Water in the legs

• Introduction / definition

Synonyms in a broader sense

• Edema
• Dropsy
• Water retention in the legs
• Water retention in the legs

Introduction / definition

A buildup of water in the legs is called edema designated. The water retention is often caused by one The liquid escapes from the Vascular system into the surrounding tissue. This is the case when the proportion of Proteins (albumin) in blood decreases or the kidneys can no longer secrete enough water and electrolytes (mainly sodium) and there is therefore more and more water in the body. Furthermore, there can also be water retention due to a Not adequate recovery through the lymphatic system (Lymphedema) come.

The Water retention can ever according to time of day or female cycle vary in their severity or only occur in certain situations. you are Not always Signs of illness, but should definitely clarified as they are often related to a medical condition, drug side effect, or a allergy Clues.

causes

There are many different causes of water buildup in the legs. These include heart diseases such as heart failure (Heart failure), as well as kidney diseases such as the so-called nephrotic syndrome or kidney inflammation.

Furthermore, vein occlusions (thrombosis) can cause water retention and swelling of a leg.

Furthermore, the occurrence of water retention after injuries in the area of ​​the leg / foot, as well as due to infections / inflammations or allergies is quite possible.

Furthermore, edema can occur as side effects of drugs (painkillers, cortisone, ASA, estrogens, antidepressants) throughout the body, including the legs.

Naturally (physiologically) occurring water retention can often be observed in the week before menstrual bleeding (premenstrual syndrome) or during pregnancy and can be attributed to hormonal changes.

Water retention can also result from diseases of the lymphatic system or from pulmonary hypertension.

You can read how pulmonary hypertension can develop and how it is treated in our article: Pulmonary hypertension - it's so dangerous

Cause heart

The Heart failure or Heart failure (Heart failure) represents a special risk factor for the development of Water retention (Edema) in the legs. Is that heart if it is weakened, it can no longer muster the strength necessary to expel the blood. As a result, it builds up blood if the right heart is weak in the great blood circulation (i.e. back into the body), if the left heart is weak, into the lung. Due to the above-average pressure in the pent-up Vessels (Veins that transport the blood back to the heart) fluid is now pressed into the surrounding tissue and water retention occurs. At a Right heart failure (Right heart failure), which for example by Valvular heart disease (Pulmonary stenosis), Lung disease with an increased Pulmonary blood pressure (Cor pulmonale) or as a result of a Left heart failure (Left heart failure) can occur, this water retention predominantly on the front of the lower legs (pretibial), on the feet and in the ankle area.

Pregnancy as a cause

During pregnancy, the increased production of the female sex hormone estrogen can lead to water retention (edema) in the tissue. These are usually natural and not signs of any medical condition. Water retention often occurs towards the end of pregnancy and after long periods of standing or sitting. This water retention does not require treatment and usually disappears after birth. However, it is also possible that through appropriate sporting activity, by putting up the legs, wearing support stockings or by avoiding very salty food, the edema decreases or occurs less frequently during pregnancy. The feet of pregnant women in particular are often swollen.

Read more on the subject at: Swollen feet, lymphatic drainage during pregnancy

However, what is known as pregnancy edema can also be a sign of an illness. For example, so-called preclampsia, in which those affected have high blood pressure (hypertension) and protein loss via the kidneys (proteinuria), water retention in the legs may occur. Since this pregnancy disease needs urgent treatment, a doctor should be consulted in the event of additional occurrences of high blood pressure, headache, flickering eyes, dizziness, ringing in the ears or even sudden upper abdominal pain.

Water retention after childbirth

In the last few weeks before the birth it may be due to the pressure that is growing uterus exerts on the pelvic vein to a Backflow obstruction of the blood in the leg veins and consequently to Water retention (Edema) come.

After the birth, the water retention usually disappears quite fast again, however, there is no general time by which the edema will have disappeared. How long the leg water retention will be after giving birth varies from woman to woman.

