Edema is swelling that occurs as a result of excessive fluid accumulation in your body’s tissues. Although most commonly seen in the lower parts of the body such as legs, feet, and hands, edema can occur anywhere in the body, including the lungs.
What is Edema?
Edema is swelling that occurs as a result of abnormal amounts of fluid accumulation in intercellular spaces. Your body’s tissues normally contain some fluid, but this fluid should remain within the circulatory system. Due to various health problems, this fluid leaks into tissues, causing swelling. The most distinctive feature of edema is that when you press on the swollen area with your finger, a depression forms and this depression slowly returns to its original state.
What are the Types of Edema?
Edema is divided into different types according to the area where it occurs and the underlying cause. Peripheral edema is the most common type and is seen in legs, feet, and hands. Pulmonary edema is fluid accumulation in the lungs due to the heart’s inability to pump blood effectively and is an emergency situation. Besides these, there are different types of edema such as fluid accumulation in the abdominal cavity (ascites) and swelling around the eyes (periorbital edema).
The main types of edema are:
Peripheral Edema:
Swelling seen in feet, ankles, and legs. It is usually a result of fluid accumulating in the lower parts of the body due to gravity. Conditions such as heart failure, kidney, or liver diseases can lead to this type of edema.
Pulmonary Edema:
Fluid accumulation in the air sacs of the lungs. It usually occurs as a result of decreased pumping power of the heart due to heart failure. It is a life-threatening emergency condition that causes symptoms such as shortness of breath, cough, and wheezing.
Ascites (Abdominal Edema):
Abnormal amounts of fluid accumulation in the abdominal cavity. It usually occurs as a result of conditions such as liver cirrhosis or advanced heart failure, causing bloating and discomfort in the abdomen.
Cerebral Edema:
Fluid accumulation in brain tissue. It can occur due to reasons such as head trauma, infection, or tumor and can lead to serious symptoms such as loss of consciousness and headache, requiring emergency treatment.
Macular Edema:
Fluid accumulation in the retinal layer of the eye. It occurs as a result of eye diseases such as diabetic retinopathy and can cause vision impairment.
What Causes Edema?
Edema usually occurs due to an underlying medical condition. The most common cause is heart failure resulting from your heart’s inability to pump blood adequately to the body. In heart failure, pressure in vessels increases and fluid leaks into tissues. Other important causes include kidney diseases (inability to excrete excess salt and water from the body), liver diseases (decreased protein production in blood), and venous insufficiency (blood pooling in leg vessels).
The main causes of edema are:
- Heart Failure: Your heart’s inability to pump blood adequately increases pressure in vessels and fluid leaks into tissues. This condition usually causes edema in legs and feet, also due to the effect of gravity.
- Kidney Diseases: If kidneys cannot excrete excess fluid and salt from the body, edema occurs. This condition usually leads to swelling around the eyes and in the legs.
- Liver Diseases (Cirrhosis): The liver’s reduction in blood protein (albumin) production causes fluid in vessels to leak into tissues.
- Venous Insufficiency: The inability of valves in leg vessels to function properly leads to blood pooling in legs and edema formation.
- Medications: Edema can be seen as a side effect of some blood pressure medications (calcium channel blockers), non-steroidal anti-inflammatory drugs, and corticosteroids.
- Prolonged Standing or Sitting: Especially in hot weather, blood circulation slows due to the effect of gravity and can cause fluid accumulation in legs and feet.
- Pregnancy: Edema can be seen due to increased fluid amount in the body and pressure of the growing uterus on vessels.
What are the Symptoms of Edema?
The most obvious symptom of edema is swelling of your body and this swelling being soft when touched. The depression formed when you press on the swollen area with your finger (pitting edema) is an important sign. Besides this, other symptoms may appear depending on the cause and location of edema. For example, in pulmonary edema, shortness of breath, cough, and wheezing can be seen.
The most common symptoms of edema are:
- Swelling: You notice visible swelling in feet, ankles, legs, or hands.
- Pitting Edema: When you press on the swollen area with your finger, a temporary depression forms even after you remove your finger.
- Skin Tightness: The skin in the edematous area may take on an overly tight and shiny appearance.
- Feeling of Heaviness: You may experience more weight or fullness than normal in the swollen limb.
- Joint Stiffness: Especially swelling of joints like ankle or knee can make it difficult for you to move.
- Shortness of Breath: In case of pulmonary edema, you may have complaints such as difficulty breathing, cough, or wheezing.
Who Gets Edema?
The main groups at risk for developing edema are:
- Those with Heart Failure: Decreased pumping power of the heart can cause fluid accumulation in the lower parts of the body.
