Edema vs. Lymphedema

Edema is swelling due to excess fluid in the affected tissue. Edema is common at the site of physical trauma (e.g. sprained ankle), among pregnant women and people who stand for a large part of their work day. Edema of the feet or legs usually improves once the person sits down and raises their feet.

The initial symptoms of lymphedema are similar to regular edema. However, lymphedema is a condition whereby protein-rich fluid collects in tissue.  Normally, protein molecules leave arterial capillaries and enter the interstitial spaces (space between the cells).
The protein molecules are too large to be re-absorbed by venules (smallest veins) and in a healthy lymphatic system, this protein-rich fluid is removed by lymphatic vessels and circulated through the lymphatic system, filtered by lymph nodes and eventually the lymph fluid returns to the circulatory system.  However, a compromised lymphatic system may be unable to collect this fluid sitting in the tissue.  Protein attracts water, so the longer it takes for the lymphatic system to "pump out" this protein rich fluid, the more fluid is attracted to the protein and more swelling occurs.

This is why diuretics are not helpful with lymphedema.  The diuretics remove some of the fluid, but do nothing to move the protein out of the tissue.

Lymphedema is a disease which, if not treated, has a serious negative impact on health. Left unchecked, the swelling due to lymphedema increases, producing elephantine limbs. Eventually the swollen tissue turns fibrotic, i.e. hardens, further reducing lymphatic functioning. In extreme cases, doctors have suggested amputation of the affected limb.

The accepted treatment for lymphedema is Complete Decongestive Therapy which consists of manual lymphatic drainage, bandaging of the affected limb, wearing compression garments, exercise and impeccable skin care.

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