Swelling

Swelling (edema) is a build-up of water in the tissues. Common causes include salt and water retention (due to medicines or heart, liver, or kidney failure), poor nutrition, pelvic tumors, or blockage in the veins or lymph system. Fluid can also build up in the abdomen. This is known as ascites (as-SIGH-tees). It makes the belly look swollen.

What to look for

• Feet and lower legs get larger when you sit in a chair, stand, or walk
• Rings feel too tight for fingers
• Hands feel tight when making a fist
• Large, puffy, or blown-up abdomen (belly)
• Trouble breathing, especially when lying down (See the section called "Shortness of breath.")
• Heart racing or palpitations (or an awareness that the heart beat is fast or irregular)

What the patient can do

• Limit your use of salt on food. Avoid use of table salt and salt in cooking, and don’t eat foods that are very high in salt.
• Talk with the doctor about how to reduce your salt intake.
• Eat as well as you can. (See the section called "Appetite, poor.")
• Take medicines as prescribed by the doctor.
• Rest in bed with your feet up on 2 pillows.
• When sitting up in a chair, keep your feet level with your chest by placing them on a stool with pillows.

What caregivers can do

• Watch for any new symptoms, especially shortness of breath or swelling in the face.
• Encourage the patient to keep the swollen body part propped up as high as is comfortable when sitting or lying down.
• Don’t add salt, soy sauce, or monosodium glutamate during cooking.
• Weigh the patient every day or 2 on the same scale, at the same time of day. Keep a list of weights and dates.

Call the doctor if the patient:

• Can’t eat for a day or more
• Hasn’t urinated, or has urinated very little, for a day or more
• Can press a finger into a swollen area and the fingertip mark remains
• Has swelling that spreads up legs or arms
• Develops a puffy or blown-up belly
• Feels that the swollen area is getting red or hot
• Has shortness of breath or a racing heart
• Has a swollen face and neck, especially in the mornings
• Gains 5 or more pounds in a week or less