Lymphostasis of the lower extremities causes and treatment, photo, diet

Lymphostasis, or lymphedema, is the excessive accumulation of protein-rich fluids in tissues.

The impaired function of the lymphatic vessels violates the drainage function of the lymphatic system, which is also part of the circulatory system, like arterial and venous. Lymphatic vessels remove excess fluid from tissues and transfer it back into the bloodstream. In addition, the maturation of immune cells occurs in the lymphatic system, and thus, it represents one of the most basic defense systems of the whole organism. The lymphatic capillaries located in the dermis are plexuses that merge into the lymphatic vessels in the subcutaneous tissue, ultimately going to the deeper system and the thoracic duct. Lymphedema can be either primary or secondary. Regardless of etiology, this condition is clinically characterized by chronic edema, localized pain, atrophic changes in the skin, and secondary infections. [1]

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Lymphedema in accordance with the etiology is divided into primary (hereditary) or secondary (acquired). Primary lymphedema is quite rare and is the result of genetic mutations that lead to underdevelopment of the lymphatic vessels and lack of lymphatic drainage function.

Primary lymphedema can be an isolated disease or part of a complex syndrome. Most cases of primary lymphedema are inherited in an autosomal dominant fashion with incomplete penetration and variable gene expression. Almost 30% of patients with primary lymphedema have identifiable genetic mutations, often in the signal form for endothelial growth factor C. [2] It has been established that more than 20 genes are associated with lymphatic abnormalities in primary lymphedema. However, there is a high degree of genetic heterogeneity. [3] Primary lymphedema is often found in the lower extremities, and only in rare cases can it appear on the genitals or upper limbs. The incidence in women is twice as common as in men. [4]

Depending on age, primary lymphedema is divided into 3 types:

  • congenital lymphedema (appears at or shortly after birth);
  • pubertal lymphedema;
  • late lymphedema, which appears at the end of life.

Secondary lymphedema is much more common than primary. It occurs due to damage or obstruction of previously normal lymphatic vessels in various diseases, recurrent infections, injuries, surgical interventions, obesity or due to malignant processes and their treatment, such as radiation therapy. [5] Lymphedema can occur in chronic venous hypertension and venous ulcers, which is associated with impaired lymphatic function in this pathology. In patients with chronic venous diseases, in 20% of cases there is also a secondary lymphatic lesion due to fluid overload. [6] Thus, phlebolymphedema refers to lymphedema caused by chronic venous insufficiency. Secondary lymphedema may also be associated with a genetic predisposition. [7]

Infectious diseases. Lymphatic filariasis (also known as elephantiasis) is the most common cause of secondary lymphedema worldwide. This is an acquired infection caused by the mosquito larva Wuchereria bancrofti. It infects people who live or come to areas endemic for the disease, mainly in sub-Saharan Africa and India. Larvae of an adult worm are planted on human skin with mosquitoes. Then these larvae migrate to the lymphatic vessels, causing obstruction of the lymphatic ducts. Herpetic infection can also, although rarely, cause lymphedema. Recurrent cellulitis and erysipelas also lead to damage to the cutaneous lymphatic ducts and can be the cause of unilateral lymphedema. [8]

Venereal lymphogranuloma – a sexually transmitted disease caused by chlamydia, can be the cause of lymphedema of the external genitalia. Tuberculosis of the lymph nodes of the neck is a much less common cause of lymphedema. [9]

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Surgical removal of lymph nodes during a mastectomy for breast cancer or treatment of melanoma leads to impaired lymphatic drainage function. Radiation therapy, which leads to almost irreversible damage to the intradermal lymphatic vessels and nodular fibrosis. The above post-therapeutic lymphedema is usually manifested by chronic unilateral edema. However, interventions on the prostate and cervix can cause bilateral edema. [10]

Podoconiosis is the cause of non-infectious elephantiasis caused by chronic damage to the feet, with prolonged barefoot walking on clay soil containing silica. This is the second most common cause of tropical lymphedema worldwide. Mineral particles absorbed through the skin induce inflammation of the lymphatic vessels and cause subendothelial lymphatic edema and vascular obstruction. Podoconiosis is an endemic disease in the highlands of tropical Africa, North India and Central America. [eleven]

Morbid obesity is one of the main risk factors for the development of secondary lymphedema. An increase in the amount of adipose tissue in dependent areas causes obstruction of the lymphatic vessels. A decrease in physical activity in obese patients is an aggravating factor. [12]

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Most members of the International Society of Lymphologists generally rely on a three-stage scale for the classification of lymphedema, an increase in the number determines stage 0 (or Ia), which gives a reference to a latent or subclinical condition where the edema does not yet appear, despite damaged lymphodynamics and subtle mechanisms of tissue disorders ( fluid/composition) and already visible clinical changes in subjective specific symptoms. This condition can exist for a long time, both months and years, before edema appears (stages I-III).

Stage I is an early accumulation of fluid with a relatively high protein content (for example, compared with “venous” edema) and manifests itself as edema, which decreases with the rise of the limb. At this stage, pitting may occur (pressure trail). In addition, at this stage, an increase in various proliferating cells occurs.

Stage II: the elevated position of the limb does not lead to a decrease in tissue edema, which is manifested by the above pitting. The late stage of the second stage is characterized by persistent edema, adipose tissue hyperplasia and fibrosis.

Stage III includes lymphostatic elephantiasis, where pitting may be absent. In addition, trophic skin disorders are revealed, such changes as acanthosis, deposition of fat and fibrosis, warty growths. These stages relate only to the physical state of the limbs. A more detailed and comprehensive classification should be formulated in accordance with an understanding of the pathogenetic mechanism of lymphedema (for example, in terms of the genesis and degree of lymphangio dysplasia, lymphatic flow disorders, lymph node dysfunction, both based on anatomical visual features and through physiological and visualization diagnostic methods) . Also important is the study of the underlying genetic pathogenesis of lymphedema, which are gradually being clarified by specialists in this field. Recent publications, combining both physical (phenotypic) results with functional lymphatic imaging (at the time of lymphangioscintigraphy (LAS)), can predict the future evolution of the classification of this disease.

In addition, it is worth noting that the inclusion of genotypic information, which is now available even with the current screening, will provide valuable information in the future for preliminary diagnosis and classification of patients with peripheral (and other) lymphedema. At each stage, a simple classification can be used, albeit a limited, but nonetheless functional assessment of the severity of the disease using a simple measurement of limb volume.

To understand what lymphostasis is, it is necessary to recall the anatomy of the human lymphatic system. It includes lymphatic vessels and trunks, lymph nodes and lymphatic ducts. This system provides an outflow of interstitial fluid from human organs, returning it to the blood. Also, the lymphatic system is responsible for the protective functions of the body, producing special lymphocyte cells involved in providing immune defense. The protein fluid entering the lymph nodes through the lymphatic vessels is purified there from toxins and waste substances.

Due to the violation in this rather complex system, the normal outflow of lymph from the organs changes, which leads to the development of edema, metabolic processes in the tissues, proliferation of connective tissue and a decrease in resistance to infection.

The causes of lymphostasis of the lower extremities are diverse. Previously, this pathology was considered rare, but now doctors are faced with it more often. Depending on the processes that led to lymphostasis, it is customary to distinguish primary and secondary lymphostasis of the lower extremities.

Classification by reason:

  • The primary form of lymphostasis.

May be the result of congenital changes in the lymphatic vessels of the legs. These are disorders of the development of blood vessels at the stage of embryogenesis: the absence of blood vessels in a certain area of ​​the limb (aplasia) or an insufficient number of blood vessels (hypoplasia).

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The disease can be both hereditary and due to past illnesses.

Given etiofactors, lymphostasis can develop primary or secondary.

  • Primary lymphostasis is characterized by a deficiency of the lymphatic system associated with congenital anomalies of the lymphatic pathways (hypoplasia, agenesis or obstruction of the vessels, valve insufficiency, hereditary syndromes). With primary lymphostasis, one or both limbs may be affected; manifestations of lymphedema are already expressed in childhood and increase in adolescence.
  • Secondary lymphostasis. Secondary lymphostasis is said to be in the event of injuries or diseases of the initially normally formed lymphatic system. Secondary lymphedema often develops in one limb, usually in the area of ​​the elevation of the foot and lower leg, and more often has a post-traumatic or inflammatory nature.

Lymphedema is predominantly found in women. 91% of patients develop lower limb lymphostasis. With the development of lymphatic edema at the age of 15-30 years, they talk about youthful lymphedema, after 30 years – about late lymphedema. In the development of lymphostasis, 3 consecutive stages are distinguished: 1 – mild transient edema, 2 – irreversible edema; 3 – elephantiasis (irreversible edema, cysts, fibrosis).

  • overweight and obesity
  • tumors of the pelvic organs
  • erysipelas of the lower extremities
  • previous surgery for cancer with the removal of regional lymph nodes and ducts (breast cancer, tumors of the chest cavity, etc.)
  • various injuries to hands and feet (including frostbite and burns)
  • heart or kidney disease (e.g., hypertension and pyelonephritis)

Can pathology be cured?

Lymphostasis refers to the pathology of the lymphatic system, which is characterized by a complete cessation of lymph circulation. It ceases to fulfill its primary functions and carry out continuous drainage of all body tissues. Edema is a clinical symptom of this pathological process. Most often, it develops in the region of the lower extremities. In the fair sex, such an ailment is diagnosed five times more often than in men.

Lymphostasis of the lower extremities is a disease of a chronic nature that affects only one or both legs. The pathology does not go away on its own; drug or even surgical treatment is required. Otherwise, the likelihood of fibrous tissue formation increases, which entails thickening of the legs (elephantiasis).

A well-formed diet helps treat such a serious problem of lymph outflow. Diet with lymphostasis of the lower extremities plays a primary role, because the disease most often develops in overweight people.

Specialists suggest limiting the consumption of salty and spicy foods, from which you constantly feel thirsty. In addition, salt contributes to the consistent accumulation of fluid in the tissues, and this negatively affects the healing process.

It is also recommended to reduce the amount of carbohydrates consumed. It is better to refuse baking, sweets, pasta and potatoes.

The diet should mainly consist of fresh vegetables and fruits, dairy products, low-fat fish.

With congenital pathology, surgery sometimes helps. But it all depends on the specific case. Secondary lymphostasis can be treated with medications and alternative methods, in combination with massage and exercise therapy at the 1st stage of the disease. Stage 2 is difficult to treat, but you can achieve a better quality of life and maintain the result for a long time.

Alas, it is possible to solve the problem radically – by amputation, or to alleviate the painful sensations of the patient medically, and physically help him in finding special devices for moving around the city and self-service himself in the bathroom and toilet – that is, in everyday life.

Clinical manifestations

Diagnosis of “lymphostasis of the lower extremities” is usually not difficult, since the clinical picture of the disease is pronounced. Swelling of one or both lower extremities is so large that the legs resemble the limbs of an elephant. From here comes the name of lymphostasis known in everyday life – elephantiasis.

Symptoms of lymphostasis of the lower extremities are quite characteristic, their severity depends on the stage of the process.

4 stages of lymphostasis are clinically distinguished:

Orthostatic stage – edema of the lower limb is formed at the level of the foot and does not go beyond the border of the ankle joint. Characteristic is the complete elimination of edema when giving the limb an elevated position. It was noted that at this stage, edema occurs periodically – more often appears in the heat and during physical exertion, in the cold season it is less common, it is completely able to disappear after rest. Osteochondrosis may appear.

The deforming stage is irreversible changes in the tissues of the lower extremity and extensive edema, which does not decrease after rest. The size of the affected limb can be several times the size of a healthy leg.

At this stage, fibrotic processes develop in the skin and subcutaneous tissue. The skin in the affected area does not fold, it becomes rough to the touch, the color changes from dark red to brown. Often streptococcal infection of the skin joins – erysipelas.

The terminal stage of lymphostasis is fibrous. Edema increases even more in volume, trophic changes in the soft tissues of the limb are characteristic – the formation of non-healing ulcers, weeping eczema, leakage of lymph from wounds, etc. Voluminous outgrowths form on the skin, the limb becomes ugly. This stage is called “elephantiasis” or, in fact, elephantiasis.

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At the last stage of the disease, there is the possibility of trophic ulcers.

At this stage, the risk of developing complications, such as erysipelas, ulceration, and infection, is high. In some cases, a tumorous disease develops – lymphangiosarcoma. And the penetration of infection from non-healing wounds on the legs into the bloodstream contributes to the development of sepsis, which can end fatally.

Treatment of lower limb lymphostasis

Lymphostasis of the lower extremities (LNK) is a fairly common disease, which, according to statistics from the World Health Organization, is more likely to affect the weaker sex. Signs of lymphostasis of the lower extremities in varying degrees of severity are noted in every tenth woman. The selectivity of the disease can be explained by the fact that it was nature who placed the obligation on bearing and giving birth to offspring, and one of the factors provoking the development of a disease such as lymphostasis of the legs is a steadily increased load on them, which inevitably occurs during pregnancy.

To understand what lymphostasis of the lower extremities is and why it occurs, you need to carefully consider how the lymphatic system in the human body functions.

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Lymphatic substance is a blood plasma filtration product that accumulates and removes toxins from it. From the interstitial space, it enters the lymphocapillaries, then into the lymphatic network and into the lymph nodes, from where, after cleaning, it returns to the bloodstream. In addition to the cleaning function, lymph removes excess fluid from the blood, preventing the development of edema.

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Lymphostasis of the lower extremities is most common in women

Depending on what factors contribute to the manifestation of pathology, specialists distinguish primary and secondary lymphostasis. Primary lymphostasis, also called Milroy’s disease, is a rare genetic disease that can occur in representatives of the same family for several generations.

The occurrence of secondary lymphostasis of the lower extremities can be triggered by a number of reasons, among which, in addition to pregnancy:

  1. Varicose vessels of the legs, as well as its complications – thrombophlebitis and thrombosis.
  2. Cardiac and/or renal failure, against which edema occurs.
  3. Complication of infectious and inflammatory lesions of subcutaneous fat tissue – the development of boils and phlegmon.
  4. Postoperative lymphostasis of the lower extremities provokes scars in the area of ​​the lymph nodes and blood vessels, compressing them and preventing the normal outflow of fluid.
  5. Neoplasms, the localization of which is the interstitial space.

Also, a sedentary lifestyle can become the cause of lymphostasis of the lower extremities. Sometimes it occurs with prolonged bed rest in people who have had a stroke or a serious injury.

The development of lymphostasis can be due to a wide range of factors. Lymphatic circulation disorder with lymphatic retention in tissues occurs with heart failure, kidney pathology, hypoproteinemia, when the lymphatic lines cannot cope with lymph outflow. Lymphostasis can be a consequence of chronic venous insufficiency in decompensated forms of varicose veins, post-thrombophlebitis syndrome, arteriovenous fistula. The removal of excess tissue fluid leads to compensatory expansion of the lymphatic vessels, a decrease in their tone, the development of valve insufficiency and lymphovenous insufficiency.

The causes of lymphostasis can be defects of the lymphatic system, obstruction of the lymphatic vessels when they are damaged (mechanical and surgical injuries, burns), compression by tumors or inflammatory infiltrates that prevent lymph flow. With lymphadenitis and lymphangitis, obliteration of some lymphatic vessels leads to expansion and valvular insufficiency of others, which is accompanied by lymphatic stasis.

An extended mastectomy performed for breast cancer is complicated by the development of lymphedema of the upper limb in 10-40% of cases. Usually, axillary lymphadenectomy (axillary lymphadenectomy) is performed during mastectomy – removal of lymph nodes, which are areas of regional metastasis. The likelihood of developing lymphostasis directly depends on the amount of axillary lymphadenectomy. Prostate cancer, lymphoma, inguinal-femoral lymphadenectomy, radiation therapy of areas of regional lymphatic drainage can also provoke lymphostasis.

In some cases, impaired lymph circulation with the development of lymphostasis is observed with recurrent streptococcal lymphangitis (with phlegmon, erysipelas), parasitic infections. In countries with a tropical climate, lymphatic filariasis is common, spread by mosquitoes (elephantism, elephantiasis). Infection is manifested by damage to the lymph nodes, their enlargement, fever, severe pain, hypertrophy of the legs, arms, chest or genitals.

Pathology is divided into 2 stages. The causes of inflammation and swelling of the lower extremities up to the foot in humans with lymphostasis are listed below:

  1. The diameter of the vessels damaged by the disease with lymph gradually decreases.
  2. The number of pathways whose function is to ensure the outflow of lymphatic fluid is reduced.
  3. Specific anomalies appear – doubling or overgrowing, in some cases obliteration.
  4. The presence of amniotic constrictions, which causes squeezing scars.
  5. Defects in the functioning of the lymphatic system, which are transmitted to humans according to genetics.
  6. Tumors or neoplasms of a congenital nature also contribute to the development of lymphostasis.

As mentioned above, leg disease is divided into stages. Symptoms of the disease, as well as the causes, vary in stages. Consider the signs of lymphostasis of the legs as the person worsens:

  • Minor edema with lymphostasis of the legs is called lymphedema. Swelling may be non-periodic. Basically, the skin on the legs returns to normal in the morning or when resting. When the lower extremities are busy with physical activity, the edema gradually increases. In this case, the skin becomes pale, and when pressed, a characteristic fold is formed. At this stage, significant changes in the legs are not observed.
  • Permanent swelling in this disease is called fibr >limfostaz nizhnih konechnostey lechenie 5 - Lymphostasis of the lower extremities causes and treatment, photo, diet

Thrombophlebitis is a dangerous disease, but with timely medical attention, it responds quite well to therapy. Thrombophlebitis without treatment can lead to ulcers, gangrene or thrombosis of large veins, disability and death .

the information on the site is not a medical diagnosis, or a guide to action and is intended for informational purposes only.

What it is? Lymphostasis is the development in the body of stagnant lymph processes in the extracellular space of tissues. In addition to the characteristic localization of the pathology of lymphostasis (in the limbs), other variants of the manifestation of functional disorders of the lymphatic system are also known – in the tissues of the breast, face or scrotum.

According to statistics, more than 200 million people around the world are susceptible to lymphostasis, and their main category is women (the age of Balzac’s heroines). And the lion’s share of lymphatic flow disorders is due to localization in two or one lower limb (in almost 90% of cases).

The development of lymphostasis begins with pathological processes that disrupt the functions of small vessels of the lymphatic system (capillaries, collectors), which is manifested only by subtle swelling in the legs. Gradually, large vessels are involved, leading to trophic changes in the limbs and an increase in their volume, manifested by elephantiasis.

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The main genesis of the development of the disease is the accumulation of lymphoid fluid in the intercellular structure of tissues, provoked by an increase in lymphatic pressure caused by an imbalance in the formation and outflow of lymph saturated with proteins.

This process causes a limited or widespread localization of tissue edema. With such edema with lymphostasis of the legs, you can successfully fight, since swelling does not cause thermodynamic (irreversible) tissue changes.

But, when changes in the form of protein destruction begin in the lymphoid fluid, fibrin and collagen fibers develop in the skin and the structure of fiber, muscle and fascial tissues.

The rapid proliferation of connective tissue leads to thermodynamic changes in the affected tissues, in the form of cicatricial neoplasms that inhibit blood flow, disrupt trophism, and provoke the development of inflammation reactions. According to the causative factor, two forms of lymphostasis are distinguished in the development of the disease:

  1. Primary, due to congenital anomalies in the development of the ducts of the lymphatic system, with the manifestation of symptoms from early childhood, or in the early puberty.
  2. Secondary, characterized by the development of the disease due to various pathological conditions. In addition to lymphedema affecting the lower and upper limbs, this group also includes lymphostasis of the hand after mastectomy.

There are many reasons for impaired lymph flow:

  1. In the human body, various lesions may occur, accompanied by tumors, because of this, the fluid in the vessels cannot move quietly.
  2. If the lymph nodes were injured.
  3. A person leads a sedentary lifestyle and moves a little.
  4. Overweight.
  5. Violation of patency in the vessels themselves.
  6. Infectious diseases that occur in severe form.
  7. Blood vessel constriction.

It is worth noting that each person has their own way stagnation of lymph in the legs. Treatment and causes mainly depend on the stage of the disease.

  1. The first stage is mild and does not cause any concern. A sick person can notice swelling in the legs only at the end of the working day, but the tissues remain soft and all symptoms disappear by the morning. In the first stage, the disease can be completely cured.
  2. In the second stage, many patients already begin to seek the help of a doctor. Soreness in the legs begins to appear gradually, and edema does not subside overnight. The skin on the legs seems taut and dense, and if you press on it, then the fossa does not disappear for a long time.
  3. The third stage is characterized by a violation in the lymphatic system. The general condition of a person significantly worsens, pain appears not only in the legs, but also in the joints.
  • Heart failure.
  • Varicose veins.
  • Pathology of the kidneys.
  • The presence of arteriovenous fistula.
  • Malformations of the lymphatic system.
  • Neoplasms that impede normal lymph flow.
  • Parasitic infections.
  • Venous insufficiency of a chronic nature.

Video about lymphostasis, its symptoms and treatment methods

The course of conservative therapy of lower limb lymphostasis includes medication and physiotherapy.

Among the pharmaceutical preparations used in this pathology, the following can be mentioned:

  1. Detralex, Vazoket, Phlebodia – phlebotonics that improve the metabolism in the tissues of the legs.
  2. Troxevasin, Troxerutin, Venoruton – drugs that increase the tone of the veins, the best result is shown at the initial stage of the disease.
  3. Curantil, Trental – blood-thinning agents that alleviate congestion and prevent the formation of blood clots.

In addition, diuretics are prescribed to relieve edema. Since the systematic use of such drugs causes potassium deficiency in the body, the doctor usually recommends taking them simultaneously with potassium-containing drugs (potassium orotate).

Physiotherapy for lymphostasis includes magnetic and laser therapy, hydrotherapy (hydromassage), ultraviolet irradiation of autologous blood.

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With lymphostasis, magnetic and laser therapy show good efficacy.

Lymphatic drainage massage performed by a professional masseur and physiotherapy exercises, which must be practiced constantly at least twice a day, also give a good effect in lymphostasis. It is advisable to enter the complex on a stationary bike or cycling.

It is necessary to constantly wear compression hosiery – golf or stockings, which should be worn in the morning, before getting out of bed.

Another way to treat and prevent the progression of lymphostasis of the lower extremities is hirudotherapy (treatment with leeches). The procedure should be performed by a qualified specialist, using animals specially grown in sterile conditions. Their repeated use is excluded.

Dietary nutrition for lymphostasis of the lower extremities should include dairy products, lean meats and fish, chicken eggs, vegetables and fruits. Excess in the diet of sugar, confectionery, fatty foods, hot spices and salt is undesirable. Frying as a way of cooking is not recommended.

In the absence of positive dynamics of conservative treatment, surgical correction is indicated to improve the outflow of lymph from the lower extremities. The operation is performed by a vascular surgeon in a hospital.

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Folk treatment

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Alternative treatment of lymphostasis can only be done in the initial stages of the disease

The use of traditional medicine at home is permissible in the initial stages of the disease, after a mandatory consultation with your doctor. This primarily includes herbal medicine – treatment with plant materials. Traditional healers recommend the following recipes:

  1. Chopped licorice root (10 g) pour a glass of boiling water and put in a water bath. After 30 minutes, remove from heat, strain, cool and add water to the original volume. Take a tablespoon three times a day for three weeks.
  2. Dilute apple cider vinegar in half with water and massage the legs with them in the direction from the bottom up to the inguinal lymph nodes. Massage should be soft, without pressure.
  3. Mix the baked onion crushed into gruel with pharmaceutical tar, put the resulting ointment on the problem area of ​​the leg, fixing it with a bandage. It should be applied at night, washing off in the morning with warm water.

Unfortunately, there is no single protocol for treating lymphostasis today, although therapy is being carried out. Its purpose is due to:

  1. Stopping the progression of the disease;
  2. Normalization of metabolic processes;
  3. Prevention of the development of deep lesions and complications.

The treatment is individual and complex, due to the different genesis of the pathology. The first step is to eliminate the causative factor (sometimes by the operational method, eliminating neoplasms that impede the movement of lymph).

The use of drug therapy in the treatment of lower limb lymphostasis is advisable only in the early stages of its manifestation, when there are no structural changes in the tissue and skin structure, or as an addition in the postoperative period. Its goal is to reduce the secretion of lymphoid fluid and restore its free movement with the help of various medications:

  • Drugs that improve the processes of lymph circulation – Detralex, Venoruton, Troxevasin.
  • Normalizing blood circulation in micro vessels – Trental and peripheral vessels – Teonikola, Drotaverina or No-shpa.
  • Providing a conclusion of a lymph from interstitial space – “Nicotinic acid” or “Coumarin”.
  • Means that ensure the normalization of metabolic processes and tissue traffic – Troxerutin, Hyaluronidase and Reopyrin.
  • Blood thinners – “Curantila” and stimulating the immune functions: “Amber acid”, “” and various vitamin complexes.
  • Antibiotics, with the addition of erysipelas.

In addition to conservative treatment, physiotherapeutic treatment methods are prescribed in the form of electro, magneto, laser stimulation and pneumatic massage. That allows you to speed up metabolic processes and normalize the flow of lymph through the system. In combination with drug treatment of lymphostasis, these procedures contribute to the normal restoration of lymphatic outflow and the strengthening of the vascular walls.

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In the treatment of lymphedema in the lower extremities, including the treatment of lymphostasis after mastectomy, along with drug therapy and physiotherapy, bandaging of the limbs with elastic tape and the use of compression therapy (the use of compression underwear) are mandatory.

How can you help yourself?

massage and compression underwear

Treatment of lymphostasis of the lower extremities at home is possible only at the initial stage of the development of the disease. Various kinesiotherapy techniques (active and passive) recommended by the doctor – active kinesiotherapy in the form of therapeutic exercises selected by a specialist and passive techniques in the form of massage can be used. Therapeutic massage can be carried out independently, or with the help of households.

Massage should be started with light circular stroking of the limb only with upward movements. Since the lymphatic system does not have a valvular apparatus, the movement of the lymph provides a difference in pressure, and it is this function that the hands should perform.

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Then come not too zealous kneading, patting and rubbing. Massage movements alternate with stroking actions.

By stroking and finishing the massage session.

As an addition to treatment, it is possible to use recipes of traditional medicine, in the form of compresses from cabbage leaves, plantain, birch and immortelle, brewed and infused for half an hour.

About nutrition and diet

Treatment of lymphostasis will not be successful even in its initial stage, if you do not carry out a correction of the diet aimed at reducing the patient’s excess weight, exacerbating the clinical picture and restoring normal processes in the vascular system. For this, the diet recommended by the scientist M. I. Pevzner is suitable, the diet of which consists of a balanced and full-fledged piranha, which has a beneficial effect on blood circulation functions.

At the same time, you should abandon the solarium procedures, visit saunas about public baths, uncomfortable and tight shoes and clothes, exclude heavy lifting, avoid situations where you need to be in a standing position for a long time, or sit in an uncomfortable position.

The result of untimely initiation of treatment for lymphostasis is disability. In addition, the timeliness of identifying the causative factor and adequate treatment will be able to protect patients from the development of infectious processes, a prerequisite for which are erosion, ulcers and ordinary wounds on the edematous surface of the skin.

  • bolezn vitiligo foto - Lymphostasis of the lower extremities causes and treatment, photo, dietVitiligo – what is it? Photos, causes and treatment, .

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Sometimes a person has lymphatic congestion in the legs, treatment in this case should be mandatory, as this greatly complicates the movement. In no case should the disease be considered only a cosmetic defect, because this is, first of all, a serious threat to life and health. The fact is that the lymphatic system performs many functions in the human body:

  1. First of all, with the help of this system, secondary absorption and return of protein to the blood is carried out.
  2. With the help of lymph, metabolism is carried out in the intercellular space.
  3. Lymph nodes play the role of protection against bacteria and viruses.
  4. In the intestines, fats are absorbed into the lymph.

When changes and malfunctions associated with lymph occur, a person can immediately feel a malfunction in his body.

Given all the symptoms and discomfort that a person experiences, all methods are good for getting rid of a disease such as lymph congestion in the legs. Treatment with folk remedies is used actively, but only as an adjunct to medication. Consider the basic recipes of traditional medicine:

  1. Chopped garlic is mixed in equal proportions with honey and aged in the dark for a week, after which the resulting medicine is taken one teaspoon per day three times.
  2. Plantain improves blood circulation. Finely chopped leaves pour 0,5 l of boiling water, leave overnight, and already in the afternoon they drink in small portions all the contents.
  3. It is recommended to drink tea from the leaves of currant and rosehip in unlimited quantities.
  4. If it is necessary to reduce the stagnation of lymph in the legs, treatment necessarily includes baths with a decoction of a string and pharmacy chamomile, they must be done every day for a long time, but the result will pleasantly surprise.

The correct way of life, a diet with the use of vegetables and fruits, as well as everything that will help improve blood flow, must be applied every day, and then the disease will recede.

Also, a good effect in lymphostasis is performed by a professional masseur, and physiotherapy exercises, which must be done constantly at least twice a day. It is advisable to enter the complex on a stationary bike or cycling.

Folk treatment

What are the signs of the disease?

In its development, this pathology passes through three stages.

  1. Lymphostasis of the lower extremities in the first stage is characterized by the appearance of minor edema mainly in the evening, which disappear on their own in the morning or after a short rest. They can increase after severe physical exertion or a long stay in a stationary state. At this stage, as a rule, there are no growths or any serious changes in the connective tissue itself. The help of a specialist, which most often consists in the use of conservative methods of treatment, gives a positive result.
  2. The second stage is characterized by the preservation of edema even after a night’s rest, the proliferation of connective tissue, the appearance of pain discomfort. Even with a slight finger press on the skin, a trace remains for a long time. Lymph congestion can cause seizures.
  3. At the third stage, lymphatic outflow disorders become irreversible, so-called fibrocystic changes occur in the affected areas, and elephantiasis gradually develops. At this stage, concomitant diseases often appear (eczema, trophic ulcer, erysipelas, deforming osteoarthrosis). In the absence of proper treatment, death due to sepsis is possible.

Lymphostasis of the lower extremities is also characterized by the appearance of the following symptoms:

  • General weakness.
  • Joint pain.
  • Inability to concentrate for a long time.
  • Headache.
  • The appearance of excess body weight.
  • White coating on the tongue.

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The forms of lymphostasis 2 are primary and secondary, and the stages are 3.

StagesTitles
1 stagelymphoderma
2 stagefibrederma
3 stageelephantiasis

Stage 1 is a harbinger of lymphostasis, and it is called lymphedema. Lymphedema is a reversible process, if you abandon bad habits in time and devote all your energy to treatment.

Stage 2 – fibredema is already irreversible due to significant damage. Permanent lymph congestion leads to skin tightening and stable pain syndromes. With prolonged standing, cramps appear. The shin increases in size in comparison with a healthy leg up to 50 cm.

Complications of stage 2 are manifested in the form of leg deformity, the skin acquires a bluish tint, often crackes, and lymph oozes from the wound for a long time. When rubbing a sore leg with rough clothes, the rubbed places heal for a long time.

Lymphostasis of the lower extremities (treatment at home occurs only under the supervision of a doctor), at 2 stages, sometimes it affects the vessels that are located close to the epithelium, and then the skin on the legs becomes burgundy, like a big big bruise.

Stage 3 – final. In medicine is called – elephantiasis. With it, the limb is deformed beyond recognition, and no longer looks like a human leg. She looks like an elephant foot, without the outlines of the feet and knees. Due to skin tightening and excess fluid, the leg becomes so heavy and sore that it is impossible to walk with it. It hurts to step, it hurts to sit for a long time.

People with elephantiasis move in a wheelchair, using crutches, and can walk independently for short distances within their own apartment. In some cases, the leg grows to such a size that you cannot sit in a stroller with it.

It is impossible to live with the present pain, the leg is operated on or, in extreme cases, amputated at the request of patients. People themselves ask to save them from the elephant’s limb, so as not to stretch a leg on the floor, which weighs more than their own body.

lymphostasis, a photo of symptoms after removal of the mammary gland

The onset of the primary stage of lymphostasis is marked by the formation of persistent and growing during the day edema on the back of the feet. The skin is taut and glossy. Light pressure leaves a recess that soon straightens.

In addition to a little discomfort in the form of bursting, the patient does not feel. There are no pain symptoms – since the swelling disappears in the morning, the patients have no particular worries, and no one is in a hurry to get medical help. Although it is in this period, the treatment of lymphostasis gives the most effective result.

Signs of the second stage are characterized by fibrotic changes in edematous tissues. The consistency of edematous tissues is dense, with pressure, soreness is noted, for a long time, an in-depth trace remains. The skin over the edema is characterized by increased sensitivity and has an unattractive appearance.

Its surface is dry, covered with cracks and folds that do not level out when stroking. At this stage of lymphostasis, there are no clear symptoms of traffic disturbance, but inflammatory reactions are noted, which appear on the skin in the form of small hyperemic spots. Muscle cramps often occur.

In the third stage of lymphostasis, noticeable changes in the skin occur. It is cracked, dry and very stretched. Massive swelling is very noticeable, which visually increases the size of the affected limb. Spilled red spotting appears on the skin – evidence of the development of inflammation reactions and the attachment of infection. Over time, obvious signs of trophic lesions of the skin cover appear.

At the fourth, last stage of the development of the disease, it is manifested by extensive signs of damage to the limbs, spreading to the lower leg and femoral zone. Pathological changes cover the joints and bones, causing their deformation.

– often a phenomenon – the loss of part of the lymph nodes together with the tissues of the gland itself, its fiber and muscle tissue, does not stop the function of the lymphatic system, resulting in the accumulation of lymphoid fluid in the tissues, forming edema. Its surplus can seep through the surgical sutures, which is often regarded by patients as the allocation of a postoperative uterus.

Swelling, after surgery, develops on the arm from the pathological process. Symptoms correspond to common symptoms that appear at different stages of lymphostasis.

In the vast majority, lymphostasis of the hand after a mastectomy does not require treatment, passes on its own for six months. Self-massage manipulations facilitate the situation, and special therapeutic exercises recommended by the doctor.

Establishing diagnosis

It is very important to promptly identify lymphostasis of the lower extremities. Photos of patients with such a diagnosis can be found in specialized medical guides. If symptoms appear that indicate this disease, you should consult your doctor. The specialist should initially examine the lower limbs, listen to all the patient’s complaints, and also collect a detailed medical history. After this, a detailed diagnostic examination is prescribed, which implies:

  • General/biochemical blood test.
  • Duplex vein scan to exclude venous insufficiency.
  • Ultrasound of the pelvic organs and directly the abdominal cavity.
  • Lymphography This study allows you to assess the condition of the lymphatic vessels.

If necessary, an additional examination of other organ systems can be prescribed to reduce the risk of disease recurrence.

Symptoms of Lymphostasis

Changes in the skin. Lymphedema can be unilateral or bilateral. Patients often complain of a feeling of heaviness and discomfort in the affected limb, especially at the end of the day. Transient minor edema is an early symptom of lymphedema. Over time, the skin acquires a pitted texture like an “orange peel”. As the disease progresses, the skin becomes more textured and rough due to its thickening and fibrosis. Persistent, non-leaking and non-passing edema indicates an irreversible stage of lymphedema. The inability to pinch a fold of skin at the base of the second finger (Stemmer’s sign) is extremely pathognomonic for chronic lymphedema. In addition, lymphedema is characterized by a symptom such as swelling of the back of the foot, which is called the “buffalo hump.”

Over time, elephantiasis develops. The skin over the affected area has a warty hyperkeratotic or “mossy” appearance. The skin in chronic lymphedema usually has cracks, ulceration with the phenomena of recurrent cellulitis. The release of a clear, light yellow liquid (lymphorrhea) is characteristic. Impetigo is also a common manifestation.

In more rare cases, patients with long-standing lymphedema have a risk of developing cutaneous angiosarcoma. This aggressive tumor is usually a reddish-purple spot or nodule that can enlarge, ulcerate, and in rare cases, metastasize. In the early stages of lymphedema, it can be difficult to distinguish from other common causes of limb edema, such as vericose disease, lipodema, and morbid obesity. Edema in chronic venous insufficiency can mimic the early stage of lymphedema. Although the edema is persistent and very similar in both cases, venous edema is usually associated with other clinical manifestations of venous diseases, such as varicose veins, hyperpigmentation, lipodermatosclerosis and the presence of venous ulcers. Moreover, venous edema stops after raising the limb. In chronic venous insufficiency, edema is usually associated with an increase in capillary hydrostatic pressure. With lymphedema, it is usually normal, and therefore raising the legs does not reduce swelling. This is the main difference from chronic venous insufficiency. [thirteen]

Lipedema, also known as lower limb lipomatosis, is a chronic progressive adipose tissue disorder. It is often mistakenly diagnosed as primary lymphostasis. Lipedema is almost exclusively characteristic of women and most often occurs a few years after puberty. It appears as a bilateral symmetrical accumulation of subcutaneous fat, mainly in the lower extremities, with small hematomas and a tendency to progressive swelling of the legs. One of the distinguishing features is that the swelling stops abruptly at the level of the ankles. Light hematomas are associated with increased fragility of capillaries in adipose tissue. [14]

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Most often, lymphostasis affects the upper and lower extremities

Stage I disease with lymphostasis of the legs is characterized by the occurrence of edema in the ankle joint
, the bases of the fingers and on the back of the foot. Edema is soft, painless, passes after some time after rest, the skin over the edema can form a fold.

In stage II of lymphedema, edema extends to the upper limb
. His character changes – he becomes permanent and dense, does not pass with a long rest, the skin cannot be folded. Gradually, elephantiasis develops. the difference in the volume of the affected and healthy limb can be 30–40 cm or more.

The limb is deformed, increases in volume, its physical capabilities deteriorate. With a long duration of the disease, hyperpigmentation of the skin, hyperkeratosis, warty formations appear. The disease is aggravated by the formation of ulcers and cracks on the skin, accompanied by profuse lymphorrhea (outflow of lymph to the surface).

About nutrition and diet

Lymphostasis is a long-term progressive disease that, as it develops, sometimes over the course of decades, goes through several stages.

The ICD-10 code for lower limb lymphostasis (the tenth version of the International Classification of Diseases, where each pathology known to science is indicated by an alphanumeric code) – I89.8.

Specialists, focusing on the symptoms, distinguish three main stages of lymphostasis of the lower extremities:

  1. Weakly expressed spontaneous edema, or, indicates the initial stage of the pathology. Typically, such lymphostasis occurs in the region of the lower leg and foot at the end of the day. It does not have painful manifestations and does not cause much concern. The skin of the legs at this stage of secondary lymphostasis retains its natural color and softness, does not tighten. When you click on it, a small dimple remains, which quickly disappears. After a night’s rest, such edema subsides on its own.
  2. Irreversible edema (fibredema) is characterized by a change in the structure of the tissue – it becomes painful, hardens (it is impossible to compress it into a fold), acquires a dark brownish tint. Pressing it causes the formation of recesses that do not smooth out for a long time. On palpation, dense fibrous cords are felt. The epidermis is significantly stretched under the influence of edema, which causes the formation of cracks on the skin surface. There is a risk of infection through the injured skin, as evidenced by spilled red spots on its surface. Because of circulatory disorders in the legs, cramps occur. The limb changes its normal shape, motor functions are violated – flexion in the joints is difficult.
  3. At the last stage of lymphostasis of the lower extremities, the so-called elephantiasis is formed. The affected areas of the epidermis are characterized by severe hypertrophy, edema changes the shape of the limb. Patients constantly experience malaise, weakness, headaches and joint pain. The motor functions of the limb are significantly impaired, it can no longer serve as a reliable support when walking. Hardly healing trophic ulcers appear on the skin, there is a threat of erysipelas and/or gangrene, the end of which can be fatal.

To prevent the disease from becoming irreversible, it is necessary to consult a doctor at an early stage of lymphostasis of the lower extremities. Timely diagnosis and proper treatment will help to avoid such a development of the situation.

  1. Mild spontaneous edema, or lymphedema, indicates the initial stage of the pathology. Typically, such lymphostasis occurs in the region of the lower leg and foot at the end of the day. It does not have painful manifestations and does not cause much concern. The skin of the legs at this stage of secondary lymphostasis retains its natural color and softness, does not tighten. When you click on it, a small dimple remains, which quickly disappears. After a night’s rest, such edema subsides on its own.
  2. Irreversible edema (fibredema) is characterized by a change in the structure of the tissue – it becomes painful, hardens (it is impossible to compress it into a fold), acquires a dark brownish tint. Pressing it causes the formation of recesses that do not smooth out for a long time. On palpation, dense fibrous cords are felt. The epidermis is significantly stretched under the influence of edema, which causes the formation of cracks on the skin surface. There is a risk of infection through the injured skin, as evidenced by spilled red spots on its surface. Because of circulatory disorders in the legs, cramps occur. The limb changes its normal shape, motor functions are violated – flexion in the joints is difficult.
  3. At the last stage of lymphostasis of the lower extremities, the so-called elephantiasis is formed. The affected areas of the epidermis are characterized by severe hypertrophy, edema changes the shape of the limb. Patients constantly experience malaise, weakness, headaches and joint pain. The motor functions of the limb are significantly impaired, it can no longer serve as a reliable support when walking. Hardly healing trophic ulcers appear on the skin, there is a threat of erysipelas and/or gangrene, the end of which can be fatal.

The treatment of lymphostasis includes the following methods:

  1. Non-drug therapy.
  2. Drug treatment.
  3. Surgical intervention.

Non-drug treatment includes a number of measures aimed at creating favorable conditions for the outflow of lymph from the lower extremities, as well as preventive measures aimed at maintaining the skin of the legs in a healthy condition. These include lymphatic drainage massage (self-massage), contrast shower, wearing compression underwear, daily toilet of the skin of the limbs, physiotherapy exercises. These are the activities that the patient himself can perform.

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Surgery is resorted to only at stages 3 and 4 of the disease.

Under the supervision of a doctor, non-drug methods of treatment include acupuncture, electrophoresis, electrical stimulation of the lymphatic vessels, phototherapy, pneumocompression, etc. Drug treatment should be aimed at improving tissue trophism (agents that improve regeneration), and combating infectious complications (antibiotics). Antithrombotic drugs, diuretics (to reduce swelling), vitamins and trace elements to increase the body’s defenses are also prescribed.

Surgical treatment is carried out at stages 3 and 4 of lymphostasis, when there is no effect from conservative therapy or irreversible destructive processes develop in the lymphatic vessels and soft tissues of the limbs. Bypass operations related to microsurgical interventions have proven themselves well. This is truly a jewelry work of a surgeon when anastomosis is created between the lymphatic vessels and veins or between the lymph nodes and veins. A lymph discharge into the venous bed is created, which prevents fluid stagnation in the interstitial spaces.

In the last stage of the disease, when the contractile function of the lymphatic vessels is completely lost, and irreversible fibrous processes have developed in the soft tissues, they resort to more traumatic operations. These include various techniques of skin plastic surgery, when excessively overgrown subcutaneous tissue is excised, the wound is sutured.

This type of surgical intervention does not provide a cure, but significantly simplifies the life of the patient and improves the appearance of the limb. However, it should be remembered that the healing of postoperative wounds in such patients is slower due to metabolic disorders in the affected limb and there is a high risk of secondary infection. This fact once again confirms that the sooner treatment is started, the more favorable the outcome of the disease.

With the mildest stage of lymphostasis, a systematic appearance of transient edema of the limb is observed, which is noticeable in the evening and disappears on its own in the morning, after rest. Edema tends to increase after physical exertion or prolonged restriction of mobility, a long stay on your feet. Irreversible changes and proliferation of connective tissue at this stage are still absent, therefore, timely access to a lymphologist and conservative therapy performed lead to a persistent regression of the disease.

Lymphostasis of moderate severity is characterized by non-disappearing edema, connective tissue growth, skin tightening and tension, which may be accompanied by pain. Pressing a finger on the edematous tissue leaves traces of an impression that lasts a long time. Persistent lymphatic edema can lead to increased fatigue of the affected limb, seizures.

  • 1) Reversible edema (lymphedema). In the region of the ankle joint, at the base of the fingers and between the metatarsal bones, a painless, still mild swelling occurs. The skin above it is pale, can form a crease. After rest, such edema disappears or decreases.
  • 2) Irreversible edema (fibredema). Edema becomes more dense to the touch (the fossa from pressing remains for a long time, the skin is not going to fold), spreads from the foot to the lower leg. Soon, the deformity of the leg becomes noticeable, it is difficult to bend, pain or a feeling of heaviness is felt in it. If a person with fibredema has to stand for a long time, cramps in the calf muscles or muscles of the foot may develop. At the same stage, the skin becomes darker, acquires a bluish tint, becomes rough and thick.
  • 3) Elephantiasis. The volume of the leg increases significantly, its contours are smoothed out. Erysipelas, eczema, trophic ulcers appear on the skin. Diseases of bones and joints of the affected leg join.
  • Diagnostics

    Lymphedema is primarily a clinical diagnosis, and therefore a thorough medical history and physical examination play an invaluable role. Late stages of lymphostasis can be diagnosed clinically without the help of additional methods. However, in the early stages of the disease, concomitant conditions, such as obesity, lipodystrophy, and venous insufficiency, can complicate the correct diagnosis, so additional examination methods may be extremely necessary. There are many diagnostic tools for evaluating lymphatic function. But the decision to use any of them should be based on the patient’s condition. Early diagnosis of lymphostasis is important because it significantly increases the success of therapy. [23]

    Medical history and physical examination

    The history should include the age of onset of the disease, a family history of lymphostasis, the history of various injuries, infections, cancer, cardiac pathology, hypothyroidism, hypoalbuminemia, sepsis, venous insufficiency or lymphatic obstruction. In addition, a significant history of the history is radiation therapy in the inguinal/axillary regions, lymphadenectomy, as well as a trip to areas endemic for filariasis. Lymphostasis of the lower extremity usually manifests itself as edema on the dorsal surface of the foot and toes with a characteristic blunt “square” appearance. Lymphedema usually begins with edema of the distal limb, and then the edema progresses proximal. The leather or dimpled skin texture (the phenomenon of orange peel) and the Koposha-Stemmer sign (the inability to pinch skin folds on the dorsal surface of the base of the second finger) are characteristic signs of chronic lymphostasis. In the later stages, the skin in the affected area becomes hyperkeratotic, papules, plaques and nodules with severe fibrosis develop.

    In most cases, the use of various imaging methods is not required for diagnosis. However, they can be used to confirm the diagnosis and assess the degree of damage to the lymphatic system to determine the most optimal therapeutic tactics.

    • Lymphoscintigraphy Is a standard instrumental method for imaging the lymphatic system to confirm the diagnosis of lymphedema. This is the most routine and commonly used research method for assessing lymphatic function. By visualizing the lymphatic vasculature, lymphoscintigraphy can detect abnormalities in the development of the lymphatic system. [24] The sensitivity and specificity of this method for detecting lymphedema is approximately 73% and 100%, respectively. [25] Despite the undeniable advantages, lymphoscintigraphy is laborious and technically difficult due to the lack of special radiological equipment in many clinics.
    • Magnetic Resonance Imaging (MRI) It is neither a sensitive nor specific imaging technique for the diagnosis of lymphedema. However, MRI can exclude other causes of limb edema and obstruction of the lymph ducts, such as soft tissue formation, including cancer. MRI can also be used to assess the presence of fluid and its nature in the soft tissues of the limbs, which helps to distinguish lymphedema from other forms of edema. [26]
    • In addition, additional methods for the diagnosis of lymphostasis can be ultrasonography, which allows to exclude venous pathology and sometimes detect signs of filariasis;
    • bioimpedance spectroscopy, which provides information on the amount of interstitial fluid in the affected limb.

    Laboratory diagnostic methods that evaluate liver and kidney function are also used. Histological studies have low sensitivity and specificity for the diagnosis of lymphostasis. [24]

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    A lymphologist is involved in the diagnosis of lymphostasis and subsequent therapy.

    A lymphologist is involved in the diagnosis and treatment of lymphostasis, but such a specialist can only be found in large cities, so most often patients with this pathology are taken by a phlebologist (vessel specialist) or surgeon. An experienced doctor is able to make a preliminary diagnosis already at the first examination of the patient, based on the external signs of the disease. But for absolute confidence in it, it is necessary to conduct a number of studies, including:

    • blood tests – to determine indicators such as erythrocyte sedimentation rate (excess of the norm signals the presence of an inflammatory process), platelet count (determines the blood viscosity index, which affects blood and lymph circulation);
    • urine tests – to exclude the connection of leg swelling with kidney disease;
    • X-ray lymphography, computed and magnetic resonance imaging of the lower extremities provide detailed information about the severity and nature of the pathological processes;
    • differential diagnosis to exclude deep vein thrombosis or postphlebitis syndrome.

    After receiving the results of the examinations, the doctor decides which treatment methods should be used in this case. At the same time, he takes into account both the stage of development of the disease and the patient’s condition and the presence of concomitant pathologies.

    If signs of lymphostasis appear, you should contact a vascular surgeon (phlebologist, lymphologist) to determine the cause of the pathology. In case of damage to the lower extremities, there is a need to perform an ultrasound of the abdominal cavity and small pelvis; with lymphedema of the hands – chest x-ray.

    To determine the location of the lymphatic block and vascular patency, X-ray lymphography, lymphoscintigraphy with Tc-99m, MRI, CT are used. These methods make it possible to judge changes in the lymphatic bed, to identify areas of crimp, lymphangiectasia, valve failure.

    Lymphostasis is differentiated from deep vein thrombosis and postphlebitis syndrome, in which lymphedema is unilateral, the swelling is mild, the presence of hypepigmentation, varicose eczema and varicose veins is determined. To exclude venous pathology, ultrasound of the veins of the extremities is performed.

    Lymphostasis of the lower extremities (treatment at home is postponed until a full study) requires professional diagnosis and the appointment of a regimen by a doctor. In order not to confuse it with temporary edema, you need to contact a phlebologist or lymphologist. A specialist in vascular diseases will do an ultrasound of the abdomen and pelvis, lymphography to determine the location of the lymph block.

    Stagnation of lymph in the legs can be easily diagnosed. The doctor knows exactly what methods to use for this. First of all, complaints and a medical history are taken into account. Urine and blood tests, the biochemical composition of blood, ultrasound of the kidneys and liver are considered mandatory, and the state of the heart is assessed. If no problems have been identified, then the doctor may prescribe additional tests:

    1. Lymphography allows you to determine the quantity and quality of blood vessels, as well as analyze their ability to let liquids pass through them.
    2. An excellent method is lymphoscintigraphy. Such diagnostics are aimed at obtaining information on the lymphatic flow and the state of the valvular vascular system.
    3. Using dopplerography, the vascular bed is examined, for this a special contrast medium is introduced into the body.

    As soon as the doctor reveals lymph congestion in the legs, treatment becomes an inevitable condition for returning to a normal lifestyle.

    Lymphostasis can be suspected by the characteristic appearance of the lower limb, but additional studies are needed to determine the causes of the condition and determine treatment tactics:

  • Dopplerography of the vessels of the legs in order to differentiate venous and lymphatic edema;
  • Ultrasound of the pelvic organs for inflammatory or neoplastic diseases that interfere with the outflow of lymph from the lower extremities;
  • lymphography – an X-ray examination of the patency of the lymphatic vessels
  • lymphoscintigraphy – radioisotope diagnostics of patency, tortuosity of lymphatic vessels, the state of their valves;
  • proteinogram – a study of protein fractions of the blood;
  • general urine analysis – to diagnose the condition of the kidneys;
  • Ultrasound of the heart, ECG – to study the condition of the heart;
  • general blood test – for inflammatory changes in it.
  • About the benefits of massage

    Massage with lymphostasis is best entrusted to a specialist. He will be able to “squeeze out” the excess fluid from the places of accumulation up without damaging the vessels. With an independent massage, you need to knead with rubbing movements from bottom to top. Visually, it looks like trying to put on invisible tights.

    The effectiveness of exercise therapy for lymphostasis depends on the stage of the disease. If the disease is at the initial stage, the swelling is weak, and the legs do not hurt when walking, then you can do active cardio training. But not all types of training will work, and there are limitations.

    Cardio training should pump the cardiovascular system, drive away excess fluid with toxins through sweat, but training should not injure the knee joints and feet. Accordingly, jumping rope and running are excluded, and classes on a stationary bike, elliptical trainer, rowing and swimming are suitable. Enough 40 minutes a day or every other day.

    In all other cases, exercise for the legs “bicycle” or “scissors”. To do this, lie down on the floor and depict the torsion or crossing of the scabbard with your feet on weight. Toes need to be kneaded, so they can do flexion-extensor movements.

    limfostaz nizhnih konechnostey lechenie 9 - Lymphostasis of the lower extremities causes and treatment, photo, dietExercise therapy is one of the methods of treating lymphostasis of the lower extremities.

    Do not forget about the ankles. They need to rotate clockwise and counterclockwise. A day you can do from 20 to 60 minutes, preferably without passes. At the initial stage of the disease, cardio training can be combined with home gymnastics on the floor, and with the advanced stage, cardio training in the form of swimming. They can be carried out on days when swelling is minimal, and the legs do not hurt.

    Special massage for lymphostasis of the lower extremities is a prerequisite for each therapy. Manual lymphatic drainage helps to activate vascular contraction, thereby helping to promote lymph. Thanks to the correct technique, many patients note a decrease in edema, a decrease in the volume of a sore leg.

    Sometimes a hardware massage is prescribed, which is otherwise called pneumocompression. However, positive results can be obtained only if the bandage is additionally used with an elastic bandage. The latter is selected exclusively by the doctor.

    When is surgery required?

    If conservative therapy is ineffective, swelling increases, the doctor makes a decision about the operation.

    Before direct surgery, staining of the lymphatic vessels with a blue dye is performed in order to better see the course and the degree of their expansion. The coloring matter is usually introduced into the interdigital spaces of the foot.

    Then, all damaged areas are removed by dressing or cauterization with a laser.

    During the operation itself, a number of additional procedures are possible (liposuction, the formation of bypass tunnels for the correct outflow of lymph, transplantation of lymphoid tissue).

    The rehabilitation period implies compliance with measures to prevent relapse of the pathology. Recommended lymphatic drainage massage, exercise therapy, relaxation.

    Methods of complex treatment at home

    If for some reason it is not possible to visit a doctor, but lymphostasis develops for symptoms, you can start treatment at home with drugs that are not able to cause significant harm to health and aggravate the situation. At home, you can comprehensively drink the vitamins of nicotinic acid and E, learn how to independently put leeches in the evenings.

    Before hirudotherapy, a 20-minute exercise therapy in combination with drainage massage is mandatory. At night you need to make a compress (to help recipes from traditional medicine). In the morning, rub Traxevasin into the swollen limb and put on compression socks.

    During the day you need to drink plenty of water, refuse salt and pepper, smoked meats. Completely revise your diet in favor of steamed food, without meat, but with vitamin vegetables and fruits.

    How to restore lymph drainage by folk methods

    Lymphostasis of the legs is treated without fail after diagnosis. The best thing for a sick person is to identify the disease in time and start treatment therapy. The course of treatment is a long time. In this case, several methods are combined for therapy. Also, many doctors recommend that patients at the initial stage conduct treatment of leg lymphostasis with folk remedies.

    • It is forbidden to go to the bath, sunbathe in the sun or go to the sauna. With thermal effects on the legs, blood vessels expand, therefore, blood circulation and the functioning of the lymphatic system are disturbed. Then lymphostasis develops.
    • Shoes with heels are not allowed to be worn. Shoes and sandals are designed to increase the load on the legs, due to which the lymphatic flow is disturbed and lymphostasis develops.
    • Conduct treatment with folk remedies. Common methods of such therapy include decoctions, compresses of honey, applying and leaving a bandage soaked in salt solution on a sore foot for the night. The traditional treatment of lymphedema with a decoction of dandelion leaves or licorice root is quite simple – you need to take the prepared drink inside to resume the lymphatic system. Also, the mixture can be applied to damaged skin tissue.
    • It is impossible for a long time to be in a sitting position, folding one leg on the other. In this position, the lymphatic and blood outflow is impaired.
    • Walking without shoes on the street is prohibited. Due to negligence, it is possible to get a foot injury, due to which an ulcer on the leg is formed, and subsequently lyphostasis.
    • Trim your toenails on time.
    • When massaging the feet or the entire lower limb, exclude kneading.
    • Avoid insect bites when hiking in the forest.

    Special compression underwear is designed to distribute pressure or to periodically bandage the affected legs. Basically, for this procedure, an elastic bandage or fabric from medical knitwear is used. With constant wear, the patient gradually swells and swells.

    Kinesitherapy

    Lymphostasis (lymphedema, lymphatic edema, elephantiasis) occurs due to an imbalance between the formation of tissue fluid and its outflow from capillaries and peripheral lymphatic vessels in the tissues of limbs and organs
    . At the same time, temporary or chronic lymph congestion is formed in the skin and subcutaneous tissue in patients.

    Along with blood vessels in our body there is a system of lymphatic vessels, on which the human immunity mainly depends. A clear, colorless fluid that fills the lymphatic system is called lymph. The main function of the lymphatic system is to conduct lymph from the tissues into the venous bed (conduction function), as well as the disposal of foreign particles, bacteria, cell breakdown products, etc. (protective function) that enter the body.

    Blood pressure maintained by the heart and blood vessels allows fluid to leak from the blood capillaries into the tissue. Under normal conditions, excess tissue fluid enters the lymphatic capillaries and is thus removed in a timely manner. The accumulation of tissue fluid is manifested in the form of edema.

    Lymphostasis is especially dangerous because various infections quickly develop against the background of lymph stagnation. Through any minor wound on the skin, the infection can penetrate the tissues very quickly.

    How else can I overcome lymphostasis of the lower extremities? Treatment (medication, surgical) should be prescribed only by a qualified specialist. Conservative therapy is the only right decision in the fight against such a disease. However, many patients prefer to seek alternative medicine.

    Very effective folk remedies are compresses with baked onions and birch tar. The onion in the husk must be baked in the oven, peeled and mixed with a tablespoon of birch tar. The latter can be purchased at almost every pharmacy. The resulting mass should be transferred to the tissue and applied to the affected area with mandatory fixation with a bandage. Such procedures are recommended to be repeated every day for two months.

    Honey has long been known for its beneficial properties. A sweet treat is actively used for such a diagnosis as lymphostasis of the lower extremities. In this case, treatment implies taking a healing infusion. To prepare it, you need to take 350 g of honey and 250 g of garlic chopped in a blender. This mixture should be infused for one week, after which you can take a tablespoon three times a day before meals. The course of treatment is two months.

    Note that it is recommended to resort to alternative medicine only after consulting a doctor.

    In folk medicine, lymphostasis is treated with an onion compress. It is necessary to dry several large bulbs in the oven, and to cover the leg with the cooled petals in the place of the edema. Wrap gauze on top, not pinching, but not free. You need to go to bed with a compressor, take off in the morning. Potato also helps. Washed, unpeeled large potatoes need to be grated on a fine grater, using gauze to make a compress for 1 hour.

    Garlic crushed in a blender must be poured into 350 g of liquid honey, corked in a glass jar and left for 7 days in a dark corner at room temperature. If you are not allergic to honey, you can take a teaspoon on an empty stomach every 2 hours, but no later than one hour before a meal.

    2 tbsp. l pharmacy plantain need to pour boiling water in a half-liter jar, insist for a day. It is advisable to drink the contents of the can during the day, in 3 sets, before meals. Freshly squeezed red beet juice cleanses the lymph well. A bitter, nasty, but effective juice can be made from the green leaves of dandelion and plantain.

    Prognosis and prevention

    The recent publication of a list of risk factors for secondary lymphedema of the type “do this, but do not do this” is largely anecdotal and insufficiently studied. Although some warnings are based on completely sound physiological principles (for example, avoiding excessive heating of an interested limb or to prevent infection), others are less supported.

    It should be noted that most published studies on the incidence of secondary lymphedema report less than 50% likelihood of developing lymphedema. Therefore, the standard use of some of these prophylactic methods to “prevent” lymphedema may be unacceptable and likely exposes patients to unnecessary therapy. Many prevention methods do not have an evidence base and have not demonstrated clearly defined risks and preventive measures.

    If the diagnosis of lymphedema is unclear or needs a more precise definition of the prognosis, it is recommended to consult a clinical lymphologist or a specialized lymphological center, if available. In rare cases, chronic lymphedema can lead to cutaneous angiosarcoma known as Stuart-Travis syndrome. The prognosis of this complication is unfavorable, the average survival of patients is approximately 19 months after diagnosis.

    For prevention, excessive load on the legs, including static, and heavy lifting should be avoided. Shoes should be light and comfortable. Careful skin care of the feet, timely disinfection of abrasions, scratches and scuffs are important. In addition, it is necessary to abandon bad habits – overeating, smoking, abuse of alcoholic beverages.

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    The answer to the question of whether lymphostasis of the lower extremities can be cured depends on the stage of the pathology. It is possible to completely get rid of the disease only at an early stage. In the future, the use of therapy can slow down the course of the disease, allowing a person to remain able to work and lead an active lifestyle.

    1. The main enemy of all mankind is nicotine. It can cause all fatal diseases in which lower limb lymphostasis will become one of the symptoms in a chain of more serious diseases.
    2. Heels. Wearing high and thin heels in youth seems commonplace. But the legs under the uneven distribution of body weight suffer. Small vessels burst from the load, veins increase. The feeling of light and barely noticeable discomfort can last from 5 to 20 years, but once this condition begins to progress. Not every woman can guess that leg lymphostasis at the age of 40 is the result of many hours of stilettos at 20 years old.
    3. Excess weight. As with heels, being overweight in youth seems like a harmless overeating of sweets. But the process is already running, because metabolism is disrupted due to ugly nutrition and bad habits. It must be restored from a young age so that in old age you do not suffer from obesity, edema, and sore feet.

    Lymphostasis of the lower extremities can be avoided by wearing compression clothing made from natural materials. If you choose narrow pants, they should be sewn from breathable elastic material. Pants should not be synthetic and disrupt the blood flow, so that the treatment of edema at home does not enter into everyday life. The skin in them must breathe.

    How to prevent lower limb lymphostasis? Medical treatment is primarily aimed at reducing the progression of the disease, which is why it is impossible to refuse it. Neglect of one’s own health can provoke even greater lymphatic edema of tissues, impaired mobility of the limbs.

    Regardless of what stage the pathology was diagnosed in, all patients, without exception, require the supervision of an experienced angiosurgeon. Moreover, course supportive therapy should be carried out throughout life.

    To prevent violations in the process of lymph circulation allows proper skin care of the legs, timely treatment of all diseases.

    Refusal to treat lymphedema contributes to even more lymphatic tissue edema, impaired mobility of the limb, and the development of chronic infection. Regardless of the stage at which lymphostasis was diagnosed, patients require the supervision of an angiosurgeon. Course supportive therapy for lymphostasis should be carried out for life.

    Careful care of the skin of the hands and feet, timely treatment of any wounds and the prevention of their infection allows to prevent lymphatic circulation in the limbs. Therapy of diseases of the kidneys, heart, venous vessels should be carried out in order to avoid decompensation of the pathology. To prevent the development of postoperative lymphedema in recent years, mammologists have abandoned total lymphatic dissection during radical mastectomy and are limited to the removal of signal lymph nodes.

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    Shown is the variable pneumatic compression, which is performed using a special device with a large number of cameras. This procedure helps to increase the level of pressure in the tissues, accelerates the outflow of fluid from the intercellular space.

    If you do not conduct active treatment, stagnation of lymph in the legs can turn into serious complications. In the affected limbs, ulcers and dermatitis will begin to form over time, weight will increase, and the body will become vulnerable to other diseases. Naturally, there are preventive methods, they are not complicated and accessible to everyone.

    It is important to lead an active lifestyle, and then you can not encounter a disease such as lymphostasis. Proper nutrition and an attentive attitude to your health will help strengthen the body and prevent the aggravation of the situation with various infections that cause deterioration of the lymphatic drainage.

    Along with the circulatory system, the lymphatic system functions in the human body. Her capillaries, like blood vessels, penetrate all human tissues. Lymph is constantly moving along them – a clear liquid, as viscous as blood. The movement runs from bottom to top along the lymphatic ducts due to muscle contraction and due to the functioning of valves that impede its reverse flow.

    For prevention, excessive load on the legs, including static, and heavy lifting should be avoided. Shoes should be light and comfortable. Careful skin care of the feet, timely disinfection of abrasions, scratches and scuffs are important. In addition, it is necessary to abandon bad habits – overeating, smoking, abuse of alcoholic beverages.

    Conclusion

    Unfortunately, today lymphostasis of the lower extremities is increasingly being diagnosed. The causes of this pathology are different. These are all kinds of diseases of the main systems of internal organs, and overweight, and parasitic infections. Modern medicine offers several treatment options, starting with drug therapy in the early stages and ending with surgical intervention for the development of complications. The sooner the patient seeks help from a doctor, the higher the likelihood of a speedy recovery. Be healthy!

    Decoctions for internal reception

    In combination with the compressor, you need to drink decoctions. Traditional medicine is rich in recipes for all diseases, so there are ways to prepare immunostimulating and diuretic decoctions in it. Almost all recipes from traditional medicine, which contain garlic, are suitable for lymphostasis.

    Garlic stimulates the immune system. It is not in vain that it is recommended as the best antiviral folk remedy in the season of influenza activity. The immunity restored with the help of garlic suppresses most viruses and bacteria. It makes the immune system work so that it restores the body’s diseases on its own, without medication.

    Real green tea is a storehouse of antioxidants in the form of catechins. They bind to free radicals, which the body cannot independently remove, and help to utilize unnecessary cell debris from the blood.

    For lovers of green tea, ginger and cinnamon, a tea cocktail of the listed ingredients can act as a decoction. If green tea is replaced with raspberry leaves, then you can prepare a decoction and insist it for several hours.

    Hirudotherapy: treatment features, duration

    Leeches are sold in some pharmacies, so hirudotherapy can be done at home. 2 leeches per day are enough. Put in place of the largest accumulation of excess fluid. When the bodies of leeches grow in volume, they must be removed and disposed of. Or wait until they fall off themselves, but it will take a long time to wait.

    The bite site can bleed even before 16 hours and allocate up to 300 ml of lymph with blood. This is due precisely to the enzyme, which continues to work and thin the blood when leeches are flushed into the toilet. There is nothing wrong with this, but it is worth considering. That is, it is better to carry out hirudotherapy from evening to night, so that you do not have to walk with bloody smudges on your feet during the day.

    Diet: rules, list of prohibited and allowed products

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    Most often, overweight people suffer from lymphostasis, so treatment will be more effective when adjusting nutrition. First of all, salt is necessarily removed from the diet, because it retains excess fluid, which you need to get rid of with lymphostasis. When using salt, taking diuretic medicines and infusions is completely useless, sometimes harmful.

    Speaking about salt restriction, we are talking about the revision of finished products from the store, which contain sodium. It makes no sense to eat freshly cooked home-made borscht with smoked sausage from the store. With lymphostasis, you need to drink plenty of clean fresh water. Not liquids like tea, coffee, mineral water and juices, but pure transparent water without gas, salt, minerals.

    In general, you need to abandon consumption:

    • soda;
    • boxed juices;
    • coffee;
    • kvass and beer;
    • tana and ayrana;
    • kefir and yogurt.

    You can drink only green tea without sugar, freshs and herbal infusions. Spicy spices banned. Food should become dietary, so you need to forget about the pan, and instead buy a double boiler and learn recipes with baking in the oven without oil. Dietary nutrition includes a maximum of fruits and vegetables, a minimum of meat and eggs.

    From protein are allowed:

    Prevention and Complications

    The main complication of lymphedema is the frequent multiple skin ulcers. Patients with lymphedema are susceptible to recurrent soft tissue infections such as cellulitis and erysipelas. The main cause of cellulitis is infection of the patient with group A streptococcus. Each episode of cellulite leads to additional damage to the lymphatic system, which contributes to the deterioration of the patient’s condition. [17] [18]

    A fungal disease such as foot dermotophytosis is extremely common in patients with lymphostasis due to chronic interdigital maceration. In addition, these patients have a 10% risk of developing angiosarcoma. Moreover, this is typical for patients with chronic lymphedema lasting 10 years. Stuart-Travis syndrome refers specifically to cutaneous angiosarcoma, which develops in patients with postmastectomy lymphedema. Angiosarcoma is a highly aggressive malignant tumor with an extremely negative prognosis and 5-year survival of less than 10%.

    Other malignant tumors that are also associated with lymphedema have also been reported in the medical literature: squamous cell carcinoma, basal cell carcinoma, cutaneous lymphoma, melanoma and Kaposi’s sarcoma. [19] [20] Despite the prevalence of specific oncological diseases in these patients, it has not yet been possible to establish a clear causal relationship between lymphedema and tumor development. One possible explanation may be a violation of the local immune response in the lymphedematous limb. [21]

    In addition, important complications are psychosocial stigmatization and a decrease in self-esteem, which are considered common among patients with lymphostasis due to impaired mobility, difficulties in choosing clothes, limb and genital deformities. [22] Summarizing the above, it can be stated that chronic edema of the lower or upper extremities causes discomfort and loss of the full functional state of the affected organ. Recurrent bacterial and fungal infections are quite common with lymphedema. Recurrent cellulitis and lymphangitis contribute to the progression of damage to the entire lymphatic system. Often there are trophic chronic intractable ulcers. Cutaneous angiosarcoma is a rare and often fatal complication, the main morphological sign of which is the appearance of red-violet spots. Serious psychosocial consequences can occur due to persistent cosmetic disorders and limited quality of life for patients with lymphostasis.

    In severe lymphedema, irreversible lymphatic outflow disorders, the development of fibrocystic changes in the tissues and elephantiasis are noted. Lymphostasis becomes so pronounced that the limb loses its contours and the ability to function normally. At this stage of lymphostasis, the development of contractures and deforming osteoarthrosis, trophic ulcers, eczema, erysipelas can be noted. The extreme outcome of lymphostasis may be the death of the patient from severe sepsis. With lymphostasis, the likelihood of developing lymphosarcoma increases.

    If you do not follow dietary nutrition, self-medicate with drugs that are not suitable for a specific organism or are intolerant due to a number of other diseases, aggravate all this by running at the last stage of the disease and massage, after which bruises remain, then you can bring your limbs to elephantiasis and trophic ulcers. In severe cases, you can lose your legs.

    Forecast. Prevention

    It is difficult to make predictions for the successful treatment of the disease, because lymph stasis affects other diseases that further aggravate lymphostasis. In treatment, it is important that the patient himself understands his problem, and follows all the doctor’s instructions. He did not break down on sweets and smoked meats, refused smoking and alcohol, regardless of nicotine and alcohol addiction.

    And if the patient’s work is related to spending a working day on his feet, lifting weights or sitting out at the computer for 12 hours, then, realizing the impossibility of combining such work and treatment, he agreed to a change of work. Money plays an important role.

    Eating sausage at a discount is cheaper than vegetables and fruits in winter, pine nuts and high-quality seafood. Making infusions and freshies cost money. The patient should be able to provide financially high-quality treatment and nutrition. Under such conditions, getting rid of the initial stage or minimizing the consequences of the neglected stage becomes real.

    Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

    For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

    He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

    Detonic