Swelling is common in people with an advanced chronic disease. Swelling in any part of the body is called edema. Edema is a buildup of fluid that can cause swelling and sometimes pain. When you have edema it is more likely to show up in your legs and feet but can also happen in your hands, arms, face and stomach (tummy). If you have edema you might have:

  • Tight, shiny or stiff skin,
  • Puffiness or a heavy feeling in your arms or legs,
  • Feeling that your clothes, shoes or jewelry is too tight,
  • Sudden weight gain, and/or
  • A dent is left in your skin when you press on it.

Some causes of swelling include:
Chronic conditions: Such as heart failure, liver or kidney failure. Some cancers can also cause it, especially kidney, liver or ovarian cancer.

  • Medications: Some medications such as steroids, anti-inflammatory drugs (e.g., ibuprofen), hormone replacement therapy or some blood pressure medications can cause swelling.
  • Treatments: Such as chemotherapy can cause swelling.
  • Problems with the veins in your legs:  Also called varicose veins. 
  • Blood clots: Blood clots which can stop the flow of blood to an area in your body and cause a buildup of fluid behind the clot.
  • Infection: When you have an infection your body sends more blood to the affected area, this can cause swelling.
  • Nutritional problems: A diet low in protein can lead to swelling because protein in your blood stops fluid leaking into your skin. 
  • Sitting or standing for a long time: Sitting on long plane flights or car rides, standing for a long time at your job.
  • Not enough physical activity: If you are managing a chronic condition and dealing with symptoms such as pain or fatigue, it can be difficult to exercise which can cause fluid to collect in your legs and feet.

Managing swelling works best when you play an active role. 

  • Try to figure out if there is a cause for your edema. 
  • Is it better or worse at different times?
  • What helps or makes it worse?

You may want to use a symptom diary to record information about your edema. Tracking this information will help you talk to healthcare team about your edema.

Physical steps you can try:

  • Medication: If you take medication (diuretics or water pills) for your swelling, take it as prescribed so your symptom doesn’t get too bad.
  • Track your weight: Weigh yourself every day at the same time (usually before breakfast and after you have had a pee). Try and wear the same amount of clothing each time. Checking your weight shows you if your body is holding on to fluid.
  • Gentle exercise: If it is safe for you, do gentle exercises like walking, swimming or riding a stationary bike every day. Exercise can help pump fluid back to your heart.
  • Massage: Helps reduce all over muscle tension and pain, it can also help to move fluid buildup from under your skin. 
  • Hydrotherapy: Uses flowing water to relax muscles and allows you to lie flat.
  • Eat a healthy diet: Speak to your healthcare team about what foods you can eat to help reduce your swelling e.g., more protein or less salt.
  • Keep track of the fluids you drink: If you are on a fluid restriction try and stick to it.
  • Wear compression stockings: These may help to push fluid out of your skin. Make sure you measure yourself for the correct size so they are not too tight. 
  • Raise the affected area: Try and rest the area of your body that is swollen by raising it higher than the level of your heart or lying down.
  • Wear loose fitting clothes: Make sure that your clothes are not too tight.
  • Avoid: Standing for long periods of time and if you can try not to cross or sit on your legs.
  • Limit or stop: Alcohol, caffeine and nicotine to see if your symptoms get better. These can make your swelling worse. 

Speak with your healthcare team if swelling is a problem for you. Your worries and questions are important to you and them. Your healthcare team may speak to you about the different medications you can take.   

  • Let them know if you think your medical condition or medications are the reason for your swelling.
  • Let your healthcare team know if a medication is working for you or if you’re having side effects. You may have to try a few different ones to know what works best for you.
  • Talk to them before taking over-the-counter medication, including vitamins and herbal remedies.

Tips on sharing your symptoms with your healthcare team:

  • Make some notes about your swelling symptoms and tell your healthcare team about them.
  • Has there been a change in your swelling?
  • What does your swelling feel like? How bad is it?
  • When does it happen and how long does it last?
  • What makes it better or worse? What have you tried already?
  • Make a list of all the medications you are taking including over the counter medications.

Get immediate help if you have: 

  • Shortness of breath,
  • An irregular heartbeat,
  • Chest pain, or
  • Leg pain or hard swelling in one leg.