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What is the reason for swelling of the lower limbs?

Q: My wife is 27 years old, average built (55 kgs), has a problem of swelling in the lower limbs, there is no pain as such, but there is a swelling in her lower limbs which she feels more when she is standing extra hours during the day. Massage does some relief to her but then it is not permanent. Please let me know if this could have been caused due to sudden weight gain? But, that has been only marginal after marriage. Also, please let me know if this can be due to some deficiency or malfunctioning of some organ. This swelling has now been with her for over 3 years, initially it used to come and go but then sometimes she feels it continuously during the day and also while sleeping. We had her tested for albumin in urine, but the test was normal. Please give your opinion on the above as she feels very uncomfortable while standing sometimes and wants to do either some specific exercise or a diet which can help her.

A:You mentioned weight gain but did not say how much, nor did you say whether she has seen a doctor and if he / she thinks whether it is water or fat. There are many causes of fluid accumulation in the legs and a proper clinical examination by a trained doctor is necessary before a cause can be identified and treatment given. Fluid can accumulate in the legs either because the veins draining blood from the legs have incompetent valves, or there is very low albumin in the blood or if there is anything wrong with the heart or the kidneys. There is a big list of causes attached to each of these. The swelling tends to be more during the day while the patient is walking about and it subsides in the night. A reduction in salt intake and the use of a diuretic (water tablet) can reduce the swelling but your best option is to consult a competent doctor.

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