Edema is an abnormal collection of fluid in the cellular space of soft tissue within the body. This abnormal collection of fluid can occur all over the body. Dependent edema is a term used for abnormal accumulation of fluid in dependent parts which are influenced by gravity.
Generally dependent edema is more common in lower body parts, over the legs, ankles in ambulatory patients and sacral area (lower back) and posterior aspect of thigh and face in recumbent patients.The location of dependent edema gives an important clue in diagnosing the cause of disease.
What Causes Dependent Edema?
Congestive heart failure: it is the most common cause for dependent edema. In an ambulatory patient, the swelling is noticed in lower legs and ankle region. Fluid accumulates in lower legs due to gravity. If the patient is lying in bed for a prolonged period, he may have swelling in the lower back and posterior portion of the thigh.It is also visible on face. In congestive cardiac failure, the muscles of heart become weak and it is unable to pump the blood in sufficient amount.
Dependent edema is one of the symptoms found in kidney damage. Your kidney removes all waste and unwanted fluids from the body. When the kidneys are damaged, there is accumulation of waste and fluid in different parts of body. The edema in kidney disorders occurs first over the eyelids and more when the patient wakes up. High blood pressure and diabetes are two chronic diseases which are mainly responsible for kidney failure.
Medicines and drugs: certain medicines are known to produce edema. NSAID, calcium antagonist drug, long term use of steroids are some of them.
Venous insufficiency is a common problem; here the blood does not reach the heart from the peripheral veins of the body. It is generally due to weak valves in the veins. The peripheral area is legs, hands, ankles, feet. There is stagnation of blood which leaks into the surrounding tissue of forming swelling in that region. Edema in lower legs due to varicose veins is one such example.
Standing or sitting for a prolonged period of time may cause accumulation of fluid in feet, legs and ankles.
Dependent Edema Symptoms
Dependent edema is a symptom in itself. There may be accompanying symptoms of the disease which has caused dependent edema. However, few local signs and symptoms that appear over the skin in dependent edema are.
- Pitting in the region of edema. If you apply hard pressure on swollen area, you may find a pit like shallow impression this is called pitting edema.
- The skin above the swollen area becomes stretched and shiny.
- There may be itching in the swollen area.
- If the skin is parched due to excessive collection of fluid in the dependent part, mostly in legs, there may be watery discharge observed in some cases.
- Person suffering from congestive cardiac failure also has breathlessness on slightest exertion.
- In case of kidney disease, there may be associated low urine output. Breathing trouble, itching all over the skin are few other symptoms.
Treatment For Dependent Edema
Dependent edema gets resolved once the disease which causes it is cured.
However, the best way to reduce dependent edema is to keep the swollen extremity elevated. The fluid moves back to the heart. It is expelled from the body through urination. If the person has swelling in lower legs and ankles, he should avoid standing for a prolonged time in one place.
Wearing tight compression stockings prevents the fluid from collecting in the lower limbs, if the edema is legs and ankles.
Patient should reduce salt intake. It is an important factor in reducing edema.
Medications such as diuretics are also useful for reducing edema. But they are used only on physician’s prescription. If heart problem is responsible for dependent edema, medications which accelerate heart pumping will help in reducing swelling.
If the cause is kidney failure, the person may require dialysis for purifying the blood and thus removing excess of waste and body fluid which are responsible for edema formation.