Vein problems
What is venous disease?
The term "venous disorders" encompasses several diseases of the veins, all of which lead to similar symptoms but have different causes.
The diseases include
- the varicose veins (Varicosis),
- the venous weakness (chronic venous insufficiency),
- the phlebitis (Thrombophlebitis) and
- the venous thrombosis.
Often several diseases are also associated with one another, as they mutually benefit one another. Phlebitis occurs primarily in varicose veins and can easily end in a venous thrombosis, i.e. an occlusion of the venous vessel.
causes
Most varicose veins appear for no apparent cause. It is assumed that standing and sitting activities favor the appearance of varicose veins. But genetic predisposition can also promote the development of varicose veins.
In rare cases, varicose veins develop as a result of an obstruction to drainage in the venous system, e.g. by a thrombosis (Blood clot).
The venous weakness arises, among other things, as a result of a weak valve in the deep leg veins. As a result, more blood has to be transported back to the heart through the superficial leg veins, which overloads these vessels. But even after a temporary closure of a leg vein, changes in the vein structures and thus vein weakness can occur.
As a rule, phlebitis develops on the bottom of varicose veins. The inflammation is favored by the pathological changes in the vein structure and the worsened blood return.
A thrombosis (blockage by a blood clot) of the leg veins occurs when the vessel wall changes, the blood composition and blood flow slow down. There are many known risk factors that favor thrombosis:
- Obesity
- several genetic diseases
- Smoke
- Obesity
- pregnancy
- the pill (see thrombosis while taking the pill)
- Vein weakness
- old age and many more.
You might also be interested in the following article: Causes of thrombosis
diagnosis
The most important thing is to detect a thrombosis without delay. Because this is an emergency and must be treated immediately. With a thrombosis there is a risk of a life-threatening pulmonary embolism (an occlusion of a pulmonary vessel).
The questioning of the patient by the doctor and the symptoms are decisive for all venous diseases. In the case of a thrombosis, there is also an important laboratory parameter (D dimers) that is determined. In addition, imaging methods, usually ultrasound, are used for diagnosis.
Read more on the subject below Detect thrombosis.
Concomitant symptoms
The venous disorders are most often accompanied by a feeling of heavy legs and leg swelling. The swelling often subsides over the night, especially at the beginning.
Furthermore, varicose veins immediately catch the eye due to their winding protrusion. In the case of varicose veins and weak veins, bluish and reddish skin changes occur over time. Itching can also occur.
Nocturnal calf cramps are also possible. In severe stages, venous weakness also leads to hardening of the skin and, in the worst case, to open areas on the legs, which hardly heal.
Painful, palpable vein cords are characteristic of phlebitis. In the inflamed area, the skin is red and swollen.
In thrombosis, pain in the calf when pressure is applied to the calf or when the foot is flexed is typical. The pain is described as pulling. Overheating and swelling of the leg are also indicative. The comparison with the unaffected leg is striking here. If a thrombosis is suspected, a doctor should always be consulted immediately.
You can read about other symptoms by which you can recognize phlebitis under:
These are the symptoms you can tell if you have phlebitis
Edema
The veins are responsible for transporting the blood back to the heart.In many venous diseases, especially venous insufficiency, the veins are no longer able to adequately fulfill their task.
The result is an increase in pressure in the veins, which presses the blood fluid into the tissue. This and the poor evacuation of fluid from the tissue leads to water retention, the edema. Since the leg veins have to transport blood against gravity, venous diseases and edema tend to occur in the legs and are favored by a lot of standing and sitting.
Raising your legs, on the other hand, relieves the veins, as the blood can drain away more easily.
Further information can also be found at Causes of edema,
Pain
As already mentioned with the symptoms, severe pain occurs especially with a thrombosis. The pain is pulling and resembles sore muscles.
It is characteristic that the pain is increased in the calf as a result of flexing the foot and compressing the calf. Pressure on the sole of the foot can also provoke pain on the sole of the foot.
Furthermore, like other venous disorders, thrombosis is accompanied by a feeling of heaviness or tension in the legs.
For