(O)edema in the elderly
Summary/Definition
(O)edema is a condition in which there is an abnormal accumulation of bodily fluids and water outside the blood vessels, resulting in an increase in intercellular fluid in the interstitial tissue and causing puffiness of the body. One of the most common forms of oedema that patients most often complain of is leg oedema. Due to the earth’s gravity, oedema usually occurs in the lower part of the body (lower limb oedema), especially in the evening after physical activity, prolonged standing or prolonged sitting. In patients who remain in a horizontal position for long periods, swelling may develop in the lumbar region. The most common causes of oedema in the elderly are chronic venous insufficiency and heart failure. In addition, oedema can be caused by taking certain medications and various diseases, such as kidney, liver and thyroid disease. Oedema is classified according to location, including joint oedema and general oedema of the whole body. Oedema is usually localised to specific areas, such as peripheral oedema (oedema of both legs or arms, oedema around the eyes, etc.), Quincke’s oedema (oedema of the skin, mucous membranes and subcutaneous fatty tissue) and ascites (fluid accumulation in the abdominal cavity). Causes of oedema in the joints can be chronic venous insufficiency, deep vein thrombosis, lymphadenitis and others. General oedema can be a consequence of heart failure, renal disease, liver cirrhosis, arteriosis, pulmonary hypertension, digestive disorders with protein loss, pelvic tumour, and also caused by taking certain medications and other reasons.
Diagnostics
Diagnosis is confirmed in consultation with a physician, including a medical history that includes a history of chronic venous insufficiency or deep vein thrombosis, heart, kidney or liver disease, medication information, weight changes and other factors associated with symptom onset. Through a general assessment examination of the patient, the localisation of swelling in the body, headaches, skin changes, varicose veins and other potentially causative conditions are identified. Laboratory tests of blood and urine, electrocardiography (ECG), computed tomography and magnetic resonance imaging (MRI) are additionally performed.
Treatment and course of the disease
Oedema can be successfully treated by targeting the underlying disease, controlling and limiting salt and fluid intake, using diuretics, resting, and using complementary therapies. First of all, the underlying disease that is the source of oedema must be treated. To reduce oedema caused by salt and water intake, it is necessary to strictly limit their intake, take diuretics and apply other therapies, such as elevating swollen limbs in the supine position, as well as performing other therapeutic procedures.
