Edema is an abnormal swelling caused by the excessive pooling of fluids under the skin. There are several different kinds of edema based on the location of the excessive fluid retention, and the health risks associated with each type of edema also vary based on location. The two most commonly diagnosed forms are peripheral edema and pulmonary edema. Peripheral edema tends to form at the body’s lowest point of gravity.
For example, if a person is standing on their feet the problem may become noticeable at the ankles or on the tops of the feet. If a person is sitting down, the excess fluid will pool near the bottom of the spine or in the lower thigh. Pulmonary edema occurs in the lungs, and generally does not show any outward evidence of swelling. Again, the pooling of excess liquid is linked to gravity, so if a person lies down on their back the pulmonary fluid will spread along the backs of the lungs. If the person is sitting up, the fluid will collect in the bottom of the lungs. Mild edema symptoms can be managed by raising the swollen area above the level of the heart so that the fluid dissipates naturally. More severe edema can be treated with diuretics that reduce the amount of fluid the body produces.
1. Swelling
One of the first signs of edema is uncomfortable swelling. As fluid builds up between the skin and muscles, the area will enlarge and gain a puffy appearance. The skin develops a shiny surface and looks like it is being stretched as the fluid level increases. This can be caused by many factors, such as standing on your feet too long, eating large amounts of sodium, or not drinking enough water. This symptom is not always immediately noticeable, and it can reduce on its own as the body becomes rehydrated or the constant pressure of standing or sitting is relieved.
In some cases the amount of fluid collecting around the ankles or knees can become so severe that it is difficult to walk. Sometimes a person will lose feeling in their feet because the excess fluid dulls the nerves. Elevating the swollen area for a couple of hours so that the fluid can drain back into the body naturally can often relieve discomfort and reduce puffiness, especially in the feet and legs. Pulmonary edema also involves swelling, but it is typically not noticeable because the excess fluid collects in the lungs and their surrounding tissues. Internal edema is generally indicated by other symptoms that can alert a medical professional that fluid has collected in the lungs.
2. Puffiness
Peripheral edema is usually noticeable at first because of puffiness in the affected area. The size of feet, hands, ankles, or knees may not change dramatically, but they can begin to look larger than normal. The fluid builds up underneath the skin and fills out the shape of the area, so that places where the skin usually contours inward are puffed outward instead. A good way to test for puffiness is to press your finger into the swollen area. If the skin does not immediately bounce back to its usual shape, the area is full of fluid that takes extra time to shift back. The divot left by finger pressure is known as edema pitting.
3. Stretched Skin
The skin over a swollen area becomes tight as the surface underneath the skin expands. Stretched skin can look shinier than usual and will lose all of its usual wrinkles or other usual creases. Sometimes the skin will take on a red or white sheen when it becomes stretched to an uncomfortable degree. There is generally no sharp pain related to the stretched skin, but some people may experience a dull ache as the area fills with excess fluid. Because pulmonary fluid retention is internal, it causes no visible external effect on the skin and must be diagnosed through different symptoms.
4. Shiny Skin
The skin over an affected area will take on a shiny look because it loses its elasticity when it is stretched over a larger area than normal. Some redness may also occur as the skin pulls tightly around the excess fluid that has built up. More severe edema will create shinier skin areas as the skin spreads to contain the expanding fluid. Wrinkles, pores, and other normal skin features are expanded and pressed together, which creates an abnormally shiny surface. As the inflammation reduces, the shininess of the skin will go away and the skin surface will look normal once more.
5. Increased Abdominal Size
One of the signs of internal or pulmonary edema is an increased abdominal size. If the stomach is noticeably larger than usual, fluid is probably collecting along the digestive tract. It is common for excess fluid to be retained in the intestinal area during a woman’s menstrual cycle, which can also increase the size of the abdomen. An increase in the abdomen during other times of the month, or an increase that does not reduce naturally within a few hours, could be an indication of internal edema and should be checked by a doctor. A swollen abdomen from edema may or may not be accompanied by pain or extreme discomfort.
6. Difficulty Breathing
Pulmonary edema’s symptoms do not present themselves visually, but manifest in a person’s breathing comfort. Difficulty breathing is one of the most obvious signs that something is wrong in the lungs. A constant, wet sounding cough is another sign that the lungs might be retaining excess water. Water collecting in the lungs can lead to pneumonia, which can be a serious medical condition. It is important to see a doctor if your breathing does not ease or your wet cough remains constant for more than a day or two. If caught early enough, excess fluid in the lungs can be treated through medication and rest.
7. Chest Pain
Some forms of edema are caused by excess fluid collecting in the cardiovascular system as well as the lungs. Both of these kinds of water retention can cause recurring chest pains as the water impedes the ability of the lungs or heart to do their jobs. The pain may occur when you take a deep breath, or it may occur as a constant dull ache. Fluid collecting in or around the cardiovascular system can be a serious health risk, so it is a good idea to visit a doctor as soon as possible if chest pain is intense or continues to be uncomfortable for longer than a few minutes.
