Water Retention

Edema (also known as dropsy or fluid retention) is swelling caused by the accumulation of abnormally large amounts of fluid in the spaces between the body's cells. It is a symptom rather than a disease or disorder. Widespread long-term edema can indicate a serious underlying disorder.

Signs and Symptoms

These will vary and may include the following.

• Swollen limbs (possibly accompanied by pain redness heat)
• Facial puffiness; abdominal bloating
• Shortness of breath extreme difficulty breathing coughing up blood
• Sudden change in mental state or coma
• Muscle aches and pains

What Causes It?

Imbalance in the body's fluid transfer can be caused by the following.

• Sitting or standing for long periods
• Certain medications
• Hormonal changes during menstruation and pregnancy
• Infection or injury to a blood vessel; blood clots; varicose veins
• Allergies to food or insect bites
• Kidney heart liver or thyroid disease
• High or low blood pressure; high salt intake
• Brain tumor or head injury
• Exposure to high altitudes or heat especially when combined with heavy physical exertion

What to Expect at Your Provider's Office

Your health care provider will look for varicose veins blood clots wounds or infections. An X ray computed tomography scan magnetic resonance imaging urine test or blood test may be necessary. Edema caused by organ failure or high altitude sickness may require hospitalization.

Treatment Options

Treatment Plan

Treatment of edema varies depending on the underlying disease or disorder. In addition to drugs that your health care provider prescribes the following can help to reduce swelling.

• Complete Decongestive Therapy (CDT)—compression bandages and "sleeves" are tightened over swollen limbs to help force fluid through other channels for reabsorption by the body
• Salt reduction diet
• Daily exercise
• Resting with legs above the heart level
• Wearing support hose
• Massage

Drug Therapies

Prescription

• Medication for your underlying disorder—consult your provider
• Diuretics—for example loop diuretics or potassium-sparing diuretics; reduce body fluid levels but also deplete important vitamins and minerals which can result in loss of bone mass; various other possibly serious side effects
• Morphine—reduces congestion and anxiety with pulmonary edema

Over the Counter

N/A

Surgical Procedures

Surgery may be required to remove fat and fluid deposits associated with a certain type of edema called lipedema or to repair damaged veins or lymphatic glands to reestablish lymph and blood flow.

Complementary and Alternative Therapies

The following nutritional and herbal support guidelines may help relieve edema but the underlying cause must be addressed.

Nutrition

• Eliminating food allergens from your diet decreases inflammation.
• A low-salt high-protein diet may help edema. (However you should not eat a high-protein diet if you have kidney disease.) You should also reduce your intake of sugar and refined carbohydrates.
• If you use diuretics add more potassium to your diet.
• Natural diuretics: asparagus parsley beets grapes green beans leafy greens pineapple pumpkin onion leeks and garlic.
• Vitamin B₆ (50 to 100 mg per day) is a diuretic. The B vitamin thiamine may be supplemented (200 mg per day).
• Vitamins C (1 000 to 1 500 mg 3 times per day) E (400 to 800 IU per day) and Coenzyme Q10 (50 to 100 mg 2 times per day)
• Potassium aspartate (20 mg per day) if you are using diuretics
• Magnesium (200 mg two to three times per day) and calcium (1 000 mg per day) help maintain fluid exchange in the body.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots.

A herbal diuretic is are best taken as a cooled tea (4 to 6 cups per day) although a tincture may also be used (30 to 60 drops four times a day). Combine three of these herbs with equal parts of two to three additional herbs from the following categories as indicated: cleavers (Gallium aparine) yarrow (Achillea millefolium) oatstraw (Avena sativa) elder (Sambucus canadensis) red clover (Trifolium pratense) and red root (Ceonothus americanus)

For cyclic edema such as swelling from menstruation:

• Ginkgo (Ginkgo biloba) strengthens the integrity of blood vessels.
• Bilberry (Vaccinium myrtillus) is a gentle diuretic.
• Topical applications of creams containing one or more of the following may help strengthen your blood vessels: horse chestnut (Aesculus hippocastanum) butcher's broom (Ruscus asuleatus) sweet clover (Melilotus officinalis) and rue (Ruta graveolens).

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

• Dry skin brushing. Before bathing briskly brush the entire skin surface with a rough washcloth loofa or soft brush. Begin at your feet and work up. Always stroke in the direction of your heart.
• Cold compresses made with yarrow tea.
• Contrast hydrotherapy involves alternating hot and cold applications. Alternate three minutes hot with one minute cold and repeat three times. This is one set. Do two to three sets per day.

Acupuncture

Acupuncture may improve fluid balance.

Massage

Therapeutic massage can assist with lymph drainage.

Special Considerations

Excessive fluid retention during pregnancy (toxemia) is potentially dangerous to both you and your baby.

Supporting Research

Balch JF Balch PA. Prescription for Nutritional Healing. Garden City Park NY: Avery Publishing Group; 1997.

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:73 155 156 188.

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:424 425 429.

Mayo Foundation for Medical Education and Research. Available at www.healthanswers.com

MDX Health Digest. Available at www.thriveonline.com

Mindell E Hopkins V. Prescription Alternatives. New Canaan Conn: Keats Publishing Inc; 1998.

Vanderbilt University Medical Center. Available at www.mc.vanderbilt.edu

Weiss RF. Herbal Medicines. Beaconsfield England: Beaconsfield Publishers Ltd; 1988:188–191 241.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.