Oedema

The symptoms you experience will depend on what’s causing the condition, but ones to look out for include:

• swelling and puffiness, commonly in your legs, feet, ankles, hands and arms - though any part of your body may be affected
• your skin may look shiny, because it’s being stretched
• discolouration of the skin in the affected area
• achy feeling in the area that’s affected
• stiffness in your joints
• rapid weight gain or loss
• when pressed for a few seconds, the skin may hold the indent
• raised blood pressure
• fast pulse
• headache

A bit of swelling every now and then is not usually a sign of anything serious - for example, if you’ve been on a flight or walking around all day, you may notice some puffiness in your legs, feet or ankles. If it subsides on its own, you probably don’t need to worry.

However, if the swelling and puffiness doesn’t subside, you should see a GP. If you have any of the symptoms mentioned above, alongside swelling, it’s a good idea to see a GP too.

If the doctor cannot diagnose your oedema, or if they suspect an underlying cause, you may be referred for tests, or to a specialist, which our GPs can refer you to.

Sometimes, oedema can develop deep inside your body, such as on your lungs. If you have shortness of breath, difficulty breathing or any chest pain, seek urgent medical attention in A&E, as this could be a sign of fluid on your lungs.

If the swelling begins after a long flight or if you’ve been immobile for a long period of time, and it is accompanied with leg pain that doesn’t go away, also seek urgent medical attention, as this could be a sign of deep vein thrombosis.

Likewise, if you’re pregnant, and you develop oedema suddenly, contact your GP or midwife urgently, as it can be a sign of pre-eclampsia.

There are many reasons that you may have oedema. Mild swelling that goes away quickly isn’t something you should need to worry about, but if the swelling doesn’t go away, it could be a sign of an underlying condition that may need to be treated.

Sometimes, the cause isn’t known - this is called idiopathic oedema and is usually treated by either losing weight, eating less salt and a healthy diet, or both.

Common medical causes of oedema include:

• Heart failure - blood that is unable to be pumped around your body properly can collect in your legs, feet and ankles. Heart failure can also lead to fluid collecting in your lungs, known as pulmonary oedema.
• Kidney disease - if your kidneys do not work properly, some of the liquid being processed through them can leak out into your tissues, causing swelling.
• Nephrotic syndrome - this is another kidney problem, where you lose protein through your kidneys, meaning you don’t have enough of it in your blood. Symptoms include oedema in your feet, hands and eyes.
• Liver disease - fluid can leak out of your liver into your abdomen and legs, causing them to swell.
• Malnutrition - the low plasma protein in the blood vessels allows fluid to leak out into the body tissues.
• Thyroid conditions - this can cause hormonal imbalances in your body, which can lead to fluid retention.
• Pregnancy - oedema is common in pregnancy, and the swelling will usually come on gradually. However, if it comes on suddenly, speak to your midwife or GP immediately, as it could be a symptom of pre-eclampsia.
• Deep vein thrombosis (DVT) - if you have swelling that comes on during a period of immobility, such as a long haul flight, and it’s accompanied with leg pain, seek urgent help.
• Allergic reaction - this can sometimes cause areas of your body to swell up.
• Varicose veins - if your veins are damaged, your veins can start to bulge, and leak fluids out into your tissues, causing swelling.
• Lymphoedema - if your lymphatic system doesn't work properly, it can’t remove excess fluid from your tissues, causing swelling. This can be a result of surgery or infections.

Medications that may cause oedema:

• The contraceptive pill - the hormone progesterone can lead to fluid retention.
• Corticosteroids
• Some blood pressure medicines
• Some chemotherapy drugs

This is not a full list of possible causes of oedema. Speak to a GP for further advice and investigation.

Most of the time, mild oedema will not need medical treatment. Simply raising and resting the affected part of the body should make the swelling go down. If your oedema does not improve though, you may need medical treatment or tests to find the underlying cause.

The treatment for your oedema will depend on what is causing your symptoms. The doctor may advise:

• Regular exercise - walking or swimming can help
• Raise your legs a few times during the day
• Losing weight - if you are overweight
• Staying active - staying in one position can encourage fluid retention

These natural options should help reduce the swelling and you can use these techniques to try to stop it happening in the future.

You may be prescribed diuretics or water tablets, but these should only be used if directed by a doctor. They can potentially damage the kidneys and, in some instances, cause side effects which can make the fluid retention worse.

If it’s discovered your oedema is caused by an underlying medical cause, this will need to be treated to relieve your symptoms.

If you have the symptoms mentioned, or if you’re worried you have oedema, our GPs can listen to your symptoms and examine you over video consultation at a time and place that suits you. It may be useful to get your blood pressure taken at a pharmacy, or buy a home blood pressure monitor.

Remember though, if you have shortness of breath, difficulty breathing or any chest pain, if the swelling begins whilst you’re flying on a plane, or if you’ve been immobile for a long period of time, and is accompanied with leg pain that doesn’t go away, or if you’re pregnant and you develop oedema suddenly, seek urgent medical attention.