What is edema, types (cerebral, pulmonary, etc.) and treatment

What is Edema?

Edema is the accumulation of fluid in the subcutaneous tissue that occurs when fluids within blood or lymph vessels leak into the skin. It consists of a solution of blood salts and proteins , which vary according to the cause of the edema. The disease causes swelling in regions such as hands, arms, ankles, legs and feet, but it can affect any other area of ​​the body.

When fluid accumulates in different areas or throughout the body, it is called generalized edema. If it occurs in certain places, it is localized edema, as is the case of swelling in the legs of individuals who have varicose veins.

Types

Edemas come in two forms: localized and generalized (also called anasarca).

When generalized, edema accumulates over the entire body, especially legs, arms, hands and the face. However, they can also occur inside the abdomen ( ascites ) and inside the lung ( pulmonary edema or pleural effusion ). Localized edema, on the other hand, is limited to compromising only a certain part of the body. The most affected areas are usually the vagina, anus and mouth.

Edema can also be classified according to its content: transudate and exudate. Transudate edema, or mole, consists only of water. The exudate, or hard, has water and proteins in its composition. This type of edema is usually inflammatory and causes pain, redness and heat.

Common edema

Caused by excess water and sodium, common edema is usually widespread swelling.

Cerebral edema

Excessive accumulation of water in a defined region or the whole brain. The increase in internal fluids causes the swelling and growth of its volume, generating more intracranial pressure.

Idiopathic edema

Idiopathic edema is common, but has an unknown origin. It is known to occur in women between 20 and 50 years old, generally using the following drugs in large quantities and without professional monitoring: diuretics, which help in the elimination of sodium and water through the urine; and cathartics, which favor the elimination of feces.

The bumps are located on the limbs and face, but can reach the entire body. Today, after the progress of several researches, it is believed that the origin is one or more of the following factors:

  • Secretion of hormones that retain water and sodium in the body;
  • As a result of inadequate diets, there is a reduction in a blood protein called albumin;
  • Intake of little salt, as in certain diets for weight loss, at the same time that the abuse of diuretics occurs;
  • Poor functioning of the venous and lymphatic return;
  • Standing for long periods of time;
  • Psychological changes that influence female hormones.

Idiopathic edema is also associated with the menstrual period, in a back and forth process each month.

Glottis edema

The glottis is an anatomical structure located in the larynx with the function of facilitating the entry and exit of air to the lungs and prevent the passage of food in the respiratory region. Glottis edema is an allergic reaction that causes swelling in this structure, which impairs its functioning.

Lymphedema

Lymphedema is due to the accumulation of lymph, a colorless liquid transported by the lymphatic system. This type of disease is the result of a blockage or destruction of the lymphatic circulatory system or an inherited condition that causes abnormalities of the lymphatic vessels. It usually affects the legs, as in the case of elephantiasis disease, which presents with edema accompanied by great deformation of the lower limbs.

Diabetic macular edema

In diabetic macular edema, fluid accumulates in the macula, a structure located in the central region of the retina. This accumulation of fluids happens due to the excess of sugar in the blood, which damages the blood vessels. The disease causes swelling of the retina and impairs its functioning.

Myxedema

It is a localized edema that occurs in cases of hypothyroidism , because of the accumulation of water, salts and specific proteins produced in the disease. It is characterized by being hard and the appearance of the skin is opaque.

Bone edema

Bone edema occurs within the bone, directly associated with bone contusions, fractures or periarticular trauma, that is, in the regions of tension and ligaments. This type of disease is rare.

Reinke’s edema

It is a lesion in the superficial layer of the vocal folds caused by the accumulation of liquid or gelatinous material. Patients who acquire this type of disease undergo changes in their voice, which takes on a hoarse and severe aspect. Reinke’s edema is caused by smoking or vocal abuse.

Peripheral edema

Peripheral edema is the swelling that affects the feet, ankles, legs, hands and arms due to the accumulation of fluids. The disorder is common to manifest itself among the elderly.

Pulmonary edema

It is the abnormal accumulation of fluid in the lungs that decreases the efficiency of the air passage, causing respiratory failure. It is a common problem in situations of vascular disorders or pulmonary pressure. Pulmonary edema may or may not be associated with heart disease.

