Alcohol and Edema

Alcohol, in the form of beer, wine, or hard liquor, may cause water retention in the hands and feet. The fluid tends to accumulate in the hands and feet because it travels downwards.  

If you experience swelling in your feet after drinking alcoholic beverages, consult with your health care provider immediately as it may be a symptom of liver damage.

Initially, alcohol acts as a diuretic, which can cause dehydration. The salty snack that you might consume while drinking alcohol may also contribute to swelling in the hands. Long-term alcohol drinking may cause severe and dangerous fluid retention in the abdomen, known as ascites. 

What’s The Connection? 

When alcohol builds up in your bloodstream, it restrains the release of a hormone known as an anti-diuretic hormone or ADH. This ADH, also known as vasopressin, concentrates the urine. In the absence of the anti-diuretic hormone, the kidneys excrete dilute urine which doesn't contain electrolytes like sodium. 

As the alcohol level drops, your body starts to accumulate fluid once again. The water is eliminated by your kidneys when your alcohol level was high did not contain sodium, so the level of sodium in the body increases. 

This process creates an imbalance in the ratio of sodium to the fluid inside the body. Since sodium is known to retain fluid, this leads to edema. 

Results of Excessive Alcohol Consumption

According to the Centers for Disease Control (CDC), excess alcohol consumption is defined as more than two drinks daily for men; and more than one drink a day for women. 

A 2007 study from the Department of Internal Medicine, showed that alcohol consumption is associated with distinctive skin changes and aggravation of dermatological disorders, including a swollen face. 

If you drink excessively, you might develop a much more severe type of fluid retention, known as ascites. This condition is caused by cirrhosis of the liver. 

While the ascitic fluid usually develops in the abdomen, it may also cause swelling in the legs and feet. Swelling in the hands may also develop from dehydration in constant alcohol use. 

If you have a swollen abdomen in addition to swollen hands and you consume alcohol, see your healthcare practitioner immediately for a liver assessment. 

Nephritis

Long-term alcohol consumption can damage the nephrons of the kidney. Nephritis is the most harmful side effect of alcohol consumption on the kidney. It involves the inflammation of the nephrons.

Nephritis can present in two ways: glomerulonephritis and interstitial nephritis.

Glomerulonephritis is the more common of the two types of nephritis. It is the inflammation of the glomeruli (the glomeruli are the functional units of the nephrons). 

Interstitial nephritis is the inflammation of the epithelial spaces between the tubules of the kidney.

When nephritis occurs, the structure and the function of the glomeruli are affected. This leads to the development of several conditions including oliguria (reduced urine production), uremia (retention of byproducts that should have been filtered and excreted along with urine), hematuria (the appearance of blood in the urine), edema, and hypertension.

When the nephrons are inflamed, blood circulation to the glomeruli is reduced and so the glomerular filtration rate (GFR) drops sharply. This means that the kidneys are no longer functioning properly as the clearinghouse of the body.

Therefore, what should have been removed from the body such as water (as urine) is retained. This leads to edema. Also, red blood cells leak out of the swollen glomeruli and are excreted in the low volumes of urine produced.

Furthermore, because blood flow to the kidneys is now reduced, the renin-angiotensin system is blindly activated. This system secretes aldosterone and causes even greater fluid retention to compound the edema associated with nephritis.

Because proteins are no longer reabsorbed in the kidneys, they are excreted from the body. Therefore, the ones responsible for keeping the blood from clotting are also lost.

This means that the edema and hypertension immediately caused by nephritis are so severe because high blood pressure is now also coupled with a high risk for the blood to clot. Because of this chain reaction, stroke is a common occurrence in alcoholics with nephritis and edema.

Alcoholic Liver Disease

Alcoholic liver disease is a disease complex including alcoholic hepatitis, hepatic fibrosis, and liver cirrhosis. It is caused by regular heavy drinking since 80% of the alcohol consumed passes through the liver to be detoxified.

The chain reaction leading from alcoholic liver disease to edema starts with the weakening and narrowing of the blood vessels feeding the liver. When these become narrow, they trigger a form of hypertension called portal hypertension.

This causes massive bleeding and the formation of enlarged, varicose veins to bypass the clogged route to the liver. Soon these veins also rupture and lead to fluid buildup in the legs and abdomen.

The fluid building up in the abdomen pushes against the diaphragm, makes breathing difficult, and may even cause pleural effusion.

Brain Edema

Binge alcohol intoxication can also cause overhydration of the brain. This is called brain edema and sometimes also referred to as cerebral edema. It is a dangerous form of edema which can cause neurological damage and quickly progress to loss of consciousness and death.

Treatment for Edema

Though it may seem illogical to drink more water when you have edema, this will help flush out the toxins and excess fluid. However, remember to only drink fluids that are low in sodium, such as plain water. 

Put the salt shaker away and keep away from processed foods high in sodium until you get the swelling in your hands, legs, and ankles, back to normal. 

Some people may have a greater propensity than others to retain fluid while drinking alcohol. Women tend to retain fluid more easily than men. Eating salty snacks while drinking alcohol might raise your sodium intake, and increase your tendency to develop edema. 

Most of the damage caused by long-term alcohol intoxication is permanent. Diuretics are not always effective for this kind of edema since the underlying conditions (kidney and liver damage) are still present.

However, furosemide is often used to treat brain edema partly because it also has an antioxidant property.

The liver is, however, more forgiving than the kidneys. It can still regenerate and function as long as it is not completely damaged. There have been cases where the liver was returned to optimal functioning even after 75% of its cells are dead.

However, the first step in treating edema caused by alcoholism is to overcome the addiction and treat the swelling with diuretics. Then the liver and kidneys can be nursed back to health with a healthy diet, antioxidants, and drugs that protect these organs. 

If your hands remain swollen for more than a day after drinking alcohol, consult your doctor immediately. Your doctor may prescribe some over the counter diuretics to reduce the swelling. You may also consider taking a natural fluid retention remedy such as Capisette to treat edema.