MASSAGE THERAPY

EDEMA is the medical term for swelling. It is a general response of the body to injury or
inflammation. Edema can be isolated to a small area or affect the entire body. Medications,
infections, pregnancy, and many medical problems can cause edema.
Edema results whenever small blood vessels become "leaky" and release fluid into nearby
tissues. The extra fluid accumulates, causing the tissue to swell.

Causes of Edema
Edema is a normal response of the body to inflammation or injury. For example, a twisted ankle,
a bee sting, or a skin infection will all result in edema in the involved area. In some cases, such
as in an infection, this may be beneficial. Increased fluid from the blood vessels allows more
infection-fighting white blood cells to enter the affected area.
Edema can also result from medical conditions or problems in the balance of substances
normally present in blood. Some of the causes of edema include:
Low albumin (hypoalbuminemia): Albumin and other proteins in the blood act like sponges to
keep fluid in the blood vessels. Low albumin may contribute to edema, but isn't usually the sole
cause.
Allergic reactions: Edema is a usual component of most allergic reactions. In response to the
allergic exposure, the body allows nearby blood vessels to leak fluid into the affected area.
Obstruction of flow: If the drainage of fluid from a body part is blocked, fluid can back up. A
blood clot in the deep veins of the leg can result in leg edema. A tumor blocking lymph or blood
flow will cause edema in the affected area.
Critical illness: Burns, life-threatening infections, or other critical illnesses can cause a wholebody reaction that allows fluid to leak into tissues almost everywhere. Widespread edema
throughout the body can result.
Edema and heart disease (congestive heart failure): When the heart weakens and pumps
blood less effectively, fluid can slowly build up, creating leg edema. If fluid buildup occurs
rapidly, fluid in the lungs (pulmonary edema) can develop. If there is heart failure of the right
side of the heart, oftentimes edema can develop in the abdomen, as well.
Edema and liver disease: Severe liver disease (cirrhosis) results in an increase in fluid retention.
Cirrhosis also leads to low levels of albumin and other proteins in the blood. Fluid leaks into the
abdomen (called ascites), and can also produce leg edema.

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MASSAGE THERAPY

Edema and kidney disease: A kidney condition called nephrotic syndrome can result in severe
leg edema, and sometimes whole-body edema (anasarca).
Edema and pregnancy: Due to an increase in blood volume during pregnancy and pressure
from the growing womb, mild leg edema is common during pregnancy. However, serious
complications of pregnancy such as deep vein thrombosis and preeclampsia can also cause
edema.
Cerebral edema (brain edema): Swelling in the brain can be caused by head trauma, low blood
sodium (hyponatremia), high altitude, brain tumors, or an obstruction to fluid drainage
(hydrocephalus).Headaches, confusion, and unconsciousness or coma can be symptoms of
cerebral edema.
Medications and edema: Numerous medications can cause edema, including:

NSAIDs (ibuprofen, naproxen)

Calcium channel blockers
Corticosteroids (prednisone, methylprednisolone)
Pioglitazone and rosiglitazone
Pramiprexole
Most commonly, these medications produce no edema, or mild leg edema.

Symptoms of Edema
Edema symptoms depend on the amount of edema and the body part affected.
Edema in a small area from an infection or inflammation (such as a mosquito bite) may cause no
symptoms at all. On the other hand, a large local allergic reaction (such as from a bee sting) may
cause edema affecting the entire arm. Here, tense skin, pain, and limited movement can be
symptoms of edema.
Food allergies may cause tongue or throat edema, which can be life-threatening if it interferes
with breathing.
Leg edema of any cause can cause the legs to feel heavy and interfere with walking. In edema
and heart disease, for example, the legs may easily weigh an extra 5 or 10 pounds each. Severe
leg edema can interfere with blood flow, leading to ulcers on the skin.
Pulmonary edema causes shortness of breath, which can be accompanied by low oxygen levels
in the blood. Some people with pulmonary edema may experience a cough with frothy sputum.

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MASSAGE THERAPY

Treatment of Edema
Treatment of edema often means treating the underlying cause of edema. For example, allergic
reactions causing edema may be treated with antihistamines and corticosteroids.
Edema resulting from a blockage in fluid drainage can sometimes be treated by eliminating the
obstruction:

A blood clot in the leg is treated with blood thinners, and the clot slowly breaks down; leg
edema then resolves as fluid drainage improves.
A tumor obstructing a blood vessel or lymph flow can sometimes be reduced in size or
removed with surgery, chemotherapy, or radiation.
Leg edema related to congestive heart failure or liver disease can be treated with a diuretic
(''water pill'') like furosemide (Lasix). When urine output increases, more fluid drains from the
legs back into the blood. Maintaining a sodium-restricted diet will also help limit fluid retention
associated with heart failure or liver disease.

LIEZEL G. MERCADO

MASSAGE THERAPY

INFLAMMATION OF OVARIES
Pelvic inflammatory disease (PID) is a condition where your reproductive organs become
inflamed. Your reproductive organs include your ovaries, fallopian tubes, uterus, cervix (lower
area of your uterus), and vagina. PID may cause chronic (long-term) abdominal pain and
problems with future pregnancies.
The ovaries are an important part of the female reproductive system. Their job is twofold. They
produce the hormones, including estrogen, that trigger menstruation. They also release one egg
each month for possible fertilization.
A number of different conditions, from cysts to tumors, can cause ovarian pain. The ovaries are
located in the lower abdomen. That means if you have ovarian pain, you'll most likely feel it in
your lower abdomen -- below your belly button -- and pelvis. It's important to have any pelvic
pain checked out by your regular doctor or obstetrician/gynecologist. Several different conditions
can cause it.
Pain in the ovaries can either be acute or chronic. Acute ovarian pain comes on quickly (over a
few minutes or days) and goes away in a short period of time. Chronic ovarian pain usually starts
more gradually. Then it last for several months.
Ovarian pain may be continuous. Or it may come and go. It may get worse with certain activities,
such as exercise or urination. It can be so mild that you don't notice it. Or pain in the ovaries can
be so severe that it interferes with daily life.

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MASSAGE THERAPY

The methods your doctor uses to diagnose ovarian pain will vary. They will be based on what the
suspected cause might be. Regardless, your doctor will take a complete medical history, do a
physical exam, and ask questions about your pain. The questions might include:

Ovarian Cysts
Cysts are fluid-filled sacs that can form in the ovaries. They are very common in women,
especially during the childbearing years. Often they form during the process of ovulation. It can
happen when the egg is not released or when the sac -- follicle -- holding the egg doesn't dissolve
after the egg is released. Ovarian cysts usually cause no symptoms and dissolve on their own.
They can, though, create a dull ache or a sharp pain if one twists or ruptures.
Other symptoms of ovarian cysts:

Irregular menstrual periods

Pain during intercourse or bowel movements
Nausea or vomiting
Feeling full after eating a small amount
Bloating
How ovarian cysts are diagnosed

Pelvic exam. This exam may reveal a lump in the pelvic area.
Ultrasound. This scan uses sound waves to create an image of the ovaries. This helps the
doctor determine the size and location of acyst.
Treatment of ovarian cysts

Watchful waiting. Most ovarian cysts will go away on their own. If you don't have any

bothersome symptoms, especially if you haven't yet gone through menopause, your doctor may
advocate "watchful waiting." The doctor won't treat you. Instead, the doctor might check you
periodically to see if there has been any change in your condition.
Laparoscopy. This is a form of surgery that uses small incisions and a tiny, lighted

camera on the end of a plastic tube that's inserted into the abdomen. A surgeon can use tools on
the end of the tube to remove some cysts. This technique works for smaller cysts. Larger cysts,
though, may need to be removed through a bigger incision in the abdomen. This is done with a
technique called laparotomy.
Birth control pills.Birth control pills may relieve the pain from ovarian cysts. They
prevent ovulation. That, in turn, reduces the formation of new cysts.

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MASSAGE THERAPY

Ovarian Tumors
Tumors can form in the ovaries, just as they form in other parts of the body. They can be either
noncancerous (benign) or cancerous (malignant).
Other symptoms of ovarian tumors

Bloating or pressure in the abdomen

Urgent need to urinate
Indigestion
Diarrhea or constipation
Loss of appetite
Unintentional weight loss or gain
How ovarian tumors are diagnosed

Computed tomography (CT), magnetic resonance imaging (MRI), andpositron emission

tomography (PET). These are detailed imaging scans that the doctor can use to find ovarian
tumors. They allow the doctor to determine whether and how far the ovarian tumors have spread.
CA-125. This is a blood test to look for a protein that tends to be higher in some (but not
all) women with ovarian cancer. CA-125 isn't effective as a screening test for ovarian cancer. But
it can be checked in women with symptoms that might be caused by ovarian cancer.
Treatment of ovarian tumors

Laparotomy. This is surgery performed through an incision into the abdomen. The

surgeon will remove as much of the tumor as possible. The removal of tumor tissue is
called debulking. If the tumor is cancerous and has spread, the surgeon may also remove the
ovaries, uterus, fallopian tubes, omentum (fatty tissue covering the intestines), and nearby lymph
nodes.
Chemotherapy. Chemotherapy involves drugs given through a vein (IV), by mouth, or

directly into the abdomen. The drugs kill cancer cells. Because they kill normal cells as well,
chemotherapy medications can have side effects. These can include nausea and vomiting, hair
loss, kidney damage, and increased risk of infection. These side effects should go away after the
treatment is stopped.
Radiation. This treatment uses high-energy X-rays to kill or shrink cancer cells.
Radiation is either delivered from outside the body, or placed inside the body near the site of the
tumor. This treatment also can cause side effects. These can include inflamed skin, nausea,
diarrhea, and fatigue. Radiation is not often used to treat ovarian cancer.

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MASSAGE THERAPY

Ovarian Pain Caused by Endometriosis

Every month, the lining of the uterus builds up in preparation to nourish a growing fetus. When
an egg is not fertilized, that lining sheds and is released from the body via menstruation. In some
women, tissue like the lining of the uterus develops elsewhere in the body. This tissue swells and
bleeds each month. It has nowhere to shed, though, and so it forms scar tissue and can be very
painful.
Other symptoms of endometriosis

Painful periods

Pain during intercourse

Heavy menstrual periods
Infertility
How endometriosis is diagnosed

Ultrasound and MRI. These scans create images of the ovaries to help the doctor spot
endometriosis.
Laparoscopy. This procedure uses a thin lighted scope inserted into a tiny hole in the
abdomen to allow the doctor to visualize the ovaries. The doctor may possibly remove a small
sample of tissue for biopsy.
Treatment of endometriosis

Pain medications. Drugs such as ibuprofen (Advil, Motrin) can help relieve some of the

discomfort of endometriosis.
Birth control pills. The pill prevents the monthly buildup of uterine tissue on the ovaries.

This makes periods lighter and reduces the symptoms of endometriosis.

Gonadotropin-releasing hormone agonists (GnRH agonists). These drugs reduce the

amount of the hormone estrogen in the body. By slowing the growth of endometriosis, they limit
its symptoms.
Laparoscopy and laparotomy. These are surgical procedures that let the doctor remove
endometriosis on the ovaries and other places. If the endometriosis is extensive, the doctor may
recommend ahysterectomy. This procedure removes the uterus and sometimes also the ovaries
and fallopian tubes.

Pelvic Inflammatory Disease

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MASSAGE THERAPY

Pelvic inflammatory disease (PID) is an infection in the ovaries, uterus, or fallopian tubes. It is
most often caused by sexually transmitted diseases like gonorrhea orchlamydia. It is one of the
most common causes of pelvic pain in women.
Other symptoms of PID

Pain during intercourse

Fever
Vaginal discharge that may have a smell
Irregular menstrual bleeding
Diarrhea
Vomiting
Fatigue
Difficulty urinating
How PID is diagnosed

Pelvic exam. The exam will enable your doctor to look for any lumps, abnormal

discharge, or tenderness in the pelvis.

Blood and urine tests. These lab tests can help identify the infection. So can cultures of

any discharge seen during a pelvic exam.

Ultrasound. This test creates an image of the pelvic area so the doctor can see if the

reproductive organs are enlarged. The doctor can also see if there is a pocket of infection known
as an abscess.
Laparoscopy. Occasionally this procedure, which uses a thin lighted scope inserted into a
tiny hole in the abdomen, is used to confirm the diagnosis.
Treatment of PID
Antibiotics. These drugs are given by mouth or through an injection. They can kill the bacteria
that are causing PID. If you are taking antibiotics for PID, your sexual partner or partners should
also get treated. There is a high likelihood that your partner has the same sexually transmitted
infection.

Ovarian Remnant Syndrome

Surgery to remove the uterus and ovaries is known as hysterectomy and oophorectomy. A
bilateral salpingo oophorectomy is a procedure in which both fallopian tubes and ovaries are
removed. In rare cases, a small piece of the ovary may accidentally be left behind. The remnant
can grow and develop painful cysts.
Other symptoms of ovarian remnant syndrome
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MASSAGE THERAPY

Pain during intercourse

Difficulty urinating

How ovarian remnant syndrome is diagnosed

Ultrasound, CT, and MRI. These scans create images of the area. They help the doctor locate the
remaining piece of ovary tissue.
Treatment of ovarian remnant syndrome
Laparotomy or laparoscopy. These procedures are done to remove the remaining piece or pieces
of ovary.

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MASSAGE THERAPY

LIEZEL G. MERCADO