Os diuréticos ajudam o linfedema?

Diuretics are a group of drugs or medications that stimulate urine creation and excretion. These medications are used to decrease fluid accumulation in the body as a treatment for many health problems. Medicines in this class are commonly known as water pills. Some examples of diuretics are furosemide or Lasix, mannitol, thiazide, etc. They are used to treat a range of health conditions such as hypertension, varicose veins, congestive heart failure, kidney failure, etc.

To understand if these diuretics help lymphedema, we need to first see what edema is and what lymphedema is.

An edema is an abnormal or accumulated collection of fluid in the tissues. This is actually caused due to some underlying medical conditions such as hypertension, varicose veins,  kidney failure  , congestive heart failure etc. Diuretics are used here to help correct the real cause of fluid accumulation.

Lymphedema is an abnormal collection of lymphatic fluid, usually in one or both arms or legs. This can be due to problems with congenital or hereditary formation of the lymphatic system, or as a secondary collection due to some other diseases. This can also happen due to radiation exposure or any injuries. Diuretics are not useful for treating the underlying cause of lymphedema.

The answer is usually negative, although there are rare exceptions.

Diuretics is the best treatment when it comes to the cure of people suffering from lower extremity swelling due to congestive heart failure. The main action of diuretics is to limit capillary filtration. When the heart functions inefficiently, it can cause increased pressure in the veins. This results in increased pressure on the tissues and therefore edema is seen. This edema is not associated with the lymphatic system and is very different from lymphedema.

Diuretics help drain excess water with the help of urine-shaped kidneys. Thus, the pressure in the veins decreases and, consequently, the pressure in the tissues also decreases, thus reducing the edema. However, if the affected person drinks additional fluids and water, that fluid may accumulate again and the edema may return. Therefore, in such cases, salt and water intake should be monitored regularly.

In some cases, if edema cannot be administered with diuretics alone, compression garments may be required to prevent fluid from accumulating.

In these cases the lymphatic system may not be affected, but these people, if suffering from congestive heart failure, may still develop swelling.

The lymphatic system

Lymphatic fluid drains through the lymphatic vessels and the lymph nodes and lymphedema occurs as a result of blockage of these lymphatic vessels or any injury or removal of the lymph nodes.

These vessels and nodes carry lymphatic fluid. Lymphatic fluid is a protein rich fluid that is responsible in our body’s immunity system. This fluid travels in the lymphatic vessels and not in the veins. Thus, reducing the pressure in the veins with the help of diuretics will be of no use in correcting lymphedema.

If a person has a mixed condition, ie lymphedema and also coexisting edema as a result of congestive heart failure, then diuretics may prove to be of some help in reducing edema. However, lymphedema has yet to be treated differently.

Whatever the causative factor of lymphedema, lymphedema has no cure. However, it is a treatable disease and symptoms like swelling and pain, etc. can be managed through drug and compression therapy, etc. However, diuretics are absolutely useless when it comes to lymphedema management alone. If lymphedema is present along with edema, then diuretics can resolve edema alone, while lymphedema will not be affected by diuretics.

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Eu sou o Dr. Ruby Crowder e sou especialista em medicina pulmonar e cuidados intensivos. Eu me formei na Universidade da Califórnia, em San Francisco. Eu trabalho no Hospital Geral de São Francisco e Centro de Trauma de Zuckerberg. Eu também sou professor associado de medicina na Universidade da Califórnia, em San Francisco.

Eu pesquisei a epidemiologia e o manejo da tuberculose em países de alta incidência e publiquei muitos remédios e artigos relacionados à saúde sobre o Exenin e em outras revistas médicas.

Finalmente, gosto de viajar, mergulhar e andar de mochila.

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