What is Lymphatic Vascular Disease?
Lymphatic vessel disease means that the lymphatic system is not working properly. The lymphatic system, which consists of lymph nodes and lymph vessels, is a network of vessels that drains lymph fluid from the tissues in your body. Lymph fluid carries toxins, immune cells, and waste products to the lymph nodes. Filtered lymph fluid is returned to the bloodstream via the lymph vessels, helping to maintain fluid balance in the body.
A poorly functioning lymphatic system causes tissues to swell with fluid. This condition is called lymphedema. This swelling usually occurs in your arms or legs.
Sometimes you can be born with a lymphatic problem that causes lymphedema. This is called hereditary or primary lymphedema. Sometimes lymphedema can occur as a complication of a disease (cancer, infection, etc.) or due to an injury. This is called secondary lymphedema.
Lymphatic vessel disease is a chronic disease for many people. However, today there are treatments that can treat this disease and provide you with relief.
What are the Causes of Lymphatic Disease?
There are many causes of hereditary, primary and secondary lymphatic disease.
Hereditary (Primary) Lymphedema
Hereditary, or primary, lymphedema is less common than secondary lymphedema. The incidence of primary lymphedema increases in individuals with a family history of lymphedema. Milroy and Meige diseases are the most common hereditary lymphedema disorders.
Secondary Lymphedema
Lymphedema, which is seen in women who have surgery for breast cancer, is one of the most common causes of secondary lymphedema. In this surgery, the lymph nodes under the arm are removed along with the breast tissue. Removal of these nodes, which drain the lymph fluid formed in the tissues in the arm, causes the lymphatic system to deteriorate, the fluid to accumulate in the arm, and the arm to swell. Cancer and radiation therapy (radiotherapy) can also cause lymphedema. The tumor tissue itself and scar tissue that develops due to radiotherapy or surgery can cause damage to the lymphatic system. Swelling in the face, tongue, and eyes after treatment for head and neck tumors is also secondary lymphedema.
What are the Signs and Symptoms of Lymphatic Vascular Disease?
The main symptom of lymphatic vessel disease is lymphedema. Lymphedema causes swelling in your arms or legs. Your fingers or toes may also fill with fluid and swell. Tissues in your head and neck may also be affected. The swelling can restrict your movement. You may feel aching or deep-seated pain in the affected area. Lymphedema can also cause:
- Skin changes
- Skin color changes
- Blisters
- Fluid discharge from the skin
- Infection
Lymphedema in the head and neck can affect vision, cause earaches and nasal congestion. It can also cause difficulty breathing, difficulty swallowing, speech disorders and increased salivation.
In an individual born with a hereditary lymphatic disease, symptoms may appear in early childhood, during adolescence and, in some cases, even after the age of 35.
What Problems Does Lymphatic Vascular Disease Cause?
Infections such as lymphangitis and cellulitis may develop due to lymphedema. Cellulitis is a bacterial skin infection. Lymphedema provides a basis for this infection to spread and spread to deep tissues. Lymphangitis is an infection of the lymph vessels caused by bacteria, viruses or fungi. In the infection, the affected area appears as a striped, spotted, red patch. These patients also experience high fever, chills and itching.
How Is Lymphatic Vascular Disease Diagnosed?
Your doctor will ask you questions about your medical history and examine you. If your doctor suspects lymphatic vessel disease, he or she may order imaging tests. The most likely test is a lymphangiogram. A type of X-ray that uses contrast dye to help clearly show your lymph nodes and lymphatic vessel network. In this procedure, a special dye is injected into a vein between your toes. X-ray images can reveal abnormalities in the lymphatic drainage system. An MRI may be used instead of a traditional X-ray.
How Is Lymphatic Vascular Disease Treated?
The goal of treatment is to reduce swelling as much as possible in a short period of time and to preserve movement and function in the affected area.
Compression is an important treatment for lymphedema. Compressing the affected limb allows lymphatic fluids to move toward the body in a normal circulatory pattern. Wrapping your arm or leg tightly with an elastic bandage or wearing a compression garment, such as compression stockings, applies constant pressure to the swollen area. This reduces the diameter of the limb and the stress on the skin. It also increases mobility.
Compression Clothing
Compression garments consist of specially designed stockings (compression stockings) or gloves that are worn over the swollen limb. Your doctor may recommend that you purchase garments with a certain degree of compression. The degree or level will depend on the severity of the swelling. Standard compression garments are available at most drugstores and pharmacies. If your limb is outside the standard size, a custom compression garment may need to be made for you. Compression levels are measured in mm Hg (millimeters of mercury). The more compression you need, the higher the pressure. Although there is no standard, commonly used measurement levels and classes are:
- Low (class 1): Less than 20 mm Hg
- Medium (class 2): Between 20 and 30 mm Hg
- High (class 3): Greater than 30 mm Hg
In lymphedema patients, step compression is often preferred. The step compression feature is either in the fabric of the garment or is achieved by bandages wrapped over it later. In step compression, the pressure is highest at the tip of the limb and gradually decreases towards the body. If the garment does not have this feature, a lymphedema specialist will teach you how to achieve step compression with bandages.
Pneumatic Compression
Another form of compression therapy is called pneumatic compression. Pneumatic compression is based on the principle that a vest or arm/leg boot is inflated and deflated by a device to ensure proper lymphatic fluid flow.
Exercise
During exercise, your muscles contract and put pressure on the lymph vessels around them. This pressure helps the flow of lymph fluid and reduces edema. A physiotherapist who specializes in lymphedema can apply an exercise massage program that suits you.
Medical and Surgical Treatments
Comprehensive decongestive therapy (CDT) is often used to treat lymphedema. This includes some of the components previously mentioned above:
- Compression garments
- Skin care
- Exercises
- Lymphatic drainage massage
Lymphatic drainage massage, also known as manual lymphatic drainage, is a massage therapy performed by an experienced lymphedema specialist. This massage stimulates the tissues and allows the lymph fluids to flow freely. How often manual lymphatic drainage is required depends on the severity of the lymphedema, its location, and how much movement the area can handle. It is usually started 5 days a week for 3-8 weeks and increased as needed by monitoring improvement. You can also receive training to perform this drainage massage at home. If you have cellulite or other skin infections or skin rashes, manual drainage may be inconvenient.
The U.S. Food and Drug Administration has approved low-level laser therapy for the treatment of lymphedema due to breast cancer. We recommend that you have this treatment performed by a physical therapist or other healthcare professional who specializes in lymphedema. Studies have found that laser therapy can be effective in reducing swelling, pain, and edema in the limb.
Liposuction may be effective in advanced stages of lymphedema where other treatment options have not been effective. Studies have shown that liposuction can reduce limb size, improve function, improve a person’s health, and improve their quality of life. However, compression garments are still necessary to reduce swelling following this procedure.
Lymphedema associated with bacterial infection is first treated with antibiotics. Antibiotics can help control pain and swelling. They are also effective in preventing the spread of infection.
What Are the Long-Term Outcomes of Lymphatic Vascular Disease?
Your outlook depends on the stage, location and cause of your lymphedema, as well as your overall health. Lymphedema is a chronic condition that requires ongoing care. There will often be some swelling. However, you will learn to cope with this swelling. It is important to get help from a lymphedema healthcare team that includes physiotherapists, cardiovascular surgeons and other specialists. There are rehabilitation centers abroad where you can receive inpatient care and are staffed by experts in this field.
The best way to manage lymphedema is to use a combination of treatments and management techniques that are right for you.