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Edema

Introduction

What should I know about Edema?

Doctors define edema as an increase in the volume of fluid in the spaces between the body’s cells. Depending on its cause, edema-related swelling may occur in a specific area or it may be distributed throughout the body.

There are many forms of edema. One type, known as anasarca, may be characterized by puffiness in the face. Other common signs of anasarca include rings that fit more snugly, or shoes that become uncomfortably tight, particularly in the evening. Another form of edema, ascites, is characterized by an excess of fluid in the lining of the abdomen and is usually associated with liver disease. Hydrothorax is yet another type of edema in which fluid accumulates in the space surrounding the lungs. Finally, idiopathic edema is a syndrome that occurs almost exclusively in women. It involves the retention of water and the accumulation of “water weight” as a part of premenstrual syndrome.

The causes of edema are related to the way fluids are distributed and transported throughout the body. Much of the fluid in the body is exchanged between the capillaries and the spaces that surround the cells. In a healthy state, a balance of pressure is maintained between the fluid in the capillaries and the fluid outside the capillaries, which is referred to as interstitial fluid. The development of edema occurs when this delicate balance of pressure is disrupted and an excess of fluid flows out of the capillaries and into the interstitial space.

Edema can also be caused by trauma to the systems that maintain a healthy balance of fluids in the body. For instance, burns, cuts, bumps, and bruises can damage the sensitive capillary tissues that control the flow of pressure into and out of the spaces between cells. The swelling that occurs as a result of these wounds is a form of edema. Chemical and bacterial invaders can damage the capillaries and trigger edema as well.

Other forms of edema are often caused by a reduction in the total volume of blood in the body. In this situation, the body compensates for the lower blood volume by retaining more water and salt. If, however, this response is insufficient to restore a proper blood volume, the retention of water and salt increases and edema can develop. This cycle is often seen in patients with congestive heart failure. In this case, the heart is unable to pump enough blood out of the heart and fill the circulatory system. The body then responds to the reduction in blood volume by retaining more and more water. Edema often follows.

Still more causes of edema include kidney failure, protein deficiency, and pregnancy, as well as the use of certain estrogen therapies and vasodilators.

Signs and Symptoms

The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.

Edema or swelling in the tissues is a symptom that the fluids in your body are out of balance. The location of the swelling is often helpful in understanding the underlying problem.

  • Edema in one specific area is often due to injury or infection. The edema that happens with bumps, bruises, burns, or infections to certain areas of the body are usually seen along with redness, heat, and tenderness in the affected area. They are a result of injury to the capillaries (very small blood vessels that supply tissues with blood).
  • Edema in one arm or leg may be due to a blockage of the blood supply or lymph to the affected limb.
  • Edema that is generalized (not limited to one certain area of the body) may be a symptom of many different disorders and your physician may do lab tests to check kidney function, liver function, heart function, and nutritional status (blood tests for the amount of protein, and other vitamins and minerals present). This type of edema is usually recognized by puffiness in the face, especially around the eyes. Rings may fit more snugly on fingers and shoes seem to be tighter, especially in the evening, or when you have been standing for a long time. When you push on the skin with your thumb, the imprint remains indented. This is known as pitting edema.
  • Liver disease may cause edema in the abdomen called ascites.
  • Changes in blood pressure or heart problems may cause edema in the legs and ankles, or in the lungs. If the heart cannot pump all the blood that is sent to it, fluid backs up in either the lungs or tissues to cause the swelling.
  • Kidney problems usually cause the body to save up salt (sodium) and water. This may also be a cause of edema.
  • Edema is often seen in pregnancy, and sometimes as a side effect if you are taking estrogens or some types of blood pressure or heart medication.
  • Edema in the face is sometimes seen in severe allergic reactions or if a patient has severe lack of thyroid hormone.

Treatment Options

Conventional

When determining a treatment for edema, physicians first try to ascertain the underlying cause. In most cases, doctors will try determine if the edema is localized to a specific region of the body or if it is present throughout the body. In many situations where edema is present, the restriction of sodium intake is the first choice in treatment, either through diet or by means of prescription diuretic drugs. Often, bedrest or elevation of legs for a period each day is also recommended. In the case of edema associated with heart failure, doctors often prescribe diuretics and other drugs to manage the circulatory system. In the case of idiopathic edema, doctors may recommend that women wear elastic stockings in addition to extended periods of bedrest.

Nutritional Suplementation


Gamma Linolenic Acid (GLA)

Research suggests that this important fatty acid may be therapeutically effective in reducing fluid retention and numerous other symptoms in women with premenstrual syndrome. (1) Studies have also suggested that evening primrose oil, which is a rich source of GLA, is a highly effective treatment for fluid retention in addition to the depression, irritability, breast pain, and tenderness that is associated with premenstrual syndrome. Other research may point to the effectiveness of using GLA during pregnancy in combination with fish oils containing two other fatty acids, eicosapentaenoic acid and docosahexaenoic acid. Researchers think this combination may ease the edema that can occur as a result of pregnancy-induced high blood pressure. (2)


Magnesium

One study has looked at the effectiveness of this mineral in treating edema associated with premenstrual syndrome. During the second month of taking magnesium, women in the study reported a greater reduction of symptoms of swelling of extremities, weight gain, breast tenderness, and abdominal bloating compared to women taking a placebo. (3)

Herbal Suplementation


Dandelion Leaf

Dandelion leaf has historically been used as a valuable food and medicinal agent. The leaf contains a high content of vitamins and minerals, including vitamin A and potassium. It is also commonly used as a diuretic. Because of its diuretic properties, it may be of use in the treatment of edema. Dandelion leaf is unique in that it is one of the few diuretics that does not rob the body of valuable potassium, as is often the case with prescription diuretic drugs. (4)


Ginkgo

Ginkgo is among the oldest living species on earth and has been used extensively as a medicinal agent worldwide for centuries. Today, it is the most frequently prescribed medicinal herb in Europe. Ginkgo has been the subject of hundreds of scientific studies that have reported positive effects in a wide range of health areas. Its application in the treatment of edema centers on its potential ability to enhance the circulatory system and improve blood flow. (5)


Horse Chestnut

Horse Chestnut is best known for its use in the treatment of edema, as well as a disorder known as venous insufficiency. In the case of edema support, studies suggest that horse chestnut may reduce leakage of fluids from the capillaries while promoting overall circulatory health. (6) , (7) What’s more, the key compounds present in horse chestnut may act as an anti-inflammatory.

References

  1. View Abstract: Horrobin DF. The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med. Jul1983;28(7):465-8.
  2. View Abstract: D’Almeida A, et al. Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia. Women Health. 1992;19(2-3):117-31.
  3. View Abstract: Walker AF, et al. Magnesium supplementation alleviates premenstrual symptoms of fluid retention J Womens Health. Nov1998;7(9):1157-65.
  4. Newall CA, et al. Herbal Medicines: A Guide for Health Care Professionals. London: The Pharmaceutical Press; 1996:96-97.
  5. View Abstract: Auguet M, et al. Effects of Ginkgo biloba on Arterial Smooth Muscle Responses to Vasoactive Stimuli. Gen Pharmacol. 1982;13(2):169-71.
  6. View Abstract: Diehm C. Medical edema protection--clinical benefit in patients with chronic deep vein incompetence. A placebo controlled double blind study. Vasa. 1992; 21(2):188-92.
  7. View Abstract: Guillaume M, et al. Veinotonic Effect, Vascular Protection, Anti-inflammatory and Free Radical Scavenging Properties of Horse Chestnut Extract. Arzneim-Forsch/Drug Res. 1994;44(1):25-35.