By Dr. Loretta Lanphier, ND, CN, HHP, CH

Swelling of body tissues can be an uncomfortable and disturbing experience, but even more importantly it can lead to critical and sometimes life threatening consequences. Edema is a serious medical condition that should never be taken lightly, but the good news is that it can, for the most part, be prevented or treated by making healthful lifestyle choices such as a wholesome diet and sufficient amounts of exercise. If you live wisely, you will probably never have to deal with edema, but we should be aware of what it is and how to best deal with it if it ever should occur.

What is Edema?

Edema [ i-dee-muh ] is a condition that results in the accumulation of excess amounts of fluid within the body. The term is derived from a Greek word for swelling, and edema is not actually a disease, but rather a symptom associated with other illnesses. Normally the body has very effective methods for regulating the balance of fluid, but when edema occurs, it is your body telling you that something is wrong, and you should definitely pay attention. Edema can also be exhibited as a side effect of certain medications, and is often associated with pregnancy. It can be found anywhere in the body, but is most common in the extremities including the face, hands, feet, legs, arms, and ankles. Edema involves either too much fluid within the circulatory system, or an excess amount between the cells of the body’s tissues, an area known as the interstitial spaces.

Under normal conditions, the body has means at its disposal to ensure that equal amounts of fluids enter and exit the body, thus maintaining balance. The most vital components involved in this process are the circulatory and lymphatic systems. As the circulatory system transports blood throughout the body via the blood vessels, it delivers nutrients and oxygen to the cells. It is also responsible for returning fluid that has been harvested of its life-giving components back to the heart. The lymphatic system works alongside the circulatory system to help recycle fluid as well. When this network is not working properly, one of two things can occur, both of which result in edema. Either too much fluid is transferred from the blood vessels into the tissues, or too little is moved from the cells back into the bloodstream. The swelling of body parts associated with edema then becomes evident.

What Are the Signs and Symptoms of Edema?

Symptoms vary depending on the underlying condition that is causing the edema, but the most common ones include:

  • Swelling, ranging from mild to severe, in affected body areas
  • Puffiness in the subcutaneous tissues (just under the skin)
  • Swollen, enlarged abdominal area
  • “Shiny” or taught skin
  • Weight gain
  • Elevated blood pressure and / or pulse
  • Swollen eyelids
  • Visibly enlarged hand and neck veins
  • Low skin elasticity in affected areas. If you push on the skin, a dimple will remain for several seconds, rather than rebounding as it normally should.

One particularly dangerous type of edema is called pulmonary edema (edema of the lungs). This very serious condition demands immediate medical attention, as it can be potentially life threatening. Symptoms unique to pulmonary edema include:

  • Labored, shallow breathing
  • Shortness of breath
  • Chest pain
  • Cough

What Are the Causes of Edema?

In a nutshell, the most direct cause of edema is leakage of fluid into the cells and tissues of the body through the tiniest of blood vessels, known as the capillaries. If they become damaged by trauma or the pressure within them is abnormally high, they will begin to leak excess fluid. When this occurs, your body responds by signaling the kidneys to release less water and sodium in order to compensate. This creates a vicious cycle by increasing the amount (and therefore the pressure) of fluid in the circulatory and lymphatic systems, thus causing more leakage, and the process continues.

There are many conditions that commonly trigger this chain of events and thereby result in edema. They include:

