Living With

How can I take care of myself?

To ease swelling, follow these steps:

• Make lifestyle changes such as quitting smoking and improving your diet.
• Move around frequently.
• Elevate your legs while sitting or lying down.
• Wear compression garments as recommended.

Protect the swollen areas from injury, as damage to the skin over the swollen area can take longer to heal and is more prone to infection.

When should I contact my healthcare provider?

Seek medical attention if you experience any of the following:

• Pain or skin discolouration in the swollen area.
• An open sore on the swollen area.
• Shortness of breath.
• Swelling that affects only one limb.
• Difficulty walking or moving.

What questions should I ask during my appointment?

• What is causing my oedema?
• Should I reduce my salt intake?
• Are there any side effects to the treatment?
• Should I wear compression socks for ankle swelling?

A Note from MD.co.uk

Oedema is a common condition with varying degrees of severity. Swelling during pregnancy is normal, especially as the due date approaches. Mild cases of oedema often resolve on their own, but more severe swelling may require medication or other treatments.

Consult your doctor for a thorough examination if swelling occurs unexpectedly and you are not pregnant, as oedema could indicate an underlying medical issue. Early diagnosis and treatment improve the chances of a positive outcome.