Edema - diagnosis of causes and treatment of diseases that cause them

The article was checked by a cardiologist, a member of the European Society of Cardiology, the Eurasian Association of Cardiologists, the Russian Society of Holter Monitoring Lozbineva O.A., is for general informational purposes only and does not replace specialist advice. For recommendations on diagnosis and treatment, consultation with a doctor is necessary.

Edema is the medical term for the abnormal accumulation of fluid in certain tissues of the body. Parts of the body swell from injury or inflammation. Medicines, pregnancy and infections can also cause swelling. Fluid accumulation occurs when it is released from small blood vessels into nearby tissues.
Fluid accumulation may occur under the skin, usually in the lower extremities or lungs. The localization area can give the practitioner the first clues as to the main cause of the development of the pathological process in the body.

Types of edema

Depends on origin:

Lymphatic - those types of edema that are caused by causes and changes associated with the lymphatic system are considered as such. Among them are primary (there are congenital malformations of the lymphatic system, usually affecting the limbs), or secondary (there are acquired damage). The latter may be the result of operations to remove tumors in the lymphatic system, or in cases of burns, strokes or infections that cause vessel destruction.
Dynamic - the lymphatic system does not show any changes, but excess fluid is felt. These include swelling of the veins caused by blood clots or problems with the blood vessels caused by strokes, inflammation, and medications. In women, the cause is varicose veins and exposure to hormones during pregnancy and the postpartum period.

The main factors are changes in the biochemical composition of tissue fluid and blood plasma. Disturbances also occur against the background of hormonal changes and increased capillary permeability.

Relieving swelling during pregnancy

In the body of a woman carrying a fetus, the concentration of the hormone progesterone increases. It is one of the causes of edema during pregnancy. In no case should it be reduced, because it is this that ensures the attachment of the embryo.

There is no need to fight physiological swelling. The main thing is to prevent it from getting worse. To alleviate the symptoms, you can carry out the mentioned water procedures and adhere to a healthy lifestyle (moderate activity, water consumption within the daily norm, adjusted for restrictions imposed by pregnancy, rest on your side).

The pathological nature of edema can only be determined by a doctor based on test results (in particular, protein in the urine). Having discovered the cause, he will prescribe treatment. It is prohibited to take any medications on your own.

Reasons for development

The veins in the legs have valves that act as "check valves" to prevent blood from flowing into the legs due to gravity. The heartbeat pushes blood through the arteries down to the legs. The blood must return to the heart to be recirculated through the veins. Blood pressure through the system and contracting leg muscles push blood up the veins, while valves prevent backflow down against gravity.

Valve insufficiency allows blood to pool in the legs and feet, eventually leading to swelling. When blood stagnates or pools in an area, fluid leaks into the surrounding tissue.

Valve insufficiency can occur for the following reasons:

with age;
from standing for long periods of time;
from sitting for many hours;
from varicose veins.

Regardless of the cause, as the valves in the legs become dysfunctional, blood pools and causes swelling, which puts pressure on the veins, causing them to widen and widen. This prevents the valves from working effectively, leading to even more swelling.

Main reasons for development:

kidney diseases: glomerulonephritis, nephrotic syndrome, renal failure;
heart diseases: heart failure;
vein lesions (varicose veins, inflammation, thrombosis);
liver diseases: cirrhosis of the liver, blockage of the hepatic veins;
diseases of the endocrine system: hypothyroidism, diabetes;
severe cancer;
nutritional dystrophy;
pregnancy;
allergic reactions: insect bites, contact with an allergen.

Depending on the type, swelling can lead to retinal detachment, stroke, seizures, and even death. It is unacceptable to ignore the problem. To determine the cause, sign up for a consultation with specialists at the Yauza Hospital.

Which doctor should I contact for swelling of the legs?

If you have swelling of the legs, you should first consult a general practitioner (general practitioner or family doctor). In order to determine the cause of the swelling, a simple examination may not be enough. You must be prepared that you will need to undergo a series of tests or undergo instrumental examination (ultrasound, MRI). In some cases, after receiving the results of the examination, the therapist may refer you to specialized specialists (cardiologist, urologist, etc.).

Edema as symptoms of diseases

In addition to vein problems, swelling can be caused by many other problems. In this case, clinical manifestations are usually observed on both legs.

Heart pathologies

When the heart begins to fail as a pump, fluid pools in areas such as the legs and lungs and causes swelling. In addition, less blood flows to the kidneys, causing fluid retention.

Lung diseases

The cause is acute pulmonary failure, which is associated with the release of transudate from the capillaries. This is fraught with infiltration of the alveoli and a sharp disruption of gas exchange in the lungs.

