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Why do my feet swell after standing for long hours?

Thursday, 16 March 2006
Answered by: Dr. Shiban K. Chaku
Senior Consultant Surgeon,
Indraprastha Apollo Hospitals,
New Delhi
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Q. I have medium fluid oedema on both feet. This happens mainly due to standing up on duty for long periods. I am 46 years old and have no other problems. I have carried out all possible tests including fasting diabetes, kidney, urine (24 hours) and all blood and urine analysis. My blood pressure is normal. I weigh 95 kg and I am 5 feet and 7 inches tall. I have a healthy lifestyle and am a non-smoker, non drinker and a vegetarian. I walk for 45 minutes everyday. I took lucilactol tablets for some time and the condition subsided, but when I stopped the drug the swelling started again. Please advise.

A.  It not unusual to get minimal swelling in the feet at the end of the day, particularly if you have been standing for long. This, however, is barely noticeable. You can realise this when your shoe starts getting tight. If you feel that the swelling is more than this, then obviously you need to know the cause. It is possible that it may not be treatable and you may have to live with the same, but at least you have to be sure that there is no serious problem. Roughly the causes are either local or systemic. The local causes are the poor function of the veins (that carry blood back to heart) and/or lymphatics (These are like veins but very fine threads and carry some residual fluid which seeps out of the circulation into the tissues. These lymphatics return this fluid back to the circulation). It is possible to have malfunction of one or the other or one could have a combination of the two causes. The diagnosis of the venous problem can be assessed with having a Duplex scan (Ultra sound with Doppler) and the lymphatics can be assessed with special scan of the lymphatics called Lymphangiogram, this is available in major hospitals in the country. If it turns out that both these are normal, then I suggest to consult a good physician, who will investigate the systemic causes of the swelling. Some of these have already been done and some more need to be added to be absolutely sure. I have to add here that swelling of the feet is a very common symptom of variety of diseases and in itself is not a particular disease and sometimes is quite harmless. Last but not the least, one has to consider that 95 kg of weight and its stress on the body could also contribute to the cause of the malady.

A.  It not unusual to get minimal swelling in the feet at the end of the day, particularly if you have been standing for long. This, however, is barely noticeable. You can realise this when your shoe starts getting tight. If you feel that the swelling is more than this, then obviously you need to know the cause. It is possible that it may not be treatable and you may have to live with the same, but at least you have to be sure that there is no serious problem. Roughly the causes are either local or systemic. The local causes are the poor function of the veins (that carry blood back to heart) and/or lymphatics (These are like veins but very fine threads and carry some residual fluid which seeps out of the circulation into the tissues. These lymphatics return this fluid back to the circulation). It is possible to have malfunction of one or the other or one could have a combination of the two causes. The diagnosis of the venous problem can be assessed with having a Duplex scan (Ultra sound with Doppler) and the lymphatics can be assessed with special scan of the lymphatics called Lymphangiogram, this is available in major hospitals in the country. If it turns out that both these are normal, then I suggest to consult a good physician, who will investigate the systemic causes of the swelling. Some of these have already been done and some more need to be added to be absolutely sure. I have to add here that swelling of the feet is a very common symptom of variety of diseases and in itself is not a particular disease and sometimes is quite harmless. Last but not the least, one has to consider that 95 kg of weight and its stress on the body could also contribute to the cause of the malady.

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