Kaki Bengkak (Swollen Legs & Ankles): Punca & Bila Bahaya

Kaki bengkak (swollen legs, ankles and feet) is usually caused by a build-up of fluid called oedema, and it often goes away on its own. Common causes include standing or sitting for too long, salty food, being overweight, pregnancy, some medicines and varicose veins. Less often, it is a sign of a blood clot, an infection, or a heart, kidney or liver problem. Swelling in only 1 leg, swelling that is sudden, painful, red or hot, and swelling with breathlessness or chest pain need urgent medical attention. Raising your legs, walking and comfortable shoes can help mild swelling.

What is kaki bengkak (swollen legs and ankles)?

According to the NHS, swelling in the ankles, feet and legs is often caused by a build-up of fluid in these areas, called oedema. In Malay this is often described as kaki bengkak air. Oedema can affect 1 or both legs, and symptoms may include:

• swollen or puffy ankles, feet or legs;
• shiny or stretched skin;
• changes in skin colour, dry skin, discomfort and stiffness;
• dents when you press on the skin.

Swelling in the ankles, feet or legs often goes away on its own. You may need medical advice if you have other symptoms or do not know what is causing it.

Punca kaki bengkak: what are the common causes?

According to the NHS, oedema in the legs is usually caused by:

• standing or sitting in the same position for too long;
• eating too much salty food;
• being overweight;
• being pregnant;
• certain medicines, such as some blood pressure medicines, contraceptive pills, hormone therapy, antidepressants or steroids (see our guide to darah tinggi);
• varicose veins, which can cause aching, heavy legs and swollen ankles;
• thyroid problems (see our guide to tiroid).

Oedema can also be caused by:

• an injury, such as a strain or sprain;
• an insect bite or sting;
• an infection;
• a blood clot;
• problems with your kidneys, liver or heart.

One leg or both legs: what can the swelling mean?

Only a doctor can find the cause of your swelling, but these clues from NHS guidance show which situations need attention:

For more on kidney-related swelling, see our guide to sakit buah pinggang. For a swollen knee joint, see our guide to sakit lutut.

Kaki bengkak tiba-tiba: when is it dangerous?

According to the NHS, ask for an urgent medical appointment if:

• you have swelling in 1 ankle, foot or leg and you do not know what is causing it;
• you have a lot of swelling after an injury, or the swelling is getting worse;
• the swelling is severe, painful or starts very suddenly;
• you also have swelling in other areas of your body, such as your face or tummy;
• the swollen area is red or feels hot;
• your temperature is very high, or you feel hot, cold or shivery;
• you have diabetes and your feet, ankles or legs are swollen (see our guide to kencing manis).

Call 999 (Malaysia emergency) immediately if you have leg swelling and:

• you feel short of breath or are struggling to breathe;
• your chest feels tight, heavy or painful;
• you are coughing up blood;
• your heartbeat is more noticeable (palpitations);
• you feel lightheaded, faint, confused, sick or clammy.

These can be signs of a blood clot in the lungs (pulmonary embolism), which can happen when a clot from the leg travels to the lungs. It needs treatment in hospital straight away.

Who is more likely to get a blood clot in the leg (DVT)? According to the NHS, the risk is higher if you are over 60, living with overweight or obesity, smoke, have had DVT before, take HRT or oestrogen-containing contraception, have cancer or heart failure, have varicose veins, are pregnant or had a baby in the last 6 weeks, have recently had surgery or a hospital stay, are confined to bed for 3 days or more, or go on a journey of more than 4 hours.

Kaki bengkak mengandung: is swelling in pregnancy normal?

According to the NHS, it is normal to get some swelling in pregnancy, particularly in your legs, ankles, feet and fingers. It is often worse at the end of the day and further into your pregnancy. Your body holds more water than usual, and the pressure of your growing womb can affect blood flow in your legs. Swelling that comes on gradually is not usually harmful to you or your baby.

Call your midwife, doctor or labour ward immediately if you have:

• a sudden increase in swelling in your face, hands or feet;
• a very bad headache;
• problems with your vision, such as blurring or flashing lights;
• severe pain just below your ribs;
• heartburn that does not go away with antacids;
• feeling very unwell, or feeling or being sick.

These could be symptoms of pre-eclampsia, a pregnancy condition that causes high blood pressure. It is most likely from 20 weeks of pregnancy onwards and can also develop in the days or weeks after birth. To ease normal pregnancy swelling, the NHS suggests avoiding long periods of standing, wearing comfortable shoes, resting with your feet up and simple foot exercises. See also our guides to tanda-tanda mengandung and tanda bersalin.

What about kaki gajah (lymphoedema and filariasis)?

People sometimes call a very swollen leg kaki gajah ("elephant leg"). Two conditions are worth knowing about:

• Lymphoedema: according to the NHS, a long-term condition that causes swelling, usually in the arms or legs, when the lymphatic system does not work properly. At first the swelling may be soft and leave a dent, but without treatment it usually becomes more severe, with a heavy, aching feeling, hard or thickened skin and repeated skin infections. It can follow cancer treatment, an infection, an injury or a lack of limb movement. Early treatment matters because it can get worse if not treated.
• Lymphatic filariasis (penyakit kaki gajah, or elephantiasis): according to the WHO, a parasitic infection spread by mosquitoes that damages the lymphatic system. Infection is usually picked up in childhood, and the visible swelling, such as lymphoedema and elephantiasis, appears later in life. It is prevented by yearly preventive medicines given in affected areas.

How can you reduce swollen legs at home?

Mild swelling in the ankles, feet or legs should go away on its own. According to the NHS, you can help it by:

• raising your legs or the swollen area on a chair or pillows when you can;
• getting some gentle exercise, like walking, to improve blood flow;
• wearing wide, comfortable shoes with a low heel and soft sole;
• washing, drying and moisturising your feet to avoid infections.

Avoid:

• standing or sitting for long periods (get up and move around every hour or so on long days or journeys);
• clothes, socks or shoes that are too tight.

Cutting down on salty food can also help, as too much salt is one of the usual causes of oedema.

How is kaki bengkak treated?

According to the NHS, treatment for swelling that does not go away on its own depends on the cause, and your doctor can advise you on the right treatment and whether lifestyle changes could help. For example:

• DVT is treated with blood-thinning medicines, usually for at least 3 months, after an ultrasound scan confirms the clot.
• Cellulitis is treated with antibiotics; keep taking them until they are finished, even when you feel better.
• Heart, kidney, liver or thyroid problems are treated by managing the underlying condition.
• If a medicine may be causing swelling, do not stop it on your own; ask your doctor whether it can be changed.

When should you see a doctor?

See a doctor if both ankles, feet or legs are swollen and:

• the swelling has not improved after treating it at home for a few days;
• it gets worse;
• you have been diagnosed with a condition that affects your heart, kidneys or leg veins.

Get urgent help for swelling in 1 leg without a known cause, swelling that is sudden, severe, painful, red or hot, swelling with a fever, or swelling if you have diabetes. Call 999 if leg swelling comes with breathlessness, chest pain or coughing up blood. If you are pregnant, contact your midwife or doctor immediately about sudden swelling of the face, hands or feet.

Frequently asked questions (FAQ)

What causes kaki bengkak (swollen legs and ankles)?

Swollen ankles, feet and legs are usually caused by a build-up of fluid called oedema (often called kaki bengkak air). Common causes include standing or sitting in the same position for too long, eating too much salty food, being overweight, being pregnant, some medicines, varicose veins and thyroid problems. Less often, swelling is caused by an injury, an insect bite, an infection, a blood clot, or problems with the kidneys, liver or heart.

Is sudden leg swelling (kaki bengkak tiba-tiba) dangerous?

It can be. According to the NHS, ask for an urgent medical appointment if the swelling is severe, painful or starts very suddenly, if only 1 leg is swollen and you do not know why, or if the area is red or hot. Call an ambulance if leg swelling comes with shortness of breath, chest pain or coughing up blood, as you could have a blood clot in your lungs.

Is swelling in one leg more worrying than in both legs?

Swelling in 1 ankle, foot or leg without a clear cause should be checked urgently. A blood clot in the leg (deep vein thrombosis, DVT) usually causes throbbing pain and swelling in 1 leg, and cellulitis, a skin infection, causes painful, hot, swollen skin. Swelling in both legs is often caused by everyday factors, but see a doctor if it does not improve after a few days of home care or keeps getting worse.

Is it normal to have swollen feet when pregnant (kaki bengkak mengandung)?

Some swelling in the legs, ankles, feet and fingers is normal in pregnancy, especially at the end of the day and later in pregnancy. Swelling that comes on gradually is not usually harmful. But a sudden increase in swelling of the face, hands or feet can be a sign of pre-eclampsia, so call your midwife, doctor or labour ward immediately if this happens.

How can I reduce swollen feet and ankles at home?

The NHS suggests raising your legs on a chair or pillows when you can, gentle exercise such as walking to improve blood flow, wearing wide, comfortable shoes with a low heel and soft sole, and washing, drying and moisturising your feet to avoid infections. Avoid standing or sitting for long periods and avoid tight clothes, socks or shoes.

Can salty food cause swollen legs?

Yes. The NHS lists eating too much salty food as one of the usual causes of oedema in the ankles, feet and legs.

Can heart or kidney problems cause swollen legs?

Yes. Swelling in the feet, ankles, legs or tummy is a symptom of heart failure, often together with breathlessness, tiredness and sudden weight gain. Swollen ankles, feet or hands can also be a symptom of later-stage chronic kidney disease. If you have one of these conditions and your legs swell, see your doctor.

Disclaimer

This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.

References

• Swollen ankles, feet and legs (oedema) — NHS
• DVT (deep vein thrombosis) — NHS
• Cellulitis — NHS
• Heart failure — NHS
• Chronic kidney disease: symptoms — NHS
• Varicose veins — NHS
• Swollen ankles, feet and fingers in pregnancy — NHS
• Pre-eclampsia — NHS
• Lymphoedema — NHS
• Lymphatic filariasis — World Health Organization