Edema not a fatal disease, says expert

Edema is the accumulation of excess fluid in any body tissue, cavity or organ, except the bone, causing swelling. The disease’s major causes are heart or kidney failure, low blood serum protein after starvation or liver failure, shock and impaired return of blood from extremities.

This was the topic of the 104th forum of the Association of Asia Brewery Medical Scholars (AABMS) with Dr. Ruby Lim, an expert on the illness, as the resource person.

"A common notion especially among older people is that when somebody develops edema, he or she will be dying soon. This is a medical myth", Lim told the gathering at Century Park Hotel. "The disease does not necessarily point to kidney disorder."

The swelling, she said, may affect the legs, ankles, and feet; the back or abdomen, and even the eyelids. Edema may be caused by a number of different medical conditions and can also be a side effect of certain drugs.

A scholar of the Asia Brewery Medical Specialty Scholarship Foundation (ABMSSF), Lim said generalized edema commonly afflicts persons with renal diseases. "Poor cardiac circulation usually has a history of chronic renal disorders."

A graduate of medicine of Far Eastern University, Lim pursued higher studies at the Manchester Royal Infirmary in England, under the scholarship program of ABMSSF. She is fellow of the Philippine College of Physicians.

Most of the forum’s resource persons were recipients of ABMSSF’s scholarship program which requires them to share their expertise with local healthcare providers upon their return from studies overseas.

Lim said edema may be localized in virtually any organ if that is caught up in an inflammatory response.

"Under this condition, however, the edema could be a minor component of what is a more complicated and extensive disease complex," she explained.

Although the disease may be localized, at some early phase, Lim pointed out, there is a tendency to form generalized edema such as ankle or pulmonary edema in early congestive heart failure.

This is possible when one of the following conditions prevail: an excess in arterial inflow; venous and/or lymphatic obstruction; and a localized change in capillary permeability.

"It is important to emphasize, however, that localized edema may appear as the first manifestation of generalized edema, largely because of normal postural considerations and the effects of gravity," Lim added.

Some of the common causes of generalized edema are: kidney disease, acute or chronic renal failure; heart disease, congestive heart failure; cirrhosis of the liver; cyclic edema, premenstrual syndrome; capillary leak syndrome; minoxidil calcium channel blockers, estrogen, and nosteroidal anti-inflammatory drugs.

She said that in addition to manipulating dietary salt, diuretic regimens and activity, it is necessary to direct therapy to treatment of each of the underlying disorders responsible for generalized edema.