Swollen but Not Silent: Oedema May Be Your Body’s Cry for Attention

Swelling might seem like a minor thing at first — maybe you stood too long or ate something salty — but if it sticks around, it’s giving serious red flag energy. Oedema is the medical term for swelling, and it’s often your body’s way of saying, “Pay attention!”

Whether fluid builds up in your legs, hands, or face, it could indicate issues with your heart, kidneys, or liver that need attention. Let’s dive deeper to understand what oedema is and why you need to take a closer look. 

You may notice swelling, particularly in the feet, ankles, and legs, with the skin appearing stretched or shiny; this can lead to difficulty walking if the legs or feet are affected, as well as tightness or discomfort in the swollen areas, mild pain or soreness, and potentially coughing or difficulty breathing if the lungs are involved.

Oedema can manifest in various forms depending on its cause or location. Oedema symptoms  signal underlying health problems, which include the following:

Location: Lower limbs

Causes

• Prolonged sitting or standing can cause fluid to pool in the legs due to gravity.
• Weakened leg veins struggle to return blood to the heart, leading to fluid buildup.
• The heart's inability to pump efficiently (heart failure) causes fluid to accumulate in the lower body.
• During pregnancy, the growing uterus and abdomen put increased pressure on the veins in the lower body. This pressure makes it harder for blood to return to the heart, leading to fluid buildup in the legs, ankles, and feet.

Location: Lungs

Causes

• In congestive heart failure, the heart can't pump blood efficiently, causing fluid build-up in the lungs.
• In kidney failure, the kidneys lose their ability to effectively filter excess fluid and waste, causing it to build up in the body and leak into the lungs.
• Lung infections (pneumonia) or lung trauma can cause fluid accumulation.

Location: Brain

Causes

• Injuries to the head, such as concussions or traumatic brain injuries
• Swelling may occur following a stroke due to a lack of oxygen or bleeding in the brain.
• Conditions like meningitis or encephalitis 
• Brain tumours can cause localised swelling

Location: Face and neck 

Causes

• When the kidneys are not working properly, they cannot efficiently remove excess fluids and waste from the body. Fluid retention can lead to swelling in the face and neck.
• Steroids can lead to fluid retention and fat redistribution, making the face appear puffy. 

Location: Arms, legs, or other areas where lymph fluid collects

Causes:

• Damage or removal of lymph nodes (often after cancer treatment) can lead to poor lymph fluid drainage and swelling.
• Certain infections, like filariasis,  can block lymph vessels, causing swelling.

Location: Entire body

Causes:

• Severe malnutrition and protein deficiency 
• Liver, kidney, or heart failure
• Severe allergic reactions (anaphylaxis)

Location: Around the eyes

Causes:

• Conjunctivitis or allergic reactions 
• Kidney disease

Location: Abdomen 

Causes:

• Cirrhosis or severe liver disease
• Abdominal cancer
• Heart failure

Oedema grading helps determine the severity of swelling based on how the skin responds when pressed. Doctors gently press the affected area and observe how long it takes for the skin to return to its usual appearance.

• Grade 1: Skin rebounds immediately, leaving a 2 mm indentation.
• Grade 2: Skin rebounds in under 15 seconds, with a 3-4 mm indentation.
• Grade 3: Skin rebounds within 15-60 seconds, with a 5-6 mm indentation.
• Grade 4: Skin rebounds within 2-3 minutes, with an 8 mm indentation.

Treatment plans are tailored based on the type of oedema and its severity. “Lifestyle changes are crucial to reducing oedema. Limiting salt intake can prevent excess fluid retention. Staying active with light exercises, like walking, can improve circulation and help reduce swelling”, says Dr Siddharth Vinod Lakhani, MD, DM, DNB (Nephrology), Consultant Nephrologist & Transplant Physician.

• Reducing Sodium Intake

Sodium, commonly found in table salt and processed foods, can worsen oedema by causing the body to retain excess fluid. Reducing sodium in your diet helps prevent fluid retention and improves the effectiveness of other treatments. 

• Compression Stockings

Compression stockings are highly effective for managing leg oedema by applying pressure to the lower limbs. These stockings help improve blood flow and prevent fluid pooling in the legs. The key is to choose stockings that provide the greatest compression at the ankle and gradually decrease as they go up the leg.

• Leg Elevation

Elevating the legs above heart level for 30 minutes several times daily can reduce swelling in the legs, ankles, and feet. However, it may not be practical for individuals who work or cannot frequently take time to elevate their legs.

• Medications 

Some medications encourage the kidneys to remove extra water and sodium from the body, which can reduce swelling. 

Oedema often signals an underlying issue, so early detection and treatment are critical. Keeping your heart, kidneys, and liver healthy prevents chronic swelling. 

Regular check-ups, staying active, and eating a balanced diet all contribute to managing oedema. If you notice persistent swelling, don’t wait — seek medical advice to address it before complications arise.

The main causes of oedema include heart failure, kidney disease, liver disease, chronic venous insufficiency, and certain medications. Pregnancy, injury, or long periods of standing or sitting can also contribute to swelling.

Yes, lifestyle changes like reducing salt intake, staying physically active, and wearing compression garments can help manage and prevent oedema. Elevating swollen limbs can also assist with reducing fluid buildup.

Oedema can often be managed or prevented by addressing the root cause, such as controlling high blood pressure, heart health, and kidney function and avoiding long periods of immobility.

Yes, certain medications, such as blood pressure medications, may cause fluid retention, leading to oedema.

Diet plays a critical role in managing oedema. Reducing salt intake helps prevent water retention while maintaining a healthy, balanced diet supports heart and kidney health, which can reduce the risk of swelling.

Yes, oedema can manifest in different forms, such as peripheral oedema (swelling in the limbs), pulmonary oedema (fluid in the lungs), and cerebral oedema (swelling in the brain), each requiring specific treatment approaches.