John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Edema definition and facts
- What is edema?
- What is pitting edema and how does it differ from non-pitting edema?
- What is a pitting edema measurement scale?
- What does pitting edema look like (picture)?
- What causes pitting edema?
- Does salt intake affect edema?
- What causes edema during pregnancy?
- What kind of doctors treat edema?
- Why does a person with heart disease retain fluid?
- Why do people with liver disease develop ascites and edema?
- Why do people with kidney disease have pitting edema?
- What causes pitting edema by heavy loss of protein in the urine?
- What medications treat pitting edema caused by heavy loss of protein in the urine?
- What causes pitting edema in people with impaired kidney (renal) function?
- What is idiopathic edema?
- What is the treatment for idiopathic edema?
- What is the treatment for patients with idiopathic edema who have become dependent on diuretics?
- How does venous insufficiency cause edema?
- Which diuretics are used to treat edema?
- Do people taking diuretics need a diet high in potassium?
- Are diuretics used for other diseases or conditions?
- Find a local Internist in your town
How does venous insufficiency cause edema?
The veins in the legs are responsible for transporting blood up to the veins of the torso, where it is then returned to the heart. The veins of the legs have valves that prevent the backward flow of blood within them. Venous insufficiency is incompetence of the veins that occurs because of dilation, or enlargement, of the veins and dysfunction of their valves. This happens, for example, in people with varicose veins. Venous insufficiency leads to a backup of blood and increased pressure in the veins, thereby resulting in edema of the legs and feet. Edema of the legs also can occur with an episode of deep vein thrombophlebitis (DVT), which is a blood clot within an inflamed vein. In this situation, the clot in the deep vein blocks the return of blood, and consequently causes increased back-pressure in the leg veins.
Venous insufficiency is a problem localized to the legs, ankles, and feet. One leg may be more affected than the other (asymmetrical edema). In contrast, systemic diseases that are associated with fluid retention generally cause the same amount of edema in both legs, and can also cause edema and swelling elsewhere in the body. The response to therapy with diuretic drugs in patients with venous insufficiency tends to be unsatisfactory. This is because the continued pooling of fluid in the lower extremities makes it difficult for the diuretics to mobilize the edema fluid. Elevation of the legs periodically during the day and the use of compression stockings may alleviate the edema. Some patients require surgical treatment to relieve chronic edema that is caused by venous insufficiency.
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