Edema without a cause?

I don’t have a problem with edema, but my sister does - in her feet, ankles, and lower legs. Don’t tell me she needs to see a doctor. She has seen her doctor; doctor did exam; doctor did tests; doctor found nothing. Sis was assertive; doctor referred her to a cardiologist (certain heart conditions can cause edema). Cardiologist found nothing. Back to her internist. Advice: keep wearing the heavy-duty hospital support hose. Sis tells me she’s going to get some insoles with magnets. Any ideas out there?

Sycorax, I have much the same problem. I use ace-type elastic bandages. Is your sister particularly overweight? Doesn’t sound like it. Does she have skin problems on her legs/ankles/feet? The only advice I can offer (which I can’t take myself due to a hip problem) is to walk whenever possible.

P.S. – How’d the sauerkraut juice work out (no pun intended)?

Sycorax, you left out too much to even begin to guess what is wrong. Did the cardiologist do ultasound tests on her heart? Doppler tests on her leg veins? Chest and leg x-rays? Is she obese? Short of breath? Cardiac history? My WAG is that the internist is probably thinking right heart failure, only because of the cardiology consult, but you say she was cleared by him.
Are those “heavy-duty hospital support hose” anti-embolism stockings? Need more info. Short answer: Get a second opinion.


Bubba - cardiologist did some kind of test on her heart, don’t recall what; it was negative. She is about 30 lbs. overweight. She’s had this edema problem for many years, but it seems to be worse recently. No history of cardiac problems. No family history of edema.
DIF - I think you’re referring to my constipation problem – no, I haven’t tried the sauerkraut juice. I must do that. Walking may help the edema eh? I’ll suggest that. Thanks.

General approach to edema:

Consider serious causes -
Heart Failure
Kidney problem (Protein in urine)
Liver problem (cirrhosis)
Blood clots
Pelvic/Abdminal mass (ovarian/testicular CA)

NOTE: Not all of these need to be formally ruled out with high-tech procedures in all patients; they should all be thought of. Some can be ruled out with a good history & physical exam.

If none of these pan out, the working diagnosis is venous insufficiency. Lifestyle treatment is usually advised first:

  • Avoid salt
  • Drink LOTS of water (sounds backwards, but
    it works)
  • Avoid aspirin, motrin, & similar anti-inflammatory meds
  • Avoid constrictive clothing (e.g. knee sox)
  • Support hose (not the same as TEDS)
  • Put your feet up whenever you can
  • Another paradox: walking is good; standing is horrible. Walking causes muscles to press on the veins, helping to pump blood upstream to the heart.

If the problem persists, re-think the list serious of serious causes. Then try a low-dose diuretic (“water pill”). Use the lowest dose possible; use it only pre-menstrually if that provides adequate relief.

Sue from El Paso