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むくみとはどういうことをいうのか?むくみとはの疑問に応える基礎知識

夕方になると足がだるくなる、靴がきつくなる、翌朝もむくみが取れない。など、むくみに悩む方は多いと思います。むくみには、一過性の症状と何らかの病気が原因で、慢性的に出る症状があります。

なかなか、むくみの症状が緩和されないという方は、後者の病気が原因かもしれません。むくみ詳しく知るためにも医学的に説明します。

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むくみとは何か?

病気2
出典:慢性的な足のむくみは病気が原因!?足のむくみの原因まとめ
一般的にいう「むくみ」とは、医学用語で「浮腫(ふしゅ)」と呼ばれています。むくみとは、何らかの影響で細胞と細胞の間の水分「組織間液または、間質液」が過剰に増加した状態を言います。全身を流れる血液は動脈を巡り、身体に必要な酸素と栄養素を運び、毛細血管に達すると小さな隙間から染み出てきます。

この染み出た水分を組織間液または、間質液と呼びます。この組織間液は、細胞に栄養を与え、逆に不必要になった老廃物や二酸化炭素を受け取とって、静脈やリンパ管で再び吸収され心臓へと戻ります。

通常は、血管から染み出た水分量と吸収する水分量は同等ですが、何らかの影響で組織間液のバランスが崩れ、組織間液が滞留してしまうと「むくみ」の症状が出ます。特に重力の影響で水分は足に溜まりやすいため、足のむくみ症状は出やすくなります。

病気が原因で起こるむくみとは?

むくみ(浮腫)が起こる病気には様々なものがあります。代表的な病気としては、心臓病、肝臓病、腎臓病、甲状腺機能低下症、足の静脈瘤、栄養障害、リンパ浮腫などです。

心性浮腫(慢性心不全・肺性心)

心臓病では、心不全があるとむくみが起こりやすくなります。心不全の症状があると、心臓から全身へ血液を送り出すポンプの力が弱まっているため、余分な水分(血液)が肺に溜まってしまいます。

このことが原因で、階段や坂道での上り下りで息切れが強くなったり、就寝後1~2時間後に胸の息苦しさや呼吸困難で目が覚めるようになります。肺に溜まった余分は、静脈のうっ血(うっ滞)を起こすために、足を中心とするむくみの症状が出てきます。特に夕方になると症状が強くなります。

腎性浮腫(ネフローゼ症候群・急性糸球体肝炎)・肝性浮腫(肝硬変)

病気3

出典:足のむくみで気になる病気①肝臓と腎臓の障害

腎臓病や肝臓病では、血液中のタンパク質のアルブミンが減少するために起こる、低たんぱく血症が原因でむくみ症状が出てきます。腎臓病では、たんぱく質が尿中に過剰に排出される状態、肝臓病では、たんぱく質合成の低下、この症状により、低たんぱく血症が起こりやすくなります。

血液中のたんぱく質は、水分を血管の中に溜めておく磁石の働きを持っているため、低たんぱく血症になると、磁石の力が低下するために、細胞外へ水分が移動しやすくなり、むくみの症状が出やすくなります。腎臓病では、顔や手足のむくみ、尿が出にくい症状が出てきます。肝臓病では、下肢のむくみ、腹痛、腹水、黄疸、手掌紅斑、意識障害など全身に症状が出るのが特徴です。

内分泌性浮腫(甲状腺機能低下症・クッシング症候群)

甲状腺機能低下症とは、甲状腺ホルモンの分泌が低下してしまう病気です。甲状腺とは、身体の新陳代謝を促すホルモン、甲状腺ホルモンが出るところになるので、新陳代謝が低下すると様々な症状が出てきます。

特に更年期以降の中・高年女性に起こることが多く、この病気を放っておくと、心臓の周りに余分な水分が溜まり、二次的に心不全を起こす場合もあります。甲状腺機能低下症は女性ホルモンが影響しているため、健康的な女性にも起こることが多く、顔や手足、目のまわり、にむくみ症状が出やすく、汗をかかない、寒がる、動悸、息切れ、手の震え、イライラ、疲れやすいといった症状も出てきます。

