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What Causes Bilateral Leg Edema In An Elderly Person?
Question: My mother is 86 years old and has edema in both legs they have swollen so much that thy have actually have leaked fluid from them. Her Dr. recommended support hose and then when she started leaking fluid he suggested wrapping ace bandages around them.To me this seems like a back woods answer,to say the least,neither have worked and now i am noticing what could be ulcers on her shins from all of this.She is not on any sort of lasix,water pill,I have asked her Dr. for some but is against it.
Her daily list of meds are as follows,600mgCalciumplusvitamind800iu 2times daily,B12 1000mcg am.,10mgAmlodipine am,potassium CL ER 20MEQ MICRO am, 40 mg lisinoprilmg am, 7.5 meloxicam mg am, Pradaxa 150 mg twice daily, Atenolol 100 mg pm, 20 mg pravastatin pm.
Her daily list of meds are as follows,600mgCalciumplusvitamind800iu 2times daily,B12 1000mcg am.,10mgAmlodipine am,potassium CL ER 20MEQ MICRO am, 40 mg lisinoprilmg am, 7.5 meloxicam mg am, Pradaxa 150 mg twice daily, Atenolol 100 mg pm, 20 mg pravastatin pm.
Brief Answer:
the cause should be investigated
Detailed Answer:
Hello,
bilateral leg edema is rarely an emergency. Thus it can be investigated without a hurry.
Potential causes include:
- heart failure (this is probably the cause). An echo (triplex) by a cardiologist should be sufficient to confirm or exclude it. Can be treated with diuretics mostly. Diet changes might be required.
- vein insufficiency: avoidance of standing is essential. Elevating the legs will help.
- drugs: amlodipine is well-known for causing leg edema. If the edema and amlodipine initiation coincide then you should consider either of the following: taking amlodipine at night only, taking less amlodipine (5mg) or changing to another drug. Meloxicam may also contribute to (or even cause) water retention and edema.
- other causes (less common): like thyroid disease for example. A simple TSH measurement is sufficient to detect it (blood test). Renal problems and low blood albumin may also cause edema. These are harder to treat and depends on various factors.
If the potassium levels are OK then I usually suggest to my patients to try the diuretic (furosemide). Meloxicam should not be used for long periods of time because of various side effects it may inflict like renal damage, peptic ulcer, worsening of arterial hypertension, etc
Why did your doctor was against lasix? Did the doctor mention a reason for that?
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
the cause should be investigated
Detailed Answer:
Hello,
bilateral leg edema is rarely an emergency. Thus it can be investigated without a hurry.
Potential causes include:
- heart failure (this is probably the cause). An echo (triplex) by a cardiologist should be sufficient to confirm or exclude it. Can be treated with diuretics mostly. Diet changes might be required.
- vein insufficiency: avoidance of standing is essential. Elevating the legs will help.
- drugs: amlodipine is well-known for causing leg edema. If the edema and amlodipine initiation coincide then you should consider either of the following: taking amlodipine at night only, taking less amlodipine (5mg) or changing to another drug. Meloxicam may also contribute to (or even cause) water retention and edema.
- other causes (less common): like thyroid disease for example. A simple TSH measurement is sufficient to detect it (blood test). Renal problems and low blood albumin may also cause edema. These are harder to treat and depends on various factors.
If the potassium levels are OK then I usually suggest to my patients to try the diuretic (furosemide). Meloxicam should not be used for long periods of time because of various side effects it may inflict like renal damage, peptic ulcer, worsening of arterial hypertension, etc
Why did your doctor was against lasix? Did the doctor mention a reason for that?
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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