Jean M.

Asares BSN 3
What causes edema?

Edema is most commonly caused by: Physical inactivity - edema is more prevalent among people who do not exercise at all, and walk very little.

Standing or sitting still for long - if you stand or sit still for a long time there is a much higher chance of swelling. Genes - researchers in Spain identified the genes that cause blindness produced by corneal edema. Surgery - there is usually some swelling after a surgical procedure.

High altitudes - especially when combined with physical exertion. Acute mountain sickness can lead to high altitude pulmonary edema or high altitude cerebral edema. Heat - especially when combined with physical exertion. 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 the woman releases hormones which encourage the body to retain fluids. Pregnant women tend to retain much 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 the 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 it, 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 levels 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 generally 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 - this 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 - a large vein that carries blood from the intestines, spleen and pancreas into the liver. The 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 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 - 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 causes cysts, which can then 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 a disease or medical condition, such as an infection or cancer, it is caused secondary lymphedema.