Varicose veins are a disease that is characterized by thinning and stretching of the veins, malfunction of the venous valves, and congestion of blood in the veins. How does a vein normally work? With each heartbeat, the blood moves through the body and then has to return to the heart. She returns through the veins. But since gravity acts on the blood in the veins of the lower extremities, nature came up with the idea of equipping them with valves that close and prevent the blood from flowing back. As phlebologists say, a vein is more complex than an artery, it plays the role of a peripheral heart: all the blood that the heart pumps pushes it back in the right direction.
Varicose veins of the legs, hemorrhoids, portal hypertension
The return of blood to the heart is facilitated by active contractions of the leg muscles. What happens if this function is violated? A healthy vein is elastic, but its muscle wall is weak. When elasticity is lost, another property of the veins is used - elasticity. First, the valves let some of the blood through, the vein expands, and the valves stop reaching and bend back. The blood begins to accumulate in the veins, which grow in size, take on a tortuous shape and become visible under the skin.
It is important to understand that varicose veins are not just a cosmetic flaw, but a serious disease that needs treatment. If you fail to treat varicose veins, complications are possible - blood stagnation contributes to thrombosis, which can lead to thrombophlebitis and a more serious complication - the separation of a thrombus and the blockage of an important artery, for example, the pulmonary artery. This is already a fatal condition that requires immediate medical attention.
However, this is not the most common case, but one in four patients who are not treated will have thrombophlebitis, thrombosis, and trophic ulcers on the legs. Women are more likely to suffer from varicose veins. Interestingly, it can affect not only the veins of the legs, but also the esophagus (for portal hypertension) and the spermatic cord (for varicocele) and plexus near the anus (for hemorrhoids).
The causes of varicose veins
Here are the main causes of varicose veins:
- the real device of the veins is a weak muscle wall;
- pregnancy - the amount of circulating blood increases, venous outflow deteriorates due to the fact that intra-abdominal pressure increases;
- hereditary predisposition;
- Standing work - for example with salespeople;
- hormonal contraception or taking hormones during menopause;
- obesity - it has been proven that having a body mass index of 27 increases the risk of varicose veins by a third;
- frequent wearing of heels;
- wearing tight clothes, corsets that squeeze large veins in the groin area;
- sedentary lifestyle;
- chronic constipation.
Symptoms: enlarged veins, swelling, heaviness, seizures
The stretching of the veins causes blood to build up above a certain level and the person begins to feel heaviness in their legs - especially towards the end of the day or when the day is spent on their feet. Later, evening swelling of the legs appears, but even at this stage the patient may not notice or pay attention to it. Visible so-called asterisks or telangiectasias appear and then enlarged, tortuous veins. Such deformed vessels no longer decorate at all and even cause pain in the legs, night cramps, and sometimes itchy skin. Many patients are already accepted on their own, some go to the doctor. Subsequent darkening of the skin, dermatosclerosis occurs on the affected area, trophic ulcers may form, which are difficult to heal.
Diagnosis of varicose veins
For diagnostics, ultrasound of blood vessels or ultrasound duplex scan of veins is mainly used - this method allows you to find damaged valves and, in particular, to show the veins that are not yet visible from the outside.
Treatment of varicose veins
Vein treatment consists of several phases, depending on the extent of the lesion. In the initial stage, you can use elastic bandages. They are thin, flesh-colored, and do not spoil the appearance. A good, correct bandage will not change width when stretched. How are bandages applied? The leg should be placed horizontally, the foot should be brought at a right angle. The first bandage is placed on the foot at the base of the toe, each subsequent round half closes the previous one. It is important to close the heel so that the blood circulation in the foot is improved. Bandaging with an elastic bandage reduces the diameter of the veins, their valves close and the veins begin to work again.
The treatment of veins with compression stockings works in much the same way - by compressing the veins. If the veins at knee level are affected, compression stockings are sufficient, higher compression tights or stockings. Compression knitwear is prescribed by a doctor on a special form, indicating the size and grade of knitwear (the patient himself can not make the right choice). The class differs depending on the intended use. So the first class belongs to the anti-embolic jersey - it is used in operations to prevent thromboembolism. The second and third grades are medical. But in the case of skin lesions over diseased veins, only third-class jerseys are used in the later stage.
Tights are used to treat veins when high veins in both legs are affected and during pregnancy. The indicator of the knitting class is not the number of cavities, as in ordinary tights (this is just the density of the product), but the pressure it exerts - in millimeters of mercury. Compression stockings are sold in specialty stores, but unfortunately they are not cheap. You put it on in the morning without taking your feet out of bed. Putting on tight knee socks or tights is not easy, so gloves or a special device are used to put them on. The jersey should lie against the leg without creases and the elastic band of the golf should not leave any marks on the skin. You have to wear knee socks or pantyhose like this all the time. The jersey is washable, but after six months it is time to replace it.
Surgical treatment of varicose veins
Ointments have a temporary tightening effect, and alternative medicine, for example leech therapy, can help briefly. However, complete elimination of varicose veins can only be achieved through surgery. The affected vein was previously removed along its entire length. Less traumatic procedures, such as injecting glue into the vein, are currently preferred. This method is called sclerotherapy and is used early on.
Coagulation, radio frequency ablation, and laser procedures are also used. All of these procedures aim to ensure that the affected vein is either no longer passable, turns into a subcutaneous tourniquet that dissolves over time, or narrows to allow the valves to work. The choice of the type of procedure is left to the doctor and depends on the degree of varicose veins, but it also takes into account how quickly the patient wants to undergo rehabilitation and recovery.
After the operation, it is necessary to wear compression stockings and take certain drugs - phlebotonics. They prevent the vein from expanding and strengthen its elastic properties. Contraindications to surgery are thrombophlebitis, diseases of the leg arteries, the presence of foci of infection, blood clotting disorders.
Prevention: plus fitness, minus constipation
First, a balanced diet with sufficient fiber (fresh fruit, vegetables, bran, cereal bread, oatmeal, etc. ) is a preventative measure to prevent constipation as it contributes to blood stagnation. Spicy, excess animal fats should be excluded from the diet. Do not abuse salty, smoked foods or alcohol - this will affect normal blood circulation. Make sure you get some physical activity - swimming, fitness, cycling are perfect. There are also special exercises to strengthen the veins. It is helpful to raise your legs regularly.
Do not self-treat varicose veins. But! You don't need to see a doctor if:
- there are small spider veins, a network that is only aesthetically pleasing without endangering health. Exercises to stimulate venous return are helpful in this phase;
- there are small bumps at the site of the veins, no edema, no pain. The treatment is exactly the same.
All other situations require a doctor's visit. Medical attention is especially urgent when thrombophlebitis has developed, skin pigmentation is compromised, trophic ulcers, and large veins are present. But it is best not to drive into this state yourself.