User:Lucarem

Lymphedema is caused by an interruption in the normal flow of lymph through specialized lymph vessels. These vessels transport the lymph toward the center of the chest. When this normal flow is interrupted, it leads to back up of lymphatic fluid and swelling of the affected area of the body. It is generally painless but can be felt as a heavy or aching sensation. Initially the swelling of lymphedema may be soft enough to leave indentations when pressed firmly with a fingertip for five seconds. Without appropriate intervention however, the swelling becomes firm over time and is no longer reversible. This may lead to difficulty moving the affected part of the body.

Lymph is created when fluid seeps out of small blood vessels through normal processes. This fluid is rich in proteins and bathes bone, muscle and other tissues. Tiny lymph vessels called lymphatic capillaries collect this fluid, keeping excess fluid from building up. Lypmphatic capillaries start as blind tubes and can be traced from their origins in the periphery of the body as they empty into progressively larger lymph channels. The larger lymph vessels contain muscle within their walls and propel the lymphatic fluid along through sequential contraction of the muscle, similar to the way food is propelled through the esophagus and intestines. Ultimately the lymphatic fluid finds its way into large blood vessels in the upper chest via the thoracic duct on the left and the lymphatic duct on the right. In this way the fluid is restored to the circulating blood stream.

Lymphedema can be divided into primary and secondary types. Primary lymphedema is associated with genetic disorders that create abnormal lymph vessels. It affects about 1:10,000 people and can manifest at birth, at puberty, or after age 35. Secondary lymphedema is due to an aquired condition such as infection, cancer obstructing the lymph vessels, or damage to the lymph vessels caused by surgery or radiation. Treatment for breast cancer can result in lymphedema of the arm on the corresponding side in approximately 20 to 40 % of women, depending on the type of treatment they undergo and the location of the tumor. In developed countries breast cancer therapy is the most common cause of secondary lymphedema. Worldwide the most common cause of secondary lymphedema is filariasis, a parasitic invasion of the lymph vessels and lymph nodes that triggers inflammation. Over time this leads to scarring which obstructs lymph flow and causes irreversible lymphedema. Lymphedema is not treated with medication, Diuretics which promote fluid loss from the body are ineffective for lymphedema. Treatment mainly consists of compression through elastic stockings or sleeves, elevation, manual treatments by specialized physiotherapists, and careful attention to skin care. It is imperative to avoid infections in the affected areas since this can further damage lymph drainage. Areas of lymphedema are particularly vulnerable to infection, probably because bacteria grow well within the stagnant protein rich fluid.