Edema

What Is It?

Edema is swelling of both legs from an accumulation of excess fluid. Edema has many possible causes:

• Prolonged standing or sitting, especially in hot weather, can cause excess fluid to accumulate in the feet, ankles and lower legs.
• Venous insufficiency is a common problem caused by weakened valves in the veins of the legs. This makes it more difficult for the veins to pump blood back to the heart, and leads to varicose veins and buildup of fluid.
• Severe chronic lung diseases, including emphysema and chronic bronchitis, increase the pressure in the blood vessels that lead from the heart to the lungs. This pressure backs up in the right side of the heart and the higher pressure causes swelling in the legs and feet.
• Congestive heart failure, a condition in which the heart can no longer pump efficiently, causes fluid buildup in the lungs and other parts of the body. The swelling is often most visible in the feet and ankles.
• Edema in the legs can occur during pregnancy because the pregnant uterus puts pressure on the vena cava, a major blood vessel that returns blood to the heart from the legs. Fluid retention during pregnancy also can be caused by a more serious condition called preeclampsia.
• Low protein levels in the blood that can be seen in malnutrition, kidney and liver disease can cause edema. The proteins in the blood help to hold salt and water inside the blood vessels so fluid does not leak out into the tissues. If the most abundant blood protein, called albumin, gets too low, fluid is retained and edema occurs, especially in the feet, ankles and lower legs.

Symptoms

Symptoms vary according to the type of edema and its location. In general, skin covering the swollen area will be stretched and shiny.

Diagnosis

To check for edema that is not obvious, you can gently press your thumb over the foot, ankle or leg with slow, steady pressure. If edema is present, an indentation will show on the skin. You should see a doctor to determine the cause of leg swelling. If both legs are swollen, your doctor will ask about other symptoms and do a physical examination. A urine test will show if you are losing protein from the kidneys. Blood tests, a chest X-ray and an electrocardiogram (EKG) also may be ordered.

Expected Duration

Edema can be temporary or permanent. Also, it can come and go depending on the cause.

Prevention