LEG EDEMA

What is edema? What are its clinical treatments and home remedies?

Overview:

Edema or dropsy is the medical term used for the swelling caused by the retention of fluid in the extravascular compartment. It can affect the small area, local edema or entire body, generalized edema. This condition usually occurs in feet, legs, or ankles. Edema appears when your blood vessels leak fluid into the nearby tissues. It can cause due to infections, pregnancy, and various medications. Edema can be intracellular, inside the cells, or it may be extracellular at interstitium or body cavities. Peripheral edema is the type of edema that causes swelling of lower legs and arms. It can affect one or both legs, and the onset is very rapid and painful. Leg edema is caused by the problem in the venous circulatory system, the lymphatic system, or the kidneys.

Leg edema is also a useful indicator for the diagnosis of many life-threatening diseases like congestive heart failure and kidney failure. Taking medications to reduce excess fluid, and the amount of salt in your body can reduce edema. When edema is a sign of any other disease, it requires separate management of disease with edema treatment.

Causes of leg edema:

Fluid builds up in your legs when the blood vessels or tissues in your legs retain more fluid than they should. This can also happen if you spend a long day on your feet or sit for too long. It may also be a sign that you are overweight or don’t get adequate exercise. Or this may be due to some more serious medical conditions that include:

Congestive heart failure:

This happens when your heart is too tired to pump all the blood, your body demands. It leads to a build-up of fluid, especially in your legs.

Vein issues:

 In thrombophlebitis and DPT, deep vein thrombosis, the early symptom is one swollen leg, as blood accumulates in the area.

Kidney problems:

Inadequate working of the kidney can lead to this condition. Instead of filtering water and excess salt from your blood, fluid gathers in your body and moves towards the lower region of the body. This causes swelling of legs.

Medications:

Some medications have a prominent side effect of causing swelling in the legs by retention of fluid. These medications include:

• Calcium channel blocker ( Amlodipine )
• NSAIDs ( ibuprofen, naproxen)
• Anti-diabetes drugs ( metformin )
• Hormonal medications and Antidepressants.

Pregnancy:

When the third trimester of pregnancy starts, a growing baby puts pressure on the veins of your legs. This causes less supply of blood to the legs and results in mild swelling of legs.(Ely et al., 2006)

Symptoms:

Symptoms of the leg edema vary according to the cause of edema. Although your legs might have these cardinal symptoms include:

• Pitting, your finger leaves a dent when you press the affected area for 5 seconds.
• Feel heavy, stiff, or achy.
• Look swollen or puffy.
• The skin in the swollen area feels warm and tight.
• Fluid accumulation causes an increase in weight and difficulty in walking.(Suehiro et al., 2014)

Prevention and Home Remedies:

The only way to prevent edema is to prevent the cause. If you have any disorder related to edema, consult your physician, and manage the primary cause of edema. Here are some preventions and home remedies that may be beneficial to prevent and treat leg edema.

Elevate your feet preferably, above your heart:

Put your leg on pillows, cushions, or even things while you sleep. It can be helpful to reduce foot swelling. Raise your feet above your heart while lying down.

Lose weight if your overweight:

Being overweight can cause reduced blood circulation to legs, and leads to swelling of the lower region. Cause pain and extra strain to feet. It can cause fluid build-up in the feet. Lose weight can possibly reduce swelling and improve blood circulation.

Massage:

Massage promotes relaxation and can be great for swelling feet. Massage from feet to heart exerts pressure that is helpful to move the fluid out of the area and reduce swelling.

The decrease in sodium intake:

Sodium causes retention of fluid in tissues. Decreasing sodium intake can help reduce swelling in your feet. Avoid taking more salty meals as it may increase in the swelling.

Magnesium supplements:

If your body retains water, you might have a magnesium deficiency. Add magnesium-rich food in your diet. These foods include:

• Almonds.
• Tofu.
• Dark chocolates.
• Spinach.

Increase potassium intake:

Deficiency of potassium can cause an increase in blood pressure and contribute to water retention. Use this potassium-rich food by the permission of your doctor can help to maintain your normal potassium levels.

• Pistachios.
• Chicken.
• Salmon.
• Banana

Herbal supplements:

Diuresis is a condition in which your body excretes too much amount of urine. It is helpful to decrease water retention in the body by continuous filtration of bodily fluid. Various herbal supplements that cause diuresis are:

• Garlic.
• Fennel.
• Cranberry juice.
• Parsley.(Jude, 2002)

Clinical Treatment:

The edema can be permanent or temporary, depending on its cause. Mild edema usually goes away on its own. Edema should be treated according to the condition that is causing it. For instance:

• If leg edema is caused by any lung disease, quitting smoking should be advised if the patient smokes. And adjuvant therapy to treat lung diseases is continued.
• If the cause of edema is related to the medications, avoid medication will cause the swelling to resolve.
• Patients with chronic heart disease associate with edema should follow precautions include monitoring of weight, low salt intake, and cutting down on alcohol.

Diuretics:

More severe edema may be treated with drugs. That helps your body to excrete a large quantity of fluid from the body in the form of urine. Diuretics also called water pills, the class of drug use to treat swelling by removing excess of water and salt. One of the most common diuretics is furosemide (Lasix). Depending on the condition of the patient and type of disease, diuretics are administered in the body. There are three types of diuretics.

1. Thiazide diuretics ( hydrochlorothiazide)
2. Loop diuretics ( furosemide )
3. Potassium K* sparing diuretic ( spironolactone )

These medications are used by the proper consultation and guidance of your physician. Be cautious in conditions. It should be avoided in pregnancy.

Reference:

1. Blankfield, R. P., Hudgel, D. W., Tapolyai, A. A., & Zyzanski, S. J. (2000). Bilateral leg edema, obesity, pulmonary hypertension, and obstructive sleep apnea. Archives of Internal Medicine, 160(15), 2357–2362.

2. Ely, J. W., Osheroff, J. A., Chambliss, M. L., & Ebell, M. H. (2006). Approach to leg edema of unclear etiology. The Journal of the American Board of Family Medicine, 19(2), 148–160.

3. Jude, T. C. (2002). Herbal Home Remedies. B. Jain Publishers.

4. Suehiro, K., Morikage, N., Murakami, M., Yamashita, O., Ueda, K., Samura, M., & Hamano, K. (2014). A study of leg edema in immobile patients. Circulation Journal, CJ-13.

5. Thaler, H. W., Wirnsberger, G., Pienaar, S., & Roller, R. E. (2010). Bilateral leg edema in the elderly. Clinical considerations and treatment options. European Geriatric Medicine, 1(6), 353–357.

6. Trayes, K. P., Studdiford, J. S., Pickle, S., & Tully, A. S. (2013). Edema: diagnosis and management. American Family Physician, 88(2), 102–110.