Medical News Today: What is dependent edema?

Edema is the term used to describe the swelling that results from excess fluid that is trapped in the tissues of the body. Dependent edema is caused by the effects of gravity and occurs when fluid pools in the lower parts of the body, including the feet, legs, or hands.

This article discusses the causes and symptoms of dependent edema, as well as the available treatment options.

Causes

Pain in leg and foot caused by dependent edema, woman sitting on couch holding her calf in pain.
A problem in the veins may cause dependent edema, which is characterized by symptoms such as swollen and shiny skin.

Gravity pulls blood toward the parts of the body that are closest to the ground. For example, edema may occur in the feet, but people who are bedbound may experience edema in the buttocks.

Usually, the blood is pumped back from feet toward the heart by the veins and the motion of the muscles. When this system malfunctions, the lower body parts begin to fill up with excess fluid, causing the swelling and puffiness of edema.

According to the American Family Physician, one of the primary causes of dependent edema is a problem with the veins, although muscular issues may also contribute.


What are the symptoms?

Signs and symptoms of this condition include:

  • difficulty putting on shoes and socks due to swelling
  • shiny skin
  • stretched-looking skin

To differentiate between dependent edema and one of the other types of edema, apply gentle pressure to the affected area.

If dents appear on the skin, which is known as pitting, it suggests dependent edema.


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Warning signs to look out for

Doctor in patient's home discussing report.
Those with dependent edema will need to monitor their skin health, and ensure they are aware of the warning signs.

People with dependent edema should be vigilant when it comes to their skin health because they are at increased risk of skin infections. When the skin stretches and breaks, it becomes more vulnerable to infections such as cellulitis, which is a bacterial skin infection that can spread rapidly to other body parts.

If anyone observes any signs of a serious skin issue, seek emergency medical attention.

Symptoms include:

  • a feeling that the skin is hot
  • pus-like drainage
  • redness
  • slow-healing wounds
  • swelling

The risk of skin infection can be reduced by keeping the skin around the affected areas clean and moisturizing the skin regularly.


What are the treatment options?

If there is an underlying cause for the dependent edema, then treating the condition may resolve the edema. Sometimes, these conditions are not curable such as in the case of heart failure, so people may need to manage the edema to limit its symptoms and reduce the risk of complications.

A person can implement some lifestyle changes to help manage dependent edema:

Elevate the affected body parts

Because gravity causes dependent edema, elevating the affected area to above heart level allows the excess fluid to drain toward the heart. If edema affects the feet, for example, lying down and propping up the legs with cushions can help.

Use compression stockings or bandages

If the feet or legs are affected, wearing compression socks or leg sleeves can stop the collection of fluid in the tissues. Compression bandages are also available to wrap other areas of the body.

Manually move body parts

People who cannot move their arms or legs should try manual mobility. This involves moving the immobile body part, perhaps with the hands or with the assistance of another person.

This type of movement can encourage the muscles to pump blood and fluids more efficiently, which can prevent fluid buildup and reduce the edema. A doctor can advise on specific exercises that may further reduce swelling.

Reduce salt intake

A high-salt diet can increase water retention, which increases the likelihood of edema. Discuss salt intake with a doctor or dietitian.

Massage

Massage may move excess fluid out of the affected area. Using firm pressure, stroke the skin in the direction of the heart. Never use pressure that causes pain.

Skin hygiene

Keep the skin clean and moisturized to prevent cracks, scrapes, and cuts, which can lead to infection.

Foot protection

If edema occurs in the feet, wear suitable shoes that do not restrict blood flow but that protect the feet from injury and infection.

What are the complications?

Dependent edema can lead to some complications, such as:

  • difficulty walking
  • discolored, thick skin
  • pain and stiffness
  • reduced blood circulation
  • stretched, itchy, or tender skin
  • ulcers
  • varicose veins


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Other types of edema

periorbital edema image credit klaus d peter 2008 br
Periorbital edema is a type of edema that affects the eye.
Image credit: Klaus D Peter (2008)

Dependent edema is just one type of edema.

Others include:

  • Cerebral edema: A severe condition that involves excess fluid in the brain. This type of edema is most commonly caused by trauma, a tumor, or a burst blood vessel.
  • Lymphedema: A swelling in the arms and legs that is usually caused by damage to the lymph nodes. It may be as a result of cancer or cancer treatments.
  • Macular edema: Caused by an increase of fluid in the macula of the eye.
  • Pedal edema: This occurs when fluid builds up in the feet and legs. This typically affects older adults and pregnant women.
  • Peripheral edema: This usually affects the legs, feet, and ankles. It can indicate a problem in the kidneys, lymph nodes, or circulatory system.
  • Pulmonary edema: Characterized by excess fluid in the air sacs of the lungs. It can lead to breathing difficulties.

Outlook

Some causes of dependent edema are curable, and the edema may resolve once the underlying condition is treated. However, other causes have no cure.

However, there are some steps that a person can take to reduce symptoms and the risk of complications. Using elevation, compression, movement, and keeping the skin clean can offer relief to many people with dependent edema.

It is always important to discuss dependent edema and its symptoms with a doctor, who can best advise a person on the most effective treatment options for their condition.

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