Edema

Edema refers to swelling in the body’s tissues caused by a buildup of fluid, most often in the feet, ankles, face, eyelids, or abdomen.

It can have many causes, including:

• Sitting or standing in one position for too long
• Eating salty food
• Some medications
• Sunburn

It can also be a symptom of a more serious condition, such as:

• Heart failure
• Kidney disease
• Liver disease

Symptoms may include:

• Swollen feet
• Swollen ankles
• Swollen face or eyelids
• Swollen abdomen

Your child may also have one or more of these symptoms:

• Tiredness after minimal activity, like climbing stairs
• Weight gain
• Trouble breathing
• A cough that gets worse at night or when lying down (this may be a sign of acute pulmonary edema, or excessive fluid in the lungs, which requires emergency treatment)

Because many conditions are associated with edema, it can have many causes. Here are some conditions that could cause edema:

Liver disease

A healthy liver helps to regulate the level of fluid in the body. If the liver is damaged, it may not be able to do this, leading to fluid buildup.

Kidney disease

If your child has kidney disease, their kidneys may not be able to remove enough fluid from their body.

Heart disease

Several types of heart disease can cause edema, including:

• Congestive heart failure
• Cardiomyopathy
• Congenital heart defects

Since the heart pumps blood to the organs, poor cardiac function can cause edema in several ways:

• If your child’s heart isn’t pumping blood efficiently, blood can build up in the parts of their body furthest from the heart, such as the legs, ankles, and feet.
• This puts increased pressure on the tiny blood vessels called capillaries, which may begin to leak blood into the nearby tissues, causing swelling.
• Because of poor heart function, the kidneys sense less blood fluid available, and begin to conserve water and sodium.
• Without enough blood supply, the kidneys have a harder time doing their job of ridding the body of excess fluid.
• Eventually, this excess fluid builds up in the lungs.

Edema itself is not hard to diagnose. Your child’s doctor will ask about their medical history, and eating and drinking habits.

The doctor will look at the swollen areas, and check to see if the skin appears stretched and shiny, and may order some lab tests. These might include:

• Urine test
• Blood tests

In some cases, the doctor may also order an imaging test, such as a chest X-ray, to get more information about what is causing the swelling.

Treating your child's underlying condition will often take care of the edema, too. Your child's health care team may also recommend:

• Diuretics: medicine that rids the body of extra fluid through urination
• Limiting the amount of salt in the child's water, to discourage water retention
• Avoiding very hot and very cold temperatures, and sudden temperature changes
• Elevating the swollen body part above the heart for a short period of time

Our pediatric experts at the Boston Children’s Hospital Benderson Family Heart Center, Division of Nephrology, and Division of Gastroenterology, Hepatology and Nutrition are all experienced in diagnosing and treating edema in children, no matter what its cause.