Edema

Edema

Edema is the abnormally high accumulation of fluid in any given location in the body. Edema can result from trauma, as in a sprained ankle, or from a chronic condition such as heart or kidney failure. The word edema is from the Greek and means swelling. The presence of edema can be an important diagnostic tool for the physician. A patient who is developing congestive heart failure often will develop edema in the ankles. Congestive heart failure means that the heart is laboring against very high blood pressure and the heart itself has enlarged to the point that it is not effectively circulating the blood. Excess fluid will leave the circulatory system and accumulate between the cells in the body. Gravity will pull the fluid to the area of the ankles and feet, which will swell. The physician can press on the swollen area and the depression left by his finger will remain after he/she lifts the pressure. The patient with congestive heart failure will develop edema in the lungs as well, and thus has a chronic cough.

Individuals who have liver failure, often because of excessive alcohol consumption over a period of years, will develop huge edematous abdomens. The collection of fluid in the abdomen is called ascites (from the Greek word for bag).

The presence of edema is not a diagnosis in itself. It signifies a more serious clinical condition that requires immediate attention. The failing heart reaches a point when it can no longer cope with the huge load of fluid and will become an ineffective pump. At that point, the only cure for the patient is to undergo a heart transplant. If the underlying problem is kidney failure, the patient can be placed on a dialysis machine several times a week to filter the excess water from the system along with any accumulated toxins.

Other medical conditions may also induce edema, including left-sided heart failure, which can cause

pulmonary edema as fluid shifts into the lungs; rightsided heart failure, which can cause swelling in the tissue of the lower legs and feet; kidney disease, because the accompanying decrease in sodium and water excretion can result in fluid retention and overload; thyroid or liver disease, which change fluid movement in and out of the tissues; and malnutrition.

Edema may occur in a single leg because of blood clots, which cause pooling of fluid; weakened veins that allow blood to gather; inflammatory diseases such as gout or arthritis; lymphedema (blocked lymph channels that prevent proper draining); and tumors that compress leg vessels and lymph channels.

Symptoms vary depending on the cause of edema. In general, weight gain, puffy eyelids, and swelling of the legs may occur because of excess fluid volume. Pulse rate and blood pressure may be elevated, while hand and neck veins may appear swollen.

Diagnosis of edema often includes one or more of the following: echocardiography, ECG (electrocardiogram), serum electrolyte tests, urinalysis, x rays, kidney function tests, and liver function tests.

Treatment of edema depends on its cause. Generally, the patient may be told to reduce sodium intake; maintain proper weight (extra weight slows fluid circulation and puts pressure on the veins); exercise to stimulate circulation; elevate the legs; use support stockings to promote circulation and decrease pooling of fluid due to gravity; get regular massages, unless blood clots are a problem; and stand and/or walk at least every hour or two during travel.

In addition, physicians frequently prescribe diuretics, digitalis, and diet for medical conditions that result in excess fluid volume. Diuretics are medications that promote urination of sodium and water. Digoxin is a digitalis preparation that can decrease heart rate and increase the strength of the heart’s contractions. Adequate non-animal-source protein intake is also important, and patients should avoid alcohol, caffeine, sugar, dairy products, soy sauce, animal protein, chocolate, olives, and pickles.

In terms of alternative treatments, diuretic herbs can also help relieve edema. One of the best herbs for this purpose is dandelion (Taraxacum mongolicum ), since, in addition to its diuretic action, it is a rich source of potassium. (Diuretics flush potassium from the body and it must be replaced to avoid a deficiency of this essential element mineral.) Hydrotherapy using daily contrast applications of hot and cold (either compresses or immersion) may also be helpful.