What is causing the swelling in my feet?

Dr I am a 41-year-old who consumes alcohol almost every night. Recently, I have noticed that whenever I drink, my feet, especially the left one, swell. I was told alcohol causes damage to the liver leading to leg oedema, so I got a general lab check-up and my liver, kidneys, heart, prostrate, blood sugar, blood count and pancreas were all okay. I still do not know exactly what is causing the swelling in my feet.  Akora Mark

Dear Mark

Painless swelling of the feet and ankles called pedal oedema is a common problem, resulting from an abnormal build-up of fluid in the ankles, feet, and legs.

Older people are much more prone to pedal oedema since they are more likely to have heart, liver and kidney disease conditions that commonly cause pedal oedema. That said, much as excessive drinking too much alcohol can lead to alcoholic liver disease which may manifest with pedal oedema, it is likely that alcohol is the direct cause of your swollen feet given that tests on your liver were normal.

Alcohol can cause the brain to produce less anti diuretic hormone which tells the kidneys to produce less urine, resulting in passing lots of dilute urine with minimal salt.

Here retention of salt and dehydration may lead to thirst which upon being quenched may lead to temporary pedal oedema. If one drinks on a hot day, or sits cross-legged while drinking, the swelling related to alcohol drinking is more likely.

This kind of swelling is temporary going off in a day or two and if not, other causes of pedal oedema like liver, heart, or kidney diseases together with obesity, anaemia, blood clots in the legs, or even varicose veins should be checked out.

Avoiding drinking alcohol if you can and if not, increasing water intake during or after drinking, reducing salt intake, elevating feet on a pillow while lying down, exercising the legs during the drinking bouts, wearing support stockings, avoiding wearing tight clothing or garters and if overweight, losing weight among others can help manage pedal oedema related to drinking.