HEALTH : Swelling - i.e. – Edema

Edema is a condition of increase in the internal fluid volume of body, which may increase several times before it may become apparent. It is manifested by a swelling which may be localized over the affected part or generalized depending on the cause. Normally plasma volume is kept constant by various forces. Any disturbance in these forces can cause edema. Edema may be generalized when it appears on the entire body or localized when it appears on a selected part. Generalized edema commonly occurs because of disorders of heart, liver or kidney. Pulmonary edema, is a sinister condition in which fluid collects in the lungs. It can be fatal if untreated. The earliest symptom is breathlessness on exertion and as it progresses patient is forced to sit up all the time because lying down aggravates the condition. Pulmonary edema can occur because of failure of left ventricle of the heart when it is localized to lungs. It may occur as part of generalized edema. Generalized edema develops because of chronic cardiac failure. This develops because of failure of functioning of the right ventricle. Long standing hypertension, abnormalities of the heart valves, ischemic heart disease, chronic lung diseases e.t.c. precipitate right ventricular failure leading to edema. The characteristic of this edema is that it appears on the legs after exertion or in the evenings. There is indentation of the skin of the ankle while pressing, which is characteristic. In later stages there is swelling of the face and abdomen also. In case of chronic diseases of the kidney or urinary infections, edema first appears on the face and that too in the morning. Along with it the sufferer would have urinary symptoms like polyurea, dysurea,e.t.c. Later on it also becomes generalized. Similar to urinary tract diseases, protein deficiency also leads to facial edema in the early stages followed by generalized edema. Cirrhosis of the liver is the commonest liver disorder leading to generalized edema. The main feature of it is predominant collection of fluid in the peritoneal cavity known as ascites.In case of persons who are bed ridden, irrespective of the underlying cause, edema is produced over the sacral region. Various conditions produce localized collection of fluid or edema. Tumors or infections of the peritoneal cavity like tuberculosis or visceral organs cause ascites. Edema of only one or two legs is seen with Filariasis, HIV infection, infections of the veins or lymph vessels. Varicose veins a condition of dilatation of the veins of lower limbs is also associated with edema. Chronic persistent infections of the skin also cause localized edema in the affected part. Everyone is familiar with the small edema or swelling which occurs due to insect bite or localized allergy in any part of the body.Apart from these causes, women of menopausal age tend to develop edema on the feet and face because of the hormonal influence. Diagnosis of the cause of edema is important for treatment. Diagnosis is made by the history, clinical examination, and relevant tests for a suspected condition. Edema appearing on the face, abdomen or feet should not be taken lightly. Something seemingly trivial may progress to something irreversible. Once a vital part of the body has developed deranged functioning it tends to go downhill. Hence if diagnosed early, these conditions producing edema can be controlled very well. Salt restriction is useful to manage edema. Diuretic drugs i.e. drugs which promote mobilization of extra fluid from the body are used in all cases of generalized edema in doses depending on the condition. When taken for long, at times the edema tends to become refractory , when their dose has to be increased. Thus the side effects of diuretics also become more. Thus a vicious cycle is established where one cannot do without the diuretic and when taken side effects are produced. These adverse effects are in the form of cramps particularly in the legs, electrolyte disturbances, and even irregularity in the heart beats. Bed rest reduces the metabolism of the body in whole. This provides rest to the affected part by keeping minimum work load on it. The specific treatment of edema is treatment of the cause producing edema. Therefore it is advisable that anywhere one notices edema, whether on the face or feet or abdomen, it should not be neglected. rachna212002@yahoo.co.uk