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Swelling
Basic
Alternative Names
Edema; Anasarca
Visual Reference
References
Massie BM. Heart failure: pathophysiology and diagnosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 57.
Ginsberg J. Peripheral venous disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 81.
Klein S. Protein-energy malnutrition. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 234.
Overview
Definition
Swelling is the enlargement of organs, skin, or other body parts. It is caused by build up of fluid in the tissues. The extra fluid can lead to a rapid increase in weight over a short period of time (days to weeks).
Swelling can occur throughout the body (generalized) or only in a specific part of the body (localized).
See also:
Considerations
Slight swelling (edema) of the lower legs commonly occurs in warm summer months, especially if a person has been standing or walking a lot.
Generalized swelling, or massive edema (also called anasarca), is a common sign in severely ill people. Although slight edema may be difficult to detect, a large amount of swelling is very obvious.
Edema is described as pitting or non-pitting.
- Pitting edema leaves a dent in the skin after you press the area with a finger for about 5 seconds. The dent will slowly fill back in.
- Non-pitting edema does not leave this type of dent when pressing on the swollen area.
Common Causes
- Acute glomerulonephritis
- Burns , including sunburn
- Chronic kidney disease
- Heart failure
- Liver failure from cirrhosis
- Nephrotic syndrome
- Poor nutrition
- Pregnancy
- Thyroid disease
- Too little albumin in the blood (hypoalbuminemia)
- Too much salt or sodium
- Use of certain drugs, including
- Androgenic and anabolic steroids
- Calcium channel blockers
- Certain blood pressure medicines
- Corticosteroids such as prednisone
- Diabetes medicines called thiazolidinediones
- Estrogen
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Symptoms
Home Care
Follow your doctor's treatment recommendations. If you have chronic swelling, ask your doctor about the options to prevent skin breakdown such as a pressure-reducing mattress, a lamb's wool pad, or a flotation ring.
Maintain everyday activities. When lying down, keep your arms and legs above the heart level, if possible, to encourage drainage. However, do not do this if shortness of breath results. See your doctor instead.
Call your health care provider if
If you notice any unexplained swelling, contact your health care provider.
What to expect at your health care provider's office
Except in emergency situations (such as cardiac failure or pulmonary congestion), your health care provider will obtain your medical history and will perform a physical examination .
Medical history questions documenting swelling in detail may include the following:
- Time pattern
- When did you first notice this?
- Is it present all the time?
- Does it come and go?
- Quality
- How much swelling is there?
- When you poke the area with a finger, does the dent remain?
- Location
- Is it overall or in a specific area (localized)?
- If swelling is in a specific area, what is that area?
- Other
- What seems to make the swelling better?
- What seems to make the swelling worse?
- What other symptoms are also present?
Tests that may be done include:
- Albumin blood test
- Blood electrolyte levels
- Echocardiography
- ECG
- Kidney function tests
- Liver function tests
- Urinalysis
- X-rays
Treatment may include fluid and avoiding salt, diuretics, or water pills. Your fluid intake and output should be monitored, and you should be weighed daily.
Avoid alcohol if liver disease (such as cirrhosis or hepatitis ) is causing the problem. Support hose may be recommended.
Review Date: 2008-11-16
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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