Do you have swelling too? Let's talk about this swelling (edema)!

Have you ever noticed that your legs, ankles or hands suddenly swell up? Or sometimes your face feels puffy? This swelling in various parts of the body is what we medically call `(Edema)` or simply `edima' in Sinhala. This actually happens when fluids accumulate inside our body tissues.

Who is more likely to develop this swelling (edema)? Is it common?

Actually, this condition called swelling can develop in anyone. But it is often seen in pregnant mothers and people over the age of 65. Also, this swelling is very common. Because, there are many factors that can cause it. Since some small swellings get better on their own, it is difficult to say exactly how many people develop this.

What happens to the body when edema develops? What are the symptoms?

So, when this swelling `(Edema)` develops, some parts of your body become larger, that is, they swell. Then it can be a little difficult to do your daily activities. Imagine, if your legs are swollen, it is difficult to walk, right? But there is good news. By keeping the swollen area a little elevated, or if you have been sitting or standing in one place for a long time, moving around a little, you can reduce this swelling. Then you will feel relief.

But remember, sometimes this swelling can be a symptom of another underlying condition. Therefore, it's best to see a doctor if you have these symptoms.

Now let's see what the main symptoms of this swelling are:

• A certain area on your body looks larger than the day before, meaning it looks swollen .
• The skin at the swollen area appears stretched and shiny .
• If your legs, ankles, or feet swell, it can be difficult to walk .
• Some people may cough and have difficulty breathing .
• The swollen area feels full and tight .
• There may be slight pain or tenderness in the affected area.

Why does the body swell like this? What are the causes of edema?

Okay, now that a doctor has told you that you have edema, the next thing you want to do is figure out why this fluid has accumulated in your body. There are several things that can cause this. Let's see what they are.

• Gravity: Simply put, if you sit or stand in the same position for a long time, things like water in your body naturally accumulate in your hands, legs, and feet. This is called ``dependent edema.`` Imagine, someone who works in a chair all day and feels like their legs are a little swollen in the evening? That's how it is.
• Weakening of the valves in the veins (venous insufficiency):Our veins have little valves inside them. When these become weak, it becomes difficult for the veins to carry blood back to the heart. This can cause blood to pool in the legs and swell, causing those blue veins to appear (varicose veins).
• Other diseases in the body: Swelling can also be a symptom of some diseases. For example, people with heart failure , lung, liver , kidney, and thyroid diseases can develop swelling. This is a very important point, because if this happens, the underlying disease needs to be treated.
• Side effects of medications: Swelling can also occur as a side effect of some medications, such as high blood pressure medications and painkillers .
• Nutritional deficiencies: If you don't eat a well-balanced diet, or if you eat a lot of foods high in salt (sodium) , your body can retain fluid and cause swelling.
• Pregnancy : As the uterus grows, the blood vessels in the lower abdomen become stretched, which is why swollen legs are common during pregnancy.
• Immune system disorders: Swelling can also be caused by things like allergic reactions, infections, burns, injuries , or blood clots.

How does a doctor accurately diagnose edema?

When you go to see a doctor, he will first examine you to see if you have any swelling. Then he will do tests to find the cause. The doctor will look carefully at the swollen areas on your body, especially any areas where the skin looks stretched and shiny.

Then, to determine the extent of the swelling, a test called a ``pitting test'' is performed. In this test, the doctor presses your swollen skin with his finger for about 5 to 15 seconds. After removing his hand, a small pit forms in that area. That pit indicates that fluid has accumulated inside your tissue.

After this ``pitting test,'' the degree of swelling (grading) is determined by how long it takes for the pits to return to normal. It is as follows:

• Grade 1: A hole of about 2 mm is formed, which quickly heals (as soon as it is tightened).
• Grade 2: A 3-4 mm hole is formed and heals in less than 15 seconds.
• Grade 3: A 5-6 mm hole is formed, and the wound heals in more than 15 seconds, but less than 1 minute (60 seconds).
• Grade 4: A large hole, about 8 millimeters, forms and takes about 2-3 minutes to heal.

How to treat edema? What can be done to reduce swelling?

The treatment for swelling really depends on what's causing it. Especially if the swelling is caused by another underlying health condition, treating that is the key.

