How does fluid retention develop? Pathophysiology

Generalized water retention Generalized
edema (swelling) affects interstitial space (between cells) throughout the body. 
The cause is a malfunction of the organs that regulate the metabolism of water:

  1. O rim,
  2. The liver.

In addition, a heart problem can change the pressure and cause widespread edema.

Retention of cardiac fluid Heart
failure reduces cardiac output and causes a decrease in blood volume (blood volume) at the periphery, in particular, less oxygen reaches the kidney. 
The consequence is the activation of the renin-angiotensin-aldosterone systemwhich causes a retention of:

  1. Na + (sodium),
  2. Water.

The decrease in blood volume also causes an increase in the secretion of vasopressin , therefore, there is a greater retention of fluid also in the collecting tubules in the kidney. 
All these mechanisms cause an increase in blood volume and this promotes fluid retention because it increases the hydrostatic pressure. 
In addition, right heart failure causes an increase in venous pressure. Reduced venous flow causes congestion at the capillary level

Renal fluid retention Renal
insufficiency may present as:

  1. Nephritic syndrome
  2. Nephrotic syndrome

Nephritic syndrome : characterized by a change in glomerular filtration, the glomerulus does not filter enough. 
The consequence is the emission of reduced urine causing an increase:

  1. Of the blood volume,
  2. The blood pressure .

This increase in volume is responsible for:

  1. From the increase in hydrostatic pressure,
  2. Formation of generalized edema.

Nephrotic syndrome
A damage to the renal glomerulus causes a change in protein permeability. 
The consequence is the passage of proteins into the ultrafiltrate (liquid with intermediate characteristics between blood and urine) that causes proteinuria(proteins in the urine). 
This causes a reduction in oncotic pressure (blood pressure caused by proteins in the blood) below 28mmHg which is required to retain the liquids inside the capillary. 
The consequences are:

  1. The movement of liquids in the interstitial space,
  2. Reduction of blood volume,
  3. Decreased glomerular filtration leading to increased secretion of aldosterone.

Aldosterone retains Na + and water, so it increases the fluids in the body. 
Fluid retention and decreased oncotic pressure cause obvious edema.


Localized fluid retention

This is edema in a limited area and the causes are local, for example:

  1. Venous obstruction – In case of venous thrombosis or venous compression in the lower limbs, the drained part of the affected vein is swollen. The swelling is in only one ankle and not in both.
  2. The lymphedema is related to something that affects the lymphatic system, for example, a tumor that starts from a lymph node or the cause may be the surgical removal of lymphatic vessels.
  3. Arm Edema – In the case of breast cancer , the surgeon can remove multiple lymph vessels. In some cases, the patient develops postoperative edema at the arm level that can be very painful.


Causes of fluid retention

Water retention can have many causes, some are physiological and benign, in other cases the origin is a disease.

The position of sitting for many hours (especially during the long flights in plane) is a common cause of swollen ankles .

The blood in the veins of the lower limbs needs an impulse to return to the heart. 
When walking, the contraction of the calf muscles works like a pump and allows the blood to rise.

Some people who are sitting all day have swollen ankles.

The reason is that the muscles are inactive and are not able to pump the fluid in the direction of the heart.

Staying standing for a long time is a similar situation. 
Due to the force of gravity, the fluid in the body accumulates in the tissues of the lower legs, causing swelling in the ankles (fluid retention). 
When the fluid is pushed towards the heart, it accumulates in the leg causing swelling.

lack of exercise is a cause of water retention. 
When we exercise, we help the leg veins work against gravity and push the blood into the heart.

If the valves in the leg veins are weakened , there is an insufficient return of blood to the heart that causes fluid retention. This pathology is known as chronic venous insufficiency.

An ankle and cinnamon injury can swell the area. 
After the injury, the most common cause is an infection around or inside the ankle joint.

Women may suffer from this disease due to pregnancy or premenstrual syndrome . 
Hormonal changes cause excessive fluid accumulation in the body. 
Even high blood pressureduring pregnancy causes this disease. 
If a woman takes a birth control pill , the estrogen present in these medicines can cause water retention and cellulitis.

Various medications cause swollen legs and water retention, for example:

  1. Medications for depression , diabetes , high blood pressure ,
  2. Cortisone  – promotes sodium retention and potassium excretion,
  3. Antiepileptics such as carbamazepine,
  4. Non-steroidal anti-inflammatory drugs ,
  5. Contraceptives,
  6. Mifepristone for medicinal abortion.

Edema and swelling in the foot may be caused by  some disorders such as:

  • Renal disease (especially in the elderly)
  • Heart Disorders
  • Liver disease (such as cirrhosis )
  • Hypothyroidism (hypoactivity of the thyroid that does not produce enough hormones)

When we eat foods high in sodium , water retention occurs.

According to a study by Osterberg KL et al.  (Gatorade Sports Science Institute, Barrington, IL 60010, USA), carbohydrates cause fluid retention . In dehydrated subjects, beverages with a carbohydrate content of 3%, 6% and 12% caused an increase in body mass index after 4 hours. 
The carbohydrates that are ingested are stored as glycogen. 
One gram of glycogen in the body binds to 2.7 grams of water. 
Glycogen is stored:

  1. In the liver,
  2. We muscles.

Here it can quickly turn into glucose to provide energy when the body needs it. 
This linkage explains why reducing carbohydrates in food or diet causes substantial weight loss at first. 
When the glycogen in the muscles is reduced, much water is lost.

lack of protein in the diet is also one of the causes of water retention. 
Proteins are essential for the regularization of water balance in the body. Many people are unaware that vitamin B6 (thiamine) deficiency can cause fluid retention.


Symptoms of fluid retention in the body

Below are some of the symptoms of water retention in the body:

  1. Swelling and stretching of the skin that becomes shiny. We can observe in the legs and in the abdominal zone.
  2. When we press the swollen area, we can see a dimple that forms for a few minutes
  3. Cellulite often appears on the back of the thighs
  4. Difficulty breathing (in case of ascites )
  5. Swollen abdomen
  6. Swelling in the face, form bags under the eyes
  7. Swollen hands and fingers
  8. Weight gain
  9. Athletes who practice bodybuilding lose body muscle definition because of the accumulating fluids.


Eye edema

The increase in fluid in the eyes may be:

  1. Corneal edema: occurs in case of corneal injury,
  2. Pupil edema: is linked to increased intracranial pressure,
  3. Glaucoma.

Causes of edema around the eyes

  • A severe allergic reaction to medications or food often manifests itself in the form of facial swelling that affects the eyes.
  • Having swollen eyes , even when the person is young, is caused by a disturbance in the functioning of the lacrimal glands.
  • The swelling around the eyes can also be due to skin problems like dermatitis . 
    The skin may swell as a result of exposure to irritants such as soaps and detergents. Cosmetic products also contain skin irritants so applying too much makeup on the eyes can also cause dermatitis.


What Causes Water Retention During Pregnancy

During the second and third trimester we observe a swelling of the body, there are many reasons for this.

The physiological causes of water retention in pregnancy are:

  • Increased blood volume
  • Retention of Na + and water in the interstitial space (between cells)
  • The uterus compresses the inferior vena cava and iliac veins.
  • Circulating progesterone causes vasodilation, the consequence is venous congestion.
  • Other causes are lack of exercise and sedentary lifestyle.

During the second and third trimesters, swelling of the body parts is normal. However, sudden swelling of the body during the end of the second trimester is a cause for concern. During this period, swelling of the hands and neck is a sign of the development of pre-eclampsia . 
This disease causes high blood pressure, which can be dangerous for the mother and the baby. 
Pre-eclampsia also causes:

  • Excessive fluid retention in the body,
  • Increased body weight,
  • Secretion of proteins in the urine.
  • Severe headache
  • Vision changes (flying flies in the visual field)

When symptoms occur, seek medical advice immediately.

In the breast – feeding phase , fluid retention is caused by the hormone prolactin that is used to produce milk.


Fluid retention during the menstrual cycle

Hormonal changes : Changes in hormones (especially increased progesterone) cause a buildup of fluid in the extremities. 
Therefore, before the onset of menstruation, some women may suffer from swollen legs and hands.

Dehydration: Women do not consume enough water. This causes dehydration . When the body is dehydrated it causes an edema, so the body retains water.

High Sodium Levels: Most women often eat foods high in sodium. The high amount of sodium causes water retention.

In the period before the menstrual cycle , even during menopause, too much water retention can occur due to hormonal imbalances. 
In practice, we see many women over 50 who have swollen legs, knees or feet after only a few hours of walking.


Water retention in men

Why does man suffer from fluid retention?

➜ When the kidneys are not able to filter the blood residues, the condition is termed as renal failure. When this happens, swelling in the legs and ankles is a common phenomenon.

➜ Thyroid problems can cause this disorder.

➜ In men who are overweight, high levels of estrogen (an underproduction of body fat) can cause swollen legs and feet .

➜ In adolescents, eating too much salt can cause fluid retention. They can aggravate the problem:

  1. The junk food (junk food or crap),
  2. Flavoring additives.

➜ Sugar is another cause. It forces the body to produce more insulin, causing water retention.

➜ Proteins in the blood attract water and play an important role in maintaining the balance of water in the body. 
When you suffer from severe protein deficiency, your blood does not contain enough protein to carry water from the tissues to the capillaries. 
This causes the accumulation of water inside the interstitial spaces.


What to do with fluid retention? The treatment

Treatment focuses on the underlying cause of fluid build-up. 
A low-salt diet is often the first step in preventing fluid build-up in the legs. 
It is not necessary to drink a lot of water, drinking little is less fluid in the body

If a person eats a lot of fruits and vegetables, does not have the thirst stimulation, instead, when you eat lots of cereals and carbohydrates, you are very thirsty.

How much and what water should we drink? 
The important thing is to drink water with little sodium, the body is able to regulate the liquids according to the needs. 
According to various theories of natural medicine, the ideal amount is between half a liter and a liter per day .


Stay physically active

Performing regular physical exercise for at least 30 minutes every day helps to detoxify the body and reduce fluid retention. 
Having a sedentary lifestyle can lead to many health problems. 
Therefore we recommend hiking . 
Bicycling, swimming or doing light exercises daily make health very well. 
When suffering from joint ailments or other health problems, consult a professional doctor to find out what exercises can be done to eliminate fluid retention.

In general, exercise bikes and Leg Press are the most useful activities because they allow you to work with your ankles higher than with other exercises.


Natural Remedies to Fight Liquid Retention

  • If the ankles and swollen legs are due to pregnancy, the woman should keep her legs elevated . This helps to normalize blood flow and reduce swelling.
  • Applying hot mustard oil to the affected area is one of the most commonly used home remedies. Drink two teaspoons of mustard in water overnight and apply the solution to the affected areas for relief.
  • The apple vinegar is beneficial to treat fluid retention legs, this product is required to spread along the legs up to the heel or the rear foot depending on the extent of swelling.
  • Among the herbal remedies , there are creams or ointments based on Asian asiatic centella and Indian chestnut that have an anti-edema action and can be applied in the swollen areas.
  • There are also Bach flowerpots , useful for liquid retention, such as Larch and Crab apple.
  • There are some very useful hand treatments, for example manual lymphatic drainage to deflate the lower limbs. 
    We can combine capacitive and resistive energy transfer , pre-therapy and draining massage for faster effects. 
    The sessions have a duration of at least 1 hour and it is advisable to repeat this treatment 5/10 times to obtain a longer lasting result.
  • You need to stop smoking and drink alcohol.
  • Attention to dietary supplements , for example creatine increases fluid retention at muscle level.

Herbal tea to eliminate fluid retention

Dandelion (Taraxacum officinale) is an herb that has long been used as a natural diuretic. 
Natural diuretics can help reduce water retention because they increase the production of urine.

It is rich in potassium and helps reduce sodium levels in the body. Also, since it is rich in magnesium , it is a good grandmother’s remedy to relieve premenstrual swelling .

In a study by Clare BA et al.  (Department of Medicine Herbal Medicine, Tai Sophia Institute, Laurel, MD 20723, USA), 17 volunteers took three doses of leaf extract of dandelion in 24 hours. 
They controlled fluid intake and urine output in the following days. 
The result is a significant increase in the amount of urine produced .

Preparation method:

  1. Leave a teaspoon of dried dandelion in a cup of hot water for about 10 minutes.
  2. Filtered,
  3. Drink this herbal tea up to three times a day.
  4. You can buy the mother tincture (extract) of dandelion (500mg one to three times a day).

Before starting herbal therapy, you need to talk to your doctor because you may interact with some medications.

Salsa has excellent diuretic properties. 
How to prepare the parsley tea:

  • Put two teaspoons of dried parsley leaves in a cup of boiling water.
  • Let it stand for 10 minutes.
  • Drink up to three times a day.

You can also drink a mixture of fresh parsley juice and lemon juice.


Do the tablets for fluid retention work?

The answer is yes. In this case, diuretic pills help remove excess water in the body, increase the frequency and volume of urine. 
However, this is not a complete and definitive cure for fluid retention. 
Your doctor may prescribe furosemide (Lasix), which is a diuretic to reduce fluid build-up.

Dandelion tablets are among the best home remedies for water retention.


Recommended food for liquid retention

Intestinal health is essential to avoid this problem, so food should be healthy and balanced.

You can not eliminate water retention with a natural remedy if you do not change your diet. 
First, we should avoid foods that contain too many carbohydrates :

  1. Sweets,
  2. Refined cereals (such as bread) or whole grains (such as brown rice).

You can do a very simple test , when you eat the cookies in the morning, rice or pasta for lunch and bread, remains the sign of the stockings on the ankles. 
Fruits and vegetables are natural diuretics because they contain too much potassium and little sodium. 
Among the recommended foods are:

  • Sweet lime
  • Onion
  • Broccoli
  • Oliva
  • Neighbor
  • Lettuce
  • Watermelon
  • Orange
  • Lemon
  • Pineapple
  • Blueberry juice
  • Raspberry
  • Papaya
  • Strawberry

Reduce water retention with potassium

Sodium or salt are key factors for body swelling. Therefore, foods rich in potassium (K) are extremely beneficial in balancing the required amount of sodium and eliminating excess fluids in the body. 
Against the swollen belly , you can eat:

  • Damascus
  • Avocado
  • Banana
  • Melon
  • Kiwi
  • Green bean
  • Nectarine


Other foods that help

Along with fruits, vegetables and foods rich in potassium, there are certain herbs that reduce water retention, for example asparagus which are extremely effective against abdominal bloating. 
The ursi grape is an herb that works in a significant way to reduce water retention, thanks to diuretic that reduce swelling.

The following is a list of foods that help reduce fluid retention in the body:

  • Asparagus
  • Salsinha
  • Dandelion
  • Celery
  • Chestnuts
  • Fennel Seed
  • White hawthorn
  • Butcher broom.


Foods to avoid

Milk and dairy products increase fluid retention, only babies should drink their mother’s milk. 
Often the swollen belly is caused by dairy products.

Sweets and sugars are generally not recommended because they are not part of a healthy diet.

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