Fluid retention or puffiness - (oedema to use the medical term) is abnormal accumulation of fluid in tissues of the ankles, legs, abdomen and the lungs. Although usually perfectly normal, for example on a hot day, it can be a sign that the heart is not pumping as well as it should (see: heart failure).

This Entry is not intended to be used as medical advice. Unusual symptoms should always be reported to your GP or equivalent health consultant.

Oedema in Pregnancy

Pregnant women should report this condition to their doctor or midwife (or both) immediately as it may be a symptom of pre-eclampsia, which left untreated can be fatal.

Treatment of Oedema

Water tablets (chemical diuretics) for the treatment of fluid retention in the legs (oedema) or abdomen (ascites). These should not be taken without medical consultation, particularly if you are already taking other medication. The current prescription drug for water retention, Bendroflumethiazide, lowers blood pressure, and lists as potential side-effects: mineral changes in body salts, feeling physically sick, loss of appetite, feeling dizzy or light-headed on standing up, feeling weak, tired, drowsy or sleepy, confusion and muscle cramps. It could cause gout and impotence, skin rash, itchy skin and allergic reactions.

More natural methods are worth looking at:

• Pineapple juice (do try to get the '100% pure pressed' in cartons, which is more expensive than the 'juice drinks' on the market, but if you read the ingredients on those packs you'll find they contain lots of water and other additives like sugar.)
• Cranberry juice
• Stinging Nettle Tea
• Dandelion Tea
• Rooibos Tea
• Fennel Tea
• Bach flower remedies
• Asparagus
• Celery
• Lettuce
• Liquorice
• Strawberries
• Pomegranate juice has been found to be an excellent tonic because of its high levels of antioxidants that prevent arteries becoming clogged with LDL (bad) cholesterol. Drinking an eight fluid ounce glass of pure pomegranate juice per day can significantly benefit several ailments due to its anti-inflammatory properties. It also contains isoflavones, (commonly found in plants such as soy), which mimic female hormones. This may be beneficial for menopausal and post-menopausal women.

Onions and leeks are very good natural diuretics. Make up a plain boiled potato soup with lots of onions and leeks - without any salt - and eat that for a day or two (for breakfast, lunch and dinner). It's actually a rather tasty soup but of course it gets boring after a day or two, so add fresh asparagus or celery if you want.

Natural remedies may or may not be as good as the drugs that will be prescribed by your doctor. It may be worth discussing with your doctor whether herbal or natural remedies will be just as good as taking the drug he is about to prescribe you. Generally, natural remedies do not cause side effects, whereas prescribed drugs commonly do. It is important to follow your doctor's advice. It is also important to read the information leaflet which is supplied with the medication.

Exercises

Try flexing your feet. While seated, point your toes and bring them back up to your leg, and back again. Rotate your feet with your legs stretched out in front of you.

Elevating your legs will also help the condition. Try to sleep (or at least rest) with your feet resting on a large pillow, or raise the end of your bed, so that your feet are higher than your heart.

Cold Compress

Place a damp towel in your fridge. When it's nicely chilled, lay it over your legs so it drapes across both ankles. For more severe swelling there's always the old fall-back method of wrapping a frozen pack of peas in a teacloth and placing the package on each ankle in turn.

Alternate the temperature in your morning shower - cold to hot then back to cold. This isn't torture; it will stimulate your body.

Water

People who suffer from a bladder weakness have a tendency to drink less and this is a big mistake, they should drink more water last thing at night and especially first thing each morning. The organs of the body will not function correctly without a plentiful intake of water. Every adult should aim to drink six to eight glasses of water a day, up to six for children. If drinking plain water is a problem, there are tasty cordials available commercially and do try some herbal teas.

Compression Stockings

These are available on prescription from your doctor or can be purchased commercially; you need to be measured by the pharmacist for the correct size and tension. Some manufacturers make open-toed varieties and supply a little silky foot cover that helps the stocking slide over the foot. The silky foot is then removed, leaving the stocking in place. If stockings are a problem there is a knee-high version, but these should not be worn if the patient has varicose veins as this may cause the veins to swell more.

Oedema and the Heart

Effects of Heart Valve Disease

If a heart valve isn't working properly, blood flow is thrown into chaos. The two main problems that occur are:

• Valves that don't shut properly, (known as Insufficiency, Regurgitation or Incompetence), causing regurgitation of blood back across the valve in the wrong direction (for example, from the aorta back into the heart).

• Valves that won't open properly, known as stenosis of the valve, means blood flow through the valve is limited.

If the problem is mild, it may go unnoticed. However, it can put excessive strain on the heart, making it swollen, less effective as a pump and more likely to have an abnormal rhythm. It can also result in a backlog of pressure, causing fluid to accumulate in the lungs (pulmonary oedema) and lower leg (peripheral oedema).

Identifying Symptoms of Coronary Heart Disease

The following symptoms are by no means always due to coronary heart disease and could be harmless or caused by other medical conditions. However, if you experience any of them it's a good idea to make an appointment to see your doctor:

• Unusual breathlessness when doing light activity or at rest, or breathlessness that comes on suddenly.

• Angina - chest pain, heaviness or tightness in the chest that comes on during exertion, emotional stress and may spread to arms, neck, jaw, face, back or stomach.

• Palpitations - awareness of your heartbeat or a feeling of having a rapid and unusually forceful heartbeat, especially if they last for several hours or recur over several days and/or cause chest pain, breathlessness or dizziness. Palpitations can also be a symptom of stress.

• Fainting - although not always a serious symptom, fainting is due to insufficient oxygen reaching the brain which may be due to many reasons, so you should report it to your doctor.

• Bluish-tinged fingernails or around lips - known medically as cyanosis - can be a result of too little oxygen in the blood. Fatigue is a common symptom that has numerous causes, including depression. It's always worth seeing the doctor if you feel unusually tired, especially if it's combined with symptoms that cannot be explained.

• Oedema.

• Severe crushing chest pain that may come on at rest and may be accompanied by sweating, light-headedness, nausea or shortness of breath and lasts more than 15 minutes may be a heart attack. Seek medical help immediately by phoning 999 and asking for an ambulance. This will ensure prompt treatment and less damage to heart muscle may occur.

'Classic' symptoms apply more to men, on whom most heart studies are based (although that is changing). Women may have different, sometimes 'milder' symptoms, which may be why women are more likely to die of their first heart attack, since it's much less dramatic than they expect. Because they're women, they put things off, thinking they have the time to deal with it later, after they've cared for everyone else. Symptoms can be: right side of the body going numb, rather quickly: First the arm, followed by the leg, then the right side of the lips/tongue. Should you experience these types of symptoms, seek medical attention immediately. Heart attacks kill more women than breast cancer.