What is the meaning of anasarca? What are the causes, symptoms and some treatment options for anasarca? Here’s a definition, pictures and insight on scrotal anasarca, its treatments and home management tips.
Perhaps you have met a person or experienced general body swelling and never understood why. This is known as edema. It can be referred to using different medical terms depending on the nature and how far reaching its consequences are to your body.
Anasarca definition, meaning
What is anasarca? This is a medical term that is used to describe general swelling of the body. It is brought about by the collection of fluid in the cells of the body. In the long run, this brings about massive swelling. Other terms for anasarca include hydrosarca or dropsy.
It is totally different from the swelling that is seen in specific parts of the body like the feet. The name is derived from a Greek word ‘ana’ that means through and ‘sarx’ which means flesh and hence generalized edema.
- On normal occasions, fluid is found in the body (within cells, areas between cells, in blood and within the lymphatic vessels).
- This helps to keep the joints and organs vital and moisturized.
- Usually, the hydrostatic pressure, which is the pressure that fluid exerts in confined spaces pushes the fluids from high pressure areas to low pressure areas.
- Osmotic pressure pulls the fluid from parts of the body with low salts called electrolytes to areas of high electrolyte concentrations.
These fluids accumulate with other minerals like the waste vitamins, minerals among others that should be distributed throughout the body.
Anasarca condition is not a disease in its own sense, but may represent or show that there is an underlying condition in the body. In other words, anasarca is a symptom of a serious underlying health problem.
For instance, patients with kidney failure or heart failure may experience massive swelling of the body. Patients of this sense need immediate and emergency attention.
Further, it is a warning sign representing an underlying serious medical condition. In general diagnosis, it is characterized by presence of generalized edema. Paradoxically, it may again cause congestive heart failure, liver failure, renal failure, and severe malnutrition.
This condition may also come as a result of retention salt and water by the body. It is a life threatening condition that calls for long term care and treatment. The swelling normally becomes evident when various parts of the body are affected.
Attached are some pictures that will give you a deeper understanding of how anasarca looks like. On your skin, the condition might look slightly different, but this is just a general overview to give you some clue.
The pictures are also generated from internet sources and there is therefore need for proper diagnosis by a doctor to ascertain the condition.
What causes anasarca (generalized edema)?
Many conditions cause edema whereby some lead to localized swelling and others result in generalized swelling as in case of anasarca. The causes may vary from heart and blood vessels to liver and kidney disease.
Drugs may also be a culprit for generalized edema. Autoimmune disorders like lupus may be associated with anasarca. Below are some them in detail:
1. Liver cirrhosis or chronic liver diseases and chronic renal diseases
This can cause generalized swelling of the body apart from other complications. Similarly, chronic renal disease or sudden renal failure can cause high blood pressure and accumulation of salt and water in the body, leading to swelling. There are some other types of chemotherapy drugs that can cause swelling of body.
2. Excess toxins in the body
When there is increased retention of toxins and water, swelling is likely to occur. A patient with heart failure experiences poor cardiac function meaning there is low amount of blood volume which is pumped by heart to other body parts.
Due to this problem, the kidney is likely to sense that there is reduced blood volume in body. In order to compensate for the reduced volume, more water and salts are retained thereby resulting to edema.
3. Severe and prolonged malnutrition and deficiency of protein
This has also been linked to anasarca. The explanation is the increase in hydrostatic pressure (pressure due to gravity) can force the fluid from the vessels into the tissue spaces leading to edema. Similarly, decreased colloid osmotic pressure (pressure exerted by proteins- albumin to blood vessels) caused by reduced plasma proteins may cause fluid leakage into the tissue spaces leading to anasarca.
The major cause of anasarca in children is protein malnutrition also known as Kwashiorkor. Cases of Kwashiorkor occur in areas of famine or poor food supply. It is most seen in children of 1-4 years of ages in African and Southeast Asian countries.
4. Excessive salt intake
The normal amounts of salt that you take is normally excreted in the urine. This is facilitated by the kidneys. The case changes when you have heart or kidney failure. In this cases, salt accumulates and in the end leads to retention of water.
5. Idiopathic edema
This is a condition whose cause is not known. It is however associated with women in premenopausal period or those who use diuretic drugs for an extended time, may be another possible cause for edema.
6. Diuretic drugs
These are drugs that when taken may increase the frequency of urination. They help reduce edema through urine excretion.
On the contrary, a rebound phenomenon can occur. Leaks in capillaries can cause fluid to pass to interstitial space making the kidney to retain salt and water when it senses there is reduced blood volume.