Quincke’s edema

Also called angioedema, angioneurotic edema or giant urticaria, Quincke’s edema is characterized by affecting mainly the soft tissues of the organism, such as lips, eyelids, genitalia, tongue, larynx, among others. Its cause is associated with hives, anaphylaxis , serum sickness and food allergies , medications or the poison of bees, wasps and ants.

Causes

Blood and lymphatic vessels are permeable and have pores that allow cells, bacteria, proteins and water to exit and enter. Edema occurs when the liquids in the vessels overflow and accumulate on the skin, which can happen in certain situations:

Physiological

Standing or sitting for a long time, especially in the heat, can cause the accumulation of fluids and, successively, swelling in the legs. During hot temperatures, the body is less efficient at removing fluids from tissues, especially around the ankles.

Inflammation of vessels or tissues

The increased permeability of the blood vessel wall is an autoimmune reaction of the body that aims to facilitate the arrival of defense cells in an inflammatory process, whether infection, allergy or trauma. With the enlargement of the pores, the liquids from the vessels leak in larger amounts to the tissues, which causes swelling.

The causes of this mechanism can be:

  • Post-surgical reaction;
  • Burns;
  • Trauma;
  • Anaphylaxis: severe allergic reaction that develops in about one to two minutes;
  • Diabetes: disease characterized by elevated blood glucose;
  • Sepsis: autoimmune disease, sepsis is an inadequate manifestation of the organism in the face of an infection. In patients with severe illnesses, such as advanced sepsis, inflammation may be widespread and swelling may be seen throughout the entire body.

Reduction of oncotic pressure

Oncotic pressure is generated by blood proteins, especially albumin and globulins. When this pressure is reduced in the blood plasma, it causes a lower concentration of proteins, which causes water to leak into the tissues from osmosis – the process of passing liquids from a medium with a lower concentration of salt to one with a higher concentration.

When the patient has a disease that lowers blood proteins, edema will result from low oncotic pressure, even if the pressure in the veins is normal. As the lack of protein affects the entire body, edema is widespread.

The following diseases can reduce cancer pressure:

  • Cirrhosis: Cirrhosis renders the liver unable to produce essential amounts of protein, especially albumin.
  • Nephrotic syndrome : a disorder that causes protein to be lost through the urine, resulting in minimal amounts in the blood.
  • Protein malnutrition: low consumption of vitamin B1, B6 and B5 can contribute to fluid retention.

Increased hydrostatic pressure

The increase in hydrostatic pressure consists of an increase in pressure inside the veins that squeezes the liquid inside it until it overflows through the pores towards the outside. It can occur for two reasons:

Problems in venous return:

When there is an increase in pressure in the veins, the blood has difficulty returning to the heart, so it accumulates in the tissues. This process can be caused by obstruction of the veins or incompetence in the functioning of the valves, in both cases it is called as venous insufficiency.

Excess fluid in the vessels:

Characterized by the retention of water and sodium (salt) by the kidney. The accumulation of salt leads to an increase in the amount of body water, successively, blood and venous pressure, favoring the appearance of swellings.

The increase in hydrostatic pressure can be caused by:

  • Heart failure : The heart does not have enough strength to pump blood throughout the body effectively, causing recurrence problems mainly at the extremity of the body, such as the legs. Edemas start at the lower limbs and expand into the lung and abdomen.
  • Renal insufficiency: the failed pumping of blood in cases of heart failure results in smaller amounts supplying the kidneys, which, in a reaction of the body itself, retains more water and sodium to restore volume, causing renal failure. The edema associated with kidney failure occurs in the legs and around the eyes.
  • Venous thrombosis: existence of clots inside the veins, which consists of the formation of thrombi that obstruct the passage of blood towards the heart.
  • Varicose veins : Varicose veins are dilated and crooked veins, common in the lower limbs and painful, especially after standing for a long period of time.
  • Pregnancy : the growth of abdominal volume makes it difficult for the fluid to return into the veins.
  • Premenstrual and menstrual state: hormonal variations cause fluid retentions that increase pressure in the veins.
  • Menopause: During or after menopause replacement therapy, hormonal variations can cause fluid retention.

Lymphedema

Edema of lymphatic origin is common in diseases such as elephantiasis, in cancers, in morbid obesity and in severe and untreated venous insufficiency. It can also occur in the arms of patients who undergo mastectomy – surgery for complete breast removal – with removal of nodes from the armpit.

