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Edema is swelling due to an accumulation of excess fluid. Your body has set fluid levels and will restore itself to its usual state within 48 hours of taking in extra water under normal circumstances. There are many causes and subtypes of edema including hypertensive, exercise, high altitude, tropical, medication and idiopathic cyclic edema.
Idiopathic Cyclic Edema
To check for edema that is not obvious, you can gently press your thumb over the foot, ankle or leg with slow, steady pressure. If edema is present, an indentation will show on the skin. A professional evaluation to determine the cause of leg swelling is needed. If both legs are swollen, your doctor will inquire about other symptoms and perform a physical examination. A urine test will show whether you are losing protein from the kidneys. Blood tests, a chest X-ray and an electrocardiogram (ECG) may be ordered.
Prevention of edema means preventing the cause. Smoking is the No. 1 cause of chronic lung disease. Congestive heart failure most often is due to coronary artery disease and high blood pressure. To avoid leg swelling on long trips or due to long hours at a desk job, stand up and walk around often; ideally you should get up once per hour. If not possible, then exercise your feet and lower legs while sitting. This will help the veins move blood back toward the heart.
When you repeatedly take laxatives, diuretics or vomit, your body will adapt to being constantly dehydrated by learning to retain more fluid than usual. When you stop these behaviors and start to take a normal diet, your body may continue to retain fluids until it learns that adequate fluid will be available, then it will release the extra fluid. People who abuse laxatives or vomit regularly are at the greatest risk for alternating between dehydration and edema.
It may take from 2 to 6 weeks following long term dehydration for your body to get used to being normally hydrated again and flush out the extra fluid it has been retaining.
Treatment focuses on correcting the underlying cause of the fluid accumulation. In addition, a low-salt diet and avoiding excess fluid intake usually helps. If you are not short of breath, elevation of the legs above the level of your heart will also keep swelling down. A low dose of a diuretic (water pill) used sparingly might be added in some cases.
For swollen ankles and feet caused by pregnancy from the enlarged uterus pushing on the vena cava, elevation of the legs and not lying on your back (either side) helps blood flow and decreases swelling.
Most patients with mild leg edema due to varicose veins can be treated with periodic leg elevation and support (compression) stockings. Sometimes surgery is needed to improve the flow of blood through the leg veins.
Also, no matter what the underlying cause of edema, any swollen area of the body should be protected from pressure, injury and extreme temperatures. The skin over swollen legs becomes more fragile over time. Cuts, scrapes and burns take much longer to heal and are more prone to infection when skin has edema underneath.
When to seek help
Call your doctor immediately if you have pain, redness or heat in the swollen area, an open sore, shortness of breath or swelling of only one limb. If the swelling has never happened before and it persists for more than a couple days, call your doctor's office for advice.
The prognosis for edema of the legs depends on the cause. For most people with edema, the prognosis is excellent.
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Bronchitis: Inflammation of the mucous membrane of the bronchial tubes, frequently accompanied by cough, hypersecretion of mucus, and expectoration of sputum. Acute bronchitis is usually caused by an infectious agent and of short duration. Chronic bronchitis, generally the result of smoking, may also be known as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema.
Capillary: Any of the smallest blood vessels connecting arterioles with venules and forming networks throughout the body.
Carpal Tunnel Syndrome: A common, painful defect of the wrist and hand. It is caused by pressure on the middle nerve in the carpal tunnel. The syndrome is seen more often in women, especially in pregnant and in menopausal women. Symptoms may result from a blow, swelling, a tumor, rheumatoid arthritis, or a small carpal tunnel that squeezes the nerve. Pain may be infrequent or constant and is often most intense at night.
Chronic: Usually Chronic illness: Illness extending over a long period of time.
Congestive: Pertaining to accumulation of blood or fluid within a vessel or organ.
Corpus Luteum: Yellow endocrine body formed in the ovary that secretes estrogen.
Diuretic: An agent increasing urine flow, causing the kidneys to excrete more than the usual amount of sodium, potassium and water.
Edema: Abnormal accumulation of fluids within tissues resulting in swelling.
Electrocardiogram: A test that shows a tracing of the electrical conduction of the heart.
Idiopathic: Arising spontaneously or from an obscure or unknown cause.
Laxative: A substance (food, herb, chemical) that stimulates evacuation of the bowels. Examples include cascara sagrada, senna, castor oil, aloe vera, bisacodyl, phenolphthalein and many others.
Lymph: A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.
Lymphatic System: A network of vessels which collect fluid from the tissues of the body and return it to the blood. Lymphatic fluid (also called lymph) is rich in white blood cells that fight infection and an important part of the body's immune system.
ng: Nanogram: 0.000000001 or a billionth of a gram.
Preeclampsia: A toxic condition developing in the last 4 or 5 months of pregnancy that is characterized by a sudden rise in blood pressure, excessive weight gain, generalized edema (especially hands, ankles, feet and face), albuminuria, severe headache, and visual disturbances. It used to be called toxemia of pregnancy. Some rise in blood pressure is normal during pregnancy, but in preeclampsia the rise is dramatic and is accompanied by other changes. The most notable of these are high concentrations of protein in the urine and a tendency to swell up, especially in the face and hands. This can cause women with preeclampsia to put on several pounds in a few days.
Premenstrual Syndrome: PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.
Protein: Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Varicose Veins: Twisted, widened veins with incompetent valves.