To give a few examples:

• If the swelling is due to a lung disease, such as emphysema or chronic bronchitis, and you are a smoker , your doctor will advise you to stop smoking .
• If you have chronic heart failure and edema, you may be told to make lifestyle changes, such as watching your weight, fluid intake, and salt intake. You may also be told to reduce your alcohol intake.
• If you have swelling as a side effect of a medication you're taking, your doctor may be able to stop the medication or reduce the dosage. But never stop taking your medication without your doctor's advice.

In addition to treating the underlying cause, there are several things you can do yourself to stop fluid retention:

• When you are sitting or lying down, place a pillow under your legs and keep them above the level of your heart.
• Instead of sitting or standing for long periods of time, move around a bit and take short walks.
• Wear special support socks/stockings or sleeves. These provide a little pressure on those areas of the body and reduce fluid buildup. For those with persistent swelling, there are even special shoes (edema shoes) designed to help with swelling.
• Reduce the amount of salt in your meals.
• Take the medicine your doctor prescribes exactly as he or she tells you. Your doctor may give you a type of medicine called a 'water pill' (diuretic). This helps your body get rid of excess fluid through urine.

What are the things you should not eat when you have edema?

Sometimes swelling can be caused by too much salt (sodium) in your diet. Salt causes your body to retain water, which can then leak into your tissues and cause swelling. Therefore, reducing salt in your diet can be a great way to help reduce swelling. This means that packaged foods, canned foods, and instant noodles are high in salt, so it's a good idea to cut back on them.

How quickly will I recover after treatment?

Depending on the cause of your swelling, this may be temporary or permanent. Swelling usually goes down within a few days. The swelling is most noticeable in the first two days, and should start to go down by the third day. You can reduce the swelling by following your doctor's instructions exactly. If the swelling doesn't go down after a few days of treatment, talk to your doctor again.

Can edema be prevented?

Sometimes, if the cause of swelling is an underlying condition like heart disease, liver disease, or kidney disease, it may not be possible to completely prevent it. But you can work with your doctor to manage the symptoms.

But if the cause of swelling is excessive salt intake, you can prevent swelling by reducing the salt in your meals.

Also, moving around frequently can help prevent swelling. Sitting or standing in one place can cause fluid to accumulate in your body tissues. If you find yourself sitting for too long, get up and move around a bit if possible. This can help reduce swelling.

What should I expect if I have edema? How can I take care of myself?

If you have a lump on your body, it's important to see a doctor right away. This is because the lump can cause your skin to stretch, and if left untreated, the lump can get worse and cause serious health problems.

Swelling can be short-term or long-term, depending on the cause. There are treatments to manage underlying conditions that may be causing the swelling. Alternatively, you can make simple lifestyle changes to reduce fluid retention and swelling.

If you have swelling, do these things to reduce swelling:

• Make lifestyle changes, such as quitting smoking and changing your eating habits.
• Move around often.
• Keep your legs elevated when lying down or sitting.
• Wear compression socks, sleeves, or stockings.

Very important: It is very important to protect your swollen areas from further pressure, injury, and high temperatures. This is because if the skin is broken in swollen areas, it will take longer to heal and there is a higher chance of infection.

When should I see a doctor immediately?

If you have any of the following , seek medical advice immediately:

• If there is pain or a change in skin color in the swollen area.
• If there is an open sore on the skin in a swollen area.
• If you have difficulty breathing .
• If only one arm or leg on one side of the body is swollen .
• If you have difficulty walking or moving around.

What questions should you ask the doctor?

It's a good idea to ask these questions when you see your doctor:

• Why do I have this swelling (edema)?
• Should I reduce salt in my food?
• Are there any side effects of the treatment?
• Do I need to wear special compression socks to reduce swelling in my ankle?

So, what are the most important things we need to remember about this swelling (edema)?

Okay, from everything we've talked about, you should now understand what edema is, why it happens, and what can be done about it.

Simply put:

• Swelling is caused by the accumulation of fluid in the body's tissues.
• There can be many reasons for this. Some are simple, while others may be a symptom of an underlying condition.
• If you have unusual swelling, especially difficulty breathing, swelling in only one arm/leg, or swelling that is accompanied by pain, see a doctor immediately.
• In most cases, this condition can be controlled with small lifestyle changes (reducing salt intake, exercising, keeping swollen areas elevated) and treatment provided by your doctor.
• Never stop taking medication or change the dosage without consulting a doctor.

So, if you or someone you know is suffering from this type of swelling, don't panic. It can be managed with the right medical advice and treatment. The most important thing is to always take care of your body.