If you've ever spent anafternoonon the couch with the TV and a bag of salted chips, orgone to bed with a belly full ofTeochew porridge and its accoutrements of salted eggs, fish,vegetables and cured meats, youre probably familiar with the feeling.

You wake up the next morning feelingpuffed up and heavier than usual. Yourring feels like it's strangling your finger. Instead of ankles, you now have cankles. And when you presson theswollen areas for a few seconds, you get weird temporary dimples. In other words, you could very well stand in for the Michelin Man.

Thats water retention or edema in action.

WATER RETENTION CAUSE #1: SALT

The most common cause for edemais eating too much sodium-loaded food. This upsets your body's sodium-to-water balance,which it needs to function. As a result, your body produces an anti-diuretic hormone (ADH) that nudges thekidneys to hold on to water if the water content in our blood is lower than usual, saidAssociate Professor Chionh Chang Yin, the chief of Changi General Hospitals Department Of Renal Medicine.

Once you have drunk adequate fluids and the water content in the blood is restored, your body stops secreting ADH, he said. In that sense, it doesn't really help for you to drink less water to minimise edema.

But edema isnt just about your bodyholding on to insufficient fluids. It also has something to do with how fluids are diverted and pooled incertain parts of the body, which leads us to the next point below.

WATER RETENTION CAUSE #2: GRAVITY

If youve been standing a lotand have swollen ankles or legs, thats gravity's effect on your body'sfluids.It reflects a shift of water between physical compartments within the body, and in this case, it is related to gravity, said Dr Chionh.

The increased volume of bloodin your legs and feet raisesthe pressure inside the blood vessels.The excess fluid in the blood vessels then leaks out into the tissue in the legs, causing them to swell. This may explain theswelling in the lower legs some runners experience after running.

And its not just water. Edema may be a result of more blood flowing down to the legs than the blood flowing up from it, said Dr Ian Phoon, who heads the Cardiovascular Diseases Workgroup at SingHealth Polyclinics.

WATER RETENTION CAUSE #3: HORMONES (FOR WOMEN)

For women, edema could sometimes be part of the dreadedpremenstrual syndrome or PMS.Some women may observe a gain of 1kg to 2kg, which is gradually lost once menstruation begins. Such rapid changein weight is likely due to the change of the water retention status, said Dr Phoon.

But he added that you cant always blame edema for the bloated feeling as it could also "be a feeling of gas in the stomach or a feeling of indigestion.

About 5 litres of water is in the blood vessels, while the rest are in the cells, organs, and tissues of the body.

Your body doesn't produce more fluids when you have edema; instead, itstoresand channelsfluids. But pregnancy is a time when yourbody actually produces fluids about 50 per centmore bloodand body fluids,according to the American Pregnancy Association.

Theextra fluid is needed to soften the body andenableit to expand as the baby develops. "Extra fluid also helpsprepare the pelvic joints and tissues to open for delivery. The extra fluids account for approximately 25 per centof the weightwomen gain during pregnancy," noted its website.

WATER RETENTION CAUSE #4: CERTAIN MEDICINES

Certain medicines can cause edema as a side effect. The Mayo Clinic website lists, among others: High blood pressure medicines, nonsteroidal anti-inflammatory medicines, steroids, oestrogens and certain diabetes medicines known as thiazolidinediones.

HOW TO SOLVE EDEMA?

It should be as easy as holding back on those chips and going to the toilet more, right? Unfortunately, the science isnt likethat. For starters, your body is made of a lot of water.

About 60 per cent of your body consists of water, said Dr Phoon. About 5 litres of wateris in the blood vessels, while the rest are in the cells, organs, and tissues of the body.

And while this percentage can be lower in those who are obese and slightly lower in women than in men, he said, it doesnt change much no matter how much water you drink or dont.

But relieving edema is actually quite simple: By elevating one's legs (and reversing the effects of gravity), or wearing compression stockings during prolonged standing, said Dr Phoon. Moving the muscles of the affected limbs also helps to pump the excess fluids away.

BUT TAKE NOTE OF MORE SERIOUS WATER RETENTION ISSUES

However, persistent or severe edema warrants a consultation with a doctor, said Dr Phoon, as there are many possible causes, including serious underlying medical conditions such as heart failure or kidney damage.

Meanwhile, Dr Chionh advised that if a swelling in the leg or body is accompanied by other symptoms such asmarkedly frothy urine, breathlessness or reduced tolerance of physical activity, it may suggest edema related to an underlying medical condition.

Read this article:
What are the causes of water retention and how do you solve it - CNA

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