Learning About Anasarca

Anasarca is a severe buildup of fluid in the spaces between your cells. Normally, the fluid in this space helps move oxygen and nutrients from your blood to your cells. But some health problems can cause too much fluid to collect in this space. Anasarca itself isn't a disease. It's a symptom of an underlying condition.

Anasarca can cause uncomfortable swelling and weight gain. Moving the swollen areas of your body may be hard to do.

Many medical conditions can lead to anasarca. They include:

• Congestive heart failure.
• Kidney failure and other kidney diseases.
• Liver diseases such as cirrhosis.
• Some conditions in the gastrointestinal (GI) system such as celiac disease.
• Endocrine conditions such as hypothyroidism.
• Malnutrition.

Medicines can also sometimes cause anasarca. Some medicines change how fluid moves inside the body. This can cause swelling. Medicines that may cause swelling include blood pressure pills (like calcium channel blockers), pain relievers like ibuprofen (nonsteroidal anti-inflammatory drugs, or NSAIDs), and steroids. Swelling may also happen due to an allergic reaction to a medicine.

The symptoms of anasarca can be different depending on the cause. They include:

• Visible swelling throughout the body.
• Swollen arms, fingers, and legs that are hard to move.
• A swollen, painful belly due to fluid buildup in the abdominal cavity (ascites).
• Weight gain due to fluid retention.
• Shortness of breath. If fluid builds up in your lungs, you may have chest pain, coughing, and trouble breathing, especially when lying down. This is a medical emergency. Call 911 or go to the emergency room right away.
• Extreme tiredness and fatigue.
• Not being able to urinate, or urinating very little.

Your doctor will ask questions about your health and review your medicines. You'll have a physical exam. Doctors from other specialties may also examine you. The goal of diagnosis is to find out why you have a buildup of fluid in your body so the cause can be treated. You may have lab tests that include:

• Complete blood count (CBC). This test gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets.
• Comprehensive metabolic panel (CMP). This blood test measures your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function.
• Urinalysis. This test checks the color, clarity (clear or cloudy), odor, concentration, and acidity (pH) of your urine. It also checks the levels of protein, sugar, blood cells, or other substances in your urine.
• Serum albumin. This test measures the amount of the protein albumin in your blood. Low levels (hypoalbuminemia) point to possible liver failure, malnutrition, or kidney disease.
• Brain natriuretic peptide (BNP) blood test. This test checks for a hormone made by your heart. It helps your doctor see if heart failure is causing the swelling.
• Other tests as needed.

Your doctor may order imaging tests, including:

• Chest X-ray.
• CT scan.
• Echocardiogram.
• MRI.
• Other imaging tests as needed.

Since anasarca is caused by an underlying condition, your doctor will work to manage that condition.

Your doctor may have you take a diuretic. Diuretics make you urinate more often. That helps reduce the amount of water and salts in your body.

If your swelling is in your legs and feet, you may get some relief by raising your legs. When you sit or lie down, put your feet on a footrest or on the arm of the couch. Your feet should be raised above the level of your heart. You can support your lower legs with pillows. Your doctor may also want you to wear elastic compression stockings during the day. Take them off at night to sleep.