Piedi e caviglie gonfie: cause, rimedi e quando preoccuparsi

Roberto Gindro

13 Oct 202211:03

Summary

TLDRThe script discusses peripheral edema, a condition where fluid accumulates in the body's extremities, leading to swelling. It highlights that while occasional swelling may not be a concern, persistent or painful swelling should be reported to a doctor as it could indicate serious health issues like heart or kidney problems. The body's water balance, the role of the lymphatic system, and various causes of edema, including hormonal fluctuations, malnutrition, and certain medications, are also covered. The importance of a proper diagnosis and tailored treatment is emphasized, along with lifestyle tips for managing symptoms.

Takeaways

🚶‍♂️ Peripheral edema is a common condition where fluid accumulates in the body's extremities, causing swelling, especially in the legs, ankles, and feet.
💧 The human body consists of 50-60% water, with a significant portion being outside the cells in the interstitial space and blood, which is crucial for regulating the passage of substances between the blood and cells.
🧪 Peripheral edema can be caused by a variety of factors, including venous insufficiency, heart or kidney disease, liver problems, hormonal fluctuations, malnutrition, and certain medications.
🩺 If you experience swelling in one leg or severe, sudden swelling without an obvious cause, it's important to seek medical attention, as it could indicate a serious condition like deep vein thrombosis or an allergic reaction.
🌡️ During pregnancy, mild swelling is common, especially in the later stages, but a sudden increase in swelling could be a sign of pre-eclampsia, which requires immediate medical attention.
🏥 The first step in addressing swollen ankles should always be to consult a doctor, who will conduct a thorough examination and possibly order specific tests based on your medical history and symptoms.
🩰 Chronic venous insufficiency often responds well to simple remedies like elevating the legs at night and wearing compression stockings, while diuretics are the first choice for swelling associated with heart, liver, or kidney disease.
💊 If medications are the cause of swelling, it may be necessary to review and adjust the treatment plan.
🍽️ General advice for managing swelling includes maintaining a healthy, low-salt diet, staying hydrated, engaging in appropriate physical activity, elevating legs at night, maintaining a healthy weight, and avoiding tight footwear.
👣 Swelling in the feet and ankles tends to worsen in the evening due to the body's position throughout the day, especially when standing for long periods, and can be exacerbated by a high-salt diet.
🧓 Older individuals often experience swelling in the ankles due to a combination of factors, such as venous insufficiency, heart and kidney issues, medication use, and other health conditions.

Q & A

What is peripheral edema and how is it commonly experienced?
-Peripheral edema, also known as peripheral swelling, is an accumulation of fluid in the extremities of the body, such as legs, ankles, and feet. It is commonly experienced as swelling and sometimes pain in the feet and ankles, often noticed in the evening after being on one's feet for a long period.
What is the body's mechanism for maintaining the balance of fluids in the interstitial space?
-The body maintains a dynamic balance of fluids in the blood and the interstitial space surrounding cells. This balance is finely regulated by the brain based on the body's needs at any given moment. The excess interstitial fluid is drained by the lymphatic system, ensuring a delicate equilibrium that allows for the proper passage of substances between the blood and cells.
What are the potential serious health issues that peripheral edema may indicate?
-Peripheral edema, when accompanied by other symptoms or persisting without explanation, may indicate serious health problems related to the heart and/or kidneys, such as heart failure, kidney failure, and liver insufficiency. It is important to consult a doctor if peripheral edema is persistent or unexplained.
What is the most common cause of peripheral edema in patients over 50 years old?
-The most common cause of peripheral edema in patients over 50 years old is venous insufficiency, a condition characterized by the progressive degeneration of the internal mechanisms of the veins, which should facilitate the return of venous blood to the heart.
How does the body's position influence the accumulation of fluid in the extremities?
-The body's position plays a significant role in the accumulation of fluid in the extremities due to gravity. When standing or sitting for long periods, fluids tend to accumulate in the lower parts of the body, such as the legs, ankles, and feet, as this is where gravity exerts its force and fluid is more likely to pool.
What are some lifestyle-related factors that can contribute to peripheral edema?
-Lifestyle-related factors that can contribute to peripheral edema include a diet high in salt, prolonged standing or sitting, wearing tight shoes, and certain medications. Maintaining a healthy lifestyle with proper hydration, balanced diet, and regular physical activity can help prevent or manage peripheral edema.
How can one differentiate between a systemic cause and an acute specific event causing swelling in the ankle?
-A systemic cause of swelling, such as heart, kidney, or liver issues, often presents with swelling in both ankles and may be chronic and gradual. An acute specific event like deep vein thrombosis, localized infection, or injury would typically cause sudden swelling in one ankle and may be accompanied by severe pain, redness, or fever.
What are some common medications that can cause ankle swelling as a side effect?
-Certain medications can cause ankle swelling as a side effect, including some blood pressure medications (especially calcium channel blockers), hormonal therapies like contraceptive pills or hormone replacement therapy, testosterone, and some antidepressants (MAO inhibitors and tricyclics), as well as cortisone.
What should one do if they notice ankle swelling during pregnancy?
-Mild ankle swelling during pregnancy is common and usually not a cause for concern. However, if there is a sudden increase in swelling or it becomes particularly severe, it could be a sign of pre-eclampsia, which requires immediate attention from a gynecologist. In case of severe headache, vision disturbances, or pain under the ribcage, one should seek medical help immediately.
What are some non-medical remedies that can help alleviate symptoms of peripheral edema?
-Non-medical remedies for peripheral edema include elevating the legs at night, wearing loose-fitting shoes, maintaining a healthy and low-salt diet, staying hydrated, engaging in appropriate physical activity to promote circulation, and avoiding prolonged periods in the same position (either standing or sitting).
What is the recommended first step when experiencing ankle swelling?
-The first step when experiencing ankle swelling is to consult a doctor, who can perform a thorough medical examination and, if necessary, prescribe appropriate tests and treatments based on the underlying cause of the swelling.