7. Clarkson syndrome.
Clarkson syndrome is a rare condition where the pores in the blood capillaries increase in size and in count. This causes fluid to go out from the blood into the interstitial fluid all over the body leading to anasarca. Swelling, decreased blood pressure and the failure of multiple organs can then follow.
Symptoms of anasarca
The symptoms of this condition keep varying based on the underlying condition. For instance, patients who have anasarca caused by renal failure may experience following symptoms:
- Loss of appetite
- No urine output
- Swelling of the feet and ankle
- Body weakness
- Shortness of breath
On the other hand, if the cause is heart problems, you are likely to have anasarca with the following symptoms:
- Unable to sleep at night unless sitting upright
- Shortness of breath
- Body weakness
- Decreased appetite
- Abdominal pain
If you are a lady and the immense edema begins to develop on the lower abdominal region or the reproductive organs, they may find that they are unable to urinate and that the blood from the menstrual cycle does not flow properly. Painful cramps and massive blood clotting during the menstrual cycle can be also developed.
It has also been observed that most people also suffer from abdominal pain and cramping sensations. In many cases, this could lead to a lack of appetite. Nausea and vomiting can be also present.
Apart from that, you will also find it hard resting at night. This is often caused because of the pain and bloating experience. In other instances, it could be a result of breathing problems. This often leads to nighttime insomnia and daytime fatigue.
Similarly, you are also likely to suffer anemia. This is because of the red blood cell or a hemoglobin deficiency within the blood
There are some other cases where you may experience:
- Exaggerated leg edema when the patient is standing up.
- Periorbital edema or swelling around the eyes especially in the morning
In the event that one of the testicles swollen compared to the other, the pull of gravity results in increased pain and discomfort, particularly when standing. The normal scrotum is anatomically on the front side, while the edematous scrotum swells between the upper legs to the hind side. The scrotum is now an obstacle to movement from one place to another, thereby changing the patient’s normal posture and pattern.
There are quite a number of causes of the edema in the testicles. They may include the following:
This leads to an increased hypertension in the vein called the portal vein. In the long run, there is vasodilation of the nerves that supply internal organs called the splanchnic nerves. (Hou & Sanyal, 2009). The result of this is decrease in blood volume circulating within the body.
Lower volume of blood in circulation prompts the kidneys to retain sodium and water. Thus, excess hepatic lymph (lymph in the heart) enters the serous membrane that lines the cavities of the abdomen and the abdominal organs called the peritoneum.
- Kidney failure
Apart from that, failure of the kidneys to filter the blood can also affect overall body fluid levels and result in accumulation of fluid in the abdominal cavity (ascites). As pressure builds in the ascitic abdomen, fluid channels into other parts of the body. With the effects of gravity, the lower extremities begin to retain fluid, and ascitic fluid fills the dependent scrotum.
- Heart failure
If the circulatory system is not moving fluid throughout the body, edema occurs. The kidneys again begin to retain sodium and water resulting in ascites in the peritoneum. This edema can often spread to the lower extremities. In severe cases of heart disease, anasarca (or generalized edema) can include scrotal edema.
The condition may present with the following symptoms:
- Testicular Lump
- Groin Swelling
- Tender Testes
- Abdominal Pain
- Pain In Testicle
- Groin Pain
- Feels Hot to Touch
- Pain In Urethra
- Painful Ejaculation
- Lower Abdominal Pain
How to relieve scrotal anasarca
Once the causes of scrotal edema have been established, proper treatment methods and techniques are necessary. It might not be easy to overcome but some procedures which can be done at home will be useful in helping you out in this case. The treatment of the underlying cause of the edema should however be prioritized. They may include:
- Elevation technique
In as much as linen can provide a skin barrier, it does not provide the necessary elevation needed to decrease edema. The required amount of elevation is 30 cm above the level of the heart to affect skin microcirculation, and thereby, reduce swelling (Abu-Own, Scurr, & Smith, 1994). Placing a rolled towel or sheet under the scrotum positions it more anteriorly (front side) in its proper normal position.
There are some compression devices that can be used successfully to decrease edema in other body parts (Hirai et al., 2006). According to some research and study, it was found that venous leg ulcers healed more rapidly in an edematous limb with compression (Escaleira, Cardoso, Rego, Macedo, & Midoes, 2010; O’Meara, Cullum, & Nelson, 2009).
Further, Garraffa, Christopher, and Ralph (2008) used compression bandaging and elevation, massage, and antibiotics to prevent inflammation of cells. Later in 2007, there was a designed waist-based pouch system, which provides a varying degree of compression as the scrotal edema resolves.
- Use of scrotal support and sling
The support is made of elastic fabric tube. The fabric is absorbent and this acts to provide a barrier between the fragile skin and the fluid filled scrotum and the groin. In addition, it also provides compression to decrease the scrotal edema. The fabric is provide in different sizes in order to give more or less pressure and greater or lesser skin coverage as required.
The support can be done away with once it is soiled or in despair. The neck strap of the support which is constructed of fabric webbing with suspender clips cam be yet again with disposable support pouches. To determine whether you will use the support or the sling or both, depends on how advanced the condition is.
If you are bed ridden, then the support alone would be sufficient. If you are critically ill, thee scrota; support can be especially in preventing fragile skin shear when you are moved about especially for cleaning purposes.
If you have abdominal distention due to ascites, abdominal wounds or increased abdominal volume, you are likely to have discomfort. From a clinical point of view, it therefore suggested that the straps would be very useful in this regard.
- Avoid compression
There are reasons why this should be so. First, the delicate skin is likely to break down and in the long run lead to necrosis if that is done. Similarly, there is the risk of hypo-perfusion of the testicles if compression is done.
Before treatment is undertaken, there is need for a proper diagnosis. Your doctor will carry out a number of blood tests and other tests to pin point the cause. After that, there will be guidance on the treatment plan. Prescription and non-prescription drugs like pills and steroids may be given. More, anasarca can be treated generally as follows:
- It is wise to first of all limit or reduce the amount of salt that you take. This is because it is made of the components sodium and chloride. In real sense, sodium always draws water wherever it flows to. Therefore, more salt means more sodium and more water drawn and hence more retention.
- You are also required to have adequate rest in bed for better recovery especially if the cause of anasarca is congestive heart failure or liver cirrhosis.
- If you have the swelling on your lower extremities, then you should lie down flat on your back and then elevate your legs and feet against the wall.
- Your doctor may prescribe diuretics. They are most commonly prescribed to reduce anasarca swelling especially if pulmonary edema, congestive heart failure or excessive sodium intake is recognized. They are of two types; loop diuretics and potassium sparing diuretics.
Combination of loop diuretics with Potassium-sparing diuretics is the common therapy for best outcomes. When you achieve proper weight, you should reduce the dose. Weight loss with diuretics should not be excess, and should only be 1-1.5 kg/day.
- Hemodialysis is also recommended. This becomes very important in kidney and liver failure cases. It is used in order to get rid of the excessive interstitial fluid.
- For malnourished patients, sufficient food and fluid intake are needed to cure anasarca. Doctors will in most cases prescribe strict high calorie, fiber and protein diets to facilitate proper nourishment. Nutrient shots could even be administered in order to get the minerals in your system within a short time.
- Thyroid hormone replacement therapy: this is very important if you have an overactive thyroid problem.
- If the anasarca is caused by second or third degree burns, then you will have to take large amounts of fluids to stay hydrated.
- Your doctor will always recommend for you the drugs and if there is one that induces edema, then your doctor will discontinue it
It is very important that the underlying condition is found out and treated immediately. Any neglect could lead to complications and even death. In case you have heart failure, then taking the medicines is not a choice. The intake should be adhered to without fail.
There are also some remedies that you can choose to use while at home. They have been used and proven to be useful to some extent. Their use however should be under the supervision of a qualified reproductive health specialist. They may include the following:
- Alfalfa plant: contains chlorophyll which is a potent detoxifier. It is recommended that you take 2,000 to 3,000 mg per day.
- Consider hawthorn berries, juniper, uva ursi and horsetails. They are natural diuretics and may increase the urine output
- Dandelion leaf and Gingko are also ideal. They enhance circulation and improve blood flow to your body.
- If you encounter or experience post-surgical edema, you should take horse chestnut, as it may reduce the problem
- If you have heart failure, then you should limit fluid intake. Excessive fluid intake can promote edema and may also cause breathing difficulties.
- It is also important to avoid taking of alcohol, animal proteins, beefs, chocolates and some dairy products that may slow reduction of edema or even promote it
- Rose hips. They are rich with bioflavonoids thus it might be helpful for edema treatment
- Salt intake should be lessened because it increased the incidence of water retention in the body.
- Since loop and thiazide diuretics will excrete potassium, except the potassium-sparing diuretics such as spironolactone or triamterene, you should take foods rich in potassium. They include bananas, orange juice, potatoes, and tomatoes.
- Undertaking mild exercise and saunas may be helpful, since sweating can lessen edema
- Wearing support hose for pitting edema is also recommendable
- When resting at home, always ensure that you keep your feet elevated. This is increases what is known as venous return to the heart and then give you relief from edema.
- You should also consume proteins that may help edema. They include: eggs, skinless chicken or turkey, broiled white fish, cottage cheese, low-fat yogurt and kefir
- Your diet should have a lot of fiber.
References and Sources