Edema on the feet
"Edema on the feet" means an increase in the lower extremities in the volume, especially pronounced with excessive use of liquid, which increases by evening, after prolonged standing or walking.
The otteral syndrome is not independentdisease. This is just a sign of another disease, but the sign is quite formidable. From the point of view of physiology, edema is a fluid accumulated in the tissue (intercellular) gaps, which leads to an increase in tissue in the volume.
The cause of swelling can be either in violation of the removal of fluid (blood and lymph) from the lower extremities or in its increased formation.
The most common reasons are from the groupmechanical obstacles. There is a compression of venous vessels with tumors or a pregnant uterus, with blockage of veins by thrombi, with lymphatic drainage of lymphatic vessels. In this case, there is an increase in pressure in the smallest capillaries and an increase in the sweatiness of the liquid of their blood plasma into the surrounding tissues.
In the bloodstream, the fluid retains salts and proteins. Therefore, a decrease in the number of proteins in the blood plasma contributes to the release of fluid from the blood into the tissue.
Acceptance of certain medications, includingnumber and recommended by the doctor, can promote fluid retention in the body. First of all (because of the frequency of admission) this refers to the group of glucocorticoids prescribed for allergies, inflammatory joint diseases, bronchial asthma, and oncological diseases. But the side effects are manifested only with prolonged admission. The same effect is possessed by preparations of sex hormones, both female and male. Female sex hormones are taken as a contraceptive (estrogen and progesterone oral contraceptives), and testosterone (male sex hormone) is prescribed for men in the treatment of sexual impotence and obesity. Also worth paying attention to drugs for the treatment of high blood pressure - from the group of ACE inhibitors
Causes of leg swelling in pregnancy
Often on foot swelling pregnant women complain. And for that there are several reasons. First, hormonal. For the preservation and normal course of pregnancy in the body is released in large quantities of hormone progesterone, which relaxes the smooth muscles not only of the uterus, but also of the vessels and promotes fluid retention in the body. Secondly, in the second half of pregnancy a large uterus squeezes large veins in the abdominal cavity, making it difficult for them to flow. This helps to increase the pressure in the veins of the lower extremities, and they swell. Thirdly, swelling of the legs (and not only) can be a sign of gestosis (late toxicosis of pregnant women), which, progressing (developing), can threaten the life of both the future mother and baby.
Diseases with foot swelling
Diseases, which are accompanied by swelling of the lower limbs, are quite diverse.
It is believed that one of the most frequent causesedema is varicose veins of the lower extremities. In a healthy body, veins are vessels that divert blood from tissues to the heart (with rare exceptions). On the legs there is a system of deep and superficial veins, connected with each other by perforating (connecting) veins. Normally, almost all of the burden is borne by deep veins. But in the event that they do not cope, then they come to the aid of superficial. To make the blood move from the bottom up, there are valves in the veins that prevent the reverse flow of blood. They push blood through the veins around the leg muscles (feet, legs, thighs). When the valve apparatus is broken, deep veins are blocked, muscles are weak, the blood in the veins is retarded and the fluid from them flows into surrounding tissues. This in turn leads to a disruption in the supply of tissues, their oxygen starvation and varicose veins.
Predisposing factors arepregnancy and childbirth, female sex, work on legs and with lifting weights, taking oral contraceptives. With varicose veins in conjunction with edema, symptoms such as leg fatigue by the evening, asymmetry of the edema on the right and left leg (more where the veins are more affected), the appearance on the skin of the legs of vascular asterisks, areas of darkening on the shins or visible visually enlarged subcutaneous veins.
Lymphedema is a serious illness, the cause ofwhich is a violation of the outflow of lymph through the lymph vessels from the lower limbs. Lymphatic vessels collect intercellular fluid with cell exchange products to transport it in one direction with veins. These are very thin and fragile vessels, so when an obstacle arises in their path, their function is disturbed and the liquid remains in the tissues. On the feet this often happens as the outcome of frequent acute erysipelas. After curing this disease, seals of connective tissue are formed on the site of the lesion, which compress the lymph vessels. As a rule, once appeared, such swelling remains forever. The last stage of lymphedema is called "elephantiasis" because of the similarity of the appearance of the patient's leg and the largest herbivore.
In order not to bring your legs to such a state, you should turn to a specialist for advice in time.
Edema on the feet is quite typical forheart diseases. Let's take a short tour of the anatomy. The heart is a muscular organ, divided into 4 cavities. His left half (atrium and ventricle) pumps blood through the arteries of the whole body. These vessels, branched, carry nutrients and oxygen to the tissues. Then, collecting carbon dioxide and other metabolic products in tissues, merging into larger vessels - veins, carry blood to the right side of the heart. From there, the blood is pumped into the lungs, where it is saturated with oxygen again and enters the left heart.
