Edema: Causes, Symptoms and Treatments - Medical News Today Edema: Causes, Symptoms and Treatments Written by Christian Nordqvist 4 397 68 Edema is swelling caused by fluid retention - excess fluid is trapped in the body's tissues. In the UK/Ireland/Australasia and some other countries, the word is spelled oedema. Swelling caused by edema commonly occurs in the hands, arms, ankles, legs and feet. It is usually linked to the venous or lymphatic systems. Edema was formerly known as dropsy or hydropsy. Edema may be generalized or local. It can appear suddenly, but usually develops subtly - the patient may first gain weight, or wake up with puffy eyes. Many patients wait until symptoms are well advanced before seeking medical help. The rest of this article refers mainly to generalized edema, unless otherwise specified. Contents of this article: You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions. Fast facts on edema Here are some key points about edema. More detail and supporting information is in the main article.

Edema is caused by the retention of excess fluid within the body's tissues. The symptoms of edema normally develop gradually over time. Approximately 4.4 million people in the US have developed edema. The three most common types of edema are peripheral, cerebral and eye edema. Swelling can result from capillaries leaking fluid into the surrounding tissue. The symptoms of edema mainly depend on what the underlying cause is. The cause of edema may be diagnosed by chest X-ray, blood tests, urine tests, liver function tests or heart function tests. Edema is normally caused by a more significant underlying disease or condition. A number of medications appear to cause pedal edema (foot edema). Lucentis (ranibizumab injection) is an FDA-approved treatment for diabetic macular edema. What is edema? The English word "edema" comes from the Greek word oidema, meaning "a swelling tumor ," which is derived from the Greek verb oidein meaning "to swell." It is estimated that approximately 4.4 million people in USA have edema. There are many types of edema.

The most common ones are: Peripheral edema - in the feet (pedal edema), ankles, legs, hands and arms. Cerebral edema - in and around the brain (cerebral edema). Eye edema - in and around the eyes, e.g. macular edema, corneal edema, periorbital edema (puffiness around the eyes. Macular edema is a serious complication of diabetic retinopathy . The CDC (Centers for Disease Control and Prevention) estimates that the number of cases of diabetic retinopathy will triple from 5.5 million in 2005 to 16 million in 2050 . Causes of edema If the capillaries (tiny blood vessels) leak fluid into the surrounding tissue the area will start to swell. This could be due to capillary damage or increased pressure. Leaking capillaries will cause the kidneys to accumulate higher than normal quantities of sodium (salt) and water in order to compensate for the capillary fluid loss. This results in more blood circulating in the body, which in turn causes even more capillary leakage into the surrounding tissue, which produces additional swelling - a vicious cycle.

Edema is most commonly caused by: Physical inactivity Edema is more prevalent among people who do not exercise and walk very little. Standing or sitting still for long If a person stands or sits still for long periods of time, there is a much higher chance of swelling. Genes Surgery There is usually some swelling after a surgical procedure. High altitudes, especially when combined with physical exertion can be a high risk factor. Acute mountain sickness can lead to high altitude pulmonary edema or high altitude cerebral edema. High altitudes High altitudes, especially when combined with physical exertion can be a high risk factor. Acute mountain sickness can lead to high altitude pulmonary edema or high altitude cerebral edema. Heat Heat, when combined with physical exertion may cause edema. During high temperatures, the body is less efficient at removing fluid from tissues, especially around the ankles. Burns The skin reacts to a burn by retaining fluid, causing localized swelling. Pregnancy During pregnancy, a woman releases hormones that encourage the body to retain fluids. Pregnant women tend to retain more sodium and water than women who are not pregnant. When a woman is pregnant, her face will typically swell, as will her hands, lower limbs and feet.

When a woman is resting in a reclined position the enlarged uterus occasionally compresses the inferior vena cava, causing obstruction of both femoral veins, leading to edema. A pregnant woman's blood is hypercoaguble (clots more easily), raising the risk of deep venous thrombosis (DVT), a cause of edema. Eclampsia, which results from pregnancy-induced hypertension ( high blood pressure ), can also cause edema. Menstruation and pre-menstruation Hormone levels fluctuate during the menstrual cycle. During the days before menstrual bleeding, there will be a reduction in the levels of the hormone, progesterone , which may cause fluid retention . The contraceptive pill Any medication that includes estrogen can cause fluid retention. It is not uncommon for women to put on weight when they first go on the pill. Menopause Around the period of the menopause , as well as after, hormone fluctuations can cause fluid retention. Hormone replacement therapy after the menopause can also cause edema.

Certain medications Such as vasodilators (drugs that open blood vessels), calcium channel blockers, NSAIDs (non-steroidal anti-inflammatory drugs), estrogens, several chemotherapy drugs, and some diabetes drugs, such as thiazolidinediones. Scientists in the University of Utah discovered why thiazolidinediones cause edema Excessive salt intake This is especially the case for people who are susceptible to developing edema. Malnutrition and/or bad diet Dietitians say low consumption of thiamine ( vitamin B1), as well as insufficient vitamins B6 and B5, may contribute toward fluid retention. Low levels of albumin may also play a part - low albumin levels can also be caused by kidney disease. Edema can also be caused by the following diseases: Kidney disease/damage Patients with kidney disease may not be able to eliminate enough fluid and sodium from the blood. This results in more pressure on the blood vessels, which causes some of the liquid to leak out. Kidney disease patients with edema will have swelling around their legs and eyes. Damage to the capillaries in the kidneys (glomeruli) that filter waste and excess fluids from the blood can result in nephrotic syndrome.

Among the many symptoms of nephrotic syndrome is an insufficient level of blood albumin, which leads to edema. Heart failure This is when the heart cannot pump blood properly to all parts of the body. If one or both of the lower chambers of the heart lose the ability to pump blood effectively, the blood can accumulate in the limbs, causing edema. Chronic lung disease Chronic lung disease includes many lung diseases, such as asthma , chronic bronchitis , COPD, emphysema , pulmonary fibrosis and sarcoidosis. Some patients may experience an accumulation of fluids in the lungs - pulmonary edema. Liver disease Such as cirrhosis , which causes scarring of the liver. This affects liver function, which causes the secretion of hormones and fluid-regulating chemicals to change. People with cirrhosis of the liver also have increased pressure within the portal vein - the large vein that carries blood from the intestines, spleen and pancreas, into the liver. These problems can lead to fluid retention in the legs and ascites (abdominal cavity).

Diabetes A patient with diabetes may have edema for several different reasons, including cardiovascular disease and its associated complications, acute renal failure, acute liver failure, protein-losing enteropathy (disease of the intestine causing protein loss) and some medications. Diabetic macular edema is the swelling of the retina in diabetes. Allergies Some foods and insect bites may cause edema in susceptible people. Arthritis People with arthritis most commonly have swelling in the ankles, feet, legs, and calves - peripheral edema. Arthritis may cause swelling for many reasons, for example, sporadic ankle swelling in rheumatoid arthritis is common and occurs mainly, as a result, of active inflammatory synovitis ( inflammation of the synovial membrane, the lining of the joint). Thyroid disease People with a disorder of the thyroid gland commonly experience edema. Brain tumor A brain tumor will accumulate water around itself, especially as it builds new blood vessels. Head injury A blow to the head may result in an accumulation of fluids in the brain or between the brain and the skull. Edema in the leg is most commonly caused by: A blood clot Any blockage, such as a clot in one of the veins can impede the flow of blood.

This causes an increase in pressure in the vein, which may result in leakage of fluids into the surrounding tissue, causing edema. Varicose veins often accompany symptoms of edema Varicose veins These often accompany symptoms of edema. Varicose veins usually occur because valves become damaged; static pressure increases, resulting in the bulging veins. The static pressure also increases the risk of leakage of fluids into the surrounding tissue. Infection/inflammation The lymph nodes may swell in response to infection. A cyst/growth/tumor Edema can cause cysts , which in turn can cause more edema. Any lump can cause edema for a number of reasons. The lump may press against a vein causing a build-up of pressure in that vein, which may result in fluids leaking into surrounding tissue. The lymph nodes may react to a tumor and swell. Lymphedema The lymphatic system helps get rid of excess fluid from tissues. If this system is damaged the lymph nodes and lymph vessels which continually drain an area may not work as they should, it could result in edema.

If the damage is due to lymphedema it is called primary lymphedema, if it is caused by disease or medical condition, such as an infection or cancer , it is caused secondary lymphedema. Recent developments on edema causes from MNT news Edema Causes - Mayo Clinic Estrogens Certain diabetes medications called thiazolidinediones In some cases, however, edema may be a sign of a more serious underlying medical condition. Diseases and conditions that may cause edema include: Congestive heart failure. When one or both of your heart's lower chambers lose their ability to pump blood effectively — as happens in congestive heart failure — the blood can back up in your legs, ankles and feet, causing edema. Heart failure can also cause swelling in your abdomen. Sometimes it can cause fluid to accumulate in your lungs (pulmonary edema), which can lead to shortness of breath. Cirrhosis. Fluid may accumulate in your abdominal cavity (ascites) and in your legs as a result of liver damage (cirrhosis). Kidney disease. When you have kidney disease, extra fluid and sodium in your circulation may cause edema.

The edema associated with kidney disease usually occurs in your legs and around your eyes. Kidney damage. Damage to the tiny, filtering blood vessels in your kidneys can result in nephrotic syndrome. In nephrotic syndrome, declining levels of protein (albumin) in your blood can lead to fluid accumulation and edema. Weakness or damage to veins in your legs. Chronic venous insufficiency, in which the one-way valves in your leg veins are weakened or damaged, allows blood to pool in the leg veins and cause swelling. Abrupt onset of swelling in one leg accompanied by pain in your calf can be due to a clot in one of your leg veins. Seek medical help promptly. Inadequate lymphatic system. Your body's lymphatic system helps clear excess fluid from tissues. If this system is damaged — for example, by cancer surgery — the lymph nodes and lymph vessels draining an area may not work correctly and edema results. Walsh D, et al. Palliative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2009. Accessed June 10, 2014. Sterns RH. General principles of the treatment of edema in adults.

Accessed June 2, 2014. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. Accessed June 2, 2014. Sterns RH. Patient information: Edema (swelling) (Beyond the Basics). Accessed June 18, 2014. Barbara Woodward Lips Patient Education Center. Tips for managing your edema. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2010. Trayes KP, et al. Edema: Diagnosis and management. American Family Physician. 2013;88:102. Products and Services Oedema - formerly known as dropsy or hydropsy Oedema What is oedema? Oedema is swelling, often in the legs and feet , due to a build-up of fluid under the skin in the spaces between body tissues. In the past it was called dropsy or hydropsy. Oedema not only causes puffiness it can also lead to aching limbs, stiff joints , skin discolouration and weight gain.

Different types of oedema Often the swelling is in one particular part of the body. Peripheral oedema. This is the most common type and occurs in the feet, legs and ankles . Pulmonary oedema . An accumulation of fluid in the air spaces ( alveoli ) in the lungs. Cerebral odema. This affects the brain . Macular oedema. This affects the eyes . Anasarca. This is oedema in all the tissues and cavities of the body at the same time. Causes of oedema Causes of oedema include: Illness - The most common diseases associated with oedema involve the heart , liver and kidneys . In these cases, oedema usually occurs because of the body's retention of too much salt. The excess salt causes the body to retain water which results in swelling. Varicose veins and thrombophlebitis can also lead to oedema. This has nothing to do with salt but is down to inadequate pumping of the blood through the veins, also known as venous insufficiency. This can cause fluid to accumulate in the extremities, especially the legs, ankles and feet.

Oedema can also be caused by long-term lung disease and thyroid disease and can be related to advanced cancer. A leg injury or surgery Burns to the skin. Idiopathic oedema is a term used to describe cases of oedema where a cause can't be found and occurs most often in women. Pitting and non-pitting oedema Pitting oedema is the most common form of oedema. If you briefly apply pressure to the swollen area by pressing on the skin with a finger and the pressure leaves an indentation that lasts for some time afterwards that is referred to as pitting oedema. In non-pitting oedema, pressing on the swollen skin with a finger does not leave a persistent indentation. Non-pitting oedema usually affects the legs or arms. It can occur in patients with lymphoedema or in some patients with hyperthyroidism . Non-pitting oedema of the legs is difficult to treat. Diuretic drugs (sometimes called water pills) are not usually effective, although elevating the legs periodically during the day and compression stockings may reduce the swelling.

Treatment for oedema Sometimes 'treatment' is as simple as taking the weight off your feet, putting your legs up and resting, especially if the weather is warm. It may also help to reduce salt intake. Regular exercise to improve circulation and losing weight can help oedema along with compression stockings and lymphatic massage. Seek medical advice if your symptoms don't go away. If there is an underlying reason for your oedema you may be prescribed medication to help treat the condition. This can include diuretics to flush excess water and salt from the body. Next Article: Fluid Retention and Tissue Swelling Due to Collection of Lymph in Dogs | petMD Fluid Retention and Tissue Swelling Due to Collection of Lymph in Dogs Lymphedema in Dogs Lymphedema is a medical in which localized fluid retention and tissue swelling are caused by a compromised lymphatic system. The watery fluid, also known as lymph, contains white blood cells and circulates throughout the lymphatic system and typically collects into interstitial spaces, especially subcutaneous fat. Congential forms of the disease has been reported in bulldogs and poodles, as well as Labrador retrievers and Old English sheepdogs.

Symptoms and Types The fluid accumulation (edema) is usually not painful and pits; that is, a depression develops if the skin is pushed with a finger (which eventually disappears if fibrosis occurs). Limb swelling, meanwhile, is present at birth or develops in the first several months. The swelling may be affect one or several limbs, and typically begins at the end of the limb and slowly moves upwards. In some cases, lameness and pain may also develop. Causes Hereditary and congenital (present at birth) forms of lymphedema are caused by malformations of the lymphatic system, such as aplasia, valvular incompetence, and lymph node fibrosis. Other potential causes include heart disease, trauma to the lymphatic vessels or lymph nodes, and heat or radiation exposure. Diagnosis You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count -- the results of which are typically normal. The most reliable test used to diagnose this condition, however, is called lymphography.

This imaging examination uses a contrast substance, which is injected directly into the lymphatic system, to better visualize the affected region before taking X-rays. CV Physiology | Tissue Edema and General Principles of Transcapillary Fluid Exchange Tissue Edema and General Principles of Transcapillary Fluid Exchange Prevention and Treatment of Edema Edema refers to the swelling of a tissue that results from excessive accumulation of fluid within the tissue. Edema can be highly localized as occurs in a small region of the skin subjected to a bee sting. Edema, however, can also comprise an entire limb, specific organs such as the lungs (e.g., pulmonary edema ) or the whole body. General principles To understand how edema occurs, it is first necessary to explain the concept of tissue compartments. There are two primary fluid compartments in the body between which fluid is exchanged - the intravascular and extravascular compartments.The intravascular compartment contains fluid (i.e., blood) within the cardiac chambers and vascular system of the body. The extravascular system is everything outside of the intravascular compartment. Fluid and electrolytes readily move between these two compartments.

The extravascular compartment is made up of many subcompartments such as the cellular, interstitial, and lymphatic subcompartments, and a specialized system containing cerebrospinal fluid in the central nervous system. The movement of fluid and accompanying solutes between compartments (mostly water, electrolytes, and small molecular weight solutes) is governed by physical factors such as hydrostatic and oncotic forces. These forces are normally balanced in such a manner that fluid volume remains relatively constant between the compartments. If the physical forces or barriers to fluid movement are altered, the volume of fluid may increase in one compartment and decrease in another. In some cases, total fluid volume increases in the body so that both intravascular and extravascular compartments increase in volume. This can occur, for example, when the kidneys fail to excrete sufficient amounts of sodium and water. When the fluid volume within the interstitial compartment (space between the cells and blood vessels) increases, this compartment increases in size leading to tissue swelling (i.e., edema). This is what happens when an ankle is sprained and swells.

When excess fluid accumulates within the peritoneal space (space between the abdominal wall and organs), this is termed "ascites." Pulmonary congestion, which can occur in heart failure as the left atrial pressure increases and blood backs up in the pulmonary circuit, causes pulmonary edema . A model that helps us to understand what causes edema is shown to the right. Filtration is the movement of fluid out of the capillary and reabsorption is the movement of fluid back into the capillary. In most capillary systems of the body, there is a small net filtration (typically about 1% of plasma) of fluid from the intravascular to the extravascular compartment. In other words, capillary fluid filtration exceeds reabsorption. This would cause fluid to accumulate within the interstitium (i.e., cause edema) over time if it were not for the lymphatic system that removes excess fluid from the interstitium and returns it back to the intravascular compartment.

Therefore, Fluid balance occurs when: Filtration = Reabsorption + Lymphatic Flow Circumstances, however, can arise in which net capillary filtration exceeds the capacity of the lymphatics to carry away the fluid (i.e., net filtration > lymph flow). When this occurs, the interstitium swells with fluid, thereby becoming edematous. Increased capillary hydrostatic pressure (as occurs when venous pressures become elevated by gravitational forces, in heart failure or with venous obstruction) Decreased plasma oncotic pressure (as occurs with hypoproteinemia during malnutrition) Increased capillary permeability caused by proinflammatory mediators (e.g., histamine, bradykinin) or by damage to the structural integrity of capillaries so that they become more "leaky" (as occurs in tissue trauma, burns, and severe inflammation) Lymphatic obstruction (as occurs in filariasis or with tissue injury) Prevention and Treatment of Edema The treatment for edema involves altering one or more of the physical factors that regulate fluid movement. For example, in edema (pulmonary or systemic) secondary to heart failure , diuretic drugs are given to reduce blood volume and venous pressure .

In heart failure patients, improving cardiac output by using cardiostimulatory or vasodilators drugs reduces venous and capillary pressures, thereby decreasing filtration and promoting reabsorption of fluid within tissues ( click here to see why increasing cardiac output decreases venous pressure). If a patient suffers from ankle edema, that person will be instructed to keep their feet elevated whenever possible (to diminish the effects of gravity on capillary pressure), use tight fitting elastic hose (to increase tissue hydrostatic pressure ), and possibly be prescribed a diuretic drug to enhance fluid removal by the kidneys. Revised 4/29/2014 DISCLAIMER: These materials are for educational purposes only, and are not a source of medical decision-making advice. Lymphedema | definition of lymphedema by Medical dictionary Lymphedema | definition of lymphedema by Medical dictionary Description Lymphedema involves blockage of the lymph vessels, with a resulting accumulation of lymphatic fluid in the interstitial tissues of the body. The lymphatic system consists of lymph vessels and lymph nodes throughout the body. The lymph vessels collect lymphatic fluid, which consists of protein, water, fats, and wastes from cells.

The lymph vessels transport the fluid to the lymph nodes, where waste materials and foreign materials are filtered out from the fluid. The fluid is then returned to the blood. When the vessels are damaged or missing, the lymph fluid cannot move freely throughout the system but accumulates. This accumulation of fluid results in abnormal swelling of the arm(s) or leg(s), and occasionally swelling in other parts of the body. Lymphedema is a very serious condition. There is no cure for lymphedema and once it develops, it can be a long-term, uncomfortable, and sometimes painful condition requiring daily treatment. When lymphedema is not treated, the protein-rich fluid continues to accumulate, leading to even more swelling and hardening (referred to as fibrosis) of the tissues. This fluid is a good culture medium for bacteria, thus resulting in reoccurring infections when there are injuries to the skin, decrease or loss of functioning of the affected limbs, and skin breakdown. Infections, referred to lymphangitis, can affect the connective tissue under the skin. Repeated infections may result in scarring, which in turn makes the tissue susceptible to more swelling and infection.

Over time, these infections result in tissue hardening (i.e., fibrosis), which is a characteristic of advanced chronic lymphedema. In very severe cases, untreated lymphedema may even result in a rare form of lymphatic cancer called lymphangiosarcoma. Lymphedema affects approximately 100 million people worldwide, including at least 3 million people in the United States. Symptoms of lymphedema include: swelling of an affected limb, which may develop gradually or suddenly tightness of the skin and a feeling of heaviness in the affected area discomfort or a feeling of "pins and needles" in the affected area pitting edema , which can be identified by observing a temporary indentation in the swollen area when pressure is placed on the affected area aching in the adjacent shoulder or hip due to the increasing weight of the swelling limb tight fitting of a ring, wristwatch, or bracelet, without a gain in weight. In 90% of the cases, lymphedema is diagnosed through observations, measurements, and symptoms. The remaining 10% require the use of more complex diagnostic tests such as lymphoscintigraphy.

Lymphoscintigraphy is a technique in which a radioactive substance that concentrates in the lymphatic vessels is injected into the affected tissue and is mapped using a gamma camera, which images the location of the radioactive tracer. Magnetic resonance imaging (MRI), computed tomography (CT) scanning, and duplex ultrasound are imaging techniques that are also sometimes used as diagnostic tools for lymphedema. There are three stages of lymphedema: Stage 1 (spontaneously reversible)—tissue is still at the pitting stage and soft to the touch. Upon waking in the morning, the limbs or affected areas are of normal or almost normal size Stage 2 (spontaneously irreversible)—tissue is non-pitting and no longer soft to the touch, fibrosis begins to form, and the limbs increase in size Stage 3 (lymphostatic elephantiasis )—swelling is irreversible and the affected areas are very swollen. The skin hardens and begins to break down, fibrosis is more extensive, and patients may need surgery to remove some of the swollen tissues. Causes Primary lymphedema is an inherited condition, where the patient is born without lymph vessels and nodes.

The swelling associated with primary lymphedema usually occurs during adolescence and affects the foot or calf. A rare form of primary lymphedema, called Milroy's Disease, occurs in pregnancy . However, secondary lymphedema, or acquired lymphedema, develops as a result of an injury to the lymph system. Specific causes include surgical treatments for certain types of cancers, especially those cancers that currently require the removal of lymph nodes. Radiation treatment for cancer or for some AIDs-related diseases such as Kaposi-Sarcoma may also result in lymphedema, as radiation may damage or destroy lymph nodes or cause the formation of scar tissue that can interrupt the normal flow of the lymphatic fluid. Specific cancers and their treatment that may result in lymphedema include malignant melanoma , breast (in both women and men), gynecological, head and neck, prostate, testicular, bladder, and colon cancer . Other causes of lymphedema include trauma to the lymphatic system from burns , liposuction, tattooing, injuries, surgery, radiation, obesity , heart or circulatory disease, and multiple sclerosis . Lymphedema in people at risk may not develop the condition immediately, but develop the condition weeks, months, or even years later.

Aircraft travel has been linked to the development of lymphedema in patients after cancer surgery, possible due to the decreased cabin pressure. In Western countries, one of the most common causes of lymphedema is mastectomy with axillary dissection (removal of the breast and underarm lymph tissue for treatment of breast cancer ), which may result in lymphedema of the breast, underarm, or arm on the side of the surgery in 10-20% of patients. This occurs because the lymphatic drainage of the arm passes through the axilla (armpit), and tissue in the axilla is removed during the mastectomy. To reduce the risk of developing lymphedema after breast cancer treatment, there is an alternative treatment that avoids axillary lymph node dissection. Sentinel lymph node biopsy is a new diagnostic procedure used to determine whether the breast cancer has spread (metastasized) to axillary lymph nodes. A sentinel lymph node biopsy requires the removal of only one to three lymph nodes for close review by a pathologist. If the sentinel nodes do not contain tumor (cancer) cells, this may eliminate the need to remove additional lymph nodes in the axillary area.

Early research on this technique indicates that sentinel lymph node biopsy may be associated with less pain and fewer complications than standard axillary dissection. Because the procedure is so new, long term data are not yet available. However, there is still a risk for developing lymphedema because of follow-up radiation treatments or chemotherapy , which may also damage the lymph nodes. Persons who have developed lymphedema after cancer treatment should be checked for a possible reoccurrence of cancer if they experience a sudden increase of swelling, for the tumor growth may be responsible for blocking lymphatic flow. Treatments Lymphedema is a chronic condition that cannot be cured, but it can be improved with treatment. There are several major components of a lymphedema treatment program, which should be administered by the health care provider in cooperation with a physical therapist trained in lymphedema treatment. Complete Decongestive Therapy (CDT; also referred to as Complex Decongestive Therapy (CDT) or as Complete Decongestive Physiotherapy (CDP)) combines manual lymph drainage (MLD) with compression techniques and with patient education on self-care needs.

The goals of the treatment program are to: remove the stagnant lymph fluids out of the tissues reduce and help control swelling soften fibrotic tissue improve the overall health of the patient. However, some lymphedema specialists feel that lymphedema patients with metastatic cancer should not be treated with CDT, to prevent the spreading of the cancer. MLD was developed in 1932 in Denmark by a doctor and his wife. It was widely used in Europe and now is accepted as a therapy for lymphedema patients in the United States. In MLD a series of rhythmic, light strokes are made in a specific sequence along the lymphatic vessels and the adjoining tissues. These movements remove the lymph fluids from the tissues and return them to the circulatory system, thus reducing swelling in the affected area. Compression techniques include the use of compression garments, compression aids, and compression bandages. These techniques encourage natural drainage and prevent swelling by supporting tissues in a way that aids in drainage. Compression garments are knit, stretch sleeves or stockings. Compression aids are custom-fitted sleeves, stockings, or pads made of fabric-covered foam. Bandages are an effective and flexible means of compression.

They work when the patient is active or is resting and can easily be adjusted to fit changing limb sizes. However, the bandage should be a special type of short-stretch bandage and not the long-stretch bandage that is commonly known as Ace bandages. Only persons who are trained in lymphedema therapy should tape or wrap swollen areas. Self-care techniques are practiced by the patient or his or her caregiver at home, between visits to the therapist. Self-care techniques include self-massage, skin care to maintain healthy tissue, nutritious diet, and exercise to increase lymph flow, increase mobility, and to improve the patient's general health. Exposure to extreme heat has the potential to increase lymphedema swelling, so an affected person or a person at risk of developing lymphedema should avoid hot tubs, saunas, and steam rooms. To keep the affected extremities as healthy as possible, a person with lymphedema should keep the swollen areas clean and avoid heavy lifting and pulling as well as avoid any type of trauma, such as cuts, bruises , sunburn or other burns, injections, sports injuries , insect bites, or cat scratches.

Some doctors and lymphedema therapists recommend that a person with lymphedema use a preventative course of antibiotics when having dental treatment, that is, starting antibiotics several days before the appointment and continuing several days afterwards. A person at risk of developing lymphedema (for example, a woman who has been treated for breast cancer) should also observe the same type of precautions to prevent the development of the condition. If infections occur, then all treatments for lymphedema should be discontinued while the infection is present, and the infection treated with antibiotics. Surgery is sometimes used to remove excess tissue ("debulking") if the swollen limb becomes so large and heavy as to interfere with movement. Exercise is important for a person with lymphedema, but only in moderation. If the extremity starts to ache, the person should lie down and elevate the swollen limb. Recommended exercises include walking, swimming, light aerobics, bike riding, and yoga . Persons with lymphedema should wear a lymphedema alert bracelet or necklace for safety during a medical emergency, explaining the risk of infections. They may also benefit from counseling and membership in support groups to deal with the psychological impact of the disease.

Sometimes patients with lymphedema will be denied insurance coverage for treatment; as a result patient advocacy groups in 2005 are attempting to get a law passed through the U.S. Congress guaranteeing insurance coverage for lymphedema. Alternative and complementary therapies The use of clinical aromatherapy in conjunction with CDT may improve the quality of life for persons with lymphedema. Clinical aromatherapy involves the use of essential oils to improve the functioning of the immune system, for the immune system is closely associated with the lymphatic system. Also a massage oil comprised of a blend of frankincense, grapefruit, hyssop, and lavender, may be used to soften scarred and fibrotic tissues. Radiation treatments can cause skin contractures , which can be helped by massage with a blend of cajeput, frankincense, hyssop, lavender, sage, and tea tree. Radiation can also have adverse effects on the bowel, resulting in poor bowel functioning, scarring, and activity restrictions. Massaging the abdomen with a blend of grapefruit, fennel, helichrysum, lavender, myrrh, and sage may improve intestinal functions.

When compression techniques are used, the underlying skin can be treated with a blend of bay laurel, chamomile, geranium, helchrysum, lavender, patchouli, and vetiver in a combination of castor oil, safflower oil, and grapeseed oil as carrier oils. Good skin care is important in preventing infections. Body oils that contain cajeput, cypress, lavender, marjoram, and rosewood can be applied after bathing to keep the skin moist and healthy. Finger nail beds can be a portal of entry for infections, so can be kept moist with an essential oil blend of chamomile, geranium, lavender, lemon, sage, tea tree, and ylang ylang. Resources Books Burt, Jeannie, and White, Gwen. Lymphedema: A Breast Cancer Patient's Guide to Prevention and Healing. Berkeley, CA: Publisher's Group West, 1999. French, Ramona Moody. Milady's Guide to Lymph Drainage Massage. Clifton Park, NY: Milady Publishing, 2003. Kelly, Deborah G. A Primer on Lymphedema.

Essex, United Kingdom: Pearson Education, 2001. Parker, James N. and Parker, Philip M.. San Diego, CA: Icon Health Publications, 2004. Periodicals Heckathorn, Peg. "Use of Aromatherapy in Lymphedema Management." Lymph Link. Oct-Dec. 2003, Vol. 15, No. 4, 6-12 Other Lymph Notes, an online information resource and support group for those with lymphedema and for the family, friends, and therapists who care for them. Web site: National Lymphedema Network, Latham Square Building, Suite 1111, 1611 Telegraph Avenue, Oakland, CA 94612-2138. Telephone: (800) 541-3259. Fax: (510) 208-3110. Web site: Lymphedema People. Web site: Lymphatic Research Foundation. Treatment goals include maintaining use of the affected limb and preventing complications.

Patient care A combination of manual lymphatic drainage, compression devices, and protection of the affected limb can make a positive difference in a patient’s quality of life. Patient management by physiatrists, other physicians experienced in lymphedema care, certified nurses, and therapists is crucial. Careful measurement of the affected limb with comparison to its opposite and diagnostic testing help to rule out other causes. If necessary, lymphangioscintigraphy can be used to examine the anatomy and functioning of the lymph system. Patients and their partners can be taught effective techniques to use at home. Compression devices are fitted over the affected limb to help maintain or reduce swelling. Compression pumps use air or fluid pressure to mimic massage’s beneficial effects. They are designed to move lymphatic fluid back toward functional nodes by providing sequential, even pressure from the distal to the proximal portions of the affected limb. Compression sleeves or stockings should be fitted by a professional, as an improperly fitted device may irritate skin and other tissues, resulting in additional swelling. Sensible weight reduction programs based on mild caloric restriction and gentle exercise help to alleviate symptoms. Overexertion of affected limbs should be avoided.

Using the affected limb for activities of daily living (bathing, hair-brushing) helps to drain lymph fluid. Supporting the arm on the back of a chair or couch provides helpful elevation for lymph drainage. In acute care settings, the affected limb should be identified by the patient and by health care providers using a loose-fitting, colored (bright pink) armband to ensure that blood drawings, injections, and blood pressure readings are not done on that limb. Skin should be kept clean and moisturized to limit chapping or chafing leading to breakdown. The patient is taught to avoid cuts and abrasions, as when using kitchen knives or other implements, to wear gloves when gardening and to wash and inspect skin after such activities, and to clean any skin breaks that occur, treating them with an antibacterial cream or ointment and a sterile dry dressing. In cases of lower extremity edema, sitting with the legs in a dependent position, crossing the legs, or standing for prolonged periods should be avoided. Extremes of heat and cold exposure should be avoided. The health care provider should be notified if the limb develops a rash or itching or pain or if the patient develops fever or flulike symptoms.

Local support groups can assist patients in dealing with body image issues, and fitting clothing to asymmetrical limbs. Resources for further information on lymphedema management include The National Lymphedema Network and other support organizations such as the American Cancer Society. congenital lymphedema Peripheral edema | definition of Peripheral edema by Medical dictionary Peripheral edema | definition of Peripheral edema by Medical dictionary Related to Peripheral edema: congestive heart failure , Peripheral neuropathy Edema Definition Edema is a condition of abnormally large fluid volume in the circulatory system or in tissues between the body's cells (interstitial spaces). Description Normally the body maintains a balance of fluid in tissues by ensuring that the same of amount of water entering the body also leaves it. The circulatory system transports fluid within the body via its network of blood vessels. The fluid, which contains oxygen and nutrients needed by the cells, moves from the walls of the blood vessels into the body's tissues. After its nutrients are used up, fluid moves back into the blood vessels and returns to the heart. The lymphatic system (a network of channels in the body that carry lymph, a colorless fluid containing white blood cells to fight infection) also absorbs and transports this fluid.

In edema, either too much fluid moves from the blood vessels into the tissues, or not enough fluid moves from the tissues back into the blood vessels. This fluid imbalance can cause mild to severe swelling in one or more parts of the body. Causes and symptoms Many ordinary factors can upset the balance of fluid in the body to cause edema, including: Immobility. The leg muscles normally contract and compress blood vessels to promote blood flow with walking or running. When these muscles are not used, blood can collect in the veins, making it difficult for fluid to move from tissues back into the vessels. Heat. Warm temperatures cause the blood vessels to expand, making it easier for fluid to cross into surrounding tissues. High humidity also aggravates this situation. Medications. Certain drugs, such as steroids, hormone replacements, nonsteroidal anti-inflammatory drugs (NSAIDs), and some blood pressure medications may affect how fast fluid leaves blood vessels. Intake of salty foods. The body needs a constant concentration of salt in its tissues. When excess salt is taken in, the body dilutes it by retaining fluid. Menstruation and pregnancy . The changing levels of hormones affect the rate at which fluid enters and leaves the tissues.

Some medical conditions may also cause edema, including: Heart failure . When the heart is unable to maintain adequate blood flow throughout the circulatory system, the excess fluid pressure within the blood vessels can cause shifts into the interstitial spaces. Left-sided heart failure can cause pulmonary edema , as fluid shifts into the lungs. The patient may develop rapid, shallow respirations, shortness of breath , and a cough . Right-sided heart failure can cause pitting edema, a swelling in the tissue under the skin of the lower legs and feet. Pressing this tissue with a finger tip leads to a noticeable momentary indentation. Kidney disease. The decrease in sodium and water excretion can result in fluid retention and overload. Thyroid or liver disease . These conditions can change the concentration of protein in the blood, affecting fluid movement in and out of the tissues. In advanced liver disease, the liver is enlarged and fluid may build-up in the abdomen. Malnutrition. Protein levels are decreased in the blood, and in an effort to maintain a balance of concentrations, fluid shifts out of the vessels and causes edema in tissue spaces. Some conditions that may cause swelling in just one leg include: Blood clots .

Clots can cause pooling of fluid and may be accompanied by discoloration and pain . In some instances, clots may cause no pain. Weakened veins. Varicose veins , or veins whose walls or valves are weak, can allow blood to pool in the legs. This is a common condition. Infection and inflammation. Infection in leg tissues can cause inflammation and increasing blood flow to the area. Inflammatory diseases, such as gout or arthritis, can also result in swelling. Lymphedema . Blocked lymph channels may be caused by infection, scar tissue, or hereditary conditions. Lymph that can't drain properly results in edema. Lymphedema may also occur after cancer treatments, when the lymph system is impaired by surgery, radiation, or chemotherapy . Tumor. Abnormal masses can compress leg vessels and lymph channels, affecting the rate of fluid movement. Symptoms vary depending on the cause of edema. In general, weight gain, puffy eyelids, and swelling of the legs may occur as a result of excess fluid volume. Pulse rate and blood pressure may be elevated. Hand and neck veins may be observed as fuller.

Diagnosis Edema is a sign of an underlying problem, rather than a disease unto itself. A diagnostic explanation should be sought. Patient history and presenting symptoms, along with laboratory blood studies, if indicated, assist the health professional in determining the cause of the edema. Treatment Treatment of edema is based on the cause. Simple steps to lessen fluid build-up may include: Reducing sodium intake. A high sodium level causes or aggravates fluid retention. Maintaining proper weight. Being overweight slows body fluid circulation and puts extra pressure on the veins. Exercise . Regular exercise stimulates circulation. Elevation of the legs. Placing the legs at least 12 in (30.5 cm) above the level of the heart for 10-15 minutes, three to four times a day, stimulates excess fluid re-entry into the circulatory system. Use of support stocking. Elastic stockings, available at most medical supply or drug stores, will compress the leg vessels, promoting circulation and decreasing pooling of fluid due to gravity. Massage. Massaging the body part can help to stimulate the release of excess fluids, but should be avoided if the patient has blood clots in the veins. Travel breaks.

Sitting for long periods will increase swelling in the feet and ankles. Standing and/or walking at least every hour or two will help stimulate blood flow. The three "Ds"—diuretics, digitalis, and diet-are frequently prescribed for medical conditions that result in excess fluid volume. Diuretics are medications that promote urination of sodium and water. Digoxin is a digitalis preparation that is sometimes needed to decrease heart rate and increase the strength of the heart's contractions. Dietary recommendations include less sodium in order to decrease fluid retention. Consideration of adequate protein intake is also made. For patients with lymphedema, a combination of therapies may prove effective. Combined decongestive therapy includes the use of manual lymph drainage (MLD), compression bandaging, garments and pumps, and physical therapy. MLD involves the use of light massage of the subcutaneous tissue where the lymph vessels predominate. Massage begins in an area of the body trunk where there is normal lymph function and proceeds to areas of lymphatic insufficiency, in an effort to stimulate new drainage tract development.

(MLD should not be used for patients with active cancer, deep vein clots, congestive heart failure, or cellulitis.) MLD sessions are followed by application of compression garments or pumps. Physical therapy is aimed at strengthening the affected limb and increasing joint mobility. Alternative treatment Dietary changes, in addition to cutting back the amount of sodium eaten, may also help reduce edema. Foods that worsen edema, such as alcohol, caffeine , sugar, dairy products, soy sauce, animal protein, chocolate, olives, and pickles, should be avoided. Diuretic herbs can also help relieve edema. One of the best herbs for this purpose is dandelion (Taraxacum mongolicum), since, in addition to its diuretic action, it is a rich source of potassium. (Diuretics flush potassium from the body and it must be replaced to avoid potassium deficiency.) Hydrotherapy using daily contrast applications of hot and cold (either compresses or immersion) may also be helpful. Key terms Digitalis — A naturally occuring compound used in the preparation of the medication, digoxin, prescribed to increase the heart rate and strengthen the force of the heart's contractions.

Diuretics — Medications used in the treatment of fluid overload, to promote excretion of sodium and water. Interstitial spaces — Areas of the body occuring outside the vessels or organs, between the cells. Pitting edema — A swelling in the tissue under the skin, resulting from fluid accumulation, that is measured by the depth of indentation made by finger pressure over a boney prominence. Resources Organizations Lymphedema and Wound Care Clinic of Austin. 5750 Balcones Dr., Ste. 110, Austin, TX 78731. (512) 453-1930. edema [ĕde´mah] the accumulation of excess fluid in a fluid compartment. Formerly called dropsy and hydrops . adj., adj edem´atous. This accumulation can occur in the cells (cellular edema), in the intercellular spaces within tissues (interstitial edema), or in potential spaces within the body.

Edema may also be classified by location, such as pulmonary edema or brain edema; types found in certain locations have specific names, such as ascites (peritoneal cavity), hydrothorax (pleural cavity), or hydropericardium (pericardial sac). Massive generalized edema is called anasarca . Classification by location does not indicate whether the edema is cellular or interstitial or occupies a potential space (for example, brain edema may be either cellular or interstitial). Edema can be caused by a variety of factors, including conditions that affect osmotic pressure, such as hypotonic fluid overload, which allows the movement of water into the intracellular space, or hypoproteinemia, which decreases the concentration of plasma proteins and permits the passage of fluid out of the blood vessels into the tissue spaces. Other factors include poor lymphatic drainage; conditions that cause increased capillary pressure, such as excessive retention of salt and water and heart failure; and conditions that increase capillary permeability, such as inflammation. Edema formation. With trauma, increased capillary permeability and dilation cause leaking into tissue space.

Initially clear, exudate in the tissue space becomes more viscous with an increase in plasma protein. From Copstead and Banasik, 2000. alveolar edema pulmonary edema in the alveoli, usually with hypoxemia and dyspnea. [idē′mə] Etymology: Gk, oidema, swelling the abnormal accumulation of fluid in interstitial spaces of tissues, such as in the pericardial sac, intrapleural space, peritoneal cavity, or joint capsules. Edema may be caused by increased capillary fluid pressure; venous obstruction such as occurs in varicosities; thrombophlebitis; pressure from casts, tight bandages, or garters; congestive heart failure; overloading with parenteral fluids; renal failure; hepatic cirrhosis; hyperaldosteronism such as in Cushing's syndrome; corticosteroid therapy; and inflammatory reactions.

Edema may also result from loss of serum protein in burns, draining wounds, fistulas, hemorrhage, nephrotic syndrome, or chronic diarrhea; in malnutrition, especially kwashiorkor; in allergic reactions; and in blockage of lymphatic vessels caused by malignant diseases, filariasis, or other disorders. Treatment of edema focuses on correcting the underlying cause. Potassium-sparing diuretics may be administered to promote excretion of sodium and water. Edematous parts of the body should be protected from prolonged pressure, injury, and temperature extremes. In the evaluation of tissue turgor, edema may be evaluated by position change, specific location, and response to pressure, as in pitting edema when pressing the fingers into the edematous area causes a temporary indentation. An ultrasound evaluation of the affected extremity is indicated to rule out thrombosis. When a limb is edematous as a result of venous stasis, elevating the extremity and applying an elastic stocking or sleeve facilitate venous return. Also spelled oedema. See also anasarca, lymphedema . edematose, edematous, adj.

Pitting edema An abbreviation—Cyanosis, Clubbing, Edema—used in physical examination of the extremities, which is a crude indicator of adequate oxygenation of blood edema Fluid retention, water retention Physical exam An excess of fluid in cells or tissues due to disease or injury, quantified as 1+, 2+, 3+. See Angioneurotic edema , Brawny edema , Cerebral edema , Cyclic edema , Cytotoxic edema, Flash pulmonary edema, Hereditary angioneurotic edema , High-altitude cerebral edema , High-altitude pulmonary edema, Leukoedema , Macular edema , Malignant edema, Pedal edema , Pseudopapillaedema, Pulmonary edema . e·de·ma (e-de'ma) (-de'mat-a) plural.edemasplural.edemata [Gr. oidema, swelling, tumor] EDEMA: Edematous arm caused by subclavian vein stenosis A local or generalized condition in which body tissues contain an excessive amount of tissue fluid in the interstitial spaces.

Synonym: hydrops See: anasarca ; ascites ; dropsy ; hydrothorax ; pericardial effusion See: illustrationedematous (e-de'mat-us), adjective Etiology Edema may result from increased permeability of the capillary walls; increased capillary pressure due to venous obstruction or heart failure; lymphatic obstruction; disturbances in renal function; reduction of plasma proteins; inflammatory conditions; fluid and electrolyte disturbances, esp. those causing sodium retention; malnutrition; starvation; or chemical substances such as bacterial toxins, venoms, caustics, and histamine. Diagnostic studies ( thorough history, physical examination, urinalysis, serum chemistries and liver functions, thyroid function, and chest x-ray) help determine the cause and guide treatment. Treatment Bed rest helps relieve lower extremity edema. Sitting with the feet and legs elevated may also reduce edema in the lower extremities. Dietary salt should be restricted to less than 2 g/day. Fluid intake may be restricted to about 1500 ml in 24 hr. This prescription may be relaxed when free diuresis has been attained.

Diuretics relieve swelling when renal function is good and when any underlying abnormality of cardiac function, capillary pressure, or salt retention is being corrected simultaneously. Any effective diuretic may be used. Diuretics are contraindicated in preeclampsia and when serum potassium levels are very low (< 3.0 mEq/dl). They may be ineffective in edema associated with advanced renal insufficiency. The diet in edema should be adequate in protein, high in calories, and rich in vitamins. Patients with significant edema should weigh themselves daily to gauge fluid loss or retention. Patient care Edema is documented according to type (pitting, nonpitting, or brawny), extent, location, symmetry, and degree of pitting. Areas over bony prominences are palpated for edema by pressing with the fingertip for 5 sec, then releasing. Normally, the tissue should immediately rebound to its original contour; therefore the depth of indentation is measured and recorded. The patient is questioned about increased tightness of rings, shoes, waistlines of garments, and belts.

Periorbital edema is assessed; abdominal girth and ankle circumference are measured; and the patient's weight and fluid intake and output are monitored. Fragile edematous tissues are protected from damage by careful handling and positioning and by providing and teaching about special skin care. Edematous extremities are mobilized and elevated to promote venous return, and lung sounds auscultated for evidence of increasing pulmonary congestion. Prescribed therapies, including sodium restriction, diuretics, ACE inhibitors, protein replacement, and elastic stockings are provided, and the patient is instructed in their use. angioneurotic edema Edema of the lower extremities or, if the patient is lying down, of the sacrum. diabetic macular edema Swelling of the retina resulting from leakage of fluids from damaged blood vessels in the eye. It is a major cause of visual loss in diabetics, and is related to poor control of blood glucose. edema of the glottis Pathological edema in the tissues lining the vocal structures of the larynx. It may result from improper use of the voice, excessive use of tobacco or alcohol, chemical fumes, or viral, bacterial, or fungal infections.

Clinically, the patient often presents with hoarseness or, in severe cases, with respiratory distress and stridor. See: epiglottitis Symptoms Initially, hoarseness and, later, complete aphonia characterize this condition. Other symptoms are extreme dyspnea, at first on inspiration only, but later also on expiration; stridor; and a barking cough when the epiglottis is involved. high-altitude pulmonary edema Abbreviation: HAPE See: hypoxia inflammatory edema Edema associated with inflammation. The cause is assumed to be damage to the capillary endothelium. It is usually nonpitting and localized, red, tender, and warm. laryngeal edema Edema of the larynx, usually resulting from allergic reaction and causing airway obstruction unless treated. Therapy consists of intravenous or intratracheal epinephrine, emergency tracheostomy, or both. malignant edema (ĕ-dē'mă) 1. Excessive fluid in cells or intercellular tissues. 2. At the gross level, used to describe physical sign commonly likened to swelling or increased girth that often accompanies fluid accumulation in a limb. [G.

oidēma, a swelling] edema (edē´mə), n the accumulation of fluid in the tissues or in the peritoneal or pleural cavities. Primary factors favoring edema are increased capillary hydrostatic pressure (increased venous pressure), decreased osmotic pressure of plasma (hypoproteinemia), decreased tissue tension and lymphatic drainage, increased osmotic pressure of tissue fluids, and increased capillary permeability. Additional renal and hormonal factors are important. Clinical manifestations may consist of a steady weight gain or localized or generalized swelling. Eczema. DROPSY | Healing herbs Healing herbs DROPSY INTRODUCTION: Dropsy, nowadays called as Edema is caused by the swelling of soft tissues due to the accumulation of excess water. It may be the swelling of any organ or tissue due to accumulation of excess lymph fluid, without an increase of the number of cells in the affected tissue. Edema is often more prominent in the lower legs and feet toward the end of the day as a result of pooling of fluid from the upright position usually maintained during the day. Upon awakening from sleeping, people can have swelling around the eyes referred to as periorbital edema.

Oedema can accumulate in almost any location in the body, but the most common sites are the feet and ankles. CAUSES: Oedema is the increase of interstitial fluid in any organ. Generally, the amount of interstitial fluid is in the balance of homeostasis. Increased secretion of fluid into the interstitium or impaired removal of this fluid may cause edema. Consequently, anything that increases oncotic pressure outside blood vessels (for example inflammation), or reduces oncotic pressure in the blood (states of low plasma osmolality, for example cirrhosis) will cause edema. Increased hydrostatic pressure inside the blood vessel (for example in heart failure) will have the same effect. If the permeability of the capillary walls increases, more fluid will tend to escape out of the capillary, as can happen when there is inflammation.Abnormal removal of interstitial fluid is caused by obstruction of the lymphatic system, for example due to pressure from a cancer or enlarged lymph nodes, destruction of lymph vessels by radiotherapy, or infiltration of the lymphatics by infection such as elephantiasis. CLASSIFICATION: Peripheral edema: Peripheral edema is caused by the accumulation of fluid in the parts of the body that are most affected by gravity.

In ambulatory people these are the legs, although in those who are bed bound the first manifestation may be sacral edema. If severe enough, peripheral edema may progress to involve the abdominal or even thoracic wall. In particular oedema, periorbital edema (around the eyes) may be present. Organ-specific edema: Edema of specific organs such as cerebral oedema, pulmonary oedema, and macular oedema may also occur, each with different specific causes to peripheral edema, but all based on the same principles. Ascites is effectively oedema within the peritoneal cavity, as pleural effusions are effectively oedema in the pleural cavity. Idiopathic (of unknown cause) edema, also sometimes called cyclical edema, occurs most often in women and just prior to each menstrual period. TREATMENT: The treatment of fluid retention in these patients is to reduce the loss of protein into the urine and to restrict salt in the diet. The loss of protein in the urine may be reduced by the use of ACE inhibitors and angiotens in receptor blockers.

Both categories of drugs, which ordinarily are used to lower blood pressure, prompt the kidneys to reduce the loss of protein into the urine. HOMEOPATHIC TREATMENT: Apis is to be used as a homeopathic treatment in those individuals afflicted with edema where there is a development of puffy swellings in the regions below the eyes or in the extremities such as the toes and the hands. Arsenicum is suitable in all forms of dropsy. Apocynum Cannabinum is useful for swelling anywhere of dropsical origin disease. Helleborus is a very useful remedy in many forms of dropsy. Hydrocephalus can be used to increase the rate of urination and to boost circulation, helping to reduce the retained water. Calcarea carb is an effective homeopathic treatment for the swelling in the tissues particularly around the knees. Ferrum met is used where the physical symptom of swelling in the extremities occurs during or after some loss of fluid. Graphites is to be used in patients who are stout and are often prone to skin conditions along with the edema. Ledum is to be used in the treatment of individuals, where swelling and tenderness are observed in the ankles and soles of the feet.

Lycopodium is to be used in the treatment of individuals suffering from digestive disorders and abdominal bloating in addition to the swelling in the various affected regions of the body. Natrum mur is to be used in the homeopathic treatment of individuals affected by edema where the reaction to an allergy may cause the swelling of the tissues around the eyes, Pulsatilla is to be used in the homeopathic treatment of individuals afflicted with edema where the symptoms may include swelling in the regions of the hands the knees and the ankles or feet. HERBAL REMEDIES: The herbal remedies are used to increase the rate of urination and to boost circulation, helping to reduce the retained water. People with any sort of kidney inflammation must not use the juniper berries. To promote the rate of urination and to increase water removal, use can be made of diuretic herbs like the horsetail, the common parsley, the yarrow, the stinging nettle, and the watercress or even the leaves of the birch tree. Knotgrass is an effective remedy. HOME REMEDIES: Pineapple is very beneficial for dropsy. It contains sufficient chlorine which stimulates the activities of the kidneys.

Black Nightingale can be taken as decoction or vegetable. Lime water is also an effective treatment. The whole belly should be covered with a large absorbent towel, which has been dipped in strong lime water and then squeezed out. Ginger is also an excellent remedy for dropsy.

Question: What is the traditional name for the disease Oedema, a swelling of any organ or tissue due to the accumulation of excess lymph fluid?
Answer: DROPSY