Ordinary and Not-So-Ordinary Causes of Swelling

Monday, July 14, 2008

ROCHESTER, Minn. — Puffy feet and swollen legs usually aren't reason for alarm. But the key word is "usually."

The reasons for edema (swelling) often are ordinary — hot weather, sitting or standing for a long time or eating too much salty food. If the swelling isn't accompanied by other signs and symptoms and goes away within about 24 hours, a visit to the doctor probably isn't needed.

Longer-lasting or recurring edema, even if fairly slight, typically warrants a doctor's appointment, according to the July issue of Mayo Clinic Heath Letter. Some causes of edema are serious, such as heart failure, kidney disease, liver damage or blood clots. Edema can be a side effect of commonly used drugs such as certain blood pressure medications, hormones, medications that open blood vessels and nonsteroidal anti-inflammatory drugs. Some herbal supplements also can contribute to edema.

A doctor will try to identify the possible causes of edema. The underlying conditions and the edema can be treated. Chronic edema can cause pain and discomfort, itchy rashes, and reddish-brown skin discoloration. Treatment options include:

Sodium restriction — Reducing salt consumption helps decrease retention of body fluids.

Diuretic drugs — These medications increase the kidney's output of water and sodium and are most effective when patients reduce sodium consumption.

Exercise — Moving and using the muscles of the affected area can enhance circulation of blood and body fluids.

Elevation — Raising the affected limb(s) over the level of the heart for about 30 minutes or longer, while sleeping, helps blood and excess fluids circulate.

Compression stockings or bandages — These keep pressure on limbs to prevent fluids from collecting in the tissues. Bandages and stockings typically are worn below the knees.

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