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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Bilat Pitting Edema Without Pain. On Nexium, Fioricet, Imitrex, Naproxen. Suggestions?

Hello, I have been having bilat pitting edema w/pain going from my calves to my ankles. It is made worse by prolonged sitting, standing and walking. Putting them up does help to anextent but it just comes back. I have a history of anemia and also have back pain. I an currently on nexium, (topomax, fioricet, imitrex for migraines), wellbutrin and I take ultram and naproxen for back pain. I also have a spinal column stimulator implant but I do not think that is affecting this issue. I am 5ft o in and weigh 175. I am active and have no health issues, blood pressure is 120/74. My doctor put me on lasix and potassium pills which has helped but i am still having pain in my legs. I am going to stop the lasix to see if the edema returns which I think it will. So far he has not run any tests to find out what the cause could be, your help is appreciated.
Mon, 26 Aug 2013
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Anesthesiologist,  's  Response
Hello,
Welcome to Healthcaremagic.
I had gone through your query and understand your concerns.

First we have to identify the cause for your Bilateral pitting pedal edema ( edema in both of your legs).
There are many causes for Bilateral pitting pedal edema.
As you have anemia, if it is a severe or long standing anemia may be the cause for your Pedal edema. If you are my patient, i will first identify the cause for anemia and begin treatment for that.
If you pedal edema is responding, then i will prescribe either oral or IV or IM iron injections.
If not responding, i will examine you and do further investigations.
Some other common causes are Congestive heart failure, cirrhosis of liver, renal failure ( nephrotic syndrome), Hypothyroidism.
About your current medication, none of the drugs can cause such profound bilateral pedal edema.
Thus you have to do following investigations.
Complete blood count,
Total protein, Albumin: globulin ratio,
other liver function tests,
Blood urea and serum creatinine
Urinalysis,
Abdominal ultrasound,
Ecg and Echocardiography,
Tsh, T4, T3.
Stool for ova and cysts.

Based on the finding from investigation, i will start treatment for the cause.

Hope this Helps. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards,
Dr.Manjeth.


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Have Bilat Pitting Edema Without Pain. On Nexium, Fioricet, Imitrex, Naproxen. Suggestions?

Hello, Welcome to Healthcaremagic. I had gone through your query and understand your concerns. First we have to identify the cause for your Bilateral pitting pedal edema ( edema in both of your legs). There are many causes for Bilateral pitting pedal edema. As you have anemia, if it is a severe or long standing anemia may be the cause for your Pedal edema. If you are my patient, i will first identify the cause for anemia and begin treatment for that. If you pedal edema is responding, then i will prescribe either oral or IV or IM iron injections. If not responding, i will examine you and do further investigations. Some other common causes are Congestive heart failure, cirrhosis of liver, renal failure ( nephrotic syndrome), Hypothyroidism. About your current medication, none of the drugs can cause such profound bilateral pedal edema. Thus you have to do following investigations. Complete blood count, Total protein, Albumin: globulin ratio, other liver function tests, Blood urea and serum creatinine Urinalysis, Abdominal ultrasound, Ecg and Echocardiography, Tsh, T4, T3. Stool for ova and cysts. Based on the finding from investigation, i will start treatment for the cause. Hope this Helps. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Regards, Dr.Manjeth.