Increased lymph nodes in the groin: causes, treatment

In a healthy person, the lymph nodes are no larger than peas or cannot be felt at all. These organs of the immune system are filters that, by letting lymphatic fluid through, retain pathogenic microorganisms, preventing them from entering the blood. When in contact with foreigners, the lymph nodes intensively produce T-, B- and NK-lymphocytes to normalize the body's condition. If it is not possible to quickly cope with foreign elements, painful changes begin to occur in the lymph nodes, leading to their enlargement, inflammatory (lymphadenitis) and non-inflammatory genesis (lymphadenopathy).

First of all, the reaction occurs in the group of lymph nodes closest to the affected organ. Hyperplasia of the inguinal nodes signals the presence of trouble in the buttocks, lateral parts of the body, intestines, reproductive organs and lower extremities.

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Epidemiology

Medical statistics show that more than 90% of cases of inguinal lymphadenopathy occur after trauma to the perineum and genitals. Out of a thousand people who seek medical help, two or three people seek it because of enlarged lymph nodes of any localization, of which about 60% are male patients and about 40% are female. Most patients with lymphadenopathy (60-80%) are over forty years old.

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Causes enlarged lymph nodes in the groin

The vast majority of cases of lymphadenopathy in this localization are caused by injuries to the pelvic floor and reproductive organs. The most likely risk factors for lymph node hyperplasia in this area are venereal, viral ( genital herpes, HIV ), parasitic and bacterial diseases of the pelvic organs, tumors such as lymphoma, blood and connective tissue diseases, dermatoses, lower limb injuries and unusually high physical loads on them. The start or cancellation of hormonal/chemotherapy may be accompanied by an increase in lymph nodes in the groin as well. Taking medications (sulfonamides, penicillins, cephalosporins, gold preparations, finlepsin, captopril and some others), vaccination can cause lymphadenopathy.

Lymph node adenopathy is divided into non-specific, the causative agent of which is in most cases staphylococci, somewhat less often - streptococci and other pyogenic bacteria, sometimes in combination with anaerobes, and specific, accompanying rubella, venereal diseases, actinomycosis, tuberculosis. The pathogenesis of hyperplasia is based on the entry of the pathogen from the primary source of infection or invasion of cancer cells into the lymph node with the lymph flow, where B-lymphocytes, having recognized the antigen, begin to produce antibodies to it. Also, the lymph node begins active synthesis of serum proteins, immunocytes (T-killers, T-helpers, NK-lymphocytes), trying to destroy foreign microorganisms. If the pathogenic microflora is not completely suppressed, then the lymph node becomes a focus of chronic infectious pathology. Its relapse ( acute lymphadenitis ) can develop as a result of decreased immunity due to endogenous or exogenous factors (nervous strain, freezing, exacerbation of an autoimmune disease, etc.).

Enlarged lymph nodes in the groin area are a sign of progressive pathology of the organs from which the lymph flow rushes to them. The upper nodes of this group increase in size when the buttocks, sides and pelvic organs are infected, the middle ones - the intestines, the lower ones - the legs.

Forms

Types of acute lymphadenitis by the nature of the inflammatory process:

• simple or serous (catarrhal) - moderate hyperplasia of the lymph nodes, they are soft, not hyperemic, mobile and not fused together, no swelling is observed, there may be slight pain when pressed;
• purulent - infiltrate from inflamed lymph nodes, severe pain syndrome, soreness, hyperemia and swelling of surrounding tissues, accompanied by a sharp rise in temperature (38-39 ° C), significant growth of lymph nodes, interfering with walking, the abscess can break through with the formation of a fistula or move to the next stage;
• adenophlegmon - inflammation spreads to the tissue surrounding the node capsule, the patient is in a feverish state, which is accompanied by chills, tachycardia, headache, difficulty breathing, hypotension (requires surgical intervention).

The above types of disease demonstrate the stages of development of one process. Timely medical attention at the stage of serous inflammation with the help of conservative treatment methods leads to complete recovery.

