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Even healthy individuals have swollen legs, ankles or feet after sitting or standing for a long period of time or prior to menstruation, however, disease may also be the cause. Whether the swelling is on one side or bilateral could be an indication of the causing disorder.

Causes of bilateral leg swelling

Cardiac Failure: In these cases, the feet, ankles and then the legs gradually swell during several weeks or months (in severe cases, the edema may reach the thigh and the lower abdomen) and when pressing a swollen area with a finger, the indentation left remains for some time. Even small movements cause fatigue and choking. Frequently there is nighttime choking, exacerbated in the recumbent position and improved when sitting up, and frequent voiding during the night.
• Kidney failure and cirrhosis of the liver. Characteristic of kidney failure is the buildup of edema around the eyes while cirrhosis may be accompanied by obvious signs (yellow discoloration in the skin and eyes, expanded abdomen, bulging veins around the navel, spiderlike blood vessels on the skin, etc.)
• Decrease of white (albumen level) blood cells (kidney failure, loss of appetite, chirrhosis of the liver).
• Hypothyroid: the edema does not hold the thumb print. Symptoms may include weight gain, thinning hair, slowed metabolism, lower heart rate, constipation and depression.
• Varicose veins: blood circulation in the lower limbs deteriorate, there is swelling of the legs, feeling of heaviness in the legs, phlebitis and brownish skin may occur.
Susceptibility to leg swelling often increases with: sedentary work, obesity, pregnancy, inactive life style, tight clothing cramping the legs and ankles (i,e.,corsets, tight belts, tight socks or hose).

Causes of unilateral leg swelling

• Deep vein thrombosis: in these cases, the circulation in the lower limbs is obstructed. The limb involved turns a bluish-purple color, is very swollen and painful. Hospital care is needed as quickly as possible and anticoagulants given to prevent serious complications (pulmonary embolism). Generally, the circulation in the affected limb. will not go back to normal – it will always swell a little more than the unaffected one.
• The affected limb will also swell when the lymphatic circulation is obstructed. These may be caused by a tumor pressing on the lymphatic veins or if lymph nodes had to be removed from the inguinal region.
• Filariasis: is not found in Hungary. The Wuchereria bancrofti and Brugia malayi, the cause of filariasis that live only in tropic and subtropic areas, can cause extreme unilateral leg swelling by obstructing the lymphatic circulation.
• Painful swelling is found at the affected areas following a lower limb injury such as ankle ligament tear, knee injury or joint inflammation.

With whom should we consult?

Should there be no indication of a concrete illness causing the leg swelling, it would be worth your while to contact your general practitioner/internist who can offer the proper care or send you on to the proper medical professional (i.e., cardiologist, oncologist, vascular surgeon, dendocrinologist

Diagnosis

Following a thorough discussion, detailed physical examination.,laboratory tests (TSH, liver function, kidney function, d-Dimer, albumin) and, if necessary, ultrasound of the veins of the lower limb. If there is possible cardiac failure and deep venal thrombosis, serious liver or kidney failure, immediate hospital examination and treatment is required. The vasculare surgeon should be consulted regarding varicose vein surgery. In the event of thyroid disease, you will be examined by an endocrinologist and set up your treatment. Depending on the possible disorder, there may be further supplemetal examinations, i.e., ultrasound of the abdomen, echocardiography, ECG.

Treatment

The trigger disease needs to be treated and any serious disease ruled out (cardiac failure, hepatic failure, hypothyroidism, thrombosis, cancer). If the causes of the leg swelling are due only to susceptibility factors (see above) or mild varicose veins, we may do the following. Venous circulation is helped by the elevation of the legs, bandaging, wearing compression stockings, exercising the leg muscles by standing on toes, walking, jogging and venous exercises: (lying flat on your back, raise your legs and draw circles with your feet for 5-10 minutes per day), then wash legs with cold water.
There are products (wild chestnut cream, Lioton gel,tablets with the active agent Diosmin) that can relieve your symptoms. For problems of lymph circulation a specialized center should be consulted.

Consult with our Medical Specialists!

The Buda Health Center, the five-time winner of the Superbrands Award, is an outpatient health care provider offering all its services in one location, through the private practices of 200 well-known physicians in 45 specialties. Our team, having worked together over several years, is a cohesive group well trained in providing the best personalized care. Feedback from our 250,000 patients, together with our experience of 18 years, has shown us the importance of a health care plan that is tailored to the
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