Swelling (Edema)

Clinically known as edema, swelling is when fluid collects in bodily tissues. It often occurs in the feet, ankles, or legs, though it can affect any body part. Swelling is a common issue that varies in severity. Mild cases typically arise due to standing for a long time or minor injury. In contrast, high salt intake, venous insufficiency, congestive heart failure, and certain medications can lead to more severe swelling.

This article discusses the symptoms of swelling and its potential causes. It also covers complications and risk factors and discusses when to seek tests or treatment for this condition.  

Symptoms of Swelling

The symptoms of swelling depend on the affected body part and the underlying cause of the issue. Typical signs of this condition can include:

• Swelling or puffiness in the skin, especially the ankles, feet, or face
• Expansion of the abdomen (a type of edema called ascites)
• Shininess and stretching of the skin
• Breathing difficulties (if affecting the chest)
• Pain or stiffness in the joints
• A dimple that remains in the skin after applying pressure for 5 seconds (pitted edema)
• Sudden weight gain

Causes of Swelling

Many factors can cause swelling. Some cases of edema are standalone, while others represent more severe problems. The most common causes of this condition are: 

• Environmental factors and diet
• Underlying diseases
• Pregnancy and hormonal changes

Hot weather and standing for long periods can cause swelling, especially in the lower limbs. Eating too much salt can also cause the condition.

Swelling may be a sign of heart and vein conditions, such as congestive heart failure, an inability of the heart to pump enough blood, and chronic venous insufficiency. Chronic kidney disease and liver cirrhosis—two serious medical conditions—can also cause swelling.

Pregnancy causes fluid retention, which, alongside the added weight of the fetus, placenta, breast tissue, and blood supply, can cause swelling in pregnant people, especially in the ankles. Hormonal changes due to monthly menstrual cycles can also cause this issue.   

What Medications Can Cause Swelling? 

Certain medications can cause swelling. This is the case with several classes of drugs, including:

• Calcium channel blockers (Norvasc, Verapamil, Cardizem)
• Oral antidiabetic drugs, especially thiazolidinediones (Avandia, Actos)
• Vasodilators (Lotensin, Prinivil, Cardizem)
• Non-steroidal anti-inflammatory drugs (NSAIDs) (Bayer, Motrin, Aleve, Naproxen)
• Estrogen (used in hormone replacement therapy)
• Chemotherapy drugs (Cisplatin, Taxotere)
• Corticosteroids (cortisone, prednisone, hydrocortisone)

How to Treat Swelling

The specific approach to treatment depends on the underlying cause and severity of the swelling. Lifestyle changes and medications are among the therapies for the condition. Here’s a breakdown:

• Reducing salt intake: Eating excess salt can cause fluid retention in the tissues, leading to edema. Reducing or cutting out salt intake may help manage the condition.
• Changing body positioning: You can manage swelling in the feet, ankles, and legs by elevating the affected body part so that it is higher than your heart. This approach is appropriate for mild cases of swelling (more serious forms require additional treatment).
• Wearing compression stockings: Specialized compression stockings help promote blood flow back to the heart and help reduce swelling in the lower limbs. You may need prescription stockings for moderate and severe swelling, whereas drugstore compression stockings may help you manage mild swelling.  
• Diuretics: Also known as water pills, diuretics act on the kidneys to increase urination (pee), which helps reduce swelling. Diuretics should be used carefully and only as prescribed since too much can lower blood pressure, cause fainting, or impact kidney function.

Certain types of swelling—such as cerebral or chest edema and more severe forms of peripheral edema—require medical care and can’t be managed independently. In addition, the sudden onset of swelling is a sign that you need emergency help. 

Complications Associated With Swelling

If left untreated, swelling can lead to severe complications. The severity and type of complication depend on the swelling you have. Peripheral swelling can cause:

• Pain, stiffness, and loss of mobility in the joints
• Stretched, itchy skin
• Skin ulcers
• Increased risk of infection

Chest swelling involving the lungs can cause severe breathing difficulties and become fatal if it persists or goes untreated. It can lead to respiratory failure—an inability of the lungs to function effectively—and acute respiratory distress syndrome (ARDS), in which the lungs become dangerously full of fluid.

Untreated cerebral edema can also become debilitating and dangerous, leading to adverse long-term effects. This condition can also become fatal and impact cognitive function and vision. 

Risk Factors

Certain populations and those living with some diseases and medical conditions are more prone to developing swelling. Common risk factors for swelling include:

• Obesity
• High blood pressure (hypertension)
• Pregnancy
• Diabetes 
• Cellulitis (a bacterial infection of the skin) 
• Alcohol consumption
• Smoking
• Older age

Are There Tests to Diagnose the Cause of Swelling?

Tests to diagnose the cause of swelling are determined based on the specific case. Alongside physical examination and medical history, several evaluations may be necessary:

• Albumin blood test: This blood test measures albumin levels, a protein manufactured in the liver, which helps prevent fluid from leaking from vessels. Insufficient levels are associated with swelling.
• Blood electrolyte levels test: This blood test determines the balance of electrolytes, which are minerals found in the body. Of these, sodium (salt) and chloride play a central role in regulating body fluid levels.
• Echocardiography: Your healthcare provider will use echocardiography if they suspect the swelling is due to heart failure or other cardiac causes. This test relies on electrodes to track heartbeat and ultrasound imaging to track blood flow in the heart.
• Kidney function tests: Several tests may also assess kidney health and function. These include blood urea nitrogen (BUN) and blood or urine assessments of creatine levels, an amino acid.
• Liver function tests: Given associations between liver cirrhosis and swelling, you may need liver function tests. Your healthcare provider may order blood or urine tests to measure levels of various proteins. 
• Urinalysis: An assessment of your urine's physical appearance and chemical and molecular composition may also be needed. Urinalysis can detect abnormal levels of albumin, blood cells, or certain proteins in the body, indicating the causes of the edema.
• X-ray: In some cases, X-ray imaging may help confirm a diagnosis by enabling healthcare providers to visualize the extent of fluid retention or swelling and any blood clots or disruptions of blood circulation.      

When to See A Healthcare Provider

While many cases of swelling are acute and can resolve independently, others can signal more serious conditions or reactions. If you develop new swelling in any of the following areas, call your healthcare provider as soon as possible:

• One or both legs
• Hands
• Abdomen
• Around the eyes

It’s also important to seek help if you have persistent swelling or a history of heart or liver problems. If you’re ever unsure about your symptoms, contact your healthcare provider. 

If you’re experiencing a rapid onset of swelling in the lips, tongue, or mouth, call 911 since they can be signs of potentially fatal or very dangerous complications.

Summary

Swelling in the body is a common issue. While many people experience swelling due to mild factors, such as standing for too long or minor injury, it may be a sign of more serious health issues for others. This condition is managed by making lifestyle changes and seeking prompt treatment from a healthcare provider. 

A Word From Verywell

Swelling is an issue that shouldn’t be taken lightly, especially if you’re living with a chronic disease or medical condition. This issue can be disruptive, painful, and uncomfortable and potentially signify a more serious medical condition. You can effectively manage swelling through prompt treatment and following your healthcare provider’s recommendations.