It manifests itself as shortness of breath at rest, suffocation, a feeling of tightness in the chest, cough with the release of foamy bloody sputum. Accompanied by the development of acidosis and hypoxia.

Kidney diseases

Excess fluid and sodium in the circulation can cause fluid to accumulate. Swelling associated with kidney disease usually occurs in the legs and around the eyes.

Damage to the tiny filtering blood vessels in the kidneys can lead to nephrotic syndrome. In nephrotic syndrome, decreased levels of protein (albumin) in the blood can lead to fluid accumulation.

Severe liver pathologies

With cirrhosis, as a rule, fluid accumulates in the abdominal cavity. Accompanied by liver failure, dilation of hemorrhoidal veins and bleeding from the esophagus.

Quincke's edema

An acute disease that is characterized by the appearance of limited angioedema of the skin and subcutaneous tissue, body systems and various organs. The reasons are autoimmune and infectious diseases, false and true allergies. It occurs acutely and goes away within 2-3 days.

Arthritis

During the inflammatory process in the joint area, a large amount of synovial fluid is released. It accumulates in the cavity of the articular structure. When inflammation spreads to adjacent soft tissues, extensive (spread) edema develops.

How to relieve leg swelling caused by heat

The best medicine in this case is gravity. Arriving home and throwing away the shoes that have become a vice, it is enough to lie down and place your feet higher (at a minimum - on several pillows, at a maximum - against the wall).

When it becomes easier to move, you need to take a shower. Ideally, a contrasting one that trains blood vessels, but you can limit yourself to just cool. In this case, you should direct the pressure to the feet: such a hydromassage will restore blood circulation.

You can disperse the fluid with light exercises: pulling the toe towards you and away from you, rotating your feet, squatting. But if you don’t have the strength to do this, and your legs hurt, it’s better not to torture them.

Foot baths are also useful. Even plain water will provide relief, but you can enhance the effects with additives. This could be sea salt or herbal infusions. Compresses made from cabbage leaves or bandages soaked in a decoction of birch leaves improve the condition of the limbs.

We treat all types of edema

Specialists at the Yauza Clinical Hospital diagnose and treat edema of various origins. We follow international protocols and use modern equipment.

For cardiovascular diseases

“Cardiac” edema develops slowly – over several weeks or months. They are characterized by symmetry and increase in size in the evening. They first appear on the lower extremities or lower abdomen, in severe cases they spread throughout the body and are accompanied by the accumulation of fluid in the abdominal cavity (ascites) and enlarged liver. In this case, the skin most often feels cold to the touch and the swelling is dense. When pressed, a hole remains.

Patients complain of shortness of breath, which worsens when lying down, and low exercise tolerance. They have wheezing in the lungs, tachycardia, pallor of the lips, and cyanosis of the nasolabial triangle. As circulatory failure is compensated, swelling decreases or disappears.

Swelling due to venous insufficiency also becomes more pronounced in the evening, causing the sensation of shoes suddenly becoming tight (due to swelling of the feet), and the legs become visually thicker, often not symmetrically. Swelling in the legs is accompanied by a feeling of heaviness, fatigue, and pain in the legs. Spider veins and an enhanced pattern of veins are noticeable on the skin. In severe cases, swelling persists constantly, cramps in the calves are possible, trophic changes develop - thinning of the skin, persistent redness, peeling, itching, and poorly healing ulcers. Timely professional medical care helps prevent or reduce the risk of such progression of the disease.

For kidney diseases

“Renal” edema can develop very quickly - in less than a day. Swelling appears mainly on the face. Swelling under the eyes is noticeable in the morning. They can also be localized on the limbs and abdominal wall. When changing postures, bodies quickly shift. Fluid accumulation often occurs - ascites or hydrothorax. Edema skin is soft or dense, pale, dry.

Swelling due to kidney disease may be accompanied by a decrease in the amount of urine excreted, a change in its color, and possibly the appearance of blood (red blood cells) and protein in a urine test. Pain appears in the lumbar region. Nonspecific manifestations include headache and weakness. Shortness of breath and liver enlargement, characteristic of circulatory failure, are not observed. Renal edema can be a consequence of an infectious disease (tonsillitis, viral infection, etc.) and requires observation and treatment by a specialist (nephrologist, rheumatologist, therapist).

Allergic

Allergic edema develops quickly (in a few minutes) and is regional in nature. They arise as a result of contact with an allergen or an insect bite. They develop most often on the face (eyes, eyelids, mucous membranes, lips), arms (fingers, hands), elbows and knees.

The development of allergic edema is accompanied by itching and rash. In severe cases, due to bronchospasm, attacks of difficulty breathing are possible, usually in the exhalation phase. Swelling of the larynx can lead to suffocation and pose a threat to the patient's life. Therefore, patients prone to such a reaction should be prepared for a dangerous situation.

It is necessary to discuss in advance with the doctor what medications will help the patient safely wait for the ambulance to arrive (delivery to the hospital) in case of an acute allergy attack and always have them available.

Prolonged swelling causes stretching of the skin, makes blood vessels less elastic, and impairs blood circulation. Swelling negatively affects the joints and causes difficulty moving. Ulcers may develop at the site of swelling, which are subsequently difficult to treat. Don't take things to the extreme. Make an appointment with a doctor and get rid of the problem.

Why do feet swell during pregnancy?

During pregnancy, the outflow of fluid is often disrupted. This is explained by large-scale changes occurring in the body:

weight gain;
changes in hormonal levels;
compression of the inferior vena cava by the enlarging uterus;
decreased mobility;
diet correction.

In most cases, swelling is considered as a variant of the physiological norm. There is no need to resort to drug treatment; it is enough to keep the situation under control. However, the spread of edema throughout the body can result in serious pathologies, such as preeclampsia.

The expectant mother should monitor the dynamics of the increase in calf circumference, blood pressure and the ratio of fluid consumed and excreted. The kidneys experience increased stress during pregnancy, so at the first alarming symptoms it is better to be examined by a nephrologist.

Diagnostic stages

Consultation and examination by a therapist. After a detailed conversation and medical examination, the patient can be referred for consultation to other specialists depending on the etiology of the disease: cardiologist, allergist, endocrinologist, nephrologist, urologist, etc.

Laboratory research. First of all, the following are carried out:

general (with leukocyte formula) and biochemical blood tests;
general urine analysis.
Instrumental studies:
ECG;
echocardiography;
Ultrasound of blood vessels of the lower extremities;
X-ray of the chest organs.

Next, the doctor prescribes a set of studies on an individual basis in each individual case.

To effectively eliminate swelling, you need to know exactly what disease is causing it. Edema is not an independent disease, but a symptom. Diagnostics using modern equipment will allow us to determine the cause of the pathology. The information obtained allows the doctor to choose the most effective treatment. Don't put off taking care of your health until later. Schedule a consultation with your doctor today to stay energized for years to come.

Stress

When a person encounters stress, a number of processes controlled by the endocrine system are activated in the body.

At the first stage, appetite decreases, and energy levels increase due to the rapid breakdown of fats. When the reaction subsides, the hormone cortisol is released, which increases appetite - the body needs to restore blood glucose levels and replenish fat reserves.

If a person is in a state of chronic stress, cortisol levels are always slightly elevated. This also leads to swelling.

Treatment of swelling

Treatment of edema is carried out in accordance with the cause of its development. Here are some general recommendations:

Limit fluid intake to 1.5 liters per day, and sometimes less.
Reduce salt intake to 1–1.5 g per day.
Diuretics should be taken only under the supervision of a doctor who monitors the patient’s condition and monitors the level of electrolytes in the blood. Diuretics can lead to a decrease in potassium levels in the body, so it is recommended to eat dried apricots, raisins, rice, baked potatoes and other foods rich in this trace element.
For cardiovascular diseases, a cardiologist, after diagnosing “cardiac” edema, selects therapy to maintain a stable state of the vascular system. A patient with heart failure should visit a cardiologist regularly throughout his life. In case of venous insufficiency, conservative or surgical treatment is carried out by a vascular surgeon-phlebologist.
If the swelling is caused by kidney disease, in addition to relieving the swelling, the doctor (therapist or nephrologist) prescribes therapy for the underlying disease, which may include antibiotics, anti-inflammatory hormonal drugs, etc.
In case of allergic edema, which is accompanied by difficulty breathing, urgent medical attention is required. Before help is provided, you should take an antihistamine, if the condition is severe - prednisolone or dexamethasone. In case of an attack of suffocation of an allergic nature, take 1-2 breaths from an inhaler recommended by your doctor (allergist).

How to relieve swelling after a bruise

Treatment for a leg bruise usually comes down to eliminating pain and swelling. The swelling in this case is caused by damage to the blood vessels and the accumulation of fluid from them under the skin. The latter puts pressure on the nerve endings, hence the pain. So eliminating swelling also helps to get rid of unpleasant sensations.

You can help a bruised limb at home:

stretch and provide peace;
apply a wet towel, ice or a heating pad with cold water;
apply a tight bandage.

You can also resort to drug treatment. External agents containing troxerutin or heparin will help. They strengthen capillaries, optimize blood viscosity and relieve inflammation.

Why us

Advantages of visiting our medical center:

Doctors. We welcome specialists of the highest qualification category, holders of academic degrees, with extensive experience in leading Russian clinics.
Individual approach. The doctor will develop an individual treatment plan for each patient in accordance with the cause of development and clinical picture of the disease.
Complexity. Effective treatment of edema and the diseases that cause them is possible thanks to the close cooperation of our clinic’s specialists - therapist, cardiologist, allergist, endocrinologist, urologist, etc.
Expert equipment. All studies are carried out using modern equipment and are highly accurate.
Comfort. All consultations, studies and treatment are carried out within our hospital, which allows our patients to save money.

You can see prices for services in the price list or check by calling the phone number listed on the website.

Passive lifestyle

A sedentary lifestyle leads to stagnation of lymph and water retention in tissues; physical activity helps improve this situation.

The lymphatic system does not have its own pump, like the circulatory system. Therefore, the movement of lymph and the return of fluid to the blood depends on the functioning of skeletal muscles.

When you sit for a long time, the pressure in the capillaries increases and fluid begins to accumulate. Get up at least once an hour and stretch your legs , ankles, rise on your toes and wiggle your toes.

Allergies and sensitivity to products

Sensitivity, or food intolerance, is a symptomatic reaction without the participation of the immune system. This is how it differs from allergic. Sensitivity is more common than allergies.

The effect of individual reactions to foods has been noted in a number of diseases and symptoms, including irritable bowel syndrome, weight gain, chronic headaches, skin conditions, autoimmune diseases and even depression. Swelling can also be a symptom of food sensitivity.

While the most common allergens are eggs, milk, nuts, wheat, soy, fish and shellfish, sensitivity can occur to unexpected foods.

For example, among arthritis sufferers, sensitivity to citrus fruits, pork, corn, oatmeal, coffee, cheeses, tomatoes, sugar, chocolate, wheat was found, and among migraine sufferers, food additives, preservatives, tea, potatoes and salt were added to the list.

To find out what food causes swelling, you need to give up potentially problematic foods for several weeks one at a time. If the symptoms weaken or disappear, you have found a product that should be excluded from the diet.

Another approach is to switch to a diet consisting of a minimum amount of foods for the same period of time, then gradually return them, observing the changes.

Potentially problematic foods: allergenic foods, fruits, alcohol, gluten-containing foods, milk and dairy products, food chemicals, spices and sugar.

Can dairy products, fruit, stress or too intense exercise cause swelling? Yes they can. But you shouldn’t limit yourself in food or physical activity - first, find out what exactly your reason is.

Author: Elena Degtyar, PhD, nutrition psychology coach and nutritionist

LITERATURE:

1. Maughan, R. J. “Impact of mild dehydration on wellness and on exercise performance.” European journal of clinical nutrition 57.S2 (2003): S19. 2. Xie, Lulu, et al. “Sleep drives metabolite clearance from the adult brain.” science 342.6156 (2013): 373-377. 3. Kannan, Arun, et al. "Renal sympathetic nervous system and the effects of denervation on renal arteries." World journal of cardiology 6.8 (2014): 814. 4. Gallen, Ian W., et al. "On the mechanism of the effects of potassium restriction on blood pressure and renal sodium retention". American journal of kidney diseases 31.1 (1998): 19-27. 5. Kreydiyyeh, Sawsan Ibrahim, and Julnar Usta. "Diuretic effect and mechanism of action of parsley". Journal of ethnopharmacology 79.3 (2002): 353-357. 6. Horita, Shoko, et al. "Insulin resistance, obesity, hypertension, and renal sodium transport." International journal of hypertension 2011 (2011). 7. Light, Kathleen C., et al. "Psychological stress induces sodium and fluid retention in men at high risk for hypertension." Science 220.4595 (1983): 429-431. 8. Espiner, Eric A. “The effects of stress on salt and water balance.” Best Practice & Research Clinical Endocrinology & Metabolism 1.2 (1987): 375-390. 9. Riebl, Shaun K., and Brenda M. Davy. “The hydration equation: Update on water balance and cognitive performance.” ACSM's health & fitness journal 17.6 (2013): 21. 10. Hong, Seung Min, et al. "Changes in Body Water Caused by Sleep Deprivation in Taeeum and Soyang Types in Sasang Medicine: Prospective Intervention Study." Evidence-Based Complementary and Alternative Medicine 2022 (2017). 11. Gerth van Wijk R, van Cauwenberge PB, Johansson SG. Revised terminology for allergies and related conditions. Ned Tijdschr Tandheelkd. 2003, 110: 328-331. 12. Gaby AR. The Role of Hidden Food Allergy/Intolerance in Chronic Disease. Alternative Medicine Review. 1998, 3: 90-100. 13. Tarasova, I. V. “Food intolerance, true food allergy and food pseudo-allergic reactions: presentation and diagnostic methods.” Allergology and Immunology in Pediatrics 3 (2008): 24-28.