By: Cat Ebeling, RN, MSN-PHN, co-author of the best-sellers: The Fat Burning Kitchen, The Top 101 Foods that Fight Aging & The Diabetes Fix
I remember flying to Thailand a few years ago. The flight is over 20 hours long. There you are, squished in with about 300 other passengers, so being able to move about and stretch your legs was a bit tricky. When I got off the plane, I was shocked to look down and see that I had ‘cankles’—you know, when your ankles are so swollen, you can hardly tell them from the rest of your leg? YIKES! Even my feet were swollen!
This is called edema—which is a collection of excess fluid in your tissues. Long flights and sitting too long are one of the causes of edema. There are many other reasons that people swell up and retain fluid–some minor, and some very serious or life-threatening.
What is Edema?
Edema means swelling, and it happens when the tiny blood vessels, or capillaries, begin to leak fluid into the nearby tissues. That extra fluid starts to build up and your body swells.
Edema often shows up in the arms, legs and feet, but it can also show up in the abdomen, and excess fluid can even collect in the lungs, which is a very serious type of edema, called “pulmonary edema”.
What Causes Edema?
While some of the causes of edema can be relatively minor, some edema is the result of serious—or even life threatening— health conditions.
Inflammation—Inflammation due to an allergic reaction, trauma, infections, rashes or even some illnesses, can cause inflammation, and as a result, edema.
Medications—Certain medications can change the body’s electrolyte and fluid balance, or cause the kidneys to be less efficient at removing excess fluid. Medications that can cause edema include corticosteroids, NSAIDS such as ibuprofen, insulin, or blood pressure medications.
Vitamin or nutrient deficiencies—Malnutrition due to a protein deficiency can cause the body to retain fluid, especially in the abdomen. Kwashiorkor is a type of malnutrition that causes a swollen, distended abdomen. Kwashiorkor most commonly affects children in developing countries where protein is scarce. Certain B vitamin deficiencies can also cause fluid retention and edema.
Electrolyte imbalances—Electrolytes are electrically charged minerals in our body fluids that help conduct electrical impulses necessary for muscles, especially the heart. Electrolytes also maintain the balance between sodium, potassium and water. When any of these essential minerals are out of balance, edema can result.
Other causes of edema include: long periods of inactivity, low thyroid, pregnancy, being on the pill, too much salt/sodium in diet, and excess sugar and carbohydrate consumption.
Treatment for more minor cases of edema include increased activity, getting thyroid and other hormones checked for imbalances, and making necessary changes in diet and nutrition.
Serious Health-Related Causes of Edema
Congestive Heart Failure—This is a common, but serious cause of edema, often in the feet and ankles. In fact, it is a hallmark symptom of heart failure. Heart failure occurs when the heart is not strong enough to efficiently pump blood throughout the body, and when the blood pools, it increases blood pressure. When this happens, fluid begins to leak out of the capillaries into extremities. More severe heart failure can cause fluid to build up in the lungs, which is called pulmonary edema. This becomes a medical emergency.
Kidney Disease—The kidneys are one of the primary fluid-regulating organs of our body. They also regulate sodium and potassium, two primary electrolytes that govern water retention. When the kidneys cannot filter enough water and sodium out, this causes a buildup of fluid in the body, which in turn causes edema.
Diabetes—Higher than normal blood glucose from high carb, high sugar consumption and poorly controlled diabetes causes fluid retention. In addition, elevated glucose damages arteries causing inflammation and stiffening—which results in atherosclerosis. When blood flow is impaired, fluid can accumulate in the lower extremities. Diabetes can also cause kidney disease and heart failure, both of which cause further edema.
Venous Insufficiency—Veins contain valves to help push blood back towards the heart to help it circulate. Over time, the valves wear out and blood can tend to pool in the legs. This pooling of blood causes varicose veins and edema. The slow-moving blood can also cause blood clots to form—which can be very dangerous, especially if they break loose and travel to the heart or lungs.
Lymphedema—Lymphedema is a type of edema related to the lymph system. The lymph system basically runs parallel to the circulatory system and helps to fight infections and filter toxins out of the blood. When there is damage to any area of the lymph system or lymph nodes, fluid will not drain properly, often resulting in swelling and edema.
Cancer, cancer treatments, surgery, trauma, and injury can cause blockages or poor lymph drainage in certain areas of the body, usually the extremities. An example of this is a woman who has had breast cancer surgery with removal of lymph nodes may have extreme swelling in the arm near the surgery, due to lymphedema.
Lymphedema can be a serious health condition because of the likelihood of the thin, delicate skin becoming injured and infection setting in. Trapped fluid also provides a fertile area for bacteria or fungus to grow. This can lead to cellulitis, which is an infection under the skin. Untreated, this kind of skin infection can spread to the bloodstream and cause sepsis, which is a life-threatening systemic infection.
Severe swelling from lymphedema can also cause the skin to crack or break and fluid can leak out. Long term, lymphedema can cause thickened and hardened skin that won’t go away. There is also a risk of a type of cancer that grows on untreated lymphedema.
Treatment for edema aims at finding the root cause of the swelling. Health care professionals should look at lab work, examine urinary and kidney function, monitor blood sugar levels, make changes in medication or diet if necessary–and in some cases, prescribe diuretic medication.