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Oedema: Types, Causes, Symptoms, Treatment And Management

Oedema is characterised by swelling of different body parts especially, legs and feet. The swelling takes place due to the excess fluid which gets accumulated in the body tissues. The body part in which oedema takes place is known as oedematous.

There are multiple conditions which cause oedema. It is not a serious disease and goes by a simple treatment but sometimes, it is a sign of underlying diseases. It can also result from the side effect of certain drugs, pregnancy or conditions like kidney disease, liver disease and congestive heart failure. [1]

Types of Oedema

When oedema occurs in feet or legs, it is known as peripheral oedema. However, there are several other types of oedema according to the body part which is affected. They are as follows:

  • Papilledema: Swelling of the eye due to the intracranial (within the skull) pressure [2]
  • Cerebral oedema: Swelling of the brain due to multiple causes like meningitis or brain trauma [3]
  • Scrotal lymphedema: Swelling of the scrotum due to obstruction or blockage of the lymphatic vessels [4]
  • Angioedema: Swelling in the tissues below the skin due to allergies or insect bites [5]
  • Pulmonary oedema: Swelling of the lungs due to lung injury or congestive heart failure [6]
  • Hereditary angioedema: A genetic condition in which blood vessels are affected. It is marked by swelling of hands, face, intestinal tract, windpipe or larynx. [7]

Causes Of Oedema

Oedema occurs when the blood capillaries (single-cell thick blood vessels) starts leaking fluid in the nearby tissues. When the fluid in those tissues exceeds, it swells up leading to oedema. There are several reasons why capillaries start leaking fluid to the surrounding tissues. Some of the causes are as follows:

Simple causes of oedema

  • Standing or staying in a single position for a long time [1]
  • Premenstrual symptoms [8]
  • Pregnancy [9]
  • Excess salty foods [10]
  • Lower levels of protein and vitamin (B1, B5 and B6) in the blood
  • Allergies [11]
  • Insect bites [12]

Oedema due to medications

  • Non-steroidal anti-inflammatory drugs [13]
  • Certain chemotherapy drugs
  • Drugs for diabetes
  • Oestrogen drugs [14]
  • High blood pressure drugs

Oedema due to medical conditions

  • Kidney disease
  • Liver cirrhosis [15]
  • Diabetes
  • Congestive heart failure [16]
  • Head injury
  • Brain tumour
  • Varicose veins
  • Blood clots
  • Damage to the lymphatic system [17]

Symptoms Of Oedema

Symptoms of oedema depend on its type and location. Common symptoms of oedema include the following:

  • Swelling [1]
  • Stiff joints
  • Stretched and shiny skin [18]
  • Dimple formation while pressing the swollen area
  • Weight loss or gain
  • Headache
  • Vomiting
  • Confusion
  • High blood pressure [19]
  • Visual disorders
  • Puffiness of eyes or face
  • Abdominal pain

Complications Of Oedema

Often oedema is ignored by people which leads to severe complications like the following:

  • Itchiness and irritation in the swollen area
  • Infection in the swollen area
  • Pain in the swollen area
  • Narrowed blood circulation
  • Difficulty in walking (in peripheral oedema)
  • Skin ulcer [20]
  • Severe pain in the swollen area
  • Tissue scarring

Diagnosis Of Oedema

The diagnosis of oedema is carried out so that any underlying conditions can easily be targeted. A medical expert first performs a visual examination of the swollen body part and depending on the location, assigns tests like ultrasound, x-ray, urine test and blood test. [21]

Treatment Of Oedema

The main purpose of oedema treatment is to prevent the accumulation of excess fluid in the body tissues. Firstly, the medical expert will ask for the medical history of the patient and accordingly, order tests. Usually, the temporary oedema goes on their own while the permanent one requires more attention. Treatment of oedema is carried out based on the underlying condition causing it.

