Edema: What to do about fluid retention in the body?
Edema is an accumulation of fluid in the ties in a place where this fluid does not actually belong. Find out why edema forms, whether it is dangerous and when to see a doctor in this interview.
How to recognize edema?
"Edema is nothing more than increased fluid retention, usually at the lowest point in the body. That's the ankle-foot area," explains Dr. med. Michael Lichtenberg, Chief Physician of the Angiology Clinic at Arnsberg Hospital and President of the German Society of Angiology – angiology is the study of vascular diseases.
Leg edema therefore predominates in diagnosis. "Edema is very easy to recognize because it leads to deformity. The ankle structure is then suddenly no longer recognizable." A light prere on the edema confirms the picture: "If you press into the soft edema, you can often see that a dent remains. If this dent persists, it is a sign of increased water retention."
Why does edema form? The causes
In pregnant women, edema is most common in late pregnancy. As a rule, such edemas are evaluated as an annoying, but mostly harmless side effect of pregnancy. Nevertheless, pregnant women who are affected should not be afraid to see their gynecologist. After birth, water retention can even increase, but usually goes away on its own over a period of a few weeks.
In other cases, edema is often the symptom of another disease. Edema can be caused by a variety of conditions, including serious diseases of the heart or kidneys. Basically, edema presents itself as very complex in terms of its possible causes: "Not all edema is the same – you always have to look closely at what is behind it." The spectrum of possible causes is broad, and the following five categories provide an overview of common triggers.
Edema due to heart failure
One possible cause of edema is heart failure. "In this case, the blood is not sufficiently transported back to the heart, whereby it then accumulates at the lowest point of the body, i.e. in the lower legs, at the ankles and in the feet, where it then comes to fluid retention."
"Not all edema is the same – you always have to look closely at what is behind it."
Dr. med. Michael Lichtenberg
Chief Physician of the Angiology Clinic at Arnsberg Hospital and President of the German Society of Angiology
Edema caused by lymphatic diseases
A typical other form of edema has a lymphatic vessel disease as cause. The lymphatic system is the most important transport system in the human body, along with the blood circulation, and is focused on the transmission of nutrients and waste products. In the case of a disease, the fluid (lymph) contained in the lymphatic vessels is not sufficiently drained off. "This can happen, for example, after repeated wound roses, which are bacterial inflammations of the upper skin layer, but also by independent diseases of the lymphatic system."
A distinction is made between Congenital and acquired diseases of the lymphatic system. "For example, tumor diseases, lymph node diseases, fatty tumors or severe infections in the abdominal and pelvic area. All this can lead to the fact that the lymph is no longer properly removed, and it comes to the lymphedema."
Edema caused by venous diseases
In these edemas, the outflow to the heart is disturbed, for example after a deep vein thrombosis in the leg. "In such conditions, the blood cannot drain properly through the vein and backs up. As a result of this congestion, fluid increasingly leaks from the small veins in the foot and ankle area – and later also in the lower leg area. This fluid often also contains destroyed red blood cells or iron. This leads to edema, which turns brownish over time."
On the basis of this brown discoloration, especially in the case of edema in the ankle area or in the lower leg, one can conclude that a venous disease is present.
Edema due to protein deficiency
Furthermore, edema can be caused by a protein deficiency. "If you have diseases that cause less protein to circulate in the blood, i.e. a protein deficiency, edema can develop. Causes for it are liver or kidney illnesses, hunger conditions or also tumor illnesses."Such edemas occur in the legs, but also in the abdomen as abdominal fluid. If there is too little protein in the blood, water cannot be retained in the blood vessels. The so-called colloid osmotic prere, which is responsible for "binding" fluid in the vessels, decreases. The fluid is thus forced into the surrounding tie and edema develops.
Edema after injuries and in osteoarthritis
Another group of edemas is caused by external factors, such as injuries following accidents. "Here it comes to a so-called reactive swelling, that is, it comes out increased inflammatory water. But also in the case of arthrosis in the joint, i.e. a degenerative, degrading joint disease, there can be fluid retention."
Risk factor obesity
Apart from diseases that can be named as a direct cause of edema, there are Risk factors that at least favor the formation of edema. These factors include body weight and alcohol consumption.
"In severely overweight patients, fat deposits cause a certain amount of outflow congestion in the veins in the abdominal and pelvic area. This is also called Compression syndrome, which means that the fat exerts prere on the veins, so that the venous blood is not transported back to the heart and backs up into the legs. This leads to increased lymph vessel congestion and increased leakage of water in the legs in the form of edema. How dangerous is edema. When should a doctor be consulted?Slight swelling in the hands, feet or face can occur in hot weather or when someone has been standing or sitting for too long. Swollen feet are therefore more common in summer than in winter. Such slight swellings subside again by themselves. But you should not wait too long, because edema is not to be taken lightly because of the different causes.