What is Edema?


Edema is observable swelling from fluid accumulation in body tissues. Edema most commonly occurs in the feet and legs, where it is referred to as peripheral edema.

The swelling is the result of the accumulation of excess fluid under the skin in the spaces within the tissues. All tissues of the body are made up of cells and connective tissues that hold the cells together. This connective tissue around the cells and blood vessels is known as the interstitium.

Most of the body’s fluids that are found outside of the cells are normally stored in two spaces; the blood vessels (as the “liquid” or serum portion of your blood) and the interstitial spaces (not within the cells). In various diseases, excess fluid can accumulate in either one or both of these compartments.

The body’s organs have interstitial spaces where fluid can accumulate. An accumulation of fluid in the interstitial air spaces (alveoli) in the lungs occurs in a disorder called pulmonary edema.

In addition, excess fluid sometimes collects in what is called the third space, which includes cavities in the abdomen (abdominal or peritoneal cavity – called “ascites”) or in the chest (lung or pleural cavity – called “pleural effusion”).

Anasarca refers to the severe, widespread accumulation of fluid in the all of the tissues and cavities of the body at the same time.

Types of Edema

Lower extremity disease
Clinically, there are two types of edema:

1. Pitting
2. Non-pitting edema

Pitting edema is the term used to describe edema when pressure applied to the skin of the swollen area is released and an indentation is left behind. For example, when the skin is pressed with a finger or when stockings or socks induce indentation.

Non-pitting edema is the term used to describe edema when this pressure-induced indentation does not occur. Non-pitting edema usually occurs in the arms and legs.

Occasionally pitting edema and non-pitting edema can occur without an underlying disease and it is then known as idiopathic edema. This is most common in women who experience it in their legs and feet when they are pre-menstrual or pre-menopausal – it is then often known as cyclical edema.

What are Some Symptoms of Edema?

Symptoms of edema may include:

  • Persistent indentation of the skin (Pitting)
  • Swelling
  • Swollen feet, ankles and legs
  • Burning, soreness, tingling
  • Numbness
  • Cramps
  • Water retention or interstitial fluid
  • Puffiness
  • Abdominal bloating
  • Night sweats
  • Skin that is warm or hot to the touch

How is Edema Diagnosed?

The medical diagnoses of pitting and non-pitting edema are determined by the symptoms during a physical examination by a qualified physician.

The medical doctor will examine the skin over the swollen area to check whether it may be stretched or shiny. By pushing gently on the swollen area for approximately 15 seconds, a dimple or indentation may be caused.

Additional tests such as a urine test, blood test, a chest X-ray and electrocardiogram (ECG) may also be performed to confirm the cause of the edema.

Edema itself is usually a symptom of an underlying condition and can be noticed as swelling or puffiness of your face, hands, feet, legs, or around your eyes. Amongst others edema can indicate disease of the heart, liver, thyroid, lymphatic system or kidneys (causing salt retention).

If anyone experiences shortness of breath, chest pain, redness or heat in a swollen edematous area, or a swelling of only one limb, they should consult a licensed medical doctor immediately.

Also, pregnant women who notice signs of edema should seek professional medical help. Because edema can be a symptom of a serious underlying disorder, and can cause serious consequences itself, it is always important to seek medical advice.

How to Deal with Edema

Depending on the causes of edema and whether it is temporary or permanent, the handling for it usually focuses on addressing the underlying condition that is causing it, as determined by a physician.

A low dose of a diuretic (water pill) may be prescribed by a licensed healthcare professional to reduce the swelling and help you expel the excess fluid, but it is important to remember this just addresses the symptom and is not necessarily addressing the cause.

If a blocked or damaged blood vessel is suspected as one of the causes of edema, surgery may be needed to improve the flow of blood.

Blood thinners may also be prescribed by your physician to break down blood clots, which can cause edema. As the clot begins to break down, fluid drainage improves and thus swelling is reduced.

Take care of sensitive skin and protect any swollen edematous areas of the body from pressure, injury and extreme temperatures. The skin over swollen areas becomes more fragile over time. Cuts, scrapes and burns in areas that have edema take much longer to recover and are open to infection.

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