Today we will talk about the disease, which affects almost a quarter of a million inhabitants of our planet - lymphostasis. With congenital lymphostasis of the face and limbs, invariably accompanied by a whole bunch of dysplastic anomalies, every ten thousandth baby is born.
The disease most often affects women from thirty to forty-five years. In the overwhelming majority( about 90%) of cases, the disease is localized in the region of the lower extremities.
What is lymphostasis?
Lymphostasis( or lymphedema) is a congenital or acquired disease of the lymphatic system caused by a loss of lymphatic fluid from the lymphatic vessels and capillaries of the located in the internal organs and extremities to the large lymphatic collectors and ducts through which it flows into the veins.
Localization of
With lymphostasis, lesions of the lower extremities are most often observed( beginning with the edema of the foot, the process gradually seizes the shin and spreads over the thigh).
The photo depicts the lymphostatic disease of the lower extremities
In some cases, lymphedema can strike:
- upper limbs( hand lymphostasis);
- mammary glands( lymphedema of the mammary glands);
- face( lymphostasis of the face);
- scrotum( scrotal lymphedema).
In medical statistics, cases are noted when lymphostasis has affected the entire body of the patient.
Reasons for
Regardless of the location, lymphostasis is characterized by the presence of edema( common or limited) of soft tissues due to lymphatic accumulation. Considering the significant( up to two liters per day) volume of lymphatic fluid production, it is possible to understand the scale of the disaster experienced by an organism afflicted with an ailment.
This pathological process is due to a disruption in the integrity of large and small lymphatic vessels. Given the etiology of the disease, lymphostasis is usually divided into primary and secondary.
Lymphostasis is a polyethiologic disease because many pathogenic factors can cause its development in the lower and upper limbs, for example:
- Varicose veins of the abdominal cavity and of the lower extremities of the . Because of chronic venous insufficiency, the vessels of the lymphatic canal widen in compensation, thus reducing their tone and developing valvular wall failure.
- Congenital anomalies of lymphatic( aplasia, hypoplasia and hyperplasia) of vessels, which inevitably result in the development of primary lymphostasis.
- Burn or injury to , resulting in damage to the vascular walls of one or more lymphatic vessels.
- Systematic squeezing of the lymphatic vessel by surrounding inflammatory or tumor tissues.
- Surgical interventions of ( for breast cancer and tumors of the thoracic cavity), resulting in the removal of lymph nodes.
- Penetration into the lymph vessels of roundworms is a filaria that provokes the development of filariasis lymphostasis. In this case, the cause of the violation of the free passage of lymph is the accumulation of helminths, narrowing the lumen of the vessel they occupy. Erysipelas of upper and lower extremities.
- Chronic renal failure may give an impetus to the development of lymphedema of the scrotum and lower limbs.
- Presence of obesity.
- Congenital disease of the lower extremities veins , referred to as the Klippel-Trenone-Weber Syndrome.
Classification of forms
Depending on the etiological factors that provoked the development of the disease, lymphostasis can be:
- Primary. With this form of lymphostasis, all the anomalies of the lymphatic channel( agenesis and vascular obstruction, venous valve insufficiency, cases of aplasia or hyperplasia), being laid down at the genetic level, are congenital in nature. The characteristic symptoms of this genetically determined disease, manifested already in infancy, are fully expressed in adolescence. In the vast majority of cases, the ailment affects only one limb( both limbs are rarely affected).
- Secondary. With secondary lymphostasis there is a malfunction in the lymphatic system, which was originally formed correctly. The cause of such a malfunction may be either a serious illness, or a trauma received during life.
Stages and symptoms
The clinical picture of lymphostasis consists of three stages. Their duration in each patient is strictly individual. The severity of the course of the disease mainly depends on the timeliness of the diagnosis and on the degree of correctness of the chosen treatment tactics.
- The initial stage of the disease is called the stage of transient spontaneous edema. Lymphostasis begins with a persistent progressive swelling that appears in the evening and disappears by the morning. Not causing any pain, it leaves at the patient a feeling of "swelling" of soft tissues. Edema of this stage is called soft, because pressing on the skin of the affected area leaves a small dimple on its surface. Because of the ability to pass without the use of medicines, they are also referred to as "reversible."Strongly stretched skin of affected areas is shiny and smooth. The disease, caught at this stage, perfectly lends itself to conservative treatment.
