ADAM Health Encyclopedia

Swelling

Definition

Swelling is the enlargement of organs, skin, or other body parts. It is caused by build up of fluid in the tissues. The extra fluid can lead to a rapid increase in weight over a short period of time (days to weeks).

Swelling can occur throughout the body (generalized) or only in a specific part of the body (localized).

See also:

• Ankle, feet, and leg swelling
• Angioedema
• Swollen gums
• Swollen glands
• Facial swelling
• Swelling in the abdomen
• Breast enlargement
• Scrotal swelling
• Joint swelling

Alternative Names

Considerations

Slight swelling (edema) of the lower legs commonly occurs in warm summer months, especially if a person has been standing or walking a lot.

Generalized swelling, or massive edema (also called anasarca), is a common sign in severely ill people. Although slight edema may be difficult to detect, especially in an overweight person, massive edema is very obvious.

Edema is described as pitting or non-pitting.

• Pitting edema leaves a dent in the skin after you press the area with a finger for about 5 seconds. The dent will slowly fill back in.
• Non-pitting edema does not leave this type of dent when pressing on the swollen area.

Causes

• Too much salt or sodium
• Burns
• Sunburn
• Too little albumin in the blood (hypoalbuminemia)
• Poor nutrition
• Pregnancy
• Drugs, including
  • Androgenic and anabolic steroids
  • Certain blood pressure medicines
  • Corticosteroids such as prednisone
  • Estrogen
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Calcium channel blockers
  • Diabetes medicines called thiazolidinediones
• Nephrotic syndrome
• Acute glomerulonephritis
• Chronic kidney disease
• Heart failure
• Liver failure from cirrhosis
• Thyroid disease

Home Care

Follow prescribed therapy to treat the underlying cause of the swelling. Discuss with your health care provider the options to prevent skin breakdown (for chronic edema) such as a pressure-reducing mattress, a lamb's wool pad, or a flotation ring.

Maintain everyday activities. When lying down, keep limbs above the heart level, if possible, to facilitate drainage. Do not do this if shortness of breath results -- see your doctor instead.

Reduced sodium (salt) in the diet may be recommended.

When to Contact a Medical Professional

If you notice any unexplained swelling, contact your health care provider.

Except in emergency situations (such as cardiac failure or pulmonary congestion), your health care provider will obtain your medical history and will perform a physical examination.

Medical history questions documenting swelling in detail may include the following:

• Time pattern
  • When did you first notice this?
  • Is it present all the time?
  • Does it come and go?
• Quality
  • How much swelling is there?
  • When you poke the area with a finger, does the dent remain?
• Location
  • Is it overall or in a specific area (localized)?
  • If swelling is in a specific area, what is that area?
• Other
  • What seems to make the swelling better?
  • What seems to make the swelling worse?
  • What other symptoms are also present?

• Albumin levels
• ECG
• Echocardiography
• Serum electrolyte tests
• Urinalysis
• X-rays
• Liver function tests
• Kidney function tests

Treatment may include fluid and sodium restriction, diuretics, or water pills. Your fluid intake and output should be monitored, and you should be weighed daily.

Avoid alcohol if liver disease (such as cirrhosis or hepatitis) is causing the problem. Vascular support hose may be advised.