Edema (Oedema)

Abnormal  accumulation of fluid in the extracellular spaces is medically termed as edema. It presents as a soft  swelling in the body, which may be localized or generalized.

Causes of Fluid Collection

One may have a localized collection of fluid in the tummy. This is called ascites and is commonly seen in patients with liver disease, certain types of cancers.

Generalized puffiness is seen just before menses or in pregnancy. This happens under the influence of hormones.

A progressive kidney disease would also cause generalized edema. Many a times, this sign goes unnoticed. The patient may just complain of recent weight gain.

Allergic response to some food, seasonal, insect bite etc. may also lead to generalized or localized swelling of the body.

Use of external hormones, like oral contraceptives, may give a puffy feel in the body. Chronic alcoholism is another cause that affects the liver and leads to edema.

Other causes of edema include all conditions proceeding towards heart failure, thyroid disorders, kidney diseases or malnutrition.

Diagnostic Approach

The underlying cause of edema needs to be investigated. For that, a detailed  history with examination is required. Particularly, the site and nature of the swelling is observed.

For example, an isolated swelling in the arm or the leg may be due to lymphatic blockage in that limb.

Facial puffiness with generalized edema in the body may be due to kidney problems.

Swelling in the lower limb with breathing difficulty points towards some cardiac problem.

Treatment

For allergic swellings, antihistaminics like diphenhydramine are given. In severe cases, an injection of epinephrine (adrenaline) may be required.

The mainstay treatment for edema is prescribing diuretics, or water pills. If the cause is cardiac, digitalis may be given to slow down and strengthen the heart beats.

Ascites, or excess fluid from the abdomen, may require aseptic drainage via a hollow needle.

Diet Modification

Most patients with edema would benefit from low salt diets. If the cause is renal, kidney, let the diet be low in fat and proteins.