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Brawny Edema Diagnosing and Understanding

Edema (also called dropsy) is a medical condition caused by excess interstitial fluid. Brawny edema is a much
more severe type of edema although it has many of the same characteristics as the more common variety.
Because brawny edema can be an indication of one or more very serious underlying medical conditions it is
important to understand how to tell the difference between the two.
If pitting occurs from pressure, this is not brawny edema.

The basic test used to diagnose brawny edema is to test for pitting. By applying pressure to the affected limb
for several seconds (usually with a fingertip), the underlying fluid is displaced and an impression or pit is
formed. The key to telling if edema has progressed to a more severe stage is whether or not a pit forms and
then slowly disappears. Brawny edema is a non-pitting form, which means that this pressure test does not form
a tell-tale indentation. The non-pitting quality is due to fibrotic changes in the subcutaneous tissues as well as
changes to the outer skin layer, too.
Beyond a palpitation test, the physical signs of brawny edema are clearly visible. The skin becomes harder and
thicker and often features a red or dark discoloration along the affected limb. The affected part also displays
significant swelling and may be warm to the touch.
This disorder can affect almost any part of the body. There have been cases of the face, arms, and hands, but
the vast majority of cases are seen in the legs, feet and ankles. This is due to the fact that some of the primary
causes of brawny edema are chronic venous insufficiency, lymphatic obstruction, and renal insufficiency. All of
these conditions may cause the body to retain fluids. Gravity draws these excess fluids to the lower limbs
where they collect and cause swelling. Brawny edema can also develop from untreated edema. For this
reason, any form of edema should be treated as quickly as symptoms appear.
Edema has many causes and just as many treatments. Compression stockings keep fluid from accumulating in
the lower extremities, diuretics may provide relief, and eating less salt and other dietary changes may also be
effective.

nonpitting edema
Type: Term
Definitions:
1. swelling of subcutaneous tissues that cannot be indented easily by compression. Usually due to
metabolic abnormality, such as increased glycosaminoglycan content, like that which occurs
in Graves disease(pretibial myxedema) or in early phase of scleroderma.
Synonyms: brawny edema

Edema refers to accumulation of excess of interstitial fluid resulting in enlargement and swelling of the affected
organ. There are two basic types of edemas, with brawny edema being the more severe form. Brawny edema is
non pitting edema (i.e. the pressure test doesnt form an indentation) and is attributed to fibrotic changes that
take place in the subcutaneous tissue along with the outer layer of the skin.
This condition can affect any part of the body, though in vast majority the brawny edema are observed to affect
the lower extremities. In other cases, edema may be present on the arms and hand and occasionally on the face.

The primary cause for the development of brawny edema is circulatory dysfunction. Some of the causes leading to
circulatory dysfunction include,

Chronic venous insufficiency due to conditions like varicose veins.


Lymphatic obstruction caused due to conditions like Hodgkins lymphoma.
Renal insufficiency caused due to renal conditions like nephritic and nephritic syndrome.

Brawny Edema Symptoms


Typically referred to as dropsy, brawny edema is characterized by swelling of the affected organ due to
accumulation of fluids. The unique feature about brawny edema is the non pitting nature of the edema i.e. the
pressure test is usually negative. Since, brawny edema is a more severe form of the condition, it is important to
be able to differentiate it, from the other forms.

Heres how,

At the affected site, use the thumb to pressure the skin over a bony surface. Ensure that the pressure is even and

press for about 5 10 seconds. Typically one should select the skin overlying the tibia if the edema affects the lower
extremity or the skin over the sacrum in case of lower back or hip.
Release the pressure after 5 to 10 seconds.
In cases of pitting edema, an indentation will be formed, which would usually rebound back to normal shape
within a few seconds. However in case of brawny edema, no indentation is formed, due to fibrotic damage of the
underlying tissue and skin.

Home Remedies For Brawny Edema


The treatment regimen of brawny edema depends upon the underlying cause. However, here are some
important lifestyle and dietary tips that are helpful,

Restrict the intake of salt in your diet. Sodium results in water retention and increases the fluid volume of the

body. Avoid processed and refined foods as most of these foods contain preservatives in the form of sodium.
A protein rich diet is recommended in individuals with brawny edema. Proteins can help improve the osmolarity

of the blood, which in turn prevents the blood from extravagation into the interstitial space. Iron deficiency anemia is
also linked with edema and hence a diet rich in green leafy vegetables, fresh fruits and nuts is important to address to
deficiency of iron in the body.
Keep your lower extremities elevated. Edema affects the lower extremities due to the inability of the blood to drain
against gravity. It is important to raise the lower extremities above the level of the heart to improve circulation.

Simple exercises of the calf muscles (in case of involvement of the lower extremity) or the arms (in case of

involvement of the upper extremity) can help in drainage of venous blood and reduce interstitial edema.
Homeopathic drug Arsenic Alb is also referred to as the homeopathic trocar. It helps in eliminating excess of
water in the body, due to its diuretic effect and reduces edema.

Blood Urea Nitrogen


A blood urea nitrogen (BUN) test measures the amount of nitrogen in your blood that comes from the waste
product urea. Urea is made when protein is broken down in your body. Urea is made in the liver

and passed

out of your body in the urine.


A BUN test is done to see how well your kidneys

are working. If your kidneys are not able to remove urea

from the blood normally, your BUN level rises. Heart failure, dehydration, or a diet high in protein can also
make your BUN level higher. Liver disease or damage can lower your BUN level. A low BUN level can occur
normally in the second or third trimester of pregnancy.

Blood urea nitrogen to creatinine ratio (BUN:creatinine)


A BUN test may be done with a blood creatinine test. The level of creatinine in your blood also tells how well
your kidneys are workinga high creatinine level may mean your kidneys are not working properly. Blood urea
nitrogen (BUN) and creatinine tests can be used together to find the BUN-to-creatinine ratio (BUN:creatinine).
A BUN-to-creatinine ratio can help your doctor check for problems, such as dehydration, that may cause
abnormal BUN and creatinine levels.

Why It Is Done
A blood urea nitrogen (BUN) test is done to:

See if your kidneys are working normally.

See if your kidney disease is getting worse.

See if treatment of your kidney disease is working.

Check for severe dehydration. Dehydration generally causes BUN levels to rise more than creatinine levels. This
causes a high BUN-to-creatinine ratio. Kidney disease or blockage of the flow of urine from your kidney causes both BUN
and creatinine levels to go up.

How To Prepare
Do not eat a lot of meat or other protein in the 24 hours before having a blood urea nitrogen (BUN) test.

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