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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Medical
Satisfied Customers: 3207
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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How can I get rid of adema, I have been on water pills for

Customer Question

how can I get rid of adema
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: I have been on water pills for 12 weeks, but I lost so much weight I was told to stop them
JA: What medications do you take daily? Are you allergic to any medications?
Customer: no allergies...pills for ulcer
JA: Anything else in your medical history you think the doctor should know?
Customer: broke hip in July, told my liver was not working
Submitted: 1 month ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 1 month ago.

Hi,

Im sorry to hear about your symptoms. Can you tell where exactly do you have edema? Is it all over your body? And which water pills were you using, do you know the name?

Customer: replied 1 month ago.
legs and feet...furosemide120 mg spionolactone 25 mg
Expert:  Dr. Muneeb Ali replied 1 month ago.

Edema in the body can be due to a number of conditions, since you have mentioned that your liver was not working that means the retention of water in your body is likely to be due to the liver failure. Now in case of liver issues, diuretics or water pills are only one of teh ways that you can get rid of the excess water, other ways would be to optimize your protein intake. You need to take a certain amount of proteins to make sure that the water stays inside the blood vessels of your body. The amount of proteins which are required per day is 0.8-1 g/kg/day. This would be calculated by your doctor and he can tell you how much proteins you need to take per day in order to keep the water inside your vessels. Secondly, not all water pills are the same, you need to be started on certain water pills like aldactone which help in reducing water and at the same prevent the side effects of the drug. in your case you were on too high a dose of furosemide which would cause problems like the weight loss. You need to be on a lower dose of furosemide. Wearing compression stockings would also be helpful as well as elevating the feet whenever you can.

Now while liver failure can certainly be the cause here, you also need to get your legs evaluated as the edema is in the feet. This sort of edema which is limited to the legs can be due to a problem with the blood vessels in the legs. Peripheral arterial disease can cause this problem and in such a case a simple doppler ultrasound would be able to diagnose the problem and then you can be treated with simple insertion of stents which would eliminate the edema. Another cause of this can be vascular insufficiency in which the veins of the legs are affected. This would again be diagnosed on a simple doppler ultrasound of the legs and once diagnosed, simple surgery can rectify this problem and your edema would be eliminated as well.

Now if you are losing proteins via the kidney which can lead to edema in the legs, then a simple drug like ACE inihibitors and reduce that loss. Once the proteins stay inside the body and the loss is prevented then the swelling in the legs would automatically start to reduce. This is one option worth looking into. Now there are also natural remedies which can help the liver, some studies have shown that using vitamin E, turmeric, black seed oil can help liver function and also help in reducing edema. You can certainly try these options after talking to your doctor about them. They may be useful in your case.

In short there are many options to reduce edema depending on the underlying cause i would recommend low dose of diuretics, compression stockings, elevation of the feet, a doppler ultrasound to rule out vessel issues, optimization of protein intake, use of ACE inhibitors and the natural remedies. All of these can help you here and you should discuss these options with your doctor.

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Expert:  Dr. Muneeb Ali replied 1 month ago.

Would you like to know anything else? Any clarifications or additional information you require, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating