Basically, lymphedema consists of the inflammation of any part of the body due to the accumulation of lymph in the tissues, and this occurs when the lymphatic system is damaged or blocked . To see the details, let’s start by knowing what the lymphatic system is.
the lymphatic system
The lymphatic system is a vital part of the immune system , that is, the system that defends our body from foreign agents and germs. It is a network of vessels, nodes and organs (such as the spleen, bone marrow, tonsils, etc.) that work together to transport a liquid called lymph into the bloodstream. Its operation is quite similar to that of the blood system , but instead of moving blood through arteries and veins, they move lymph through vessels and lymph nodes.
It should be noted that lymph is a transparent liquid rich in proteins, salts and water, among other substances, but also in white blood cells , which is why it helps to fight infections, which is why it is so important for the immune system. This liquid is produced from excess liquids that the blood capillaries expel into the interstitial space, generally in the most distal areas of the body, which is later collected by the lymphatic vessels, and transported back by them to the blood system.
On the other hand we have the lymph nodes , which are small nodules, which can be found in many parts of the body (neck, armpits, chest,…), responsible for filtering substances foreign to the body, such as infections or cancer .
The “problem” with this system is that, unlike the blood system, it does not have an organ such as the heart that pumps the lymph to the upper areas of the body, so in order to distribute the lymph throughout the body it uses muscle contractions as “activator” of lymphatic circulation.
lymphedema
Returning to what interests us. Lymphedema is a type of inflammation, which, as we have said, is due to the accumulation of lymph in some areas of the body because the lymphatic system is damaged and cannot mobilize it.
It is quite common to find it on the arms and legs , but it can also be found on other parts of the body, such as the face, neck, belly or genitals.
What are the causes?
As lymphedema is a problem in which swelling appears as a result of the lymphatic system not being able to eliminate lymph properly, we can distinguish between two types of lymphedema depending on the causes .
Primary lymphedema is the one that is due to an underdevelopment of the lymphatic system, that is, the number of vessels is so small that it is not capable of transporting lymph. In this case, it is a problem from birth , only it begins to manifest itself with age, since the small vessels are capable of mobilizing the small amounts of lymph that children have. The problem comes as the child grows, since the amount of lymph also increases, but not the number of vessels, so it will begin to accumulate, and therefore the problem becomes evident, which worsens over time.
On the other hand, secondary lymphedema is much more frequent than primary lymphedema, since it appears due to problems unrelated to the development of the lymphatic system . They are due to obstructions or alterations in the morphology of the vessels or lymph nodes due to different factors.
One of the most common factors is the scar tissue that the lymphatic vessels acquire after a major intervention, especially after cancer treatment , either surgical or radiotherapy. It can also occur as a consequence of habitually repeated infections or with many relapses, but it is very infrequent, except when it is caused by a tropical parasite called Filaria , which produces filariasis, commonly known as elephantiasis , due to the characteristic exaggeratedly large swelling of the the legs that happen to resemble the feet of an elephant.
Generally, except in the case of filariasis where the skin is thick and wrinkled, the skin of secondary lymphedema is simply swollen but remains healthy.
And this has a solution?
Lymphedema has no cure , the little that can be done is to relieve the accumulation of lymphatic fluid in the extremities using compression stockings or bandages, massaging the affected areas, elevating the limbs or performing special exercises for the extremities.
Something that is important are the measures to prevent worsening , which consists of avoiding heat, vigorous exercise and tight clothing. In addition, if you go to the doctor for any reason, it is advisable to avoid handling the affected limb (vaccinations, taking blood pressure, punctures, etc.), which will prevent the edema from getting worse.
And do not forget that good skin and nail care can help prevent infections, and thus prevent worsening.
References:
American Cancer Society (2020, February 1). What is lymphedema? Cancer.org. https://www.cancer.org/en/treatment/treatments-and-side-effects/physical-side-effects/lymphedema/what-is-lymphedema.html
Cancer.net (2012, June 22). Fluid buildup or lymphedema . Cancer.net. https://www.cancer.net/es/assimilaci%C3%B3n-con-c%C3%A1ncer/efectos-f%C3%ADsicos-emocionales-y-sociales-del-c%C3%A1ncer/manejo- of-the-side-effects-f%C3%ADs/accumulation%C3%B3n-of-l%C3%ADfluid-or-lymphedema
Douketis, J.D. (2020, November 5). Introduction to the lymphatic system . MSD Manual General Public Version; MSD Manuals. https://www.msdmanuals.com/en/home/heart%C3%B3n-and-blood-vessel-disorders/lymph%C3%A1tic-system-disorders/introducci% C3%B3n-al-lymphatic-system%C3%A1tic
Douketis, J.D. (2020, November 5). lymphedema . MSD Manual General Public Version; MSD Manuals. https://www.msdmanuals.com/en/home/heart%C3%B3n-and-blood-vessel-disorders/lymph%C3%A1tic-system-disorders/lymphedema
National Cancer Institute (2021, November 24). Lymphedema (PDQ®)–Patient Version . Cancer.gov. https://www.cancer.gov/espanol/cancer/tratamiento/efectos-secundarios/linfedema/linfedema-pdq
Mayo Clinic (2021, November 11). Lymphedema – Symptoms and Causes . Mayoclinic.org. https://www.mayoclinic.org/es-es/diseases-conditions/lymphedema/symptoms-causes/syc-20374682
Medlineplus. (2021). lymphedema . National Library of Medicine. https://medlineplus.gov/spanish/lymphedema.html
