Oedema: Why our bodies swell

Hey doctor

My body becomes swollen every morning, especially around the thighs. What might be the problem?

Dear reader,

The swelling of the body is likely to be due to oedema. This is swelling that develops due to build-up of fluid in the body tissues and under the skin. While it can affect any body organ and any part of the body, it is more commonly seen in the feet and the legs. You may notice swelling, heaviness, shiny or puffy skin and when you press the area, a dimple that takes long to flatten/ go back to normal may form. Other symptoms depend on the specific body part or organ affected. For instance, there is difficulty in breathing when there is pulmonary oedema (build-up of fluid in the lungs). Mild swelling or oedema may develop as a result of standing or sitting for too long, or as a result of hormonal changes during the menstrual cycle or during pregnancy, or as a result of a high sodium (salt) diet. There are also some medications that may trigger development of oedema such as some hypertension medicines, some pain medications and hormonal medications. However, oedema may also develop as a result of serious illnesses like heart disease, kidney disease, liver disease, severe anaemia, low protein levels in the body, having a blood clot and as a result of problems with the circulatory system, either the blood vessels or the lymphatic system.

While the swelling or oedema is painless, there is potential for developing complications, both from the underlying illness and from the swelling itself. If the swelling continues for a while, it can lead to itchiness of the skin, pain, stiffness, reduced blood flow, skin ulcers, risk of infection and scarring.

It is advisable for you to be reviewed by a health care provider urgently for thorough evaluation, including relevant tests that may include blood tests, scans, studies of the blood vessels among other tests. Once the underlying condition is diagnosed, then it will be managed. Other measures that may be prescribed include medications to reduce the swelling, compression garments (if necessary), and lifestyle changes like exercise and reduction of salt intake, though they may not be appropriate depending on the specific diagnosis.

Dear Doctor,

What can we feed children with developmental disorders like autistic children during the festive season since most of the foods available are junk foods?

HM

Dear HM,

It is best to provide healthy nutritionally balanced and adequate foods at all times for all children and adults. However, there will be situations when consumption of junk food is unavoidable. The occasional or rare intake of these foods is usually not harmful.

For children with developmental disorders, there may be an individualised diet developed in conjunction with the developmental specialist and the nutritionist. While the research on the use of diet for autism treatment is inconclusive, there is an interplay between the autism spectrum disorder, diet and gut health, which means that you may see some changes when the diet is changed. This may be due to eating patterns, food selectivity and reactions to food, which can then affect the quality of nutrition and gastrointestinal health, leading to nutritional deficiencies or having problems with the digestive system (such as pain, reflux, constipation, diarrhea) which then affects behavior.

During the festive season, there may be different factors that affect the child, including disruption of routine, travel and interaction with new people. In regards to food, children with autism tend to have selective eating due to sensory selectivity to the look, texture, smell and taste; also due to behavioural inflexibility and sensitivity to the environment in which the food is provided. The festive season may affect all of these and any resultant challenges may be due to one or a combination of these factors, rather than, or in addition to the food itself.

Hey there doc

I am always having a persistent problem of skin dinfections; mainly white patches, and they have troubled me for a long time. Please help

Dear reader,

The recurrent white patches on the skin may be as a result of fungal infection, allergic skin conditions like eczema, or inflammatory skin conditions.

Skin fungal infection can cause white patches, itching, dryness and scaling. The infection may recur when the weather is warm and humid, or if you have sweaty or oily skin. The infection may also be recurrent if your immunity is weak, or if the infection is not treated completely. You may also get recurrent infection from shared items such as clothing, towels, lanyards, or from spread of infection from another part of the body such as the feet. Treatment involves use of antifungal medications either as tablets or by application. Sometimes treatment may be given for a long duration so as to completely clear the infection.

Fungi also shed spores, which are like tiny seeds that collect in our clothes or shoes, waiting for the right conditions for them to grow again. Clothes need to be washed, dried out in the sun and if possible, ironed inside-out, and shoes should be cleaned regularly.

Eczema, or allergic dermatitis, is usually recurrent and can lead to formation of white patches on skin, itching, dryness and scaling. The skin lesions may be darker in colour in some people. The recurrence of the symptoms may not be predictable, though some people are able to identify triggers. Treatment may include anti-allergy or steroid medications, or other medications to control the inflammation. Skin care involves keeping the skin moisturised, using mild soap, and protecting the skin from harsh chemicals and avoiding long and hot showers.

Since you have had this skin problem for a long time, it is advisable for you to seen by a skin specialist for examination and possibly evaluation of a skin sample to determine the exact diagnosis so that you can get treatment that is specific for you.

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