What is lymphoedema?

A condition impacting millions, known by few.

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What is lymphoedema?

Lymphoedema, pronounced [lim-fa-dee-mah] is a chronic condition where protein rich fluid, called lymph, collects in the tissues just below the skin, causing swelling.

The lymphatics form part of your immune system, helping to deal with infection at a local level, but just as importantly, they are responsible for cleansing your tissues and maintaining a balance of fluids in your body. It can be likened to a waste disposal system, taking tissue fluid, bacteria, proteins and waste products away from the tissues around the skin, fat, muscle and bone. If, for whatever reason, the lymphatic system is not working correctly (such as a result of damage, trauma or surgery), or the vessels do not have the ability to drain adequately, the fluid in the tissues builds up (as when a river is dammed and flooding occurs). Swelling occurs when the amount of fluid in an area is greater than the capacity of the lymphatic system to transport it away. Lymphoedema can therefore be defined as “an abnormal accumulation of protein rich fluid in the tissues”. The swelling can be in any part of the body, most often in the arms and legs, but also the breast or chest wall, head and neck, or genitals.

Click here to learn more about the lymphatic system.


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What is the Lymphatic System?

A significant number of people are simply not aware that besides the blood circulation system, the body has another circulation system – the lymphatic system.

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What is the Lymphatic System?

Whenever we hear “lymph…” most of us immediately think of lymph nodes. We know that we have them in the neck and groin, for example, and that they can become swollen when our bodies are fighting an infection. This is certainly true but not the whole story. The lymph nodes, which are present throughout our body (there are several hundreds of them) are part of an interconnected lymphatic system.

Your lymphatic system runs throughout your entire body and is parallel to the venous and arterial system (commonly known as the bloodstream). However, unlike your veins, the lymphatic system is not a closed system and has no central pump (i.e. your heart). It consists of hundreds of lymph nodes, lymph vessels, and lymph capillaries spread throughout the body in a similar way to blood vessels. You can think of the lymphatic system as a "waste disposal system" system for the body, taking tissue fluid, bacteria, proteins and waste products, away from the tissues around the skin, fat, muscle and bone, filtering it and then returning it back to the blood circulation. Your lymphatic system serves an important immune role to help prevent spread of infection, or even cancer cells, as the lymph nodes contain defence cells (infection-fighting cells) called lymphocytes, which attack and break down bacteria. The lymphatic system has three main functions, fight infection, drain excess fluid and lipid (fat) absorption. Without a functioning lymphatic system, you could not live. Lymphoedema occurs when the lymphatic system is partially defective.

Click here to learn more about the types of lymphoedema.


RELEVANT QUESTIONS?

Is there a cure for lymphoedema?

Lymphoedema has no known cure.

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Is there a cure for lymphoedema?

Lymphoedema has no known cure. However, with correct diagnosis and appropriate treatment, there is much that can be done to help manage and effectively control the symptoms. Left untreated, the condition will deteriorate leading to an increase in swelling. Many people experience swelling for months, even years, before assessment, diagnosis and treatment are initiated. It is important to understand the condition so you can manage your lymphoedema as effectively as possible.

Click here to learn more about the types of lymphoedema.


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Who should diagnose me?

Many people experience swelling for months, even years, before assessment, diagnosis and treatment are initiated.

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Who should diagnose me?

It is recommended you visit your GP if you experience the typical symptoms of lymphoedema and are concerned you may have the condition. Your GP may refer you to a specialist lymphoedema treatment centre for further assessment. There are a number of lymphoedema clinics throughout the UK, with clinicians who specialise in lymphoedema treatment.

Unfortunately, there is no single official diagnostic criteria for determining if someone has lymphoedema. This becomes even more complicated if you have primary lymphoedema where the symptoms may have been present since birth, or have been around for a long period of time, and gradually worsened. There are some diagnostic or imaging tests that can be performed to help with diagnosis. However, a thorough and full assessment, including a physical examination and history of symptoms are key, and typically all that is used for a correct diagnosis.

Click here to learn more about the signs and symptoms of lymphoedema.


RELEVANT QUESTIONS?

Are there other types of swelling?

There are other types of swelling that should not be forgotten about.

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Are there other types of swelling?

There are other types of swelling that should not be forgotten about.

Lipoedema
Often confused with lymphoedema, lipoedema is an adipose tissue disorder or abnormal accumulation of fatty tissue. It affects mostly women, often developing around the time of a hormonal change (i.e. puberty, pregnancy or menopause). The condition leads to tissue enlargement most commonly around the legs, hips and/or buttocks. Unlike lymphoedema, the enlargement usually stops at the ankles and the feet are spared. However, it tends to be in both legs. It mostly affects the lower limb but can develop in the arm (the hands are usually spared). It often leads to a sensation of the limbs being ‘heavy and tight’ and the skin may be tender to touch, cooler than unaffected areas, sensitive and/or bruise easily. Despite dieting or increasing physical activity, the volume of the limb does not decrease and there is a distinct disproportion between the limbs and the trunk. Those who have had lipoedema for many years often develop a lymphatic component, as the fatty tissues tend to obstruct lymphatic drainage. This is known as lipo-lymphoedema. The surface of the skin is more uneven, there may be ridges of fat under the skin, the limb is more distorted and mobility may be inmpacted.

Lymphovenous oedema
This condition results in both the venous and lymphatic systems not functioning adequately due to an underlying venous problem/disease and results in a swelling. When valves weaken or there are abnormalities in the venous walls, blood can flow backwards and increase the pressure in the veins, known as venous hypertension. If venous hypertension is sustained over time, the vein walls stretch and the valves no longer close. This further increases hypertension which can lead to a pooling of blood, discomfort and varicose veins. The common signs are staining of the skin, spider veins and varicose veins. A swelling occurs when the increase in lymphatic flow to the area is much greater than the lymph transport capacity.

Click here to learn more about the types of lymphoedema.


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