Cause cancer

With some Cancers but also with the Treatment of cancer water may build up in the legs (Edema) come. These water retention are usually due to one congested lymph drainage path to explain from the legs.

For one, such a Lymphatic congestion due to the infestation of Lymph nodes or the Lymphatic drainage pathways through the cancer itself or through its resettlement (Lymph node metastases) arise, on the other hand Cancer therapies such as. the Irradiation or the Removal of lymph nodes disrupt the lymphatic drainage and thus cause water retention in the legs.

By manual Lymphatic drainage such as Compression therapies can they Lymphatic vessels stimulated and the lymph drainage promoted and hardening of the tissue prevented.

diagnosis

First, the detailed questioning (anamnesis) the patient is an important first step in recognizing water retention (Edema) in the legs and their causes Heart, kidney or cancer diseases as well as existing Pregnancies and taking certain drugs be queried. Changes depending on the time of day and the woman's cycle, as well as recent weight gain, can also be of great interest.

After that, the patient should see the doctor physically examined become. Here the legs are first opened very precisely Changes in color and shape as well as on Swelling inspected. It is then checked whether the water retention can be depressed and as visible dent stay behind. Is it a so-called venous congestive edema e.g. by a Heart failure, a dent usually remains after the swollen area has been pressed in. A so-called behaves differently Lymphedemawith no pushing away by the high protein content in the edema fluid is possible. Furthermore, the lung and the heart be assessed in the medical clinical examination.

Come as another diagnostic measure Blood tests in question. Here should Kidney parameters (e.g. Creatinine), Egg whites, Electrolytes, BNP (brain natriuretic peptide) in suspected cardiac insufficiency and D dimers to exclude one venous vascular occlusion (thrombosis) can be recorded.

In addition, imaging procedures such as x-rays or ultrasound (sonography) can show possible additional accumulations of water in the lungs or in the abdomen.

Symptoms

As a rule, the water retention is on the legs painless and are only recognized by the swelling. However, it is possible that due to the swelling Feeling of tension and heaviness occurs in the affected leg area. Patients find the pinching shoes and tight pants described. Especially in the evening complaints about an increased feeling of heaviness due to the increased water retention.

therapy

Depending on which Cause of water retention in the legs, this should first be recognized and treated.

Therapy of water retention as a result of a Heart failure, kidney or liver disease initially aims at one Flushing out excess fluid from. This washout can take the form of diuretic drugs (Diuretics) respectively. Lies in the fluid build-up in the legs Kidney failure so can a Renal replacement therapy such as blood washing (dialysis) are used.

In case of a Lymph drainage disorder are the water retention through physiotherapy procedures as the Lymphatic drainage or that Wearing compression stockings or Compression bandages treated. In addition, those affected should actively use their legs to reduce swelling elevate to facilitate the removal of the accumulated liquid.

Is the Cause of water retention in one hormonal imbalance with a dominance of the female sex hormone estrogen, depending on the severity, a antiestrogenic treatment be considered.

As an additional and long-term therapeutic measure against most types of water retention should be on sufficient exercise (Swimming, running, cycling etc.) and one balanced diet rich in fluids be respected.

In the pregnancy can take measures like that Elevate the legs, especially after long periods of standing or sitting, that Wearing support stockings, Foot baths or. Alternating showers / alternating baths or regular exercise prevent or reduce water retention in the form of swimming, cycling or going for a walk.
Also should be used during pregnancy adequate hydration (Mineral water, unsweetened tea or fruit spritzer) and one balanced nutrition be respected.

forecast

The prognosis for water retention on the legs is very different and depends very much on the underlying cause and the success of the therapy.

Water retention in the legs, which was caused by hormonal cycle fluctuations or pregnancy, has a very good prognosis and a tendency to regression, whereas water retention due to a weak heart or kidney disease usually only disappears when the underlying disease is treated.

If the water retention is based on what is known as lymphedema, it may well happen that the symptoms can only be alleviated with regular lymphatic drainage, bandages and compression stockings, but the water retention no longer disappears.

Read more about the topic here: Lymphedema.