Swollen Feet / Pedal Edema Symptoms

Causes, Symptoms, Diagnosis and Treatment

Pedal edema, or foot edema, is the medical term for swelling in the feet and ankles due to fluid retention in surrounding  body tissues. Pedal edema commonly affects the lower extremities of the body, most commonly feet.

What is pedal edema?

The accumulation of excessive fluid results in swelling, which is typically painless and leaves an indentation when the skin surface is pressed. This condition is referred to as “pitting” edema. It is caused by fluid leaking from small blood vessels into the surrounding tissues. Pedal edema can range from mild to severe and is often seen in both feet, though it can also affect only one foot or ankle.

Types of edema

Understanding the different types of edema is crucial for accurate diagnosis and effective treatment. Types of edema are:

• Peripheral Edema: een in the lower limbs, particularly the legs, ankles, and feet. Caused by cardiac failure, impaired kidney functioning, and  poor blood circulation
• Pulmonary Edema
  Fluid gets accumulated in the lungs, making it difficult to breathe, and becomes a medical emergency requiring immediate attention. This condition is often caused by heart failure, lung infections, COPD, or kidney failure. 
• Cerebral Edema
  This condition is seen when fluid builds up in the brain. A severe head injury, a burst blood vessel, or a tumor can all contribute to this dangerous condition.
• Macular Edema
  Fluid builds up in the macula, which is in the center of the retina at the back of the eye. This is a serious complication of diabetic retinopathy. 
• Lymphedema
  Lymphedema is the buildup of lymphatic fluid, commonly seen in the arms or legs, due to damage or blockage in the lymphatic system. It often occurs after surgery or radiation therapy for cancer.
• Angioedema
  Angioedema is a type of edema that occurs in the deeper layers of the skin, often affecting the face, lips, eyes, and throat. It can be caused by allergic reactions, certain medications, or hereditary conditions.
• Generalized Edema (Anasarca)
  Is a widespread swelling throughout the body. It often indicates a serious underlying condition like severe heart failure, kidney disease, or liver cirrhosis.
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Causes of Pedal Edema

Pedal edema can be caused due to various underlying causes. Being aware of the possible causes can facilitate an early diagnosis and course of treatment. Common causes include 

• Prolonged standing: Gravity causes fluid to gradually pool in the feet and ankles when standing for long periods without breaks. The swelling subsides after resting.
• Pregnancy: Hormonal changes and increased blood volume during pregnancy frequently cause mild swelling in the lower parts of the legs, especially in the ankles and feet. This is generally harmless but should be closely monitored.
• Medications: Medicines like corticosteroids, antidepressants, and hormone treatments can cause fluid retention over prolonged use and lead to edema in the extremities.
• Heart failure: When the heart is damaged or weakened, it can’t pump blood as efficiently, As a result, blood can back up in the legs, ankles, and feet, causing edema. 
• Kidney disease: Various types of  kidney disorders can lead to the impairment of the kidneys to filter and regulate the fluid and sodium, which over a period of time causes fluid retention and becomes visible as pedal edema.
• Liver disease: Liver disease causes increased pressure in the liver’s portal vein, which causes the fluid to build up in the surrounding tissues, which is seen as pedal edema.
• Injuries and Trauma: Sprains, fractures, and physical damage to the feet or ankles injure blood vessels and soft tissues. Increased leakage directly causes localized swelling.
• Allergies: Fluid leaking from dilated blood vessels is part of the immune response during allergic reactions, which can further lead to edema.

Symptoms of Edema

• Swelling or puffiness of the tissue right under the skin, especially in legs or arms.
• Stretched or shiny skin.
• Skin that holds a dimple, also known as pitting, after it’s been pressed for a few seconds.
• Swelling of the belly, also called the abdomen, so that it’s bigger than usual.
• Feeling of leg heaviness.

The following steps are to be taken for diagnosing pedal edema.

• Clinical examination with medical history
• Physical examination and assessment of symptoms 
• Examination of legs and checking for pitting on the skin
• Diagnostic blood and urine tests
• Imaging tests like X-rays if necessary
• Heart and kidney function tests
• Checking for blood clots in the legs

Treatment of pedal edema focuses on addressing the underlying cause, improving circulation, preventing further fluid retention, and actively draining excess fluid from the limbs.

• Addressing the underlying problem: Consulting a medical professional for treating heart failure, kidney disease, liver disease, or other medical conditions causing fluid retention is very important to completely treat pedal edema.
• Alternate medications: stopping medications that cause fluid retention as a side effect.
• Improving the flow: keeping the legs raised above heart level when lying down or sitting improves drainage of excess fluid from the limbs, reducing swelling.
• Using compression stockings: Wearing specialized elastic stockings applies gentle pressure to prevent fluid accumulation in the feet and ankles.
• Reducing Sodium Intake: Following a low-salt diet decreases fluid retention throughout the body. This prevents additional fluid from being held in the tissues.
• Medication: Diuretic medications promote urination and excretion of excess fluid from the body, which can relieve swelling.

Immediate medical attention should be sought if sudden or severe pedal edema is noticed accompanied with chest pain, breathlessness, or confusion. Edema affecting only one limb, being unresponsive to rest, or presenting with other concerning symptoms may point to a serious underlying condition. It is essential to consult a doctor to prevent complications and 

receive appropriate treatment.