Therapy
The therapy should be started before elephantiasis is present. Elephantiasis is a stage of lymphedema that cannot be reversed. Therefore, an adequate therapy should already be carried out beforehand.
This consists of conservative methods such as the consistent elevation of the affected body region. Physical measures such as lymphatic drainage, where the therapists press the lymph fluid with their hands in the direction of the heart, and compression therapy using bandages and compression stockings can also be used. A lot of exercise also helps to improve lymph drainage.
If the lymphedema is caused by an underlying disease such as an infection, it should be treated with antibiotics for bacteria or other antimicrobial substances (e.g. against the threadworm). This is the only way to prevent a permanent weakness of the lymphatic system, thus preventing elephantiasis. If these measures alone do not provide sufficient therapy, an operation can also be performed.
This involves the removal of lymph vessels that no longer fulfil their function. If necessary, new lymph vessels can be implanted (transplanted) in their place. In addition, so-called draining measures can be used. In this case, the lymphatic fluid is artificially drained from the congested vessels.
Course of disease
Elephantiasis is preceded by a long history of disease. Often, the first thing that happens is a triggering event such as trauma, surgery or even radiation in the case of cancer. In tropical regions, an infection with bacteria or parasites as a trigger is also conceivable.
After that, a so-called latency stage initially occurs. In this phase the lymphatic system is already weakened, but the tissue fluid can still be completely removed. Gradually, the lymphatic system is overloaded, resulting in fluid retention with soft swelling in the tissue. Later, the tissue undergoes a fibrotic transformation, so that the changes are irreversible. In the final stage there is massive swelling of the body part with rough, hardened and thickened skin.
Prognosis
Elephantiasis is an irreversible stage of the disease, which means that the changes in the affected area of the body cannot regress. Nevertheless, a relief of the symptoms can be achieved. However, elephantiasis poses a permanent risk of complications such as infection of the tissue and skin.
These can only heal poorly due to poor blood circulation and the lack of removal of fluids and toxins. Therefore, prevention of infection is crucial for the prognosis of elephantiasis. It is therefore difficult to make a generalized statement on the course of the disease.