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Complications and consequences

Swollen lymph nodes in the groin that last more than two weeks, even if they do not cause serious discomfort, should not be ignored. You can miss the development of such serious diseases as tuberculosis, oncopathologies, and others. You must definitely see a doctor and find out what caused it. This condition can be a symptom of serious health problems, and the earlier the diagnosis is made and treatment is started, the greater the chances of restoring health.

Acute lymphadenitis usually causes serious discomfort, and people try to get rid of it. However, they do not always immediately consult a doctor, but try to treat themselves with folk methods, which can lead to purulent inflammation. Complications of purulent lymphadenitis can be an abscess or adenophlegmon, which require surgical intervention.

The body's response to a local inflammatory process can be the entry of infection into the systemic bloodstream, the appearance of purulent foci in distant organs, and sepsis.

Untimely treatment of acute lymphadenitis is fraught with the development of purulent inflammation of the veins, the consequence of which may be phlebothrombosis or pathology of lymph drainage and the development of elephantiasis. Thrombophlebitis of the lower extremities may end in blockage of the pulmonary vessels and the death of the patient.

Chronic sluggish inflammation of the lymph nodes, which does not cause any particular trouble and is ignored by the patient, can lead to hypoplasia of the lymph nodes, their scarring and degeneration. Connective tissue grows in the affected lymph nodes, drainage of lymphatic fluid is disrupted, chronic edema appears, and in severe advanced cases - lymphostasis (elephantiasis of the legs, scrotum).

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Diagnostics enlarged lymph nodes in the groin

The cluster of lymph nodes in this area is one of the largest in the body. Hyperplasia of one or more nodes may indicate the existence of a serious pathology of vital organs. How to determine the enlargement of the lymph nodes in the groin? With their normal size, palpating the nodes on your own is problematic. Enlarged superficial lymph nodes are noticeable visually, since their size can reach 50-60 mm. They are painful, especially when walking. An ultrasound examination can give an accurate conclusion about the presence of pathological changes in the nodes of the inguinal group, and to find out the reason for their enlargement, a number of diagnostic measures must be carried out.

The first and very important step in determining the etiology of lymph node hyperplasia is a thorough collection of anamnestic information, infectious, professional, migration. The organs and tissues from which the lymph flow leads to the enlarged lymph nodes are examined. Nodes in other clusters are monitored. The size, intensity of pain, single nodes or those connected to each other and surrounding tissues, density and elasticity are taken into account.

The patient is prescribed laboratory tests - blood (clinical), biochemistry, rheumatic, serological tests, urine and others depending on the presumptive diagnosis of the underlying disease. Sometimes, to establish an accurate diagnosis, a puncture biopsy of the contents of the lymph node is prescribed, its excision for histological examination.

Instrumental diagnostics – ultrasound examination, radiography, computed tomography and magnetic resonance imaging.

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Differential diagnosis

Differential diagnostics is performed to distinguish specific lymphadenopathy in tuberculosis, syphilis, toxoplasmosis, and other infections. Malignant and metastatic neoplasms and blood diseases are excluded. Local hyperplasia should be differentiated from generalized hyperplasia, nonspecific lymphadenitis from phlegmon and osteomyelitis.

Treatment enlarged lymph nodes in the groin

The size of the lymph nodes can increase under the influence of many factors, so first the cause of hyperplasia is established, depending on which treatment is prescribed. There is no independent therapy for enlarged lymph nodes.

In case of non-inflammatory lymphadenopathies arising from lymphogranulomatosis, leukemia, metastasis, the underlying disease is treated as with specific lymphadenitis. Depending on the underlying disease, recommended treatment regimens for tuberculosis, venereal diseases, infectious mononucleosis, and childhood infections are used.

Conservative treatment of enlarged groin lymph nodes is performed in non-specific chronic lymphadenitis, acute catarrhal and in the initial stages of the purulent process. In chronic disease, the main goal of therapy is to identify and eliminate the source of prolonged infection of the lymph nodes. It is not always possible to identify the cause of chronic inflammation of the inguinal lymph nodes. In such cases, treatment is prescribed to eliminate inflammation in the lymph nodes and increase the body's defenses.

Antibacterial drugs of the penicillin series are prescribed, for example, Augmentin, the spectrum of action of which is expanded due to the presence of clavulanic acid in its composition. An antagonist of almost all bacterial pathogens infecting the genitourinary tract, skin, bones, soft tissues, intestines, active against pathogens of gonorrhea and syphilis. Available in forms for oral administration and intravenous injection, dosed individually taking into account the severity and localization of the infectious and inflammatory process. It is used at any age, the exception is the first trimester of pregnancy and lactation. It can cause allergic reactions, since antibacterial drugs of this series cause them most often. In case of renal failure, patients require dose adjustment, in case of liver failure, it is prescribed with caution, especially intravenously.

An alternative choice is second-generation cephalosporins. For example, Cefuroxime axetil, which is active against the main infectious agents that cause inflammation of the lymph nodes, staphylococci and streptococci. It is used for infections of the urinary and genital organs, bones, joints, skin and soft tissues. It is available for oral administration, as well as for intramuscular and intravenous injections. It is dosed individually, used from the first days of life, during pregnancy and lactation, its use is undesirable, its effect has not been studied. In case of renal dysfunction, the dosage is adjusted. It causes allergic reactions, special care should be taken by people with an established allergy to penicillin drugs.

In the treatment of acute lymphadenitis, antibiotic therapy is also used, the choice of drug is based on the sensitivity of the infectious agent of the primary focus. The primary infection is eliminated simultaneously with the treatment of the inflamed lymph nodes. After its elimination, catarrhal inflammation usually goes away. Purulent inflammation requires longer treatment. The patient must stay in bed, in addition to antibacterial therapy, painkillers and general strengthening therapy are administered. In addition to antibiotics, leukocyte production stimulants are prescribed, for example, Methyluracil. Activates hematopoiesis, especially leukopoiesis, promotes cell renewal and restoration, increases cellular and humoral immunity, relieves inflammation. Contraindicated in leukemia, lymphogranulomatosis, bone marrow cancer. Occasionally, when using suppositories, a slight burning sensation is felt, there may be skin and vegetative-vascular allergic disorders.

Oral administration is carried out during or after meals. The recommended dose for children aged 3-8 years is 250 mg, over eight - 250-500 mg, the number of doses per day is three. Adult patients are dosed 500 mg four times a day, the maximum allowed daily dose is six. In the treatment of inflammation of the colon, suppositories are prescribed - from one to four units per day. Long-term non-healing skin surfaces are treated with 10% ointment simultaneously with oral administration.

Likopid is a powerful immunostimulant, used in severe cases in the treatment of purulent lesions to prevent sepsis. It has bactericidal and cytostatic properties, activates the resorption of tumors. Pregnant and lactating women are not prescribed, children aged 3-15 years are dosed at 1 mg / day for no more than ten days. It can cause mild hyperemia that does not require its cancellation, is not prescribed in case of exacerbation of autoimmune processes, with febrile temperature in the patient, lactose intolerance. The tablets are taken orally or dissolved under the tongue until completely dissolved half an hour before meals. The dosage and therapeutic regimen are developed by the attending physician individually, taking into account the characteristics of the disease and interaction with other prescribed drugs.

In cases of primary infection in the form of bedsores and other long-term recurring wound formations, the infection site is treated with Vishnevsky ointment. It is used in combination with other measures, destroying pathogenic microorganisms in the primary site and promoting its healing.

In the initial stage of acute non-specific lymphadenitis, Ichthyol ointment is used. It does not have a pronounced antiseptic effect, but it powerfully resists inflammation, soothes and heals the wound surface. These are old, fairly safe and proven remedies, the use of which contributes to the sanitation and healing of the primary source of infection, and, accordingly, to the reduction of lymph nodes.

Vitamin therapy is used in a complex of measures to strengthen the immune system and the general condition of the body. Prescriptions are made based on diagnostic findings and medications used in treatment regimens. Vitamins C, E, A, group B, vitamin-mineral complexes accelerate the process of infection destruction and patient recovery.

Physiotherapy is widely used in the treatment of enlarged groin lymph nodes: medicinal electro- and phonophoresis, galvanization, UHF and laser therapy. In the initial stages of catarrhal inflammation, physiotherapy can lead to recovery. However, the use of physiotherapy procedures is contraindicated until the exact origin of the enlarged lymph nodes is established.

If a primary purulent source of infection is detected, then in almost all cases it is opened, sanitized and drained surgically.

In advanced forms of the disease, when drug therapy and physical therapy have proven ineffective, surgical treatment is necessary. It involves opening the abscesses, sanitation and drainage of the wound. In case of necrotic changes in the lymph nodes, it may be necessary to remove the node itself. However, this operation is performed in extreme cases, since the patient subsequently develops lymphostasis and elephantiasis of the lower part of the body.

Folk remedies

When lymph nodes are enlarged, folk remedies can be successfully incorporated into therapeutic regimens. However, they cannot be used independently, without a diagnostic examination and consultation with a doctor.

In the initial stages of serous lymphadenitis, it is advisable to use compresses, which should definitely not be done in the case of suppuration.

The following compositions can be used for compresses:

1. The easiest way is to buy echinacea tincture at the pharmacy, dilute one part of the tincture in two parts of warm water, soak natural fabric or cotton pads in the solution, apply to the enlarged nodes, secure, wrap a woolen scarf on top, and leave overnight.
2. Bake one large onion, peel and mix until smooth with a tablespoon of tar (pharmacy). Apply the mixture to a piece of natural fabric or a cotton pad, apply to the inflamed areas, secure and wrap a woolen scarf on top, leave overnight.
3. Place a mixture of crushed dry herbs (a teaspoon of each): yarrow, St. John's wort, walnut leaves and mistletoe on the bottom of a saucepan, add water (200 ml), boil and simmer on low heat for three to five minutes. Soak cotton pads or pieces of cotton fabric in the strained warm decoction and apply, securing and wrapping to the sore spots overnight.

Compresses are applied to the inflamed lymph nodes until they noticeably decrease.

It is recommended to drink herbal infusions that help cleanse the lymph and relieve inflammation both in the primary focus and in the lymph nodes. Infusions can be drunk in all cases of non-specific lymphadenitis.

1. The same tincture of echinacea - drink a solution of 25-40 drops in 100 ml of water twice or three times a day. Contraindicated for use in autoimmune diseases. If the treatment regimen includes a medicinal immunomodulator, be sure to consult a doctor.
2. Make a mixture of dried and crushed hazel leaves and bark (1/4 cup each), pour ½ liter of boiling water into a thermos, leave for about an hour, stir, strain. Drink before each meal, shaking the infusion each time and measuring out ¼ cup per dose. Take for two to three weeks, then repeat at intervals of one week.
3. Prepare the raw material - soft young pine shoots in crushed form should fill a two-liter container. Put them in a saucepan, pour three liters of water, boil and, reducing the heat, cook for 90-120 minutes, covering with a lid. Then strain the resulting broth into another container, add a glass of sugar and cook for another two hours. Cool the finished broth and take one tablespoon after meals once or twice a day. The duration of treatment is a month and a half, after a two-week break it can be repeated.

To prepare herbal infusions, use fireproof glassware or white enamelware. It is advisable to store the infusions after straining in a glass container.

To reduce the size of lymph nodes, use herbal treatment. It is good to cleanse the lymph nodes with an infusion of St. John's wort: a tablespoon of the herb is poured with ½ liter of boiling water, the infusion is filtered after 20 minutes. Drink half a glass three times a day and eat food after half an hour.

