How should I manage severe swelling in abdomen and legs?

Question

Hi doctor,

I am having extreme swelling from under the breast to the belly. My legs and feet are also very swollen and painful. I have gained 40 pounds in two years with no change in diet or activity. My lower legs and ankles were swollen about a year ago. I went through all the horrible heart testing and finally, my heart is fine.

My current medications are Bupropion, Carvedilol, Cetirizine, Furosemide, Losartan, Potassium, Hydrochlorothiazide, Gabapentin and Norco.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Swelling of the feet and ankles, known as pedal edema, occurs due to fluid accumulation in the tissues. There are various potential causes of edema, one of which is congestive cardiac failure or right heart disease. If it progresses, the edema may also appear in the abdominal wall.

To assess the nature of the edema, check if it is pitting by applying pressure with your index finger for 5 seconds and observing if it disappears upon release. Additionally, watch for prominent neck vessels, asthma, lung problems, or shortness of breath during daily activities.

Note any right-sided abdominal pain or tenderness just below the right rib cage. It would be helpful to know the duration of elevated blood pressure and whether there is facial puffiness. Observe for any decrease in urine output or frothy urine and inform if you have hypothyroidism.

Edema can be associated with cardiac, liver, or kidney issues, and further tests like 2D echo, ECG (echocardiogram), chest x-ray, serum albumin, CUE, 24-hour urine volume and protein, and thyroid profile may be required for a comprehensive evaluation. While your blood pressure is perfect, the diuretic dose cannot be further increased.

Reducing salt in your diet may help, and another drug like spironolactone, Aldactone, or Lasilactone could be introduced for cardio protection. Consult your specialist doctor and discuss the above medicine to address your condition effectively.

I hope it helped with the query.

Please let me know if you have any more questions on your mind.

I would be happy to guide you.

Thank you.