Integrative Treatment for all Types of Lymphoedema

Lymphoedema

Lymphoedema, also known as elephantiasis occurs due to the damage in the lymphatic system which results in the swelling of body parts. Feeling tightness, heaviness and redness in the affected area are the some of the symptoms of lymphedema. There are different approaches to treat the condition and patients can avail the primary lymphedema treatment in India at IAD.

The causes of Lymphoedema can be connected with different conditions. Breast cancer related lymphoedema is an example. IAD offers an integrative treatment method such as Ayurveda treatment for lymphodemea.

There are 3 stages of lymphoedema in the consensus classification of International Society of Lymphology (ISL).

  • Stage I: Oedema spontaneously reversible on the overnight elevation of affected part and skin is normal.
  • Stage II signifies that limb elevation alone rarely reduces tissue swelling and pitting is manifest. Skin remains normal.
  • Stage II late: Irreversible oedema on overnight elevation and skin is thickened.
  • Stage III: Irreversible oedema and elephantine changes manifested by gross hyper trophy and trophic changes and warty growth and nodules over the skin.

Lymphatic Filariasis is the commonest cause of lymphoedema, especially of lower extremities. Lymphoedema due to Lymphatic Filariasis generally tends to increase in size if left untreated, leading to the development of deep skin folds, nodules of varying sizes, warty changes and bizarre appearance causing great disability affecting movements.

  • Lymph scrotum and lymphorrhoea are complications leading to recurrent secondary infection.
  • Chronic wounds on lymphoedema may complicate each other.
  • Lymphangiosacrcoma is a rare complication.

Genito-urinary lesions of Lymphatic Filariasis can also present with other forms of lymphoedema. They are:

  • Hydrocele
  • Lymphodema of scrotum and penis
  • Lymphoedema in vagina with lymphangieatsia
  • Acute epididymo-orchitis and funiculitis

Other causes of lymphoedema are also treated in IAD. They include,

Primary lymphoedema: Primary lymphoedema may occur at birth, adolescent age (praecox) or manifest after 30 years of age (tardum).

Secondary lymphoedema: All varieties of lymphoedema that have an identifiable cause including Lymphatic Filariasis are grouped under this. Following are the common causes that precipitate lymphoedema.

  1. Trauma
  2. Phlebolymphodema
  3. Surgery
  4. Chronic wound
  5. Malignancy
  6. Congenital Lymph node Fibrosis
  7. Arteriovenous malformation
  8. Klippel Trenaunay Weber Syndrome

Varicose veins associated with lymphoedema are recorded when standing and should be managed by elevation, ankle movements and support bandages. In classical cases of varicose ulcers some amount of lymphoedema is observed.

Cellulitis of lymphodematous leg is the most dreaded complication often induced by bacterial entry lesions such as intertrigo or folliculitis, mandating prolonged hospitalization and often resulting in large chronic wounds. Cellulitis may also lead to septicaemia when patients have associated immune compromising conditions such as diabetes mellitus, portal hypertension, chronic sleep apnoea etc.

Gravitational eczema long standing Lymphoedema often is associated with other disabilities that further disable the patient. Obesity is often associated with lymphoedema due to lack of physical exercise. Lymphoedema can also occur in uncommon anatomical sites like the lower abdominal wall.

Operative Treatments are available for lymphoedema are not practiced in IAD as they are often not successful. Following are the surgical treatments of lymphoedema

  1. Omental transposition, entero mesenteric bridge operations, and the implantation of tubes or threads to promote perilymphatic spaces (substitute lymphatics) have experimented in a few surgical centers in India.
  2. Nodal-venous shunt and debulking surgery are the commonest. Debulking surgery, is, removal of excess skin and subcutaneous tissue of the lymphoedematous limb. Lymphoedema usually recur after the surgery.
  3. Currently available surgical options are not successful in improving lymphoedema. Liposuction has been reported to completely reduce non-pitting, non-fibrotic, extremity lymphoedema.

IAD is the pioneers of elephantiasis treatment in Kerala. Today IAD is a trusted name for lymphoedema treatments in Kerala and will continue to serve the patients with the best treatment methods.

'