Health Topics 
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                                    Healthy Living
                                 
                             
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             July 2010 
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            | Swelling of Feet and Legs | 
         
        
            | Dr. Dhiman Sen | 
         
        
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                        Is there  reason to get worried if your feet are swelling up?
                           Any painless swelling of the feet or ankles is called oedema. This is the result of abnormal fluid accumulation in tissues, and is most often seen in the lower parts of the body, especially the feet and ankles – blame it on gravity!   
                        
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                        Oedema is usually seen as an increased stretching and shininess of the swollen area of skin, which dimples when gently pressed down upon. Though it is a common problem, especially in the elderly, oedema does not run in families, nor is it possible to transmit it to others through close contact.    
                         
                        Oedema has many causes, some temporary and some permanent, some requiring simple mechanical interventions like keeping one’s legs raised to counter the effects of gravity, to others requiring urgent doctor’s attention for analysis of the underlying cause for proper redressal.     
                         
                        10 Benign  Causes 
                        Feet and ankle swelling can ring alarm bells in the  minds of patients and doctors alike, because the underlying causes may range  from the innocuous to the more serious incurable diseases.   
                        
                            - Excessive salt intake
 
                            - Pregnancy
 
                            - Old age
 
                            - Prolonged standing
 
                            - Long-haul air flights or car-rides
 
                            - Obesity
 
                            - Menstruation
 
                            - Local injury or infection
 
                            - Varicose veins
 
                            - Certain medications like Amlodipine or oestrogens (in birth control pills)
 
                         
                        6 Serious Causes 
                        
                            - Clots in the leg veins
 
                            - Hypertension in pregnancy (called pre-eclampsia)
 
                            - Heart failure
 
                            - Liver failure
 
                            - Certain kidney diseases like nephrotic syndrome
 
                            - Protein malnutrition
 
                         
                        5 Home Remedies 
                        Try these simple steps before you decide on meeting a doctor. 
                        
                            - Lower the salt content of your diet
 
                            - Exercise your legs
 
                            - Elevate your legs above the heart while lying down
 
                            - Wear support stockings
 
                            - Stop incriminating medications
 
                         
                        Preventing Oedema 
                        
                            - avoid wearing restrictive clothing
 
                            - Adopt weight losing measures
 
                            - Avoid sitting or standing without moving for prolonged periods
 
                            - Take out time for stretching exercises and walking around while on long-haul flights or car rides
 
                         
                        When to See Your Doctor 
                        
                            - If you notice a sudden increase in the degree of swelling, especially if you are pregnant
 
                            - If you have an associated decrease in urine volume
 
                            - Increased redness or pain over the area
 
                            - Chest pain
 
                            - Shortness of breath
 
                            - Fever
 
                            - History of liver/heart/kidney disease
 
                         
                        
                            
                                
                                    To classify your foot swelling severity, your doctor will evaluate your answers to questions        about symptoms (such as how often you have foot swelling attacks and how bad they are), along        with the results of your physical exam and diagnostic tests. Foot swelling severity often changes        over time, requiring an adjustment to treatment        
                                     
                                    
                                        
                                            
                                                | Foot Swelling classification | 
                                                Sings and Symptoms | 
                                             
                                            
                                                | Mild intermittent | 
                                                Mild symptoms up to two days a week and up to two nights a month | 
                                             
                                            
                                                | Mild persistent | 
                                                Symptoms more than twice a week, but no more than once in a single day | 
                                             
                                            
                                                | Moderate persistent | 
                                                symptoms once a day and more than a night a week | 
                                             
                                            
                                                | Severe persistent | 
                                                Symptoms throughout the day on most days and frequently at night | 
                                             
                                        
                                     
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                        Dr. Dhiman Sen is Consultant – Internal Medicine at Apollo Gleneagles Hospitals, Kolkata | 
                     
                
             
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