  • Pregnancy: It is normal for pregnant women to swell a bit, because due to the needs of the developing fetus, it is necessary for them to have more fluid available in their bodies. Hormonal changes also may affect fluid levels. Many women “with child” experience edema in the feet, legs, and face.
  • Premenstrual symptom: Many women also have the propensity to swell from edema as they enter their monthly cycle. This is probably due to hormonal changes associated with the onset of menses.
  • Certain medications: The most common culprits include:
  • Some blood pressure medications
  • Estrogen (from hormone replacement therapy)
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Steroids
  • Calcium blockers
  • Thiazolidinediones (drugs used to treat diabetes)
  • Kidney dysfunction: If the kidneys are not operating properly they cannot sufficiently rid the body of water and sodium. Compromised kidneys also often experience damage to the minute blood vessels called the glomeruli. This retention of excess fluid causes edema, often showing up in the legs and around the eyes.
  • Thyroid disease: One of the consequences of poor thyroid function is the retention of too much protein in the blood. This can also trigger edema.
  • Liver disease: Advanced liver disease can cause the swelling associated with edema, especially in the areas of the liver, legs, and abdomen. When cirrhosis (scarring of the liver) occurs, pressure is common in the main blood vessel (portal vein) that carries blood from the spleen, pancreas, and intestine into the liver. This often results in edema.
  • Congestive Heart Failure (CHF): This cardiac condition is characterized by decreased ability of the heart muscle to effectively pump blood throughout the body. Failure on the left side of the heart can result in pulmonary edema. If the problem is in the right side of the heart, pitting edema can occur, usually causing swelling in the legs and feet. Dimples from pushing on the skin are also common with pitting edema.
  • Lymphedema: If the channels within the lymphatic system become obstructed, edema can also result. This can be caused by physical trauma to the lymph system, infection, or as a side effect of chemotherapy and / or radiation treatment for cancer.
  • Immune system response: When the immune system is triggered in response to an infectious agent or wound, both the circulatory system and the lymphatic system are involved. Blood flow is increased to the area, and the lymphatic system delivers white blood cells as well. Both of these factors can contribute to edema. The swelling of a bruised or strained muscle is a good example.
  • Malnutrition: If the levels of certain proteins in the blood become too low due to improper nutrition, the body tends to compensate by sending more fluid from the blood vessels into the interstitial spaces. Edema can result.
  • Blood Clots: These cause blockage of blood vessels, and can result in excess fluid retention in the area. Blood clots can be life threatening in some cases, and may cause noticeable pain. However, some may exhibit few symptoms, other than swelling. That is why it is foolish to ever ignore signs of edema.
  • Tumors: Certain masses, malignant or benign, can cause blockage of blood or lymph vessels and lead to edema.
  • Varicose veins: Veins that have weakened walls or valves cannot transport blood properly, and the result can be the pooling of blood leading to edema.

How Can Edema Be Treated or Prevented?

As mentioned at the beginning of this article, most of the time wise lifestyle choices will prevent or lessen the effects of edema. Diet and exercise are vital factors in the occurrence and prevention of edema. They can also play a key role in avoiding conditions that cause edema.

Allopathic medicine also employs certain medications in the treatment of edema. The term “The Three D’s” refers to diuretics (medications that promote urination and elimination of fluid and sodium), digitalis (a drug that increases the strength of heart contractions, while simultaneously decreasing heart rate), and diet (limiting foods that contribute to edema, especially sodium).

Medication may be called for in some cases, but there are many natural and noninvasive treatments that can be very effective as well. Here are some common sense tips that will help you to avoid or eliminate edema:

  • Diet: As is the case with all wellness issues, what we put in our bodies has a tremendous effect on our overall health. Most Americans consume the Standard American Diet (SAD), which among other things, is typically very high in sodium. Too much salt can cause many types of health problems, such as hypertension (high blood pressure), heart disease, and other conditions that can lead to edema. Insufficient amounts of protein can also cause edema in some cases, but don’t load up on the wrong types of protein, such as high-fat animal protein. Get ample amounts of protein mainly from plant sources such as beans and legumes.
  • Exercise: An ongoing, consistent exercise routine is one of the most valuable lifestyle choices one can ever make. It affects so many factors related to your health. Specifically relating to edema, ample physical exercise can prevent edema, and help to heal the body from it. If you develop edema, focus on exercises that employ the affected body parts.
  • Watch your weight: Obesity is another issue that negatively impacts your health in many ways. Your body has to work a lot harder to carry around extra weight, and one of the many consequences can be edema.
  • Massage: Rubbing down areas where swelling occurs is very therapeutic. Use gentle, consistent strokes that move towards the heart. This will help your circulation and the edema.
  • Compression garments: Stockings, gloves, or sleeves that compress swollen areas may help to eliminate or minimize pooling of fluid in these areas.
  • Avoid prolonged inactivity: Sitting or standing in one place with minimal body movement can contribute to edema. For example, when traveling, be sure to get up and walk around every couple of hours in order to boost your circulation.
  • Manual Lymph Drainage (MLD) can help combat edema for folks with lymphedema. This gentle form of massage to help increase circulation in the lymphatic system has been commonly used in Europe for the last 70 years.

It is best to make wise choices that will keep you healthy and avoid such health complications as edema. However, it is never too late to change. Sometimes an issue such as edema can be a wake up call that stimulates one towards making better lifestyle choices that will promote wellness in the future.

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