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Pitting vs Non Pitting Edema

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Pitting vs non-pitting edema - what is the difference?

Medication, pregnancy, or an underlying heart, liver or kidney disease can be the cause of swelling known as edema. This swelling is excess fluid that has accumulated in tissues.

Edema can occur nearly anywhere in the body, including the brain and the eyes. But it is most evident in the feet, legs, ankles, and arms. Physicians describe two types of edema - “pitting” and “non-pitting” edema. Let’s learn the differences.

Diagnosing Edema

To understand what might be causing your edema, your doctor will perform a physical exam and ask about your medical history.

This information is often enough to determine the underlying cause of edema. However, some patients need X-rays, blood tests or urine analysis, ultrasound exams, or magnetic resonance imaging (MRI) to determine the cause.

Pitting Edema

Any form of pressure can indicate pitting edema, including elastic in socks or tight clothing. Doctors identify pitting edema by applying pressure to the swollen area - simply depressing the skin with a finger. If this causes an indentation that stays for some time after the release of the pressure, this type of edema is referred to as pitting edema.

The indentation made on the skin is due to the fluid leaking out of the capillaries into the subcutaneous tissue. The extent and duration of the indentation are good indications of the severity of the pitting edema.

Assessment of Pitting Edema

The four grades of pitting edema
Grade 1+ Edema: Pit of 2 mm or less. Slight pitting with no distortion. Pitting disappears immediately.
Grade 2+ Edema: Deeper pit measuring between 2 mm and 4 mm. No easily discernible distortion and the pitting disappears in 10 to 15 seconds.
Grade 3+ Edema: Noticeably deep pit measuring between 4 mm and 6 mm. The area looks distinctly fuller and swollen. The indentation will take as long as 1 minute before it disappears.
Grade 4+ Edema: Very deep pit lasting between 2 to 5 minutes before it disappears. Indentation will measure 6 to 8 mm in depth and the affected area will look distorted.

Understanding Pitting Edema

Conditions involving the heart, liver, and kidneys are critical causes of pitting edema.

Patients who receive intravenous fluids can also develop edema. Systemic diseases like rheumatoid arthritis often cause pitting edema, as they affect the various organ systems of the body. An isolated condition that involves an extremity (like a twisted ankle) can also cause pitting edema.

Diagnosing Non-Pitting Edema

With this type of edema, pressure on the affected area does not persist. This type of edema is more complex than pitting edema, as the process involves more than fluids simply filling up interstitial spaces. Doctors believe that the fluid is less sensitive to touch due to some internal pressure affecting the swollen area - that it’s “pushing back”.

Understanding Non-Pitting Edema

Non-pitting edema is often associated with three medical conditions - myxedema, lipedema, and lymphedema.

In myxedema (a condition involving underactive thyroid gland), the tissues are gradually filled with water-loving hyaluronan molecules which attract fluid to the tissues. These molecules absorb water and swell up to cause the edema. This creates pressure (osmotic pressure) that acts against the external pressure caused by touch. The osmotic pressure would make the affected area appear taut.

Non-pitting edema of the legs is known as pretibial myxedema, which involves swelling of the skin that occurs in patients with hyperthyroidism.

A similar mechanism is involved in lipedema and lymphedema, conditions in which the lymphatic system breaks down and the lymph nodes swell up. Lymphedema may be a congenital disorder (present at birth) or can occur after mastectomy or lymph node surgery. The osmotic pressure generated by the swollen lymph nodes may be responsible for the constant internal pressure pushing the fluids against the skin. This occurs even when pressure is applied to the affected area.

Non-pitting edema usually affects the legs or arms. If the pressure applied to the skin does not result in a persistent indentation, this type of edema is referred to as non-pitting edema.

Pitting and Non-Pitting Edema Are Treatable

Sometimes pitting edema and non-pitting edema occur without any underlying disease and this is known as idiopathic edema. This is common in women who experience it in legs and feet, during their pre-menstrual or pre-menopausal period.

You don't have to live with edema of any kind forever. Treatment of edema depends on the causes of edema and whether it is temporary or permanent.

To treat either type of edema, doctors will first determine the cause and whether it is temporary or permanent. Initial treatment will focus on that medical condition.

3 Ways to Reduce Edema
Follow a healthy diet and avoid excess sodium. Eat plenty of fruits and vegetables, and very little fast food or packaged food (like chips).
Take prescribed diuretics and get regular exercise as prescribed by your doctor to help
reduce pitting edema.

Losing excess weight will boost your health and reduce your edema symptoms.


Losing excess weight will boost your health and reduce your edema symptoms.

Supplements designed to make your veins stronger will help prevent fluid from pooling in your extremities.

You may also consider taking a natural fluid retention remedy such as Capisette to treat edema.

It contains herbs such as horse chestnut, gingko biloba, and buchu extracts which are known to be effective in reducing water retention.

Don’t Ignore Edema

We think of salt as the biggest culprit for swelling and fluid retention, but the truth is, there are hundreds of reasons why the body retains water. Some reasons are life-threatening, and others are simply the result of an unhealthy body.

In any case, edema is a warning sign that something is not right in the body. Never ignore edema and assume it will go away on its own. In many cases, edema is a symptom of something more serious going on in the body. Living a healthy lifestyle, eating vein-strengthening supplements, and keeping the right balance of electrolytes in the body are some of the most effective ways to prevent edema and many of the health problems that cause the swelling in the first place.

Next Article: Edema Diet: Foods to Avoid for Edema