So much water is flowing throughout our bodies, which is good for our muscles, organs, and blood flow. However, sometimes our body holds on to way too much water, causing certain parts to swell up and get super puffy. Water retention, also known as edema or fluid retention, can happen to anyone’s circulatory system. Most of the time, people severely swell up in their legs, hands, and feet. Some cases can be more serious than others, which is why you must pay attention to important indicators as to what you might be experiencing.
There are many causes of water retention—your diet, lifestyle, medication, and hormones can all be big factors. It can be easily treated if you maintain a healthy lifestyle and remain aware of what your body is consuming. We called on Dr. Karnika Kapoor to spell out all of the signs of water retention to be aware of.
Read on to learn everything you need to know to fight off water retention.
Meet the Expert
Karnika Kapoor, DO, is a primary care physician at the Medical Offices of Manhattan. She is a member of The American Academy of Family Physicians, The New York State Academy of Family Physicians, The American Osteopathic Association, and the American College of Osteopathic Family Physicians.
Symptoms to Watch Out For
Many symptoms of water retention depend on the cause (more on that below), but according to Kapoor, the major symptom is swelling or puffiness in your skin that causes it to appear stretched and shiny.
“This typically is worse in the areas of the body that are closest to the ground because of gravity,” explains Kapoor. “Therefore, water retention is generally the worst in the lower legs (called peripheral edema) after walking about, standing, sitting in a chair for a period of time, or at the end of the day. It accumulates in the lower back (called sacral edema) after being in bed for a long period. Pushing on the swollen area for a few seconds will leave a dimple in the skin.”
You should also be aware of an increased size of your abdomen and difficulty breathing. Kapoor also explains that water retention is more common in women due to hormonal changes with menstrual cycles throughout the month and pregnancy.
Causes of Water Retention
“Pregnant women retain extra fluid,” says Kapoor. “Swelling commonly develops in the hands, feet, and face, especially near the end of a normal pregnancy. Swelling without other symptoms and findings is common and is not usually a sign of a complication.”
Monthly Menstrual Periods
“Water retention in women that occurs in a cyclic pattern, usually once per month, can be the result of hormonal changes related to the menstrual cycle. This type of swelling is common but does not require treatment because it resolves on its own over time,” explains Kapoor.
“Water retention can be a side effect of a variety of medications, including some oral diabetes medications, high blood pressure medications, non-prescription pain relievers (such as ibuprofen), and estrogens,” says Kapoor. If you're concerned any of your medication is causing adverse side effects, make sure to talk to your prescribing doctor.
Chronic Venous Disease
“A common cause of water retention in the lower legs is chronic venous disease, a condition in which the veins in the legs cannot pump enough blood back up to the heart because the valves in the veins are damaged,” explains Kapoor. “This can lead to fluid collecting in the lower legs, thinning of the skin, and, in some cases, development of skin sores.”
According to Kapoor, heart failure, also called congestive heart failure, is due to a weakened heart, which impairs its pumping action. “Heart failure can cause swelling in the legs and abdomen, as well as other symptoms,” says Kapoor. “Heart failure can also cause fluid to accumulate in the lungs (pulmonary edema), causing shortness of breath. This can be a very dangerous condition requiring emergency treatment.”
Deep Vein Thrombosis
“Retention can also develop as a result of a blood clot in the deep veins of the lower leg (called deep vein thrombosis, or DVT),” Kapoor explains. “In this case, swelling is mostly limited to the feet or ankles and usually affects only one side (the left or right); other conditions that cause edema usually cause swelling of both legs.”
Kapoor says that cirrhosis is scarring of the liver from various causes, which can obstruct blood flow through the liver. “People with cirrhosis can develop pronounced swelling or retention in the abdomen (ascites) or in the lower legs (peripheral edema),” she says.
According to Kapoor, reactions to some medications and some inherited disorders can cause fluid to leak out of the blood vessels into surrounding tissues (Angioedema). “This can cause rapid swelling in the face, lips, tongue, mouth, throat, voice box, limbs, or genitals,” she says. “Symptoms may include hoarse voice, throat tightness, and difficulty swallowing. Swelling of the throat can interfere with breathing and may be life threatening. Sometimes, this type of swelling occurs in the bowel (the intestinal wall) and can result in abdominal pain.”
Ways to Combat Water Retention
"Not all types of water retention require treatment,” says Kapoor. “Water retention related to pregnancy or menstrual cycles is not usually treated.” However, here are some ways to help if your bloating can be adjusted:
- Reduce salt in your diet: “Sodium, which is found in table salt and processed foods, can worsen retention,” says Kapoor. “Reducing the amount of salt you consume can help to reduce retention.”
- Medication: According to Kapoor, diuretics are a type of medication that causes the kidneys to excrete more water and sodium, which can reduce water retention. “Diuretics must be used with care because removing too much fluid too quickly can lower the blood pressure, cause lightheadedness or fainting, and impair kidney function. You may have to empty your bladder more frequently after taking a diuretic. However, other side effects are uncommon when diuretics are taken at the recommended dose.”
- Compression stockings: “Leg swelling can be prevented and treated with the use of compression stockings. Stockings are available in several heights, including knee-high, thigh-high, and pantyhose. Knee-high stockings are sufficient for most patients,” she says.
What Are Compression Stockings?
They're socks that apply gentle pressure to your legs and ankles. They work to boost circulation to the legs, as well as promote lymphatic drainage and prevent blood from pooling in the veins. People tend to wear compression socks on long flights to help with blood flow.
- Body positioning: “Leg, ankle, and foot swelling can be improved by elevating the legs above heart level for 30 minutes three or four times per day,” explains Kapoor. “Elevating the legs may be sufficient to reduce or eliminate water retention for people with mild venous disease. You should also avoid sitting and standing still for too long. Try to walk and exercise regularly. When a certain area of your body is affected by water retention, avoid extremes of temperature, such as hot baths, showers, and saunas. Make sure you massage the affected area. Stroke it firmly in the direction of the heart, it may help move the fluid.”