An infusion of birch buds, prepared in the same proportions and strained after cooling, is taken three times a day, one tablespoon, for 4-5 days, a third of an hour before meals, then the dose is increased to ¼ cup and taken for another week or two. This remedy is contraindicated in gastric ulcers.

An infusion of rose hips is also prepared, which must be crushed before preparation. This infusion is taken three times a day 20 minutes before meals. It is better to drink it through a straw, since rose hips have a negative effect on tooth enamel. You can rinse your mouth immediately after drinking.

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Homeopathy

Homeopathic preparations can be included in treatment regimens as means of increasing the body's defenses. Moreover, they usually do not cause side effects and do not interact with medications.

For example, Anaferon, which is a combination of homeopathic dilutions of affinity-purified antibodies to human γ-interferon. Effective in viral and bacterial infections of the genitourinary organs, in case of immunodeficiency of various genesis. Contraindicated in case of allergy to the components, during pregnancy and lactation.

Sublingual administration: one tablet, three to six pieces per day; after the acute symptoms have been relieved, take one piece for eight or ten days.

For children, children's Anaferon is produced:

At the age of 6 months - 3 years, one tablet is dissolved in clean water (15 ml) and given once a day. Take for a week.

Lymphomyosot is a homeopathic preparation containing 16 components. Enhances lymph flow, relieves intoxication and inflammation, reduces exudation, activating cellular and humoral immunity. Available in drops and injection solution. Pregnant and lactating women take only as prescribed by a doctor. Contraindicated in case of hypersensitivity to the ingredients. Be careful with thyroid pathologies. Skin allergic reactions may occur in rare cases.

The drops are dissolved in water (10 ml) and held in the mouth for absorption as long as possible, three times a day before meals half an hour or an hour after. Patients aged 12 and older are given 10 drops, infants - one or two, from one to three years - three, from three to six - five, from six to 12 - seven.

To relieve acute conditions, a single dose is taken every quarter of an hour, but not more than 10 times. Then switch to the usual dose.

In case of hyperthyroidism, take half the dosage corresponding to your age, increasing it daily by one drop and bringing it up to the age norm.

In severe cases, an injection solution is prescribed. A single dose is one ampoule and is used from the age of six. Injections are made two or three times a week intramuscularly, subcutaneously and intravenously, and at acupuncture points.

Oral administration of the solution from the ampoule is also possible; to do this, its contents are diluted in ¼ glass of water and drunk throughout the day at equal intervals, holding the liquid in the mouth.

Homeopathic pharmacies in large cities usually have complex preparations used for lymphadenitis. They usually contain Aurum metallicum, Calcium fluoricum, Silicea, Bromum, Tuberculinum, and may contain other substances.

Calcium fluoricum (calcium fluoride) is used for very dense nodes, Barium jodatum (barium iodide) is also often prescribed for enlarged lymph nodes, as are other drugs. At the same time, a homeopathic doctor will take into account many other symptoms and modalities in a particular patient. Therefore, if you want to be treated with homeopathy, you must consult a doctor of the appropriate profile.

Prevention

To prevent diseases that cause enlarged lymph nodes in the groin, it is worth following simple rules:

• To prevent sexually transmitted infections, it is worth observing basic rules of sexual hygiene;
• to avoid infection of internal organs by pathogenic microorganisms – sanitary and hygienic standards;
• eat a balanced diet, including more fruits, vegetables, and fresh juices in your daily menu;
• move more, walk in the fresh air;
• avoid stress, contact with toxic substances, harmful radiation;
• do not get carried away with medications;
• try to avoid injuries, and if you do receive one, try to prevent purulent complications;
• Do not let inflammatory diseases progress by contacting a doctor in a timely manner.

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Forecast

If you see a doctor in a timely manner, lymphadenopathy, in most cases, does not pose a threat to life. Most often, enlarged inguinal nodes have an infectious cause and can be treated conservatively. The prognosis and prospects of each patient directly depend on the establishment of the main diagnosis.

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