クッシング症候群は、副腎皮質でつくられる副腎皮質ステロイドモルモンのひとつ、コルチゾールが増えすぎるために起こる病気です。また高血圧、糖尿病、骨粗しょう症、感染症などの病気を引き起こす場合があります。顔がむくんで赤ら顔になる、手足が細くなる、腹部が太るといった症状が出てきます。

静脈性浮腫(静脈瘤・上大静脈症候群)

Painful varicose and spider veins on womans legs
出典:足の甲のむくみを放っておくのは危険かも…!考えられる病気や解消法

静脈瘤とは、足の表にある沢山の表在静脈が拡張し、蛇行屈曲して浮き出た状態のことをいいます。静脈弁の機能不全による一次性の静脈瘤と、生まれつき静脈が拡張している先天性静脈拡張症の二次性静脈瘤があります。

静脈瘤の多くは一次性のものが多く、立ち仕事の多い女性に起こることが多い症状です。また、肥満の方や妊娠中の方に起こる場合もあります。上大静脈症候群は、上大静脈が閉塞または、外部からの圧迫によって狭くなり起こる病気で、静脈血の還流障害を起こしてしまいます。

静脈瘤では、足の静脈の蛇行屈曲、足のだるさ、痛み、むくみといった症状が出てきます。上大静脈症候群では、顔、まぶた、腕のむくみの症状が出てきます。

栄養障害性浮腫(メネトリエ病・蛋白漏出性胃腸症・ビタミンB1欠乏症)

メネトリエ病、蛋白漏出性胃腸症とは、血漿蛋白、アルブミンが消化管内に異常に漏れ出すことによって起こる低蛋白血症です。メネトリエ病は、過形成性胃炎とも呼ばれ一般的には中年以降に発症します。

蛋白漏出性胃腸症はリンパ系の異常、毛細血管透過性の亢進、消化管粘膜上皮の異常が原因でおこります。顔、下肢、全身のむくみ、腹痛、下痢、嘔吐、吐気といった症状が出てきます。ビタミンB1欠乏すると、脚気やウェルニッケル・コルサコフ症候群が起こります。手足のむくみ、しびれ、動悸、筋力低下などの症状が出てきます。

リンパ性浮腫(リンパ浮腫)

リンパ管の圧迫や狭窄により、リンパ管の流れが悪くなり、リンパ管の成分が外に漏れ出して起こるむくみ症状です。蛋白質がリンパ管から漏れ出して、組織内に蓄積されると組織細胞の変性が起こり、その部分が徐々に硬くなっていきます。乳がんや子宮がんの術後に二次性として起こる場合もあります。若い女性に多く、夕方になると足やかかと、手の甲のむくみ、皮膚の硬化などの症状が出てきます。

その他(特発性浮腫、月経前緊張症、妊娠高血圧症)

特発性浮腫は、主に月経がある女性に、原因がないのに全身にむくみ症状が現れます。自律神経の異常が原因と推定されています。月経前緊張症は、月経1週間前から続く精神的、身体的症状です。月経がはじまると自然に解消される場合が多い症状です。

女性ホルモンの変化が関係しています。妊娠高血圧症候群は、妊娠20週以降、分娩12週までに起こる高血圧が見られる場合と、蛋白尿を伴う場合があります。妊娠高血圧症候群は胎児の発育不全や健康状態の悪化をまねきやすいので、定期的に診断を行う必要があります。

病気以外のむくみ

病気5

出典:食生活から改善!全身のむくみをとる方法

むくみには、生活習慣の乱れや運動不足、ストレス、冷えが原因で起こる場合もあります。多くの女性が悩む、むくみには一過性のものが多く、食生活で塩分摂取を抑えたり、ウォーキングやストレッチなどで適度な運動をしたり、マッサージなどを行い、全身の血行を改善することで症状が改善されることがあります。また、市販の飲み薬やサプリメント、漢方薬を併用して利用することでむくみの解消が期待できます。

早めの対処を心がけよう!

病気や症状ごと、詳しく説明させていただきましたが、もし該当する症状などが長期間続いている場合は、自己判断せず、必ず医師の診察を受けるようにしましょう。慢性的なむくみでも、治療をすれば改善する場合が多いので、早めの受診をおすすめします。また、一過性のむくみでも、放置しておくと、慢性的なむくみになる場合もあるので、定期的なケアを心がけるようにしましょう。

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妊婦の方が妊娠中のむくみを解消するための4つのポイント

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