- The progression of the disease leads to a stage of irreversible edema. The consistency of the swollen tissues becomes dense. When palpating the affected areas, the patient may experience pain. Traces( small dimples), left after palpation, for a long time remain on the surface of the skin. Violation of blood circulation and lymph flow leads to inflammatory regeneration of soft tissues. The clinical picture of this stage is supplemented by the presence of muscle cramps, provoked by the insufficiency of local blood supply. Particular attention is caused by a change in the color of the affected skin. Massive edema leading to significant stretching of the skin, often results in their cracking. This process is often joined by a bacterial infection, as evidenced by the presence of diffuse red spots, hot when feeling. The growth of connective tissue leads to the hardening of the skin and the formation of dense fibrous bands, which firmly hold its upper layers with fatty subcutaneous tissue. As a result, it can not be displaced or folded.
- The last stage of lymphostasis is characterized by the development of irreversible elephantiasis. Severe irreversible edema leads to a significant increase in the size of the affected area of the body, the formation of contracture and the development of deforming osteoarthrosis. As a result of the development of induration( compaction) and fibrosis of soft tissues, the skin becomes dark brown. Lack of adequate treatment can lead to the formation of warty rashes and trophic ulcers, accompanied by the flow of lymphatic fluid( lymph).Medical statistics have data on a number of deaths caused by generalized septic lesions of the entire body of the patient.
Diagnosis
When the patient has first signs of lymphedema, the patient should immediately be consulted by a vascular surgeon, phlebologist( doctor dealing with veins) or a lymphologist( specialist in the treatment of lymphatic system diseases).
- If the disease has affected the lower extremities, ultrasound of the pelvic organs and the abdominal cavity are prescribed.
- Lymphostasis of the hand requires radiographic examination of the thoracic cavity.
- To determine the exact location of the site in which the lymphatic fluid block was formed, a number of specific examinations are prescribed: X-ray lymphography, MRI, computed tomography, lymphoscintigraphy. With the help of these techniques, specialists receive information about the pathologies of the lymphatic channel, the rapid expansion of lymphatic vessels( lymphangiectasia), identify the geography of areas of increased crimp of the vessels, determine the degree of valvular insufficiency.
- At the diagnostic stage, differentiation of lymphedema from ailments with similar symptoms( such as post-phlebitic syndrome and deep vein thrombosis), reveals areas of increased hyperpigmentation, ascertain the presence of varicose veins and varicose eczema.
- For the elimination or detection of venous pathologies, ultrasound dopplerography( UZDG) of the veins of the lower extremities is prescribed.
How to cure primary and secondary lymphostasis at home
Treatment of lymphostasis should pursue the following objectives:
- to stop the progression of the disease;
- to restore metabolic processes in soft tissues;
- prevent possible complications.
- Drug treatment consists of taking tablets. To normalize the circulation of lymph will help the reception of troxevasin, detraleksa and tablets veuroruton forte. To improve the peripheral circulation of blood appoint no-shpu and theonikol. Restore blood microcirculation will help medication trental.
- The diet for lymphostasis should be low-calorie and almost salt-free , as the salt retaining the liquid in the body only contributes to the progression of edema. Food of patients with lymphostasis should be rich in plant and animal proteins, polyunsaturated fatty acids. It should limit the use of sweets, bakery and pasta, some types of cereals. But the consumption of fresh fruits, vegetables and fermented milk products is only welcome.
- Compression therapy is reduced to wearing special compressible underwear with distributed pressure or to regular bandages of affected limbs. For bandaging, you can use elastic bandage or special products from medical knitwear. By promoting the outflow of lymph, these measures help significantly reduce swelling.
- For lymphostasis, sessions of lymph drainage massage are required, combining deep lymph node massaging with rhythmic and gentle stroking of the external skin. After the massage, which takes about an hour, it is recommended to apply a medical bandage.
- Patients with lymphostasis are very useful sessions of physiotherapy exercises , swimming and Nordic walking.
Treatment of lower limbs
- Drug therapy for lower limb lymphostasis is mediated by troxevasin and actovegin.
- It is compulsory to wear compression linen.
- A patient with leg lymphostasis is assigned a subcaloric diet with a low content of table salt and a restriction of carbohydrates.
- The use of medicinal leeches with lymphostasis helps to reduce edema, activate immunity and renew the lymphatic fluid. The recommended frequency of treatment sessions is two times a week. At the same time, no more than five leeches can be used. The maximum duration of the course is twelve sessions. Between courses are required breaks. Hirudotherapy sessions can only be performed by a trained specialist - a hirudotherapist.
- It is mandatory for lymphostasis of the legs is the treatment of exercises, useful running, swimming and cycling.
- A manual lymph drainage massage will speed recovery.
