Hello XXXXXXX

Thanks for posting your query. Swelling of the feet is called pedal edema and is caused by accumulation of an excessive amount of watery fluid in cells or intercellular tissues. It can be due to cellulitis, congestive heart failure, kidney disease, arthritis, high altitude ( less likely in case of Laguna vista), menopause ( can be a cause in your case), high salt intake and any blood clot in the veins causing DVT. Are you taking some medicines like laxatives or hormone replacement treatment? abusing these drugs can also cause bilateral pedal edema.

In your case, since swelling is not being decreased by diuretics also, hence I suggest you an immediate physician consultation. You need to get blood tests, kidney function tests, electrolyte levels, ECG and stress ECHO, venous Doppler of the legs and urine tests done.

Till that time, follow these lifestyle measures to alleviate the symptoms:

1)     Increase muscle activity with walking, avoid standing in place for long periods of time and avoid sitting with the feet dependent.

2)     Limit salt intake and stop taking any laxatives (if you are taking them).

3)     Elevate the legs when sitting and wear leg wedges while sleeping, support socks and proper fitting shoes and socks.

4)     Keep your fluid intake adequate by taking plenty of fluids.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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Hi XXXXXXX

As you have clearly mentioned that you were diagnosed with cirrhosis of liver, then, I suppose this is the reason behind the collection of fluid in the lower limb.

In cirrhosis, liver is not able to produce enough albumin. Albumin is a protein which is present in the blood circulation and due to its osmotic effect (pulling effect), it is able to keep the fluid in the circulation.

With the deficiency of albumin, the pulling effect is lesened and the fluid tends to move out of the blood capllaries into the tissues.

The legs being the dependent area of the body, the fluid tends to accumulate there. Diuretics (spironolactone) are the mainstay of therapy in such a scenario.

The definitive therapy is only liver transplantation. Please consult a hepatologist for the same.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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Hi XXXXXXX

Thanks for the follow up query.

Retaining of water due to change in climate is unlikely and the one that is not controlled by water pills is likely due to organic causes like liver cirrhosis which you had earlier. Weather change from cool and dry to hot and humid is unlikely to cause pedal edema. I suggest you to get investigated for liver cirrhosis and liver failure which may be the causative factors in your case.

Hope this answers your query.

Wishing you good health.

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