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Swelling

Edema; Anasarca

Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup 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 all over the body (generalized) or only in one part of the body (localized).

Considerations

Slight swelling (edema) of the lower legs is common in warm summer months, especially if a person has been standing or walking a lot.

General swelling, or massive edema (also called anasarca), is a common sign in people who are very sick. Although slight edema may be hard 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.

Causes

Swelling can be caused by any of the following:

  • 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, such as corticosteroids or drugs used to treat heart disease, high blood pressure, diabetes

Home Care

Follow your health care provider's treatment recommendations. If you have long-term swelling, ask your provider about options to prevent skin breakdown, such as:

  • Flotation ring
  • Lamb's wool pad
  • Pressure-reducing mattress

Continue with your everyday activities. When lying down, keep your arms and legs above your heart level, if possible, so the fluid can drain. DO NOT do this if you get shortness of breath. See your provider instead.

When to Contact a Medical Professional

If you notice any unexplained swelling, contact your provider.

What to Expect at Your Office Visit

Except in emergency situations (heart failure or pulmonary edema), your provider will take your medical history and will perform a physical examination. You may be asked about the symptoms of your swelling. Questions may include when the swelling started, whether it is all over your body or just in one area, what you have tried at home to help the swelling.

Tests that may be done include:

Treatment may include avoiding salt or taking water pills (diuretics). Your fluid intake and output should be monitored, and you should be weighed daily.

Avoid alcohol if liver disease (cirrhosis or hepatitis) is causing the problem. Support hose may be recommended.

References

Raftery AT, Lim E, Ostor AJK. Abdominal swellings. In: Raftery AT, Lim E, Ostor AJK, eds. Churchill's Pocketbook of Differential Diagnosis. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:10-25.

Seller RH, Symons AB. Swelling of the legs. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 31.

    • Pitting edema on the leg

      Pitting edema on the leg - illustration

      Pitting edema occurs when fluid collects in the tissue. By pressing a thumb or finger firmly against the tissue for a few seconds, a dent can be produced. When the finger is withdrawn the dent may persist for several minutes.

      Pitting edema on the leg

      illustration

      • Pitting edema on the leg

        Pitting edema on the leg - illustration

        Pitting edema occurs when fluid collects in the tissue. By pressing a thumb or finger firmly against the tissue for a few seconds, a dent can be produced. When the finger is withdrawn the dent may persist for several minutes.

        Pitting edema on the leg

        illustration

      Review Date: 12/10/2016

      Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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