Hand treatment after mastectomy
In an overwhelming( more than 70%) majority of cases, limostasis of the hand develops after surgical removal of the mammary gland( mastectomy) and lymph nodes. Since surgery is the only way to save the life of an oncological patient, you can not do without it.
As a result of removal of lymph nodes, lymph begins to accumulate in the tissues of the shoulder zone. The operated patients, performing a special complex of therapeutic exercises, manage to completely restore lymph circulation in their body.
Video massage that will be useful for hand lymphostasis:
Symptoms of hand lymphostasis usually occur four weeks after the operation.
- Lymphostasis of the hand is treated with phlebotonics, immunostimulants, enzymes and angioprotectors.
- The most effective method of treating lymphostasis of the hand is lymph drainage massage, which can be performed independently. Raising his sick hand high and resting it in a vertical wall, the other hand begins to perform massage movements, directed from elbow to shoulder, and then from the brush to the elbow. You need to massage smoothly, gently, but with some pressure. Comprehensive tissue treatment should be done for five minutes.
- Compression knitwear, which contributes to the outflow of lymph, also speeds up the healing process, so its wearing is recommended by leading experts.
- In modern clinics, the treatment of lymphostasis of the hand is also carried out using laser therapy, muscle stimulation and magnetic therapy.
Erysipelas of the hand with the lymphodema
Infection of the affected limfostazom limbs of the coccus group can develop erysipelas, accompanied by high fever, intolerable pain, reddening of the skin.
In addition to the above drugs used in the treatment of lymphostasis of the hand, erysipelas requires the connection of antibiotics of local and systemic action. Thanks to them, it is possible to stop the spread of the inflammatory process and prevent the propagation of pathogenic microflora.
After the course of antibiotics, it is necessary to restore the liver's protective functions and intestinal function, taking lacto- and bifidobacteria and hepatoprotectors.
How to relieve swelling?
You can cope with swelling with lymphostasis by:
- wearing compression knitwear;
- regular self-massage, aimed at reducing lymphatic vessels and thereby contributing to the improvement of lymph flow;
- application of traditional medicine methods;
- passing the course of hardware massage;
- sessions of hirudotherapy;
- course of lymphatic drainage massage.
A video about lymphodrainage massage for lower limb lymphostasis:
For lower limb lymphostasis, the feet should be given elevated position as often as possible. During night rest it is necessary to put under them a small pillow or an oblong roller.
Reviews about therapy
Victoria:
Lymphostasis has been suffering for fifteen years. I went through the operation and procedures of laser therapy, I regularly take medication prescribed by my doctor - I did not experience any special improvements. The only salvation for me is the compression knitwear of the Scottish firm Sigvaris. In it, my aching leg is almost not swollen. I recommend to everyone who is familiar with this problem.
Maria:
I was diagnosed with lymphodema thirteen years ago. Since then, I've tried a lot. Personally, I am helped by sessions of hirudotherapy. After the course of procedures, swelling subsides, the effect lasts for several months.
Elena:
I was born with lymphostasis, so I know everything about this ailment. Personally, for me there is no better means than daily light self-massage. Usually I do it before going to bed, stroking my aching leg, moving from the tips of my fingers to my knee( in no way the opposite).Equally effective is swimming in the river or in the basin: after water procedures, swelling not only becomes mild, but also significantly reduced.
Complications of
- Disease, which has reached the stage of irreversible edema, is accompanied by the formation of joint contracture, the development of deforming osteoarthritis. In this state, a person can not do without outside help, since he can not self-service himself.
- Soft tissues involved in the inflammatory process are covered with trophic ulcers, which is fraught with the attachment of a bacterial infection.
- An extremely dangerous complication of lymphostasis should be considered erysipelas of the extremities, often leading to the development of sepsis and ending with the death of the patient.
Prophylaxis and prognosis of the disease
- Prevention of lymphedema consists in limiting the physical activities of associated with lifting significant weights.
- A good effect is the prophylactic use of preparations-venotonics , having lymphotropic effect.
- Wearing comfortable shoes on the firm sole will significantly reduce the risk of developing the disease.
- The prognosis for life of patients suffering from lymphostasis is generally favorable to , especially if the disease was detected at the earliest stages of development. Started lymphostasis leads a person to a total loss of ability to work and disability.
- Patients who have undergone a mastectomy operation in most cases recover fairly quickly and can lead an active lifestyle. The full course of rehabilitation in these cases usually takes no more than a month.
- To prevent the development of lymphostasis, high-quality care for the skin of the upper and lower extremities will help, which provides timely treatment of with even minor wounds that excludes the possibility of their infection.
Video about lymphostasis: