Varicose veins

Varicose veins of the lower extremities are usually asymptomatic in humans. Usually, the only problem with this pathology is a cosmetic defect in the leg due to protruding superficial veins. In this case, the disease may be accompanied by pain or increased sensitivity of the skin of the legs. Depending on the severity of the disease, the patient can be treated with non-pharmacological, drug or surgical methods. Read more about the first symptoms of varicose veins, the nature of the disease process and effective methods of treatment and prevention, read our brochure.

What is it

Varicose veins are a disease that only people with varicose veins suffer from. Animals did not have this problem, which suggests that the disease is related to the upright posture. When a person stands up, the main part of the circulating blood begins to lie below the level of the heart. In this case, poorer blood circulation in the opposite direction leads to stagnation.

According to statistics, some disorders of the venous system are observed in 80% of people in developed countries. Furthermore, increasingly, similar problems are found in people at a young age. In all likelihood, one of the reasons why varicose veins are increasingly "rejuvenating" is a sedentary lifestyle, which only contributes to the stagnation.

It is interesting to note that under the age of 20, varicose veins of the lower extremities occur with equal frequency in both men and women. However, after the age of 20, women begin to dominate the disease structure. This is due to the process of pregnancy and childbirth, which is a serious factor in the development of venous diseases.

Characteristics, causes and development mechanism of varicose veins

The exact reasons for the development of varicose veins of the lower extremities are unknown. Currently, it is believed that the disease is caused by congenital or acquired defects of the valve apparatus of the veins of the lower extremities.

For the unimpeded upward flow of blood through the veins, the coordinated action of the venous valves is necessary. These valves open only to allow blood to flow upward. However, with a valve defect, a partial decrease in blood flow can also occur. This is how venous insufficiency develops, manifested by edema, cramps of the muscles of the legs and dilation of the venous vessels.

Leukocytes may also be involved in the pathogenesis of the development of varicose veins. This issue is currently under active research. It is thought that with the prolonged accumulation of leukocytes in the tissues of the vessels (especially in the area of \u200b\u200bthe valve apparatus), an inflammatory process develops, spreading along the venous layer.

Since the venous valves are subjected to constant mechanical stress, inflammation develops particularly rapidly in the region of the venous valve device.

Currently, the vast majority of people in developed countries lead a sedentary lifestyle. But why doesn't everyone get varicose veins? Consider the main risk factors that contribute to the onset of this pathology:

• Genetic factors. . . Despite the fact that the specific genetic mechanisms involved in the development of varicose veins have not been established, most experts agree on the presence of such a factor. At the same time, there are objections to weight-related heritability in the development of varicose veins. For example, this is the prevalence of varicose veins among ethnic Africans and African immigrants who have moved to live in the United States. If the prevalence of varicose veins in sedentary Africans is about 0. 5%, in migrants it rises to 20%. These numbers suggest that genetic factors are, at least, not the only factor in the development of the disease, and most likely, do not predominate.
• Fat. . . Overweight and obese people are at increased risk of disease. It is important to note that obesity contributes to varicose veins both by increasing stress on the vessels and associated with an increased risk of other diseases that affect the vessels (diabetes, hypertension, and others). ).
• Pregnancy. . . This is one of the most obvious factors in the development of venous insufficiency of the lower extremities. In this case, the main risk factors were an increase in circulating blood volume, as well as compression of the retroperitoneal veins by the developing fetus in utero. According to epidemiological studies, the second pregnancy onward leads to a significantly increased risk of varicose veins. After your first pregnancy, the chances of developing varicose veins remain low.
• Hormonal imbalance. . . Hormones are involved in the pathogenesis of most diseases. These conditions include varicose veins. This is especially true for women who are using hormonal contraceptives, as well as those who are using hormone replacement therapy to treat certain conditions (for example, osteoporosis) or during their periods. Premenopausal. It has been shown that female sex hormones (especially estrogen and progesterone) decrease vascular tone and destroy collagen fibers. Thus, the walls of the veins are pathologically dilated.
• Lifestyle. . . A person's lifestyle has a great influence on the course of the disease. A sedentary lifestyle, as well as work that involves prolonged standing or sitting (for example, security guards, drivers, office workers, service workers, and others) contributes to the development ofdevelopment of varicose veins. You should also pay attention to your diet. The lack of sufficient amounts of vegetables and fruits in the diet aggravates the condition of the walls of blood vessels.

Stages of varicose veins of the lower extremities

Currently, several classifications of varicose veins of the lower extremities are used. The CEAP International Classification, adopted in 1994, is considered generally accepted. CEAP is an acronym, where each letter corresponds to the name of a classifier:

• C (Clinical)- clinical type of disease (type of affected vein, presence of pigmentation, eczema, trophic ulcer).
• E (Origin)- the etiology of the disease (congenital, primary, secondary).
• A (Anatomy)- anatomical localization of pathology (superficial or perforated veins).
• P (Pathophysiology)- type of disorder (venous reflux, obstruction, or a combination of both).

The course of the disease takes place in six stages:

• Phase 0. . . The earliest stage of varicose veins, which even a doctor cannot reliably diagnose. At this stage, there are no external signs of the disease. Ultrasound diagnosis did not reveal the presence of pathology. At the same time, a person in stage 0 is worried about symptoms such as swelling, a feeling of heaviness in the legs, as well as cramps, indicating the presence of problems with blood vessels.
• Early stage. . . In the early stages of the disease, spider veins are prominent on the skin of the legs, less than 1 mm in diameter. Veins of medium size can grow up to 3 mm in diameter. At this stage, doctors are not always able to establish an accurate diagnosis, since the presence of such asterisks does not always indicate varicose veins.
• Second stage. . . At this stage, veins may appear and disappear depending on the condition. For example, veins become evident after prolonged sitting, standing, or lifting heavy objects. The diameter of the veins at this stage is 3 mm or more. Blood clots usually form in the second stage.
• The third stage. . . If in the earlier stages of the disease the swelling of the legs appeared and disappeared, then in the third stage the swelling of the legs became permanent. Leg edema is most severe in the evening.
• Fourth stage. . . At this stage, significant nutritional changes occur. In particular, tissue nutrition is disrupted near the affected veins. The patient has skin changes such as scleroderma (inflammation of the fatty tissue under the skin), eczema, as well as darkening or discoloration of the skin. For the fourth stage of the disease, pigmentation changes are characteristic. For example, the skin in the area of the affected vessels may turn brown and even black, which indicates a concentration of pigment in this area. The opposite situation is also possible, when, due to a pathological process, the pigment does not penetrate into the affected area, which leads to the appearance of pale skin color. If at this stage varicose veins are not treated, then the problem will only worsen with the further appearance of trophic ulcers.
• Fifth stage. . . At this stage of the disease, in addition to the above symptoms, vegetative ulcers appear, and the wounds heal quickly. If you do not apply any measures to treat the sores reappear again and again.
• Sixth stage. . . Non-healing trophic ulcers appear. In the affected area, the temperature rises markedly and pus may drain from the wound.

You should not wait for the development of the terminal stage - you should go for a second visit to register and monitor the progress of the disease. Sometimes symptoms improve on their own, and sometimes they progress rapidly. Therefore, it is necessary to monitor the situation in order to take timely measures.

Symptom

Consider the main symptoms of varicose veins of the lower extremities at different stages of the disease:

• Pain. . . This is the earliest sign of the disease. Because pain is a nonspecific symptom, it cannot be diagnosed based on this symptom alone. With varicose veins of the lower extremities, the pain is often localized along the venous trunk lines.
• Foot in foot. . . The same applies to the initial symptoms, when the veins in the skin are not yet evident. Usually, the feeling of heat is accompanied by a sharp pain.
• Muscle cramps and itching. . . Usually disturbed at night.
• Be swelled the leg. . . In the early stages of the disease, swelling is mild and transient. As a rule, they appear in the evening and disappear in the morning. However, the more advanced the disease, the more severe it becomes and they become permanent.
• Skin discoloration. . . As a rule, with varicose veins, the skin of the lower extremities darkens. In the area of the affected veins, the skin turns brown. In the advanced stage of the disease, eczema and dermatitis appear. The final stage of varicose veins is characterized by the appearance of trophic ulcers. Initially, these are ulcers that are healing, but later form non-healing wounds.
• Spiders have veins. . . In the medical literature, such asterisks are called telangiectasias. In some people, varicose veins may be limited to the spider veins without progressing to larger veins.
• Varicose veins. . . The most characteristic sign of varicose veins is varicose veins on the surface of the legs.

