Lymphostasis

Lymphostasis (lymphedema) is a disorder of lymph drainage accompanied by swelling. The volume of the limb increases in this condition. Severe lymphostasis is called elephantiasis. The impetus for development can be an injury (bruise, injury, fracture, burn), often the disorder of lymph drainage occurs after operations. Lymphedema can occur against the background of a parasitic infection, streptococcal infection, heart and kidney diseases. The occurrence of this pathology is often facilitated by radiation therapy. In tropical countries, lymphatic filariasis occurs, this disease is carried by mosquitoes.

Treatment of the disease is physiotherapeutic and surgical. Massage helps. Adherents of traditional medicine advise using tar, honey, plantain, and garlic in treatment. But traditional methods help only in the early stages.

ICD-10 code

According to the international classification of diseases, the diagnosis of lymphostasis has the code 189.8. ICD 10 is the international classification of diseases of the 10th revision, approved in 2007.

Lymphostasis is a chronic stagnation of lymph, it makes a person obese. Immunity decreases, metabolism is disrupted, complications arise in the musculoskeletal system, a person loses working capacity. This condition does not threaten life directly, but significantly reduces its quality.

Causes of lymphostasis

Lymphostasis can be congenital or acquired.

Let's consider the stages of the disease using the example of lymphostasis of the lower extremities.

• In the first stage (called lymphedema), we see swelling of the ankle joint, which goes away after rest and intensifies in the evening and in hot weather.
• The second stage (fibredema) is a dense swelling of the entire lower limb, constant and persistent. The leg is deformed, warts appear.
• The third stage is elephantiasis. It is accompanied by deformation and irreversible swelling. This often makes it difficult to move. This stage is treated by liposuction.

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Lymphostasis after mastectomy

During a mastectomy, axillary lymphadenectomy is performed – removal of the lymph nodes. How to treat lymphostasis after a mastectomy? As a rule, diuretic herbal infusions, massage and a swimming pool are prescribed. Removal of lymph nodes and vessels is performed to increase the effectiveness of the operation, but it is impossible to predict how this will affect the woman's health. If any hard seals appear, you should consult a doctor.

Lymphostasis of the extremities

Congenital lymphostasis is caused by underdevelopment of the lymphatic system. Lymphostasis of the extremities in adults is caused by soft tissue tumors, inflammation and trauma, and endocrine system disorders. Over time, the skin becomes dense and the limb loses its contours.

In addition to local symptoms, the patient often experiences lethargy and inattention.

To diagnose lymphostasis of the extremities, it is optimal to undergo MRI.

An effective method of treatment is massage of the buttocks, thighs, hardware massage. Ultrasound and mud therapy, heat therapy are used.

Lymphostasis of the lower extremities

Congenital lymphostasis of the lower extremities is a hereditary disease. Postoperative scars and injuries also provoke a disruption of lymph outflow. As a result, the changes are initially unnoticeable, and the patient consults a doctor only when he sees thickening of the skin and an increase in the volume of the limb.

The disease begins with a soft swelling on the back of the foot. Over time, folds appear at the site of the swelling.

At first, the patient is prescribed conservative treatment, physiotherapy and compression hosiery. Of the medications - Actovegin and Troxevasin.

A diet is chosen wisely, salt consumption is limited, swimming, running and cycling are recommended.

Among folk methods, a decoction of plantain and dandelion roots, and treatment with bee products have proven their effectiveness. Women should stop wearing high heels.

Lymphostasis of the thigh

First, it is necessary to identify the cause of the thigh lymphostasis. Most often, this is varicose veins and deep vein thrombosis.

In untreated cases, hip lymphostasis is easily treated with therapeutic exercise. Simple exercises cleanse the blood vessels and strengthen the muscles, helping to get rid of insomnia. As soon as the muscles become more trained, the load can be increased. Swelling is reduced if you keep your legs elevated.

Lymphostasis of the leg

Factors that provoke lymphostasis of the lower leg:

1. Obesity
2. Face
3. Operations

At first, the patient rarely goes to the doctor. Many are accustomed to swelling at the end of the day or in hot weather. There is no pain at the lymphedema stage. The patient notices that the limb is enlarged. The skin is swollen. If you contact a surgeon at this stage, he will prescribe a course of lymphatic drainage massage and exercise therapy, sanatorium treatment.

In the second stage of lymphostasis, the swelling is no longer soft. It does not subside after sleep.

At the third stage, the limb loses its contours and the patient has difficulty walking. At this stage, surgical treatment is performed - removal of the altered skin. Treatment of elephantiasis is a difficult task.

Lymphostasis of the foot

Lymphostasis is a slowly progressing disease. At an early stage, swelling of the foot appears. Gradually, the swelling spreads, folds appear.

At all stages, the patient is advised to bandage his legs with elastic bandages or wear special underwear.

Operations performed at the third stage provide only a cosmetic effect, they do not restore trophism. Therefore, it is so important to start treatment on time - at the stage when only the foot is affected. At this stage, ointments "Troxevasin" and "Actovegin" are prescribed.

What other diseases can cause an increase in limb volume? These include obesity, limb gigantism, and neurofibromatosis. Self-medication is not recommended. An increase in limb volume with lymphostasis is usually not accompanied by varicose veins.

Lymphostasis of the arm

Often, arm lymphostasis is a consequence of mastectomy (removal of the mammary gland). During the operation, regional lymph nodes are removed, and sometimes the pectoralis minor muscle.

Lymphostasis of the arm manifests itself as persistent swelling of the limb. The swelling disrupts the structure of the skin, making it dense and dark. Deformation of the upper limb may occur. Trophic ulcers form on the skin. In addition to mammary gland removal, arm lymphostasis can be caused by burns and dislocations, infections, and radiation. Lymphatic drainage may not be impaired after surgery if the patient does exercises aimed at improving lymph drainage. In most women who have undergone surgery, swelling disappears within a month after mastectomy.

Primary lymphostasis of the upper limb manifests itself in adolescence.

The secondary form is a consequence of erysipelas of the hands, obesity, and previous operations and injuries.

Recommendations for patients with arm lymphostasis. The surgeon recommends wearing a compression sleeve. It increases the pressure in the lymphatic vessels, and they begin to work more intensively. With arm lymphostasis, you should avoid skin injuries, wear clothes that do not restrict movement, do not visit the sauna and do not sunbathe.

• The first stage is accompanied by slight swelling. If you seek help, this condition is reversible.
• The second stage is accompanied by a more dense swelling. The skin on the hand is stretched, which causes pain. Treatment is still possible, but longer and more complicated.
• The third stage is irreversible. Wounds appear on the hands. The fingers become deformed.

Anyone who has an increased risk of developing a disorder of lymphatic drainage from the arm should consult a phlebologist. He will prescribe an ultrasound and clinical laboratory tests.

Treatment for arm lymphedema includes:

1. Manual lymphatic drainage;
2. Compression sleeve;
3. Therapeutic exercises.
4. Electrical muscle stimulation.
5. Laser therapy.
6. Magnetic therapy.

Lymphostasis of the neck

Lymphostasis of the neck, head, pelvic cavity and genitals is rare. Lymphostasis of the neck is manifested by its swelling, trophic changes in the skin and eczema.

Primary and secondary lymphostasis of the neck are distinguished. Primary lymph drainage disorder develops with Meige, Turner, Klippel-Trenonem syndrome and is often combined with other developmental defects. Secondary lymphostasis is caused by infections, injuries and neoplasms. Parasitic diseases and erysipelas can also provoke lymphostasis of the neck. Lymphostasis of the neck develops after injuries, especially if the patient lies down for a long time.

Treatment of lymphedema should be started at the early stages. Exercises prescribed by the surgeon promote lymph movement. They are accompanied by slight muscle contractions.

There is a technique of lymphatic drainage massage – hardware and manual.

Exercises and massage can be combined with surgical treatment. Lymphatic drainage disorder requires an individual treatment plan.

Lymphostasis on the face

Lymphostasis most often develops on the lower and upper extremities, but can also occur on the face. The patient notices that the swelling increases in the warm season, decreasing in winter. It can completely disappear after sleep. The feeling of heaviness and distension is disturbing.

As a result of the development of lymphatic drainage disorder, local tissue immunity weakens. The load on the skin increases, acne may worsen.

Lymphography is used for diagnosis.

Treatment methods for facial lymphostasis: lymphosorption, lymphatic drainage. The treatment process requires patience and persistence.

If conservative methods are ineffective, lymphostasis on the face is treated surgically: by surgical creation of anastomoses or transplantation of lymph nodes.

Lymphostasis in breast cancer

Lymphostasis in breast cancer develops because the surgeon, along with removing the breast, also removes nearby lymph nodes, which disrupts lymph flow.

In 20% of those operated on, there is no disruption of lymph outflow; in 90% of those who did, swelling is observed within 1 month after the operation.

To prevent postoperative lymphostasis it is necessary:

1. A week before the operation, start doing gymnastics for the muscles of the shoulder girdle. The lymphatic system of athletes easily copes in the case of forced removal of lymph nodes. Exercises should be continued after the operation for at least 9 months.
2. It is necessary to reduce salt consumption: give up cheese, pickles and lard. Limiting salt consumption reduces tumor growth. Salt can be replaced with seaweed.
3. It is possible to recommend the use of diuretics: honeysuckle, goldenrod, oats, eggplant.
4. After surgery, radiation therapy may be prescribed. Recommendations for preventing such a phenomenon as lymphostasis in breast cancer should also be followed if the patient is prescribed radiation.

Lymphostasis of the scrotum

Lymphostasis of the scrotum develops against the background of surgical operations on the genitals. Disruption of lymph outflow occurs with rough coagulation and is quite common. After surgery, scrotal edema occurs in the first day, but is characterized by a benign course and quickly passes.

This disease can also occur with filariasis. Filariasis (filariasis) is caused by filariae (nematodes). Adult filariae are parasites of the lymphatic vessels. They are transmitted by mosquito bites. Endemic to South America and China. Adult parasites remain in the human body for 15-20 years. Mostly, the pelvic lymph nodes are affected, which causes scrotal lymphostasis. In patients with filariasis, the genitals enlarge. The skin on them is edematous and wrinkled.

Treatment of filariasis is carried out with notezin and ditrazin. After getting rid of nematodes, scrotal lymphostasis usually goes away quickly.

Postoperative lymphostasis

Secondary lymphostasis is an acquired tissue edema that occurs as a result of surgical interventions, inflammation, trauma, and heart disease. After surgery, lymph flow is disrupted because the lymphatic vessels are ligated or removed. Cell waste products accumulate in the tissues. With postoperative lymphostasis, the skin becomes dry. Gymnastics is prescribed after many surgeries, especially if there is a risk of developing a lymph flow disorder (for example, when removing a mammary gland). In addition to gymnastics, patients are prescribed a compression bandage, swimming, and Nordic walking. In severe cases, liposuction is performed. Anti-inflammatory drugs and drugs that improve lymph flow are prescribed. It is necessary to ensure that clothing does not restrict movement. Postoperative lymphostasis, if you pay attention to it in time, can be successfully treated conservatively.

Posttraumatic lymphostasis

Post-traumatic lymphostasis often occurs after bruises, dislocations, and fractures.

• At the first stage of the disease, the swelling is mild, disappears after rest, and increases with prolonged limitation of mobility.
• At the second stage, the swelling is constant, the skin is thickened. When pressed, a mark remains.
• The third stage is the elephantiasis stage. The patient develops eczema and trophic ulcers.

The following groups of drugs are used for treatment: phlebotonics, enzymes and immunostimulants.

Laser therapy is an effective physiotherapeutic procedure. It is necessary to perform a special set of exercises.

Chronic lymphostasis

Lymphostasis can be congenital (primary) and acquired (secondary).

Congenital lymphostasis is based on underdevelopment of the lymphatic system. Hereditary lymph drainage disorder manifests itself in several family members.

Secondary chronic lymphostasis is provoked by:

• Soft tissue tumors
• Traumatic injuries
• Radiation therapy for tumors
• Operations
• Parasites
• Chronic venous insufficiency
• Pathologies of the heart and kidneys.

Women get sick more often than men.

When lymph drainage is disrupted, fluid and protein accumulate in the tissues. Blood circulation deteriorates. Tissue hypoxia occurs. The skin thickens, becoming a gateway for infection.

At first, a small swelling occurs, but there is no pain. Then it thickens and does not go away after sleep. The limb (and it is chronic lymphostasis of the limbs that doctors most often encounter) is deformed.

Under the influence of elastic compression, the swelling may disappear completely at the first stage.

To diagnose chronic lymph drainage disorder, a consultation with a phlebologist, ultrasound, blood and urine tests, and MRI are indicated.

In advanced cases, when the disease has progressed too far, doctors are forced to resort to surgical intervention. The goal of the operation is to reduce the thickness of the limb and restore lymph flow.

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Lymphostasis in children

Lymphostasis in children is caused by abnormalities in the development of the lymphatic system. It develops on the lower and upper limbs and on the face. Prevalence is 1:10,000. Congenital lymphostasis can be combined with limb dysplasia. The disease most often begins to manifest itself in adolescence and young age, when the load on the lymphatic system increases.

Diagnostic methods: lymphography, ultrasound.

Treatment consists of a combination of massage, exercise therapy, compression hosiery, and lymphatic drainage.

Lymphatic drainage – gentle massage of the limb for 30-45 minutes. Contraindications: tumors and venous thrombosis.

It is important for children with congenital lymphedema to monitor their body weight, as obesity contributes to its development.

Compression stockings are used to treat congenital lymph drainage disorders. They are best made to order.

Why is lymphostasis dangerous?

At the first stage, the lymphatic drainage disorder does not manifest itself in any way, except for minor edematous syndrome. Patients rarely seek medical attention and, unfortunately, if left untreated, the disease leads to disability. The third stage of the disease is called "elephantiasis". The patient's limbs acquire a characteristic appearance. Women experience particularly severe discomfort. Their psychological balance is disturbed.

Also, a patient with lymphostasis is very susceptible to infections.

Pain due to lymphostasis

Skin tension causes pain in lymphedema.

Lymphedema

Lymphedema is the first stage of the disease. Lymphostasis and lymphedema are successfully treated in the early stages. The main goal of treatment is to prevent complications and improve the appearance of the limb.

Wearing a bandage is the most important part of the therapy, it can reduce swelling by 50%. Compression hosiery is also prescribed, which is selected individually. Staying in one position for a long time is contraindicated. It is necessary to avoid saunas and hot baths.

Lymphostasis and lymphedema increase the risk of skin infection with fungi. The skin of exposed areas of the body requires special protection.

Physical therapy is performed. It helps to speed up the movement of lymph.

Patients should not overload their kidneys and heart.

Elephantiasis

Elephantiasis is a late stage of chronic lymphostasis. Elephantiasis affects the limbs and genitals.

Thanks to the development of microsurgery, surgical treatment of the disease has become more successful, a good cosmetic effect is provided, such interventions are minimally invasive. At the last stage, conservative treatment is ineffective.

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Treatment of lymphostasis

Treatment of lymphostasis in Ukraine is often unsuccessful. Therefore, many patients are interested in where they can undergo treatment for this disease in Germany. This is an opportunity to get rid of this unpleasant disease forever, causing physical and psychological suffering.

Vascular surgeons in Germany have priority in developing solutions to the problem of impaired lymphatic drainage. Indications for surgical treatment are found in 3-5% of patients. Lymphostasis treatment programs in Germany are compiled individually.

Treatment in Israel

Treatment of lymphostasis in Israel is very effective due to the proximity of healing springs. The substances they contain improve the outflow of lymph.

Phlebologists with a worldwide reputation work in Israel. In the clinics, the patient feels comfortable thanks to Russian-speaking support.

Treatment in Belarus

Treatment of lymphostasis in Belarus is carried out in sanatoriums, where a full range of physiotherapeutic procedures is used. Pneumatic compression systems have become the most popular. They have proven their effectiveness. This method eliminates edema and venous congestion, improves tissue oxygen supply, improves tissue trophism and skin turgor.

Drug treatment

Drug treatment of lymphostasis plays a supporting role.

Groups of drugs for the treatment of lymphostasis:

1. Phlebotropics: flavonoids (Detralex), Troxerutin, Escin, Escusan.
2. Coumarins.
3. Diuretics (water pills).

Detralex is a venotonic. It is taken twice a day during meals. The course of treatment is three months. Contraindications: intolerance to the drug. Do not use during lactation.

Troxerutin is a drug with venotonic activity and anti-inflammatory action. Increases the elasticity of blood vessels and improves trophism. Available in capsules and ointments. The capsules are taken without chewing, with food. Dosage: 1 capsule 3 times a day. The course of treatment is about 5 weeks. Gradually, the dosage can be reduced to one capsule once a day.

Troxerutin gel is applied in a thin layer to the affected areas 2-3 times a day. Avoid contact of the gel with eyes and mucous membranes.

Side effects: headache, rash, itching, urticaria, hyperemia of the skin.

Escin is a glycoside based on horse chestnut fruits. It has an anti-edematous and anti-inflammatory effect. Contraindications: chronic renal failure, 1 trimester of pregnancy. Do not use during breastfeeding.

Dosage: orally - 40 mg 3 times a day. Then the dose is reduced to 20 mg 3 times a day. The drug is also available in gel form. It is applied to the affected areas several times a day.

Aescusan has an effect similar to escin, but it also contains vitamin B1. Decongestant and venotonic drug.

Directions for use: Take 12-15 drops of the solution for oral administration 3 times a day before meals. Dissolve the drops in a small amount of water.

The drug is also available in tablets. The tablets are taken one at a time three times a day. The course of treatment is three months.

Side effects may include gastrointestinal irritation, nausea and allergies.

The drug is contraindicated in early pregnancy, in kidney diseases and for nursing mothers. It is not recommended for use in childhood.

Traditional treatment of lymphostasis

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Tar treatment

Bake the onion in the oven, peel it and add a tablespoon of tar. Apply to the affected area. The course of treatment is 3 months.

Treatment with garlic

Take garlic, peel and mince. Pour 250 g of garlic with 350 g of liquid honey and leave for 10 days. Take three times a day one hour before meals for 2 months.

Treatment of lymphostasis with plantain

Take two tablespoons of plantain leaves, pour two glasses of boiling water. Strain the decoction in the morning. Take four times a day before meals. Folk treatment of lymphostasis with this method lasts 3 months.

Treatment of lymphostasis with leeches

Treatment of lymphostasis with leeches reduces limb tension. Leeches are placed on lymphatic collectors. The average number of leeches per session is 4. The frequency of placement is 2 times a week. Treatment courses can be repeated after 5 months. The method has proven itself in cases of impaired lymph drainage after mammary gland removal.

Medicinal leeches are safe and are used only once.

Prevention of lymphostasis

What is the prevention of lymphostasis? How to avoid a disease that is so difficult to treat? This is, first of all, timely treatment of wounds, kidney and heart diseases, an active lifestyle, and obesity prevention.

This disease can be prevented by simply adjusting your diet and lifestyle.

Lymphostasis is a disease that causes physical and psychological discomfort, but with today's development of medicine, it is not life-threatening and can be controlled. Complex treatment will help overcome the violation of lymph outflow. Your persistence and positive attitude will help you with this.