Peripheral oedema is commonly encountered and is often associated with ageing and venous insufficiency. Typically, as valves in veins start to fail, fluid pools in the lower legs, helped by gravity. Other non-pharmacological causes include heat, trauma, conditions affecting hormone levels (eg pregnancy or menstruation), heart failure, thyroid imbalance, kidney disease or liver failure.^3,5,7

Angioedema describes a rapid swelling, with the most common sites affected being eyelids, lips, tongue, hands, feet, or the genitals. Less commonly affected are the bowel, leading to stomach pain and diarrhoea, or the throat, and can require emergency medical treatment if swelling blocks airways or swallowing.^8,9

Causes can include:^8,10

·     - allergic reaction to foods, medicines (eg penicillin) or other substances, with itching and possibly anaphylaxis;

·     - non-allergic reaction (with no itching) to medication, particularly angiotensin converting enzyme (ACE) inhibitors;

·     - a rare but serious hereditary form, possibly triggered by stress, surgery, pregnancy or oral contraceptives;

·     - lymphoma (cancer affecting the lymph system)

·     - connective tissue disorders eg lupus;

·     - idiopathic (unknown) causes.

‘Lymphoedema’ as a term is being replaced with ‘chronic oedema’, describing oedema irrespective of cause lasting longer than three months. It is typically associated with cancer, diabetes, obesity, reduced mobility or other long-term conditions.^11,12