Other causes

Other conditions that may favor the appearance of edema:

  • Hypothyroidism: myxedema occurs, which is the retention of water, salt and specific proteins of hypothyroidism;
  • Chronic lung disease;
  • Hypovolemia;
  • Arthritis;
  • Eat very salty food.

On the legs, edema is usually caused by:

  • Varicose veins;
  • Leg injury or surgery;
  • Infection or inflammation;
  • A cyst or tumor;
  • A blood clot that blocks nerve circulation.

Medicines

The following classes of medications may favor the appearance of edema, so the patient should consult his doctor before taking them. Are they:

  • Antidepressants;
  • Antihypertensives, specifically calcium inhibitors, increase the permeability of the vessels in the lower limbs (beta-blockers, clonidine , nifedipine , amlodipine, hydralazine , methyldopa , among others);
  • Hormones (corticosteroids, estrogens, progesterone , testosterone);
  • Non-steroidal anti-inflammatory drugs;
  • Contraceptive pill;
  • Drugs that increase hydrostatic pressure, such as insulin , rosiglitazone, tamoxifen , minoxidil ;
  • Diuretics;
  • Cathartics.

Groups of risk

Edema is not transmissible or hereditary and can affect anyone. However, the following groups are more fragile to acquire the disease:

  • Seniors;
  • Pregnant women: The body of a pregnant woman retains more water and sodium to account for the fluid needed by the fetus and placenta, which increases the risk of acquiring the disease;
  • Diseases : People with chronic diseases, such as heart failure, cirrhosis and insufficiency;
  • Users of certain medications : non-steroidal anti-inflammatory drugs, steroids, estrogens and diabetes medicines of the thiazolidinedione class.

Symptoms

The symptoms depend on the amount of edema that the individual has in the body and in the place they are located. But in general, the following occurs:

  • Swelling of the skin, ankles, face or eyes;
  • Stretched or shiny skin;
  • Small sinking in the skin when pressed with the finger, a sign called locker or Godet sign;
  • Increased abdominal size;
  • Infection or inflammation;
  • Discoloration of the skin;
  • Body pain;
  • Joint stiffness;
  • Pain in the affected region;
  • Weight gain or reduction;
  • Increased blood pressure and pulse.

Specific symptoms

In addition to the similar signs, the symptoms of edema vary according to the cause of the disease. The most common specific symptoms are:

  • Infection or inflammation: minor allergic reactions, may not cause symptoms. However, in cases of patients allergic to insects such as bees, greater edema may be observed, with tense skin, pain and limited movement.
  • Food allergy : can cause swelling in the throat or tongue, preventing the passage of air.
  • Legs: with edema in the region, the movement of the legs can be impaired with the feeling of heaviness.

Lymphedema

Of lymphatic origin, lymphedema is differentiated by not having the presence of a locker, by reaching the limbs asymmetrically and being more deforming than venous edema.

When to see a doctor?

The patient should see a doctor immediately if he has difficulty breathing, shortness of breath and chest pain . These symptoms can be the first signs of a serious condition called pulmonary edema.

Edema may occur when the individual remains seated or standing for a long time. If the swelling does not reduce after the movement has returned, the health professional should be informed. Persistent swelling and pain in the legs can be symptoms of deep vein thrombosis (deep blood clot in the veins).

How is Edema diagnosed?

In order to diagnose the disease, the dermatologist starts the consultation with an analysis of the patient’s medical history and current status. The edema can be recognized by observation and by gently pushing the swollen area for a few seconds, which should confirm the disease by leaving a small sink in the skin. If this has occurred, your healthcare professional may order blood tests and the following tests to find out the cause of the disorder:

X-ray

Radiography, or x-ray , exposes a part of the body to a light dose of ionizing radiation in order to produce images of the interior of the organism. The test can find signs of pulmonary edema.

Ultrasound

The ultrasound system converts sound waves into two-dimensional images of regions such as internal organs, tissues, vascular network and blood flow. Through this method, it is possible to visualize, in real time, the internal structures of the organism and evaluate possible changes. The applications of the ultrasound exam can be abdominal, cerebrovascular, cardiological, among others.

Computed tomography

Examination of images using x-rays to capture detailed images of bones, organs and other specific structures of the body. Tomography is effective in investigating pulmonary and cerebral vessels, so it may be able to diagnose pulmonary and cerebral edema.

MRI

Examination that uses the magnetic field and radio frequency waves to produce images of internal organs and tissues. It is often used to examine the brain, joints and spinal discs. Magnetic resonance imaging can help diagnose bone edema.

Urine test

The urine test is intended to diagnose problems that affect the renal and urinary system, such as, for example, nephrotic syndrome (or nephrosis) and acute renal failure.

Cardiac function tests

Fundamental exams to assess patients with heart failure. They usually consist of the joint observation of cardiovascular and respiratory function, providing data on the individual’s circulation and metabolism.

Liver function tests

It consists of several laboratory evaluations performed to obtain details about the patient’s liver. The test can look at problems such as low levels of albumin in the blood and signs of cirrhosis .

Is edema curable? What is the treatment?

Edema requires specific knowledge of the cause to be treated correctly. In the mild manifestation of the disease, as in the physiological causes, the swelling disappears on its own after resting and elevating the legs.

When edema is severe, such as those caused by heart, kidney or liver failure (cirrhosis), health professionals can prescribe medications to reduce excess fluid accumulated through the urine, these being diuretics. If the cause of the disease is different, supervised use of the medication is advised so as not to dehydrate the patient or cause kidney damage. If edema is caused by diuretics, the doctor must find alternatives or discontinue use.

Tumors or lymphomas can be removed or shrunk with surgery, chemotherapy or radiation.

Lymphedema

Unlike edema, lymphedema has no cure, but it can be controlled from a series of treatments, such as compression stockings, skin care, daily foot lift and massages to optimize lymphatic circulation ( lymphatic drainage ). Diuretics are also indicated when the disease has been newly diagnosed.

Medicines

As edema has several causes, treatment varies according to the diagnosis established by the health professional. In general, the classes of drugs usually indicated to treat this disease are:

  • Diuretics, such as Furosemide ( Lasix );
  • Venotonics;
  • Specific drugs for the cause of edema, which may or may not be associated with diuretics.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Natural Medicines

The following natural medicines are not guaranteed as to their effectiveness or precautions against adverse reactions. To avoid any complications, the patient should visit a specialist doctor.

Apple vinegar

Put one or two tablespoons of apple cider vinegar in a glass of water and drink throughout the day.

Epsom salt

Epsom salt eliminates excess fluids and toxins from the body. The patient should bathe in a bathtub with two glasses of epsom salt for 15 minutes. The procedure should be performed 3 times a week.

Tea tree oil

When the inflammation is caused by insect bites, place a cotton ball wet in the tea tree oil twice a day on the affected area.

Massage

Like lymphatic drainage, massage activates the lymphatic system helping to drain fluid retention in tissues. The massage can be performed with olive oil, several times a day.

Parsley

Boil a spoonful of parsley in two glasses of water, drinking only once a day. Parsley has a diuretic effect that eliminates excess fluids in the body by blocking sodium absorption.

Grape seed extract

It can lower blood pressure and help relieve swelling related to varicose veins.

Living together

Patients can take the following measures to help reduce tissue fluid retention:

  • Losing weight, as excess fat causes pressure inside the veins;
  • Perform exercises regularly and in moderation;
  • Lift your legs three to four times a day to improve venous circulation, especially after long periods of sitting or standing;
  • If the patient has edema in the legs, use support stockings to maintain the flow of liquid up to the feet and ankles.
  • Consult your doctor or nutritionist for suggestions on diet improvements and substitutions to limit the amount of salt in your daily diet;
  • Protect swollen areas from pressure, injury and extreme temperatures. The lesions take longer to heal and can become infected;
  • Avoid the consumption of cigarettes and alcohol;
  • Avoid standing for a long time, in order not to force the lower limbs any more.

Complications

Edema, if not treated properly, can worsen the swelling and become increasingly painful, with the discomfort of joint and muscle stiffness. The lack of medical follow-up increases the risk of the following complications occurring:

  • Swelling even more painful;
  • Difficulty walking;
  • Scars on internal tissues;
  • Stretched, itchy skin;
  • Increased risk of infection in the swollen area;
  • Reduction of blood circulation and elasticity of arteries, veins, muscles and joints;
  • Infection in the swollen area;
  • Skin ulcers.

How to prevent Edema?

To prevent edema the patient must maintain a healthy life, with weekly exercise, reduced sodium in his diet and frequent visits to a health professional.


Edema is a disease that can be easily treated, as long as the patient undergoes medical monitoring and recognition of the cause of the disorder. Share this article with your family and consult a health professional if you experience any of the symptoms.

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