Edema

Edema General Information

Edema is a general medical term referring to the accumulation of large quantities of fluid in the interstitial spaces (these are spaces in the tissue that are not included in the blood vessels). The accumulation of fluids leads to swellings of the affected body parts, and can affect limbs (the peripheral version of the affection) but can also affect internal organs, as they too have interstitial spaces – for example, the air spaces in the lungs (alveoli). There are also cases where the fluid accumulations appear in the body cavities, either abdominal or peritoneal, or in the lung or pleural cavity. The Edema can be severe and widespread, under the form of large accumulations of fluid widespread in the organism, in the tissues as well as in the cavities, and this form of the disease is called anasarca.

Apart from the localization of the fluid accumulations, the affection can be also categorized in two types: pitting and non-pitting Edema. The pitting form of the illness is characterized by the fact that pressure causes indentations in the affected body part – for example, if slight pressure is applied with the finger, the indentation will persist over a period of time after removing the finger, while the non-pitting form of the affection is simply characterized by the lack of the appearance of these indentations. The non-pitting form is usually localized in the limbs (arms or legs), and is more commonly caused by disturbances of the lymphatic system, or can appear as a complication of hyperthyroidism affections. This version of the disease is more difficult to treat than the pitting kind.

Edema Symptoms

The symptoms of the disease may appear as obvious to the patient as well as to the doctor, under the form of swellings of the arms and legs, ankles, wrists or abdomen. Initially, the swelling will appear as the day progresses, but later on as the disease sets in, the swellings will appear immediately in the morning and will continue to worsen for the entire day. In severe cases, there may appear ulcerations on the skin of the affected limbs, leading to further complications. If the Edema is undetected and left untreated, future symptoms that are likely to appear include a rise in the patient’s blood pressure, accompanied by mild to severe headaches worsening with time. The patient will feel the need to urinate more often throughout the day, and will start experiencing palpitations. The patient will also rapidly gain weight due to the increased fluid retention within the body, and may experience widespread swellings in other body parts.

Although the signs of Edema might not be very visible in the initial stages of the disease, the patient may feel that things are “getting smaller” around him. He or she may have difficulties putting on shoes, or the rings may not fit any more – or if they are already on, they are very tight. Tight bracelets may become a problem as well, and even socks or any other tight piece of clothing can become bothersome. In such cases, if the problem appears constantly over a period of time, it is advised that you check with your health care specialist in order to further check the problem and obtain a clear diagnosis.

Edema Treatment

The treatment of Edema starts by treating the underlying causes of the disease. Typically, it is caused by affections of the lungs, kidney, liver, heart or obstructions of the blood vessels. Common causes are also malnutrition, hyperthyroidism and affections of the lymphatic system. The real cause must be identified and treated as well, before starting the treatment of the Edema in itself.

Treatment usually consists of a combination between a controlled diet and medication. The patient should avoid high salt intakes, as salt favors the retention of water in the organism, and also should try to keep the affected body part elevated as much as possible, as it helps drain the fluid from the accumulation. In cases of localized Edema in the legs or feet, the patient should avoid long periods of standing or sitting, as a lying down position is much more favorable for the treatment.

Diuretic treatment may also be applied. The most commonly used are the diuretics that assist the functions of the kidneys, in regulating water and salt balance, and as examples of such medications there are butethamides (Bumex), torsemides (Demedex) or furosemides (Lasix). These are prescribed in varying dosage, depending on the patients medical records, general health conditions and current health state, and administered either orally (in most cases) or intravenously, for more effective and  prompt results. In cases where this treatment is not sufficient, the doctors may also prescribe supplementary intakes of thiazide diuretics, such as hydrochlorthiazide (Hydrodiuril) or metolazone (Zaroxolyn).

In some cases, nutritional supplements or additional medication may be required, in order to prevent depletion of body potassium due to the diuretics. Further modifications in the diet may be in order, to compensate for the potassium loss, and the patient diagnosed with Edema will be told to consume potassium-rich food, such as potatoes, tomatoes, certain fruits and orange juice. Among the medications that can be prescribed in such situations, there are spironolactone (Aldactone), amiloride (Midamor) and triamterene (Dyrenium). Also, in case of high bicarbonate concentrations, another medication that is commonly used is acetazolamide (Diamox). High bicarbonate concentrations are sometimes encountered in patients that are regularly taking diuretics.

Some patients with impaired kidney functions may not need nutritional supplements or additional medication, as their kidneys already retain an abnormal quantity of potassium in the organism. It is recommended that you closely follow the prescription, dosage and intake guidelines given by your personal health care specialist, in order to avoid further complications and / or intoxications. Also, a general health exam may be in order before receiving an exact diagnose and treatment, since Edema is often underlined by other affections and treatment may depend on the treatment associated with the other affections. It is strongly advised that the patient does not self-medicate, instead going to a doctor specialized in that area of expertise.