Outlines

00:00

👣 Peripheral Edema: Causes and Concerns

This paragraph discusses the common issue of peripheral edema, which is the swelling of the extremities due to the accumulation of fluid. It explains that while occasional swelling without other symptoms might not be a cause for concern, it can sometimes indicate more serious issues related to the heart or kidneys. The paragraph delves into the physiological aspects of fluid balance in the body, the role of the lymphatic system, and the factors that can disrupt this balance leading to edema. It also highlights the importance of seeking medical advice when experiencing persistent or unexplained swelling, especially if it is unilateral or accompanied by other symptoms.

05:03

🚨 When to Seek Medical Attention for Swelling

This paragraph emphasizes the importance of seeking medical attention for swelling, particularly when it is accompanied by additional symptoms or does not resolve within a few days. It warns against ignoring unilateral swelling, severe pain, sudden onset, or the absence of redness/heat, fever, or chills, as these could be signs of more serious conditions. The paragraph also addresses the common occurrence of swelling during pregnancy, which is usually harmless but could indicate pre-eclampsia if it suddenly worsens. It advises pregnant women to seek immediate medical attention if they experience severe swelling, severe headaches, vision disturbances, or pain below the ribcage.

10:05

🩺 Medical Evaluation and Treatment of Swelling

The paragraph outlines the process of medical evaluation for swelling, starting with a thorough medical history and physical examination to identify potential causes. It explains that specific tests may be ordered based on the findings, which could include evaluations of the heart, liver, kidneys, and circulatory system. The paragraph then discusses various treatment approaches depending on the underlying cause of the swelling, such as mechanical therapies for chronic venous insufficiency, diuretics for heart or liver-related edema, anticoagulant therapy for deep vein thrombosis, and decongestive physiotherapy for lymphedema. It also suggests lifestyle adjustments and home remedies that can help manage swelling, such as elevating the legs, maintaining a healthy diet low in salt, staying hydrated, engaging in appropriate physical activity, and wearing well-fitting shoes.

Mindmap

Keywords

💡Edema periferico

Edema periferico refers to the swelling due to the accumulation of fluid in the peripheral parts of the body, such as ankles and feet. In the video script, this term is introduced as a common symptom that many might experience, especially in the evening after prolonged periods of standing or sitting. The explanation in the video provides an accessible description of what this medical term means in everyday terms and emphasizes the importance of consulting a doctor if such swelling is persistent or severe.

