Causes Of Oedema

Oedema is one of the most common symptom of a number of diseases, which may be localized or generalized.

Conditions which are associated with oedema or the causes behind oedema include cardiac failure, nephrotic syndrome or nephritic syndrome, acute or chronic liver failure, acute or chronic renal failure, hepatic venous thrombosis, protein energy malnutrition disorder, thaimine deficiency (wet beriberi), pre-menstrual fluid retention, pregnancy and drugs (such as corticosteroids, non steroidal anti inflammatory drugs, oestrogen, calcium channel blockers and certain vasodialators).

There are different ways through which oedema can occur. For example oedema in case of liver failure, nephrotic syndrome, malnutrition and malabsorbtion occurs because of low serum albumin caused due to reduced synthesis or increased loss. It is worse in dependent regions of the body.

Oedema may occur locally along with some infection or inflammation and systemically in severe sepsis and in drug related conditions due to leakage of proteins in the cells.

In conditions such as deep venous thrombosis or venous insufficiency, pregnancy and heart failure, oedema takes place due to venous pressure or obstruction.

Oedema due to lymphatic obstructions is seen in conditions like infection, filariasis, malignancy, radiation injury or some congenital abnormality.

How to diagnose oedema?

The cause of oedema is usually known from the history of occurrence of oedema or from the examination of cardiovascular and gastrointestinal systems. It is usually followed by urine test for proteins and serum albumin levels.

Where ascites or pleural effusions cause diagnostic difficulty, aspiration of fluid and microscopy for cells usually clears up the picture.

Management in oedema

When a specific cause is known then diuretics are commonly used. In generalized oedema and sodium retention, sodium intake is restricted with administration of diuretics.

In nephrotic syndrome, renal failure and in severe cardiac failure, high doses of diuretics may be required to achieve a fluid balance and negative sodium.