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 Women's Health

July 2010
Swelling of Feet and Legs
Dr. Dhiman Sen
 
Is there reason to get worried if your feet are swelling up?

Any painless swelling of the feet or ankles is called oedema. This is the result of abnormal fluid accumulation in tissues, and is most often seen in the lower parts of the body, especially the feet and ankles – blame it on gravity!

Oedema is usually seen as an increased stretching and shininess of the swollen area of skin, which dimples when gently pressed down upon. Though it is a common problem, especially in the elderly, oedema does not run in families, nor is it possible to transmit it to others through close contact.

Oedema has many causes, some temporary and some permanent, some requiring simple mechanical interventions like keeping one’s legs raised to counter the effects of gravity, to others requiring urgent doctor’s attention for analysis of the underlying cause for proper redressal.

10 Benign Causes
Feet and ankle swelling can ring alarm bells in the minds of patients and doctors alike, because the underlying causes may range from the innocuous to the more serious incurable diseases.
  1. Excessive salt intake
  2. Pregnancy
  3. Old age
  4. Prolonged standing
  5. Long-haul air flights or car-rides
  6. Obesity
  7. Menstruation
  8. Local injury or infection
  9. Varicose veins
  10. Certain medications like Amlodipine or oestrogens (in birth control pills)
6 Serious Causes
  1. Clots in the leg veins
  2. Hypertension in pregnancy (called pre-eclampsia)
  3. Heart failure
  4. Liver failure
  5. Certain kidney diseases like nephrotic syndrome
  6. Protein malnutrition
5 Home Remedies
Try these simple steps before you decide on meeting a doctor.
  1. Lower the salt content of your diet
  2. Exercise your legs
  3. Elevate your legs above the heart while lying down
  4. Wear support stockings
  5. Stop incriminating medications
Preventing Oedema
  1. avoid wearing restrictive clothing
  2. Adopt weight losing measures
  3. Avoid sitting or standing without moving for prolonged periods
  4. Take out time for stretching exercises and walking around while on long-haul flights or car rides
When to See Your Doctor
  1. If you notice a sudden increase in the degree of swelling, especially if you are pregnant
  2. If you have an associated decrease in urine volume
  3. Increased redness or pain over the area
  4. Chest pain
  5. Shortness of breath
  6. Fever
  7. History of liver/heart/kidney disease
To classify your foot swelling severity, your doctor will evaluate your answers to questions about symptoms (such as how often you have foot swelling attacks and how bad they are), along with the results of your physical exam and diagnostic tests. Foot swelling severity often changes over time, requiring an adjustment to treatment

Foot Swelling classification Sings and Symptoms
Mild intermittent Mild symptoms up to two days a week and up to two nights a month
Mild persistent Symptoms more than twice a week, but no more than once in a single day
Moderate persistent symptoms once a day and more than a night a week
Severe persistent Symptoms throughout the day on most days and frequently at night

Dr. Dhiman Sen is Consultant – Internal Medicine at Apollo Gleneagles Hospitals, Kolkata


    
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