Anasarca Definition:- It is a medical term used to define a condition where a person experiences edema or swelling of different parts of the body due to fluid retention in various body tissues.
What is Anasarca?
It is a medical condition which is marked by swelling in different parts of the body due to excessive fluid retention in various body tissues. It is also known by other names like hydrosarca, leucophlegmatia or dropsy. The bloating caused by excessive fluid retention, makes the body look like an inflated balloon.
The main cause of the edema is accumulation of fluid in the subcutaneous tissues. When the edema is confined to a particular part of the body, it is called localized Anasarca. In a person having this condition, fluid increase of >=3-4 L is detected.
It is similar in pathology to edema, the only difference being that it lasts for a longer duration of time and the severity is more as compared to edema.
To understand the mechanism of fluid retention, it is important to first understand the composition of the body. Almost 60-65% of our body weight comprises of water of which two-third parts likes inside the cells while one third-part lies outside the cells. Further, the fluid outside the cells is divided into interstitial fluid and plasma fluid. Interstitial fluid is present between the cells and plasma cells in present in the blood vessels. Collection of excessive fluid between the interstitial spaces is the cause of edema. There are several causes that lead to the collection of extra fluid and the same will be discussed in later part of this article.
Who is mostly affected by this condition?
There is no specific age, gender or race that is affected by this disorder. It can occur to people of any age or gender.
There are several body mechanisms or medical conditions that can lead to fluid retention in the body. Some of them are:
– Reduced Osmotic pressure
– Increased Hydrostatic pressure
– Sodium retention
– Certain medications
– Kidney disease
– Heart failure
– Liver disease
Reduced Osmotic pressure
Plasma proteins in the body exert osmotic pressure which leads to fluid retention in the blood vessel. This is similar to the pressure exerted by magnets on iron. When there is an overall decrease in the plasma level, it leads to fluid leak into the interstitial spaces, finally resulting in fluid retention.
Increased Hydrostatic pressure
Blood is found in blood vessel which is like a tube that allows liquid to pass through its walls in order to reach the neighboring tissues. Hydrostatic pressure is defined as the pressure exerted by liquid to escape into the neighboring tissue. Thus, when there is more liquid, the pressure also increases. This usually happens due to venous stasis in which blood flows down and collects to form a pool. All conditions causing venous stasis lead to edema which finally turns into Anascara over a period of time.
One of the most important organs in the human body, the kidney is responsible for regulating the concentrations of different salts in the body like sodium and potassium. An affected kidney cannot perform this function properly which leads to increased concentration of these salts.
Increased level of sodium in the body is a major cause of water retention. It leads to increased liquid in the blood, thereby increasing the hydrostatic pressure and reducing the osmotic pressure. Both these mechanisms ultimately lead to increased fluid retention in the body.
Some steroids like prednisolone lead to fluid retention in the body.
Kidney Disease or Nephrotic Syndrome
It is a disease of the kidney in children in which the glomerular membrane that acts like a sieve, starts leaking to the plasma proteins like albumin. As a result of this, excessive amount of Albumin is found in the urine which in turn reduces the osmotic pressure. All the conditions together result in edema which starts begins to affect the tissues around the eyes, giving the eyes, an inflated look. This slowly leads to Anasarca, when the protein level falls below 2.5 gm/100 ml.
This kidney problem also leads to sodium retention.
This is one of the most serious causes of Anasarca. When the heart fails and stops pumping blood, it results in venous stasis leading to increased hydrostatic pressure and severe edema. The fluid retention begins in the feet and ankle and spreads to other parts of the body resulting in severe Anasarca.
Liver Cirrhosis is also a leading cause of severe water retention in the body. When the parenchymal cells of the liver get replaced by unwanted fibrous tissues, it leads to a decrease in the production of protein. This in turn leads to decrease in osmotic pressure, resulting in fluid retention in the body. On the other hand, fibrous tissues compress the blood vessels leading to increase in hydrostatic pressure, also resulting in fluid retention.
Protein energy malnutrition is a leading cause of Anasarca in children. Kwashiorkor, a disease caused by protein malnutrition in children causes’ edema.
Some of the possible symptoms of Anasarca are:
– Water retention
– Bloating or increase in the size of the abdomen
– Shortness of breath
– Swollen legs or arms
– Pain in the swollen area
– Ring tightness
– Extreme fatigue
– Body weakness
– Loss of appetite
– Blood pressure issues
– Difficulty in urination (especially in males)
If your edema does not seem to go away with time, then you must consult your doctor immediately. The doctor may ask questions about your medical history and prescribe various medical tests depending upon the severity of your condition. Physical examination may include tests like:
– Blood electrolyte levels
– Kidney Function Test
– Liver Function Test
The color of the urine can help in determining the severity of the disease.
– Blood albumin
This test can help the doctor spot hypoalbuminemia, which means low level of albumin levels in the blood which leads to fluid retention.
– Electrocardiogram or ECG
The selection of treatment depends on the severity of edema in patients. Different treatment methods for Anascara are:
This process uses a man-made membrane to remove excess body wastes like urea and excess water from the body. It comes very handy in eliminating excess fluids from the body.
Reduce Corticosteroid dose
This approach involves decreasing the corticosteroid dose in patients who have cardiac, liver and kidney problems.
These are special medicines that help in eliminating excess fluids from the body.
In patients where protein deficiency is responsible for Anasarca, Albumin infusion is used. 25% solution of diluted Albumin is administered to patients with normal blood levels.
Anasarca Home remedies
Below are certain tried and verified home remedies that can help in reducing edema and providing relief from symptoms like bloating:
If the patient has an underlying kidney condition, it is recommended to reduce sodium intake, in order to avoid edema.
Eat high fiber foods
Include high fiber foods like eggs, boiled white fish, lentils, lean chicken etc in your diet. This may help in reducing edema.
Activities like walking, exercising, dieting and dancing for at least thirty to forty five minutes a day can lead to sweating which can help in reducing edema to a great extent.
Keep your feet elevated
In cases of edema, it is best to keep your feet elevated in order to increase venous arrival.
Limit fluid intake
For patients with chronic renal failure and congestive heart failure, it is important to reduce the fluid intake. Increased fluid intake can cause edema and shortness of breath.
Juniper, uva ursi, hawthorn berries and horsetails are natural diuretics that can help you get rid of edema.
Increase Potassium intake
Diuretics excrete potassium; hence patients need to keep the potassium levels at bay. Include food likes banana, potatoes, orange juice and tomatoes to maintain potassium levels.
Edema can affect different parts of the body. Let’s take a look at these pictures to see what edema looks like in different patients and different parts of the body:
Edema in the feet
Edema in hands
Edema in the face