Understanding Edema: Causes, Symptoms, and Treatment Options

Understanding Edema: Causes, Symptoms, and Treatment Options

Almost all of us have had oedema in its harmless form, for example, swollen eyelids in the morning after drinking too much alcohol, swollen feet in summer or swelling after an insect bite. However, oedema, also known as dropsy, can also be a symptom of a severe medical condition. What is oedema, and how is it treated? You can find out here.

Payment: Definition

Edema, often called “dropsy”, is the accumulation of water from the vascular system in the interstitial tissue, primarily connective tissue. Painless swelling mainly occurs in the affected area. Typical: If you press on the swelling with your finger, a dent remains, which only gradually recedes.

Edema is not a disease in its own right but a symptom of an existing underlying disease. They can occur sporadically but also in the whole body and affect many other regions besides the skin, for example, the lungs ( pulmonary oedema) or the brain (cerebral oedema).


How does oedema develop?

There is usually a balance between the transfer of liquid from the smallest blood vessels – the arterial capillaries – into the connective and supporting tissue and the outflow of tissue water into the venous capillaries and its drainage via the lymphatic vessels. In the case of oedema, this fluid exchange between the capillaries and the tissue is disrupted, meaning more water enters the tissue than is transported away.

This is the case, for example, with all diseases that affect blood circulation, such as heart and kidney failure. In the first case, the heart’s pumping capacity is impaired so that the return flow to the heart is restricted, and the water collects – according to gravity – above all in the area of ​​both ankles and the backs of the feet. In the case of kidney weakness, proteins are excreted with the urine, which would otherwise attract the water in the blood and thus hold it back.

Other common causes of oedema are liver cirrhosis (leads to oedema in the abdomen = ascites ), allergies and medications such as calcium channel blockers used in heart disease. Some congenital diseases are also associated with oedema.

Common forms of oedema

Standard forms and types of oedema are:

  • leg oedema
  • pulmonary edema
  • cerebral oedema
  • Angioedema

A unique form is lymphedema, in which the lymph nodes are not functional or have been destroyed or removed due to a disease (e.g. cancer). As a result, tissue fluid and degradation products can no longer be sufficiently removed. There is tissue swelling, which can affect individual limbs and the whole body. The tissue appears bloated and doughy; the swellings are challenging to dent in contrast to “normal” oedema.


Leg oedema: water in the legs

Leg oedema, i.e. water accumulation in the legs, is caused, for example, by weak veins whose venous valves no longer function well enough. The used blood, which should be transported to the heart, sinks into the legs.

As a result, high pressure builds up in the vessels, too much fluid is pressed out of the blood into the surrounding tissue, and the leg swells. Other causes are cardiac and kidney failure.

Pulmonary oedema – water in the lungs

Fluid transfer from the capillaries into the lungs is most often caused by a chronic weakness of the left ventricle – the blood is not sufficiently pumped into the systemic circulation and backs up in the pulmonary circulation. Other causes of pulmonary oedema are kidney failure, lung diseases and altitude sickness.

Cerebral oedema: life-threatening water retention

The life-threatening increased accumulation or rearrangement of fluid in the brain tissue is caused by various external and internal disorders, for example:

  • tumours
  • inflammation
  • poisoning
  • vascular damage
  • brain diseases
  • injuries
  • operations or
  • the altitude sickness

Since the bony skull has no opportunity to expand, cerebral oedema can compress essential areas of the brain and supply vessels, which leads to reduced blood flow and tissue death.


Angioedema: Edema in various parts of the body

This accumulation of water in the subcutaneous tissue, formerly known as Quincke’s oedema, shows up as fleeting, often massive swellings, especially on the face (on the lips and eyelids), more rarely on the tongue, genitals and other organs. They don’t usually itch, but depending on the severity of the swelling, they can be painful. If the larynx is affected, there is even a risk of suffocation.

Angioedema usually resolves within one to three days. It occurs either as part of an allergic reaction (mediated by the neurotransmitter histamine) or – much more rarely – due to the insufficient function of a specific molecule (C1 inhibitor), which slows down the immune system in the event of uncontrolled reactions. This form is usually congenital (hereditary angioedema).

Therapy of “dropsy”

Since oedema expresses an underlying disease, its treatment is the top priority. The extent of the oedema (or its reduction) is often a good indicator of whether the therapy works, for example, for heart or kidney weakness. Depending on the location and severity of oedema, intensive care treatment is necessary – for instance, in the case of cerebral oedema and pulmonary oedema.

Lymphedema swelling is treated with special compression stockings or gloves and sleeves that put pressure on the limbs; the affected limbs are elevated. Special massages  ( lymphatic drainage ) and physiotherapy provide additional relief.


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