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Edema is the excessive accumulation of fluid (swelling) in the soft tissues of the body. If you have edema for a long period of time, you may develop pigmentation, reddening, and/or hardening of the skin.

You may have swelling throughout your body. This is known as generalized edema or "anasarca". You may have edema that is localized in your upper body and which involves your face, arms and neck; or you may have "dependent" edema which involves the swelling of your legs and ankles and occurs most often at the end of the day. Finally, you may have periorbital edema, which is swelling around your eyes, usually upon awakening.

Although each type of edema may be caused by a variety of conditions, the location of the swelling sometimes gives your physician important information that helps him to diagnose any underlying illness.

What causes edema?
There are many causes of edema, but the most common ones are underlying kidney, liver or heart diseases.

Edema may be caused by diseases of the liver such as cirrhosis. Cirrhosis is a condition which is characterized by irreversible scarring of the liver. Edema may also be caused by a disease of the kidneys known as nephrotic syndrome". Nephrotic syndrome is distinguished by a large amount of protein in the urine, weight gain, high blood pressure, and anorexia.

Edema may be caused by diabetes or AIDS. It may be produced by the use of steroids or by chemotherapy. Another cause of edema is superior vena cava syndrome. This condition involves the narrowing of the vein which returns blood from the upper body to the heart.

Swelling may be caused by cardiac as well as other conditions. Congestive heart failure is a major cause of edema of the legs. If you have heart failure there may be a back up of blood returning to your heart. This causes congestion (edema) in your body's tissues.

Edema in various parts of the body may also be caused by rarer cardiac conditions such as: constrictive pericarditis, valvular disease, or a cardiac tumor.

Other causes of edema include: fractures, skin infections, or prolonged immobility.

Your doctor will be particularly interested in determining the reason for your edema so that he can devise a proper treatment plan.

The history and physical examination are very important tools for diagnosing edema.

During the physical examination, your doctor will press gently on your skin to determine if it pits. This is one method of diagnosing the presence of edema. When outside pressure is applied, the edematous fluid is temporarily displaced. The displacement causes a depression or "pitting".

Your doctor may order urine and blood tests which are also important tools for diagnosing the cause of edema.

If you have a history of edema of the legs after prolonged sitting, and if you are older and confined to a wheelchair, your edema may be unrelated to illness.

How is edema treated?
Therapy for edema involves treating the underlying cause(s).

If you have heart failure, for example, your doctor will probably prescribe diuretics (water pills). Diuretics may cause depletion of your body's potassium which can lead to the following side effects: dizziness, severe weakness, or severe leg cramping. If you experience any of these symptoms, call your health care professional.

You doctor may prescribe other medications for heart failure such as ACE inhibitors and Digoxin.. He may put you on a reduced sodium diet of no more than 3 grams of salt daily. He may suggest bed rest and/or recommend that you keep your feet elevated when you are sitting.


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