- Kidney and Liver Patients: Impairment of these organs’ functions leads to the body’s inability to maintain fluid and salt balance.
- Elderly Individuals: With age, there may be natural slowing in the circulatory system and organ functions.
- Pregnant Women: Edema may occur due to increased fluid amount in the body during pregnancy and pressure of the growing uterus on vessels.
- Those Leading Sedentary Lives: Prolonged sitting or standing can slow blood circulation and cause edema in legs.
- Those Using Certain Medications: Edema may develop as a side effect of some blood pressure medications or pain relievers.
- Excessive Salt Consumers: Excess salt causes the body to retain more water, facilitating edema formation.
How is Edema Diagnosed?
Edema diagnosis begins primarily with physical examination and taking the patient’s history. Your doctor evaluates the location of swelling, when it started, and other accompanying symptoms. Various tests are performed to determine the underlying cause of edema. Blood tests, urinalysis, ECG, heart ultrasound (echocardiography), and kidney function tests are the most commonly used methods in making the diagnosis.
The main methods used to determine the cause of edema are:
- Physical Examination and History: Your doctor examines the edematous area and checks whether there is “pitting edema” by pressing with a finger. Additionally, information is obtained about your medical history, eating habits, and medications you use.
- Blood Tests: Performed to evaluate liver, kidney, and thyroid functions, check blood protein levels, and control electrolyte balance.
- Urinalysis: Your urine sample is examined to evaluate kidney functions.
- ECG and Echocardiography: If heart failure is suspected, these tests are performed to evaluate your heart’s electrical activity (ECG) and pumping power (echocardiography).
- Venous Doppler Ultrasound: If there is suspicion of blood clot (deep vein thrombosis) or venous insufficiency in leg vessels, ultrasound is performed to evaluate blood flow in vessels.
How is Edema Treated?
Edema treatment is planned according to the underlying cause. If the cause of edema is heart failure, heart medications (diuretics, beta blockers, etc.) are used to increase your heart’s pumping power and excrete excess fluid from the body. In conditions such as kidney or liver disease, special treatments for these diseases are also applied. In mild edema cases, lifestyle changes and salt restriction may be sufficient.
The methods applied in edema treatment are:
Treatment of Underlying Disease
The main cause underlying edema (such as heart failure, kidney disease, or liver disease) is treated.
Diuretic Medications (Water Pills)
These medications help your kidneys excrete more salt and water, reducing excess fluid in the body and thus edema.
Lifestyle Changes:
- Salt Restriction: Limiting your daily salt intake prevents your body from retaining water.
- Physical Activity: Regular exercise improves your blood circulation and reduces edema.
- Leg Elevation: Keeping your legs above heart level while resting helps fluid return from legs.
Compression Stockings
Especially in edema due to venous insufficiency, compression stockings are used to reduce swelling in legs and support blood flow.
What are the Risks and Complications of Edema?
Untreated edema can lead to serious complications. The most important risks are worsening of the underlying disease and problems caused by edema itself. The main complications that edema can cause are:
- Pulmonary Edema: Spread of edema to the lungs can cause shortness of breath and respiratory failure. This is a life-threatening condition requiring emergency medical intervention.
- Skin Infections: Prolonged edema can cause stretching and cracking in the skin, making you more susceptible to infections.
- Delayed Wound Healing: Edematous tissues receive inadequate oxygen and nutrients, so your wounds heal later.
- Movement Restriction: Swelling can cause stiffness in joints and movement restriction.
- Worsening of Underlying Disease: Edema may be a sign of worsening of underlying conditions such as heart failure or kidney disease.
When Should You See a Doctor?
If you notice sudden onset or gradually increasing swelling in your legs, feet, hands, or anywhere on your body, you should definitely see a doctor. Especially if there are symptoms accompanying swelling such as shortness of breath, chest pain, palpitations, or dizziness, this may be a sign of an emergency situation and you should go to the nearest emergency room without delay.
You need to see a doctor or emergency room immediately in the following situations:
- Sudden Onset Swelling: If you notice sudden and obvious swelling on one or both sides of your body, especially in your legs.
- Shortness of Breath: If there are conditions such as shortness of breath, wheezing, or difficulty breathing while lying down (orthopnea) accompanying swelling.
- Chest Pain or Pressure: These symptoms may be related to heart failure or heart attack.
- Painful Swelling in One Leg: Sudden onset and painful swelling in one leg requires emergency intervention as it may be a sign of deep vein thrombosis (clot in vessel).
- Weakness and Palpitations: Significant weakness or feeling of irregular heartbeat accompanying edema.
Reference: Edema
