Causes Of Chronic Edema: Complications & Treatment Guidelines

Edema is leakage of fluid from the tiny blood vessels called capillaries into surrounding tissues. This fluid gets accumulated in the interstitial space giving rise to swelling and several other symptoms. Actually edema is a medical terminology used for swelling. Edema can be acute or chronic. Acute edema develops suddenly and lasts for few hours or days.

Edema becomes chronic when the leakage and resulting swelling continues for several weeks or months.  There are several possible reasons that can produce edema. It can be related to a health condition or may be due to factors such as gravity, immobility for long time etc.

It is necessary to know and understand the causes in order to manage chronic edema appropriately without causing any complications.

What Are The Causes Of Chronic Edema?

Edema can be acute or chronic. Acute edema usually develops in legs and it is temporary. Sitting for long time in one place or standing too long without moving legs can lead to swelling in the legs. This occurs due to gravitational effect. Occasionally consuming too much of salt in food or poor intake of nutrients can also cause acute edema.

Women often feel swelling in their legs and ankle few days prior to their periods.

The edema resolves after menses. This occurs due to hormonal changes in a woman during her fertile period.

Besides the above causes of temporary edema, sometimes the swelling prolongs for a period of time, may be for weeks and months. Such cases are considered as chronic edema. There are several diseases that can produce chronic edema. This may include:

  • Congestive cardiac failure is a condition in which the heart muscles become weak and cannot pump blood sufficiently to the body. This leads to accumulation of blood in the extremities. Fluid leaks out of the blood vessels and gets collected in the nearby tissue producing swelling (edema). This may remain for a long time.
  • Cirrhosis of liver is a chronic failure of liver. In this condition edema is present in legs and abdomen. Occasionally patient may also develop swelling on face.
  • Kidney failure can lead to retention of sodium and fluid in the body. This ultimately leads to swelling around the eyes and legs.
  • Infection such as filariasis produces edema in leg and scrotum. It occurs because the lymph flow is blocked. Filariasis is a disease caused by W. bancrofti germs that are spread by mosquito bite.
  • Varicose veins in legs can produce chronic edema in the affected lower extremity. In varicose veins, the valves of deep veins become weak. Hence the blood from vein is not pushed up sufficiently. It stagnates in the blood vessel eventually the fluid seeps out from it causing edema in the ankle and leg.
  • Chronic edema can also occur due to some medicines. Anti hypertensive, NSAIDS, steroid, contraceptive pills, all can cause edema if taken for long period of time besides other side effects.

Treatment Guidelines For Chronic Edema

Majority cases of edema resolve effectively without any symptom. But it may not be so if edema is chronic. In such case there is a need to find the underlying cause and treat the condition as well as the swelling. Most often diuretic are prescribed to eliminate fluid from the body through urine. The response of diuretic is quick and swelling is reduced substantially.

However, in chronic edema, the fluid collects again due to the underlying pathology. Hence, the aim must be to address the cause. For example if the patient is suffering from congestive heart failure he needs proper medications to improve the heart function. If the swelling is caused due to medicines, doctor may have to change or reduce the dose of medicine.

Alternative treatment include: Massage therapy, reduced salt intake, applying compression bandage, keeping the leg slightly elevated while lying down in bed.

Complications Of Chronic Edema

Complications due to chronic edema include:

  • Pain in legs due to swelling.
  • Stiffness in leg.
  • Difficulty in walking if the there is pronounced edema in leg.
  • Stretching of skin.
  • Cracks and itching on the affected area of edema.
  • Ulceration of the skin.
  • Formation of scars in the deeper layer.
  • Loss of skin elasticity.
  • Frequent infection in skin.

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