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What is idiopathic oedema?
Oedema is the medical term for fluid retention. Idiopathic is a term which means 'unknown cause'. Idiopathic oedema is therefore a condition of mild fluid retention where the cause is not fully understood. Oedema can be caused by various conditions, especially diseases of the heart or kidney. However, people with idiopathic oedema are otherwise healthy and do not have a kidney or heart disease to account for their oedema. Idiopathic oedema is not serious but can be a nuisance.
Who has idiopathic oedema?
Idiopathic oedema mainly affects women in their middle years. It can become worse as you get older. Many women find that the oedema worsens at certain times of the month (usually just before a period).
What causes idiopathic oedema?
The underlying cause seems to be due to fluid 'leaking' out of the small blood vessels into the tissues. Why this occurs in some people is not clear. It is usually worse after you have been standing for long periods as there is increased pressure in your veins when standing compared to lying down. Going on long journeys or sitting still for long periods of time can also worsen the swelling. Stress can also lead to fluid retention.
One possible cause is the retention of salt. When the body retains salt it also holds on to fluid and thereby causes the oedema.
A possible cause of fluid retention often overlooked by people and difficult to diagnose is due to binge eating alternating with strict dieting. This can cause intermittent fluid retention.
What are the symptoms?
Mild swelling of the feet, hands, abdomen, breasts and face may occur. This is worse at the end of the day and may disappear after a night's rest. Rings may need to be taken off and looser clothes may need to be worn in the evening.
Many people with idiopathic oedema find that they weigh about two kilograms (four pounds) more in the evening compared to the morning. You should use the same scales to weigh yourself, after you have been to the toilet, morning and evening.
What are the treatments?
Idiopathic oedema is not an easy condition to treat and cannot often be cured. Many people are reassured that their fluid retention is not due to a serious medical condition. Learning to live with it and changing into loose evening clothes is all that is required for most people.
However, the following tips may be helpful:
Avoid prolonged standing
This may not always be easy, especially if you are in a job which requires you to stand for long periods of time. Wearing support stockings or tights will often help to reduce swelling of ankles and legs. There are now many different types and sizes meaning they are fairly comfortable to wear. Many of the tights and stockings are now available on prescription from your doctor.
Weight loss
Many people with fluid retention are overweight and losing weight can make a big difference to improve the oedema. A gradual weight loss (rather than fasting and binging) is recommended.
Salt restriction
Idiopathic oedema can often improve greatly if your reduce your salt intake. One way is to stop adding salt to food and also reduce the amount of processed foods you eat as these often contain large amounts of salt.
Eating foods rich in potassium
Eating potassium-rich foods can actually help reduce the sodium (salt) levels in the body and so improve the oedema. Potassium rich foods include most fruits, especially bananas and also tomatoes. You should not take potassium supplement tablets though.
Diuretics (water tablets)
Many people take these for oedema due to other medical conditions. However, in idiopathic oedema diuretics may make things worse in some people as they alter the salt and water balance of the body. They are not necessarily the easy answer to the problem. However, they can help for some people. A doctor is the best person to discuss whether or not they may help you. Also, there are different types of diuretics, and some are not advised for idiopathic oedema. So, it is best to discuss with a doctor before using any diuretic.
References
- Dunnigan MG, Henderson JB, Hole D, et al; Unexplained swelling symptoms in women (idiopathic oedema) comprise one component of a common polysymptomatic syndrome. QJM. 2004 Nov;97(11):755-64. [abstract]
- Ely JW, Osheroff JA, Chambliss ML, et al; Approach to leg edema of unclear etiology. J Am Board Fam Med. 2006 Mar-Apr;19(2):148-60. [abstract]