💡Insufficienza venosa

Insufficienza venosa, or venous insufficiency, is a condition characterized by the veins' failure to adequately circulate blood back to the heart, particularly from the lower limbs. This is a common cause of edema periferico in older patients. The script discusses this as a primary reason for ankle swelling in individuals over 50 years old, highlighting the degenerative nature of the mechanisms within the veins that support blood circulation.

💡Sistema linfatico

The 'sistema linfatico' or lymphatic system is critical for draining excess interstitial fluid and preventing edema. In the script, it's mentioned in the context of explaining bodily fluid balance and how disturbances in this system can lead to fluid accumulation, thus causing swelling. The analogy of a mountain lake and streams helps illustrate how fluids are managed in the body.

💡Malassorbimento

Malassorbimento, or malabsorption, refers to the body's inability to absorb nutrients properly from the digestive tract. This condition is listed in the script as one potential cause of edema, relating it to insufficient protein and vitamin levels that can exacerbate swelling in the ankles due to nutritional deficiencies.

💡Linfedema

Linfedema is a specific type of swelling mainly caused by a blockage in the lymphatic system. The script mentions this condition to explain another potential reason for ankle swelling, underscoring its difference from general edema due to its focus on lymphatic obstruction rather than a broad fluid accumulation.

💡Diuretici

Diuretici, or diuretics, are medications that help the body expel excess fluid by increasing urine production. They are often used as the first line of treatment for swelling associated with heart, liver, or kidney disease, as mentioned in the script. The treatment section of the video emphasizes the use of diuretics in managing conditions that lead to fluid retention.

💡Anamnesi

Anamnesi refers to the medical history collected by healthcare professionals to aid in diagnosis. In the script, it's emphasized that no tests should be conducted without a thorough anamnesi and physical examination by a doctor, which can guide further diagnostic testing based on the patient’s symptoms and history.

💡Trombosi venosa profonda

Trombosi venosa profonda, or deep vein thrombosis (DVT), is a condition where a blood clot forms in a deep vein, usually in the legs. The script mentions this as a more serious and specific cause of unilateral swelling, highlighting the importance of immediate medical evaluation and treatment.

💡Insufficienza cardiaca

Insufficienza cardiaca, or heart failure, occurs when the heart is unable to pump blood effectively, leading to fluid build-up in the extremities. The script discusses this condition as a potential cause of peripheral edema, particularly noting the risk of fluid accumulation due to decreased blood pumping efficacy.

💡Calze compressive

Calze compressive, or compression stockings, are specialized hosiery designed to help prevent the occurrence and progression of venous disorders such as edema, phlebitis, and thrombosis. In the script, compression stockings are recommended as a mechanical treatment for chronic venous insufficiency, aiding in managing symptoms by improving blood flow and reducing swelling.

Highlights

Edema is a common condition that can cause swelling in the feet and ankles.

Peripheral edema is caused by an accumulation of fluid in the body's extremities.

The human body contains 50-60% water, which plays a crucial role in various physiological processes.

Interstitial fluid is essential for the exchange of substances between blood and cells.

The body maintains a delicate balance between blood and interstitial fluids, regulated by the brain.

Lymphatic system plays a key role in draining excess interstitial fluid.

Edema can be a symptom of more serious underlying health issues, such as heart or kidney problems.

Venous insufficiency is a common cause of peripheral edema in older adults.

Certain medications can cause swelling in the ankles, such as blood pressure drugs and hormonal therapies.

If you notice swelling in only one ankle, it could be due to specific acute events like deep vein thrombosis or localized infections.

Swelling in the ankles can worsen in the evening due to the body's position and heat.

In older people, ankle swelling can be a combination of various conditions, such as heart and kidney issues, and medication use.

Pregnancy can cause mild swelling in the legs, ankles, feet, and fingers, especially in the later stages.

Sudden increase in swelling could be a sign of pre-eclampsia, requiring immediate medical attention.

If you're concerned about swollen ankles, it's crucial to consult a doctor for a proper examination and diagnosis.

Treatment for edema depends on the underlying cause and may include mechanical therapies, diuretics, anticoagulants, or physiotherapy.

Lifestyle changes, such as a low-salt diet, regular exercise, and elevating legs at night, can help manage ankle swelling.

Grandmother's remedies, such as wearing loose shoes and maintaining a healthy diet, can provide relief for ankle swelling.