Pronounced edema may indicate a long wayheart failure. With ischemic heart disease, because of a lack of oxygen flow through vessels clogged with atherosclerotic plaques, it is not able to work at full strength, which leads to a decrease in the rate of blood passage through the vessels. The longer the blood flows through the vessel, the more liquid from the blood can pass into the tissues. Insufficient work of the heart also slows the drainage of blood from the lower limbs. Therefore, edema appears primarily on the legs and is accompanied by symptoms such as shortness of breath and pain in the heart, under the left scapula and in the left arm, intensifying with physical exertion, cyanosis of the lips and nails, weakness, palpitations. For cardiac pathology symmetrical edema is characteristic, more by the evening, leaving a pit with pressure, an increase in the liver. Such patients need a doctor's supervision, and, if necessary, a cardiologist's advice.
Swelling on the feet can also be a signkidney disease. In this case, they develop rapidly, against back pain, temperature, changes in color and amount of urine, edema on the face in the eye area. Often this is preceded by a week or two of colds or tonsillitis. Edemas in this case develop due to a violation of the excretion of salt and water by the affected kidneys, and also because of a decrease in the amount of protein in the blood plasma and an increase in the permeability of the vascular wall. Protein albumin is produced in the liver, and is found in the blood and tissues. Normally, albumin does not penetrate the kidneys into the urine. Therefore, if you find a protein in the urine analysis, this is a serious sign of the disease. Such patients are often treated by nephrologists and urologists in conjunction with a therapist.
With hypothyroidism (decrease in hormone productionthyroid gland) there are puffiness, which does not leave a fossa when pressed, combined with a general gain in weight, inhibition, lethargy, propensity to constipation and depression.
Local edema on the foot may appear wheninflammatory diseases of the joints of the legs. In this case, edema is detected only over the affected joint, this area has an elevated temperature to the touch, movements in the joint are painful, its function is violated. This may be a sign of arthritis or arthrosis of the joint. In this case, a consultation with a rheumatologist may be required.
With cirrhosis of the liver, swelling may also occuron the lower extremities and in the cavities of the body (in the abdominal cavity, around the heart and lungs). The cause of this may be a violation of the production of albumin by the liver or a violation of blood flow due to cicatricial changes in the liver tissue through which a large volume of blood passes to the heart. Such a patient, as a rule, has a long-lasting liver disease against a background of viral hepatitis, toxic alcoholic liver damage or heart disease. Such patients are observed in a hepatologist and infectious disease specialist.
Examination of patient with edema on legs
It is not difficult to detect the swelling independently. First, try pressing on the shin area in the tibia and wait a few seconds. If after this uncomplicated manipulation there is a fossa that does not disappear for a long time - this is a clear sign of edema.
Examination of the patient with edema begins with a visit to the physician's doctor who, after a thorough survey and examination, can indicate the range of possible causes of this condition.
After this, the patient is examined in the laboratory andif necessary, is referred for consultation to a specialist. It is worth to pass blood and urine tests, not only general, but also showing the kidney and liver function, to make an electrocardiogram (ECG).
Treatment of leg swelling
For the treatment of edema of the lower limbs,first of all, to identify its cause and influence it: to select cardiac drugs, to cure kidney diseases, to normalize the operation of blood vessels. Independently you can reduce the intake of salt (along with it, fluid retention in the body) and excessive water intake. If the doctor has not revealed any contraindications, then you can use herbal teas, which contain jasmine, lemon, mint, cranberries, cranberries. If possible, exclude wearing high-heeled shoes, and at home give your feet an elevated position (above the level of the heart). I draw your attention to the fact that diuretics, including herbs, are taken only for the intended purpose and under the supervision of a doctor. Uncontrolled use of them can lead to increased excretion of potassium from the body, which is fraught with serious irregularities in the work of the heart.
Complications of leg swelling
Swelling of the feet should not be underestimated. It is better to visit a doctor to make sure that the reason for this is simply fatigue and heat, and not a serious illness. After a timely diagnosis of heart disease, it makes it possible to prevent a heart attack and stroke, and the kidney diseases treated in time will not lead to chronic kidney failure.
One of the most formidable complications of defeatvenous bed of the lower extremities is a violation of the integrity of the skin, up to the development of ulcerative defects and gangrene, in which amputation of the lower limb is indicated.
With untreated deep vein thrombosis, the development of thromboembolism of the pulmonary artery is possible.
What kind of specialist doctors can help with edema on the legs?
Therapist or general practitioner (family doctor).
Take care of your health. And remember that it depends only on you.
Moskvina Anna Mikhailovna, doctor-therapist