Water retention

OFTEN when trying to lose weight you may hear that the scale results might be influenced by water retention.

The term ‘water retention’, according to Dr Tanesha Davis, internist at the St Ann’s Bay Hospital, is also known as fluid retention and it signifies an abnormal accumulation of fluid in the circulatory system or within the tissues or cavities of the body.

Dr Davis said reference to water retention can also be quite ambiguous, and may be interpreted in a plethora of ways, but edema is more specific.

“This is defined as the apparent increase in interstitial fluid volume or the tissues of the body. Different terms are assigned to the accumulation of fluid in the different cavities of the body such as “ascites” for the peritoneal cavity. But in this case when we use the term water retention we are referring to the fluid accumulated in the tissues (edema) and not the cavities of the body to avoid oversimplification of this common complaint,” she said.

She added that depending on its cause and mechanism, edema may be localised (isolated to one area) or generalised (widespread), but is recognised in its generalised form by puffiness of the face, which is most readily apparent around the eyes, and by the persistence of an indentation of the skin after pressure, known as “pitting” edema.

“In its more subtle form, edema may be detected when the ring on a finger fits more snugly than in the past or when there appears to be some difficulty in putting on shoes, particularly in the evening,” Dr Davis said.

Below Dr Davis explains some common causes of water retention/edema.

1. “Edema occurs as a result in the derangement in the composition, pressure or calibre of the blood vessels or the lymphatic system,” she said.

2. According to Dr Davis, loss of protein from the body through the urine or gastrointestinal tract or decreased production from liver impairment or poor intake or nutritional value can cause fluid retention or edema to occur because the fluid essentially leaks from the blood vessels into the tissues. “Causes of such derangements include liver failure, kidney failure, malnutrition and protein losing enteropathies,” she said.

3. Dr Davis said simply hanging the legs down for too long or being on your feet for prolonged periods of time can cause edema. This is otherwise known as orthostatic edema and usually causes mild ankle swelling. “Poor circulation of the blood to the legs can also result in mild leg swelling or edema,” the internist said.

4. According to Dr Davis, edema can also occur on occasions where the heart is unable to adequately pump the blood forward, thus essentially causing a back up of blood, which increases the pressure in the venous and capillary systems causing the fluid to leak into the tissues. She said this is otherwise known as heart failure.

5. “The lymph system is another transport mechanism of fluids of the body that when it becomes obstructed can cause edema. Some causes include certain cancers and infections,” Dr Davis said.

6. Dr Davis said certain drugs have also been known to cause edema. “These include commonly used blood pressure medications called calcium channel blockers, for example nifedipine, vasodilators, example hydralazine, methydopa, prednisone and oestrogen hormones,” she said.

With regards to treating water retention, Dr Davis said the method depends on the cause; however, if it is due to a drug, the drug can be discontinued after prior consultation with a doctor.

“As with most medical illnesses, lifestyle changes are paramount. Interventions such as reducing the salt in the diet, exercise and elevation of the legs at nights have all been shown to reduce edema. Medical therapy commonly involves treatment with a class of drugs known as diuretics, otherwise called water pills,” she said.

Additionally, Dr Davis explained that there are many natural agents that are said to have diuretic properties, such as cucumber, asparagus, artichoke, celery and cranberries.

“However, at this point they are not to replace the traditionally prescribed diuretics,” she said.

The internist further advised that people who have been noticing swelling to the face or legs, weight gain or pitting edema should seek medical attention as soon as possible.

“There are many diseases that if treated promptly may result in an increased life span and quality of life,” Dr Davis said.

— KIMBERLEY HIBBERT