What is Edema?

Edema is a medical term for a type of swelling characterized by fluid buildup in tissues. The exact incidence and prevalence are difficult to estimate due to the wide range of factors that can contribute to its development. Edema can occur in any part of the body, depending on the underlying causes, ranging from local swelling to generalized swelling1.

If untreated, edema can lead to infections, ulcers, cardiorenal syndrome, and, in some cases, increase the risk of mortality1.

What are the symptoms of Edema?

Symptoms of edema include1:

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What are the Causes of Edema?

Edema can be caused by different conditions like1-4,

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Why is edema a critical symptom in patients with heart failure and kidney disease?

Heart failure is a condition that occurs when the heart is not capable of pumping blood as expected. Major symptoms of heart failure include swelling in the lower extremities, difficulty in breathing and fatigue. Heart failure causes an increase in pressure inside the vein and leakage of fluid-electrolyte into space outside the blood vessels, leading to edema1

The kidneys play a crucial role in regulating the body's fluid balance and removing waste products from the blood. When the kidneys are not functioning properly they tend to accumulate fluid which leads to edema1.

What are the physical measures to manage edema?

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    Elevation of extremities:

    Raising the affected limb above heart level for 30 minutes,three to four times a day, helps drain edema using gravity1

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    Physiotherapy:

    Qualified physiotherapists provide gentle massage to reduce swelling and inflammation1

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    Compression:

    Improves blood flow in the extremities using elastic stockings, gloves, wraps, or muscle pump activator (MPA) devices. This prevents blood pooling and fluid buildup in swollen areas1.

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    Ice application:

    It reduces edema and is useful in the acute phase of managing edema1.


What are treatment options available to manage edema?

Salt restriction: Reducing salt intake to 5-6 grams/day decreases water retention without causing harm1.

Diuretics:Diuretics increase renal sodium, water excretion, and urine output, making them useful for managing edema. Loop diuretics (like Torsemide and Frusemide) are the first-line therapy for edema1.

How can patients screen themselves for the risk of edema?

A simple self-evaluation test can help assess the risk of systemic issues in patients with systemic diseases, which may impact long-term morbidity and mortality

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When to see a doctor?1

Please consult your doctor if you have

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    Swelling1

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    Stretched or shiny skin1

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    Pain or discolored
    skin in swollen area1

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    The skin that holds
    a depression after pressing1

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    Shortness of breath1

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    Fatigue1

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    Edema Score ≥3 when
    screened using patient
    self-evaluation questionnaire
    mentioned above1

References

  1. Mathur G, et al. Edema India: Executive Summary of Screening, Diagnosis, and Management of Edema. J Assoc Physicians India. 2024 Jul;72(7):68-72
  2. Bobkova I, Chebotareva N, Kozlovskaya L et al. Edema in Renal Diseases – Current View on Pathogenesis. Nephrology @ Point of Care 2016; 2(1): e47-e55. Aslesha E. A Review on Edema. RRJPA. 2016;5 (2): 63-70; Lent-Schochet D, Jialal I. Physiology, Edema. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537065/: Accessed on Sep 2024
  3. Aslesha E. A Review on Edema. RRJPA. 2016;5 (2): 63-70;
  4. Lent-Schochet D, Jialal I. Physiology, Edema. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537065/: Accessed on Sep 2024

  5. Document code : IN-NP-V4-2024-0030