Oedema (Swelling and Fluid Retention)

Oedema is swelling caused by fluid collecting in the tissues. It most often affects the feet, ankles and legs, but can involve the hands, face, abdomen or lungs.

It is a sign, not a diagnosis. Mild ankle swelling after a long flight or hot day is harmless. Persistent or worsening swelling needs an explanation, because it can come from the heart, kidneys, liver, veins or lymphatic system, or from medication.

Symptoms

• Puffy, tight or shiny skin
• A dent that remains after pressing the skin for several seconds
• Shoes, socks or rings feeling tight
• Heaviness or aching in the legs
• Weight rising over days
• Swelling around the eyes in the morning
• Breathlessness if fluid also gathers in the lungs

Causes and risk factors

Swelling in both legs commonly results from weak leg vein valves, prolonged standing or sitting, obesity, pregnancy, and medicines such as amlodipine, anti-inflammatory painkillers, steroids, pregabalin and some diabetes drugs. Medical causes include heart failure, kidney disease with protein loss, liver cirrhosis, low blood protein and an underactive thyroid. Swelling of one leg suggests deep vein thrombosis, infection, a ruptured knee cyst or a blocked pelvic vein. Lymphoedema follows damage to lymph channels, for example after cancer surgery or radiotherapy, and lipoedema is a painful, symmetrical fat disorder of the legs that spares the feet.

How it is diagnosed

• History and examination: One or both sides, pitting or firm, speed of onset, medicines and associated breathlessness.
• Blood tests: Kidney and liver function, albumin, thyroid, BNP and blood count.
• Urine test for protein: Detects nephrotic syndrome.
• Venous duplex ultrasound: Excludes deep vein thrombosis and maps faulty vein valves.
• Echocardiography: When heart failure is suspected.
• Lymphoscintigraphy or ICG lymphography: Confirms lymphoedema and helps plan microsurgery.

Treatment options

• Treat the cause: Heart failure, kidney or liver treatment, or changing a culprit medicine.
• Compression and elevation: Graduated stockings, leg raising and calf exercise for venous and lymphatic swelling, once arterial disease is excluded.
• Diuretics: Useful in heart, kidney and liver-related fluid overload. They are not appropriate for venous swelling or lymphoedema.
• Anticoagulation: For deep vein thrombosis.
• Vein procedures: Endovenous laser, radiofrequency or foam treatment when faulty superficial veins are responsible.
• Decongestive lymphatic therapy: Specialised massage, bandaging, skin care and exercise for lymphoedema.
• Lymphatic surgery: Lymphovenous bypass or lymph node transfer in selected cases, and specialised liposuction for advanced lymphoedema or lipoedema.

When it is urgent

Seek urgent local care for sudden swelling of one leg with pain or warmth, swelling with breathlessness or chest pain, swelling of the lips, tongue or throat, a red hot spreading area with fever, or, in pregnancy, sudden swelling of the face and hands with headache.

Travelling to Türkiye for treatment

Unexplained swelling should first be assessed at home, because urgent causes must be excluded. Planned treatments are where travel can fit: vein ablation in a visit of a few days, or lymphatic surgery and lipoedema liposuction with a stay of 1 to 2 weeks. Long flights worsen swelling and raise clot risk, so wear compression if advised, walk regularly and drink water.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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