The first step to treat oedema is diuretic drugs. The drug lessens oedema symptoms like bloating and swelling. Diuretic drugs like furosemide and ethacrynic are used to increase urine production and help the body get rid of the excess body fluid. However, there's a risk of dehydration in such cases. [22]

How To Manage Oedema

  • Avoid standing or sitting in the same position for a long time
  • Limit the salt intake in your food
  • Perform regular exercise
  • If necessary, lose some pounds
  • Raise the legs above the heart level while sitting or lying
  • Dress warmly in winter season or cold weather
  • Quit smoking
  • Eat a balanced diet
View Article References
  1. [1] Lent-Schochet D, Jialal I. Physiology, Edema. [Updated 2019 Jan 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  2. [2] Rigi, M., Almarzouqi, S. J., Morgan, M. L., & Lee, A. G. (2015). Papilledema: epidemiology, etiology, and clinical management. Eye and brain, 7, 47–57. doi:10.2147/EB.S69174
  3. [3] Nehring SM, Tadi P, Tenny S. Cerebral Edema. [Updated 2019 Mar 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  4. [4] Pastor, C., & Granick, M. S. (2011). Scrotal lymphedema. Eplasty, 11, ic15.
  5. [5] Kaplan A. P. (2008). Angioedema. The World Allergy Organization journal, 1(6), 103–113. doi:10.1097/WOX.0b013e31817aecbe
  6. [6] Iqbal MA, Gupta M. Cardiogenic Pulmonary Edema. [Updated 2019 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  7. [7] Abdulkarim A, Craig TJ. Hereditary Angioedema. [Updated 2019 Jun 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  8. [8] White, C. P., Hitchcock, C. L., Vigna, Y. M., & Prior, J. C. (2011). Fluid Retention over the Menstrual Cycle: 1-Year Data from the Prospective Ovulation Cohort. Obstetrics and gynecology international, 2011, 138451. doi:10.1155/2011/138451
  9. [9] Davison, J. M. (1997). Edema in pregnancy. Kidney International Supplement, (59).
  10. [10] Paller, M. S., & Schrier, R. W. (1982). Pathogenesis of sodium and water retention in edematous disorders. American Journal of Kidney Diseases, 2(2), 241-254.
  11. [11] Takada, Y., & Yoshida, S. (2005). Toxic, allergic, and inflamatory edema. Nihon rinsho. Japanese journal of clinical medicine, 63(1), 113-116.
  12. [12] McKnight, A. J., Koshy, J. C., Xue, A. S., Shetty, M., & Bullocks, J. M. (2011). Pediatric compartment syndrome following an insect bite: a case report. Hand (New York, N.Y.), 6(3), 337–339. doi:10.1007/s11552-011-9338-4
  13. [13] Frishman, W. H. (2002). Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. The American journal of cardiology, 89(6), 18-25.
  14. [14] Stachenfeld N. S. (2008). Sex hormone effects on body fluid regulation. Exercise and sport sciences reviews, 36(3), 152–159. doi:10.1097/JES.0b013e31817be928
  15. [15] Maekawa, H., & Toda, G. (2005). Edema in liver disease. Nihon rinsho. Japanese journal of clinical medicine, 63(1), 80-84.
  16. [16] Navas, J. P., & Martinez-Maldonado, M. (1993). Pathophysiology of edema in congestive heart failure. Heart disease and stroke: a journal for primary care physicians, 2(4), 325-329.
  17. [17] Sleigh BC, Manna B. Lymphedema. [Updated 2019 Jan 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  18. [18] Turchin, I., & Barankin, B. (2006). Dermacase. Chronic venous insufficiency. Canadian family physician Medecin de famille canadien, 52(10), 1217–1225.
  19. [19] InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Causes and signs of edema. 2008 Nov 5 [Updated 2016 Dec 30].
  20. [20] Luca, S., & Romeo, S. (1999). Edema and skin ulcers of the lower limbs as a collateral effect of nifedipine. A clinical case report. Minerva cardioangiologica, 47(6), 219-222.
  21. [21] Trayes, K. P., Studdiford, J. S., Pickle, S., & Tully, A. S. (2013). Edema: diagnosis and management. American family physician, 88(2).
  22. [22] Ellison, D. H. (1994). Diuretic drugs and the treatment of edema: from clinic to bench and back again. American Journal of Kidney Diseases, 23(5), 623-643.

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