The Take-Home Messages about Leg Swelling:
Edema (or swelling) of the lower limbs is common in older adults. The most common cause (about 70%) of leg edema is due to Chronic Venous Insufficiency (CVI). Other serious causes of edema include congestive heart failure, kidney disease, and liver disease. Always be sure to get evaluated for new or worsened leg swelling, to make sure one of these more serious medical problems isn’t at hand. If the leg swelling is present in one leg only, or if there’s a lot of pain, or if you notice other serious symptoms along with the leg swelling (shortness of breath, chest pain, cough or trouble breathing when lying flat), this could be a sign of an urgent problem which needs medical attention right away. But again, most leg swelling in aging adults is chronic venous insufficiency. The ideal management of this chronic condition includes “lifestyle” measures such as elevating the legs regularly, using compression stockings, reducing salt intake, and doing exercises which improve fluid movement in the legs.
It’s important to get help from your health providers to manage CVI, because without treatment, it can cause complications such as ulcers (skin sores), infections, and reductions in quality of life. Diuretic medications (“water pills”) can sometimes help to reduce edema from CVI, but the side effects can be serious: dehydration, potassium depletion, urinary incontinence and low blood pressure. So geriatricians recommend using these medications with caution in older adults. They are also not a substitute for the lifestyle measures listed above. To learn more about edema, here are some useful links:
Treatment of edema (American Family Physician Review)
Patient education: Low-sodium diet (Beyond the Basics) – UpToDate
Patient education: Edema (swelling) (Beyond the Basics) – UpToDate
Phlebotonics for venous insufficiency – Martinez-Zapata, MJ – 2020 | Cochrane Library
Chronic Venous Insufficiency | Circulation (ahajournals.org)
Dr. Nicole Didyk is a board-certified geriatrician in Canada and a regular expert contributor to Better Health While Aging. You can learn more from her by visiting her site TheWrinkle.ca, or her aging health channel on YouTube.
Taken from article: https:// betterhealthwhileaging.net /leg-swelling-in-aging/
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