Dear Doctor,

When I walk for a long distance or stand for a long time, my feet tend to swell. What could be causing this and what do I do to prevent it?

Tetero

Dear Tetero,

You have not specified your age. Is there associated joints pain, skin discoloration in legs, itching, swollen and dilated veins, any one or more of these symptoms? Do you feel breathless also, when the swelling appears?

Swelling over feet occurs due to build up of fluid within the feet. It can be due to injury to the feet or ankle like a sprain or soft tissue injury. It can be secondary to local skin conditions like fungal infections or eczema. Here there would be associated skin discoloration or eruptions which are itchy. Varicose veins is dilatation of the veins which commonly occurs over legs in people who walk much or stand for long hours continuously. The dilated veins are visible to the naked eyes. Elderly people can have swelling over feet due to stiffness of joints. Women sometimes get swollen feet as part of premenstrual syndrome or during menstruation, Repeat urinary tract infections can cause swelling of feet along with that of face. It can also be due to protein malnutrition.

Deficiency of thyroid hormones also causes swelling over feet as one of the manifestations. Among serious medical conditions, it can be due to heart, liver or kidney disorders. One would have associated other features of heart, kidney or liver failure along with swelling.

Diagnosis is based on clinical features. Relevant tests done for thyroid, heart, kidney, e.t.c. help to identify or exclude the disease of that part. Treatment consists of treating the underlying cause.

Primary prevention of swelling over feet is by a healthy life style. Taking a balanced diet, drinking much water, regular physical exercise, adequate rest, keeping body clean and dry, all these help to prevent the conditions causing swelling over feet. Prevention now would imply prevention of aggravation. Restricting salt and fluid intake would be useful.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital