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Suggest Treatment For Swelling In Hands And Lower Legs

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Posted on Wed, 7 Oct 2015
Question: my dad was having swallowing in hands and lower legs specially. he was asked for three tests. i am attaching reports. but all looks normal. then what can be the reasons for edema? he was treated with alcoholism. medicines- baclofen 10 mg and stablon 12.5 mg 3 times a day.
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
may be electrolyte imbalance, ruling out cardiac cause is important as well

Detailed Answer:
Hello
Welcome to HCM,
I understand your concerns for your father.

He has swelling in hands and legs.
The reports of kidney function (blood urea and creatinine), thyroid functions and urine examination appear to be normal.

It would have been great if you could have gone the other kidney function tests as well, especially serum protein levels (albumin and globulin) and serum electrolyte level (sodium, potassium and chloride).
This would have ruled out hypoproteinemia and electrolyte imbalance as the cause of edema.

The possible explanation for this could be:
As the alcohol level drops, the body starts to accumulate fluid. The water eliminated by kidneys when your alcohol level is high does not contain sodium, so the level of sodium in the body increases. This process creates an imbalance in the ratio of sodium to fluid inside the body. Since sodium is known to retain fluid, this leads to edema.

Other than this, does your father have symptoms like shortness of breath, palpitations, excessive fatigue and weakness? This may indicate a cardiac cause of swelling.

Also, postural hypotension and anemia can also cause swelling in limbs. Get his blood pressure and hemoglobin levels checked too.

Kindly consult your doctor for assessment of these causes.

Hope you find my answer satisfactory and helpful.

Feel free to ask further for more doubts.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (18 minutes later)
you answered it quite satisfactory .

but your explanation caused doubt in me. if high alcohol increase sodium in body which in turn cause edema, then why its happening when he is not drinking at all. since last three months.


secondly he dont have any cardiac problem.


and what are all the test to know if postural hypotension and anemia is the cause?
doctor
Answered by Dr. Shubham Mehta (35 minutes later)
Brief Answer:
complex physiological mechanisms.

Detailed Answer:
This all depends on alcohol causing disturbed anti-diuretic hormone levels.

When alcohol builds up in bloodstream, it restrains the release of a hormone known as anti-diuretic hormone or ADH. This ADH concentrates the urine. In the absence of the anti-diuretic hormone, the kidneys excrete dilute urine which doesn't contain electrolytes like sodium.

As the alcohol level drops, the body starts to accumulate fluid once again. The water eliminated by kidneys when alcohol level was high did not contain sodium, so the level of sodium in the body increases.

This process creates an imbalance in the ratio of sodium to fluid inside the body on long term.

This imbalance can cause edema.

The physiological mechanism is complex.

For postural hypotension, blood pressure can be checked in lying down and immediately in standing position, then observing the change in BP. Your doctor will help in this.

For anemia, go for testing his hemoglobin levels.

Hope this helps.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (17 hours later)
his edema increases on days when he has to stand or walk longer hours since he is a teacher. otherwise early in morning swallowing reduces.

so this way can we neglect reasons other than postural hypotension? and can be sure it is because of blood pressure?
doctor
Answered by Dr. Shubham Mehta (2 hours later)
Brief Answer:
most probably due to postural hypotension.

Detailed Answer:
Most probably yes.
The reason should be postural hypotension if his symptoms are more due to excessive walking or standing and reduce in early morning.

However, I would still recommend that his blood protein and electrolyte levels be tested to confidently rule out common medical cause for his symptoms.

Thanks and Regards.
Dr. Shubham Mehta, MD.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

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Suggest Treatment For Swelling In Hands And Lower Legs

Brief Answer: may be electrolyte imbalance, ruling out cardiac cause is important as well Detailed Answer: Hello Welcome to HCM, I understand your concerns for your father. He has swelling in hands and legs. The reports of kidney function (blood urea and creatinine), thyroid functions and urine examination appear to be normal. It would have been great if you could have gone the other kidney function tests as well, especially serum protein levels (albumin and globulin) and serum electrolyte level (sodium, potassium and chloride). This would have ruled out hypoproteinemia and electrolyte imbalance as the cause of edema. The possible explanation for this could be: As the alcohol level drops, the body starts to accumulate fluid. The water eliminated by kidneys when your alcohol level is high does not contain sodium, so the level of sodium in the body increases. This process creates an imbalance in the ratio of sodium to fluid inside the body. Since sodium is known to retain fluid, this leads to edema. Other than this, does your father have symptoms like shortness of breath, palpitations, excessive fatigue and weakness? This may indicate a cardiac cause of swelling. Also, postural hypotension and anemia can also cause swelling in limbs. Get his blood pressure and hemoglobin levels checked too. Kindly consult your doctor for assessment of these causes. Hope you find my answer satisfactory and helpful. Feel free to ask further for more doubts. Take care.