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
What is the treatment for patients with idiopathic edema who have become dependent on diuretics?
Patients with idiopathic edema often become dependent on diuretics, and this dependence may be difficult to interrupt. A period as long as three weeks off diuretics may be required to break the dependency cycle. The withdrawal from diuretics may lead to fluid retention that produces major discomfort and swelling. Moreover, there are definite risks associated with the prolonged use of diuretics in these individuals, which are compounded by the tendency to increase the doses of the diuretics.
As a result of chronic diuretic use and abuse, people may develop:
- A deficiency of potassium
- Depletion of blood volume in the blood vessels
- Kidney insufficiency or failure
Other side effects of diuretics include:
- High blood sugar (diabetes)
- High uric acid (gout)
- Muscle cramps
- Tender and enlarged breasts (gynecomastia)
- Pancreatitis (inflammation of the pancreas)
Although withdrawal from diuretics is the most important factor in treating these patients, other medications have been used to try to minimize the fluid retention. These medications include ACE inhibitors, low-dose amphetamines, ephedrine, bromocriptine (Parlodel), or levodopa-carbidopa (Sinemet) in combination. However, their effectiveness is uncertain and side effects of these drugs may occur. For example, hypotension (low blood pressure) may be seen with the use of ACE inhibitors, especially if the patient is also taking diuretics.
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