Fluid retention or 'bloating' is a common problem, but it can be treated and even avoided. Sarah Jewell expands.

Fluid retention or puffiness (also medically known as oedema) is the abnormal accumulation of fluid in parts of the body such as the ankles, legs, lungs and abdomen.

Fluid can build up for a variety of reasons. Many people, for example, will have experienced swollen ankles if they have been on a long flight or if they have just been standing for too long. A high-salt diet can also lead to water retention. However, swollen ankles can also be an indication of something more serious such as heart disease, liver problems or kidney failure. Thrombosis and varicose veins can also cause ankle swelling.

Fluid retention in the abdomen, ankles and fingers is one of the most common symptoms of premenstrual syndrome (PMS). Liz Bates, 34, suffers from PMS and each month her body swells up: 'I can easily put on half a stone overnight - I get a very swollen stomach that goes very hard and I get swollen fingers and ankles. My skin goes tight and I feel like I am going to burst.' This swelling and bloating can take place up to two weeks before her period starts and she also feels 'very lethargic and very emotional.' To try and combat this swelling, Liz takes water tablets prescribed by her doctor.

Simple treatments
Water tablets are diuretics and they increase the amount of salt and water passed in the urine, so as Liz says 'you have to go to the loo a lot.' There are several types of diuretic, some of which lead to loss of potassium so doctors often prescribe a potassium supplement with them.

An alternative to water tablets for fluid retention with PMS is to try vitamin and mineral supplements, especially vitamin B-6 (Pyridoxine) and vitamin E, gamma-linoleic acid (GLA), and calcium and magnesium. These can be effective in lessening breast tenderness and bloating.

Flower oils such as evening primrose oil (which contains GLA) and starflower oil are also recommended, but you should always inform your doctor if you are taking herbal supplements.

Other ways of trying to relieve the symptoms of water retention with PMS are to eat a healthy, balanced diet that's low in saturated fat and sugar, high in carbohydrates and low in salt. Gaynor Bussell is dietary advisor to the National Association for Premenstrual Syndrome (NAPS) and as she says: 'our blood has to be maintained at a certain dilution, so if we take in more salt we need more fluid to excrete the salt. But what happens is the kidneys are put under too much pressure, which leads to a build-up of fluid. In women, this tends to gather in the abdomen.'

Around 80 per cent of salt in our diet comes from processed food, so it's important to eat as much unprocessed food as possible. Gaynor Bussell adds that 'even bread can contain a lot of salt. The body needs four grams a day, but most people are probably eating about 12 grams a day.' It is also a good idea to take regular exercise to alleviate the symptoms of fluid retention.

Warning signs
In some people, swollen ankles accompanied by breathlessness can be a sign of heart disease. If the heart fails to pump blood properly around the body, the lungs can fill with fluid and water, which results in fluid accumulating in the ankles and shins, or in the back if a patient is lying in bed. In the past this was known as 'dropsy'. Doctors will prescribe diuretics to reduce the volume of blood circulating around the body and therefore reduce the strain on the heart and the blood pressure. It is essential to see a doctor for tests if these symptoms occur.

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