In the summer, the symptoms of varicose veins become more pronounced. This is due to the high ambient temperature, which already contributes to the dilation of the veins. So during the hottest hours, from 10 a. m. to 4 p. m. , it's best to be in a well-ventilated area.

When to see a doctor?

You should consult your doctor at the first symptoms of the disease - pain, swelling or appearance of spider veins. Because the early stages of varicose veins are difficult to diagnose, they can be misdiagnosed at first. The patient should carefully monitor the condition of the legs and regularly be monitored by a phlebologist.

Diagnose

Diagnosis of lower extremity venous insufficiency:

• Examine the outer skin of the legs;
• Doppler ultrasound;
• Double-sided vein scan;
• Phlebography.

Treatment Features

Varicose veins of the lower extremities are treated with both conservative and surgical methods. Cautious treatment is reduced to the following activities:

• Drug treatment. . . This is the intake of drugs that improve the sound of the vein walls. At the same time, the patient is prescribed drugs that reduce capillary permeability and improve blood microcirculation. If there is a risk of blood clots forming, then anticoagulants are also prescribed.
• Compression therapy. . . This is wearing a special compression knit fabric, which reduces the load on the foot. The benefit is being able to evenly distribute the load, even during heavy exertion. When compression clothing is used, congestion and swelling can be avoided.
• Remedial exercise and lifestyle changes. . . Patients are advised to exercise to reduce stress in the legs. It is important to avoid sitting or standing for long periods of time. If you have to stand or sit for a long time at work, then you need to take breaks more often.

If conservative treatment of varicocele does not bring the expected results, then a decision is made to intervene surgically. Usually these are minimally invasive interventions, including:

• Therapeutic therapy- the introduction of substances that glue the affected vessel walls. This treatment leads to resorption of the spider veins.
• Laser coagulation- the introduction of laser guided light into the vein and the laser beam to the vessel wall, this also leads to gluing of the vessel wall and further resorption of the vessel.
• Lost TV signal- gluing the veins using high frequency current.
• Vein ablationRemoval of the affected vein, in which blood circulation has decreased by up to 90%.

In some countries, you may be able to get free surgery under mandatory health insurance. But it is not a fact that all kinds of compulsory insurance are offered everywhere. In all cases, help will be provided, but it is necessary to find out if it will be conventional or laser removal.

Contraindicated for people with varicose veins

• Sedentary lifestyle. . . It is important to avoid sitting or standing for long periods of time. Physical activity will help avoid blockages in the veins.
• Run and exercise vigorously. . . With physical activity, it's important not to overdo it. If you have varicose veins, walking is definitely better than running.
• Unbalanced and unhealthy diet. . . You need to give up junk food, even if your health seems to allow it. You should limit your intake of sweets, semi-finished products as well as meat-rich broths and smoked meats. But eating lots of vegetables and fruits would be a good idea.
• Hot tub and shower. . . For people with problems with blood vessels in the extremities, procedures with very hot and prolonged water are contraindicated.

Complications of varicose veins

Varicose veins can be complicated by trophic ulcers, phlebitis (inflammation of the veins), and deep vein thrombosis. Then there is the formation of blood clots in the deep veins that threaten human life.

Conclusion

Symptoms of varicose veins of the lower extremities, as a rule, do not appear immediately. Different people have a different set of manifestations. For example, sometimes with this pathology there is no edema or no local increase in temperature or pain. This is by no means the absence of disease. Timely visit to the doctor will significantly slow down the progression of the disease or even stop it, preventing the development of nutritional changes.