Edema! Includes Causes---thanks Pam

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> Edema! Includes Causes

>

>

> http://www.healthat oz.com/healthato z/Atoz/ency/ edema.jsp

>

> 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.

>

> 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.

>

>

> For Your Information

>

> Books

> Monahan, Frances D., and nne Neighbors. Medical-Surgical Nursing:

> Foundation for Clinical Practice. 2nd ed. Philadelphia: W. B. Saunders

> Co., 1998.

> Organizations

> Lymphedema and Wound Care Clinic of Austin. 5750 Balcones Dr., Ste. 110,

> Austin, TX 78731. (512) 453-1930.

>

> The Essay Author is Kathleen D. RN.

>

" and the beat goes on....... " Sonny Bono " It's not the years in your life that

count. It's the life in your years. " Abraham Lincoln

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