What is lymphedema?
In layman terms, Lymphedema can be defined as a swelling in the limbs caused due to the abnormal build up of fluids in the body. The lymphatic system, made up of a network of lymph glands and lymph nodes, plays an important role in the protection of the body from harmful substances. This medical condition develops in cases of trauma to the lymphatic system of the body, particularly if the lymph nodes or the lymph vessels are missing, damaged or removed due to a surgical procedure.
There are two variants of the condition, namely primary lymphedema and secondary lymphedema. Primary lymphedema is congenital and occurs due to missing or undeveloped lymph vessels. The condition may be apparent at birth or develop during the teenage years and sometimes may not show up till adulthood. Secondary lymphedema is acquired and much more common than hereditary lymphedema. It may occur in the upper limbs after breast cancer surgery in case of women. The lower limbs or the groin area might be affected in case of surgery for ovarian or uterine cancer. In men, secondary lymphedema commonly affects the legs after a treatment for prostrate, colon or testicular cancer.
Certain diseases that may inhibit proper functioning of the lymphatic system can be a cause for lymphedema. Another cause for acquired lymphedema, which is quite widespread in the tropical areas, is lymphatic filariasis, a parasitic infection spread by mosquitoes. Lymphatic filariasis is also known as elephantiasis. Lymphatic malformations are the result of irregular prenatal development of the lymphatic system and may affect any part of the body.
It is difficult to diagnose the presence of lymphedema in a patient, because the condition develops gradually. The initial signs may be general observations like heaviness in the arm or foot. This is the mild stage edema where the accumulation of fluid is not detectable. As the disease develops further, there is increased fluid retention in an entire limb. There are marked changes in the appearance of the skin and the formation of cysts and corns. A definitive diagnosis of the disease can be made by measuring the circumference of the affected part and comparing it with the other non- affected limb. The hardening of the tissues in the more advanced stages of lymphedema is known as fibrosis.
The treatment of lymphedema depends on the severity of the condition and the quantum of fibrosis present in the affected body part. Patients usually follow a therapy suggested by their doctor that may include a combination of a massage, bandaging and the use of compression garments. They may also make use of a sequential gradient pump intermittently. In addition, some patients follow an exercise routine to keep the limbs moving and stimulate circulation. It is advisable to use bandages while performing any activity as this enhances the pumping action of the lymph vessels which stimulates the flow of fluids in the body.
The manual lymph drainage system for the treatment of lymphedema involves the gentle massaging of the skin to stimulate the flow of the fluid to return it to the blood circulatory system. The kidneys help to filter the excess fluid and eliminate it from the body through urination. Surgical techniques have also been developed to treat lymphedema.
