Swelling

Edema; Anasarca

Slight swelling (edema) of the lower legs is common in warm summer months, especially if a person has been standing or walking a lot.

General swelling, or massive edema (also called anasarca), is a common sign in people who are very sick. Although slight edema may be hard to detect, a large amount of swelling is very obvious.

Edema is described as pitting or non-pitting.

• Pitting edema leaves a dent in the skin after you press the area with a finger for about 5 seconds. The dent will slowly fill back in.
• Non-pitting edema does not leave this type of dent when pressing on the swollen area.

Swelling can be caused by any of the following:

• Acute glomerulonephritis
• Burns, including sunburn
• Chronic kidney disease
• Heart failure
• Liver failure from cirrhosis
• Nephrotic syndrome
• Poor nutrition
• Pregnancy
• Thyroid disease
• Too little albumin in the blood (hypoalbuminemia)
• Too much salt or sodium
• Use of certain drugs, such as corticosteroids or drugs used to treat heart disease, high blood pressure, diabetes

Follow your health care provider's treatment recommendations. If you have long-term swelling, ask your provider about options to prevent skin breakdown, such as:

• Flotation ring
• Lamb's wool pad
• Pressure-reducing mattress

Continue with your everyday activities. When lying down, keep your arms and legs above your heart level, if possible, so the fluid can drain. DO NOT do this if you get shortness of breath. See your provider instead.

If you notice any unexplained swelling, contact your provider.

Except in emergency situations (cardiac failure or pulmonary congestion), your health care provider will take your medical history and will perform a physical examination. You may be asked about the symptoms of your swelling. Questions may include when the swelling started, whether it is all over your body or just in one area, what you have tried at home to help the swelling.

Tests that may be done include:

• Albumin blood test
• Blood electrolyte levels
• Echocardiography
• ECG
• Kidney function tests
• Liver function tests
• Urinalysis
• X-rays

Treatment may include avoiding salt, diuretics, or water pills. Your fluid intake and output should be monitored, and you should be weighed daily.

Avoid alcohol if liver disease (cirrhosis or hepatitis) is causing the problem. Support hose may be recommended.