Swelling of the lower limbs (oedema)

Q: MY ANKLES have been swelling, what could be the cause? Can I do anything for the swelling?

A: Swelling of the ankles as a result of the buildup of fluid in the tissues is called oedema. The causes of such include various illnesses, medications and occasionally allergies. A combination of medications, exercise, diet and lifestyle adjustments is often used in its treatment. While oedema can occur in any part of the body, the most affected areas are the feet, ankles and (lower) legs.

Causes of oedema

• Gravity pulls water down into your lower limbs. The pull of gravity is accentuated if you are sitting or standing in one spot for an extended period.

• If the valves in the veins of your legs are not functioning properly, this often leads to fluid accumulating in your feet and ankles. n A range of medical conditions can result in a buildup of fluid in your lower limbs. Especially diseases affecting such organs as the heart, lungs, kidneys, liver and thyroid.

• Certain pain, diabetes, high blood pressure medications, steroids and hormones can cause oedema.

• Pregnancy often causes mild oedema.

This is only a problem if associated with high blood pressure and or protein in the urine.

• Premenstrual fluid retention.

• Diets high in salt can result in fluid retention and oedema of the feet and ankles.

• Inadequately functioning lymphatic system as a result of damage, infection or cancer.

• Other causes include allergies, injury, burns, clots in the veins of the legs, and reduced protein in the diet.

How do you know that you have oedema?

• The feet and ankles look swollen.

• Skin often looks shiny.

• Difficulty seeing the veins or bones in the foot or around the ankle.

• Applying pressure with your fingers to the swollen area leaves an indentation/ dimple (pitting).

• The feet may feel heavy, and you may have difficulty walking.

What are the complications of untreated oedema?

• Chronic ulcer (“sore foot”).

• Difficulty walking.

• Poor circulation.

• Cellulitis (infection in the soft tissue).

• Pain in the lower limbs.

How can oedema be managed?

The specific treatment depends on:

• The cause

• If its likely to be temporary or long term n The patient’s preferences First and foremost, your doctor will take a detailed history and conduct a thorough physical examination. Thereafter they may order additional tests if necessary.

General measures which are often recommended:

• Avoid standing or sitting for long periods of time in one position

• Elevation of feet while seated or on pillows while lying

• Compression stocking

• Reducing salt intake

• Medicines which help your body get rid of excess fluid (i.e. a water tablets/ diuretics)

• Gentle exercise including walking often helps

• Wear comfortably fitting footwear Underlying heart, lung, kidney, liver, thyroid and lower leg circulatory problems are treated appropriately.

See your health care provider immediately:

• If you were to experience shortness of breath or chest pain

• If the overlying skin becomes bruised or cracked or a sore develops.

• If there is any increased in temperature/ warmth, pain, redness in one or both legs

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg. com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp) Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.