Dr. Toshi Is In! "Diuretics"

Dear Dr. Toshi,

I'm taking a medication called furosemide (also called Lasix), which is known as a "pee pill." What does it do for the heart? My doctor says it's good for the heart, but it sure makes me go to the bathroom often.

Many people take medications called "diuretics," which you may know as a "water pill" or "pee pill." One of the things it does is make the kidneys make more urine. The medication called "furosemide" is one of them. Diuretics also cause the body to get rid of excess sodium, help relieve the heart's workload, and decrease the buildup of fluid in the lungs and other part of the body.

Unwanted extra fluid in body tissue can cause a condition called edema (swelling). You can have edema in any part of the body, including the lungs, for various reasons. If your doctor or provider determines that you have extra fluid, you may be prescribed a diuretic to help get rid of it.

(By the way, please remember that it's always important to ask your doctor or provider about your own specific health condition because everyone is different, and no doctor can give anyone the most appropriate advice without actually seeing and examining the patient.)

There are many things that can cause edema, but I'll talk about one condition that's related to the heart today: namely, congestive heart failure. There are several types of heart failure, but congestive heart failure is a type of heart failure that causes "congestion," where the heart loses the ability to pump blood efficiently causing it to get congested with blood, which may result in fluid collection and edema in different parts of the body. By the way, heart failure is a condition that nearly 6.2 million Americans have, and it's the leading cause of hospitalization in people older than 65. It develops gradually due to different causes such as high blood pressure, coronary artery disease, obesity, diabetes, sleep apnea, and other conditions.

You may wonder how edema (excessive fluid) and congestive heart failure are related. So, let me draw a big picture. As you recall, the heart is actually two pumps: one is on the right side of the heart, and one is on the left. The blood comes into the right side of the heart from different parts of the body, then it's pumped into the lungs in order to get fresh oxygen and get rid of carbon dioxide. That oxygenated blood then goes into the left side of the heart, which pumps it out to the body. It circulates like this: body to the right side of the heart, then pumped to the lungs, then to the left side, then pumped out to the body, and back to the right side, and so on. That's called our circulation.

The problem occurs when the right side of the heart gets weak and cannot pump the blood forward to the lungs as it should. You end up having congestion, like traffic congestion, and the blood backs up to the rest of the body (especially in the ankles and legs because of gravity). The fluid in the blood seeps out of the blood vessels into the surrounding tissues, causing swollen ankles and legs. This excessive fluid stresses and damages not only the heart but the rest of body, too.

Now, let's talk about the left side of the heart. If the left side of the heart gets weak as a pump, the blood also gets backed up, but this time it backs up into the lungs. In the lungs, excessive fluid leaks into the lungs causing them to be full of fluid. This is called pulmonary edema. When this happens, the person has a hard time breathing. This can be fatal if not treated right away.

If you were told that you have a heart condition and should take "pee pills" or "water pills" (diuretics), they will help your body get rid of excessive fluid, which makes your heart's job easier so it doesn't have to work as hard.

If you have congestive heart failure (CHF), it's important to weigh yourself daily so you and your doctor can know if you have excessive fluid in your body. Also, eat less salt because water follows salt in your body. If you ever develop symptoms like chest pain, shortness of breath, a feeling like you're suffocating or drowning, a cough with frothy sputum, wheezing or gasping for breath, cold clammy skin, a rapid irregular heartbeat, or other concerning symptoms, be sure to call 911.

Dr. Toshiko ("Toshi") Luckow, MD, is a Family Physician at the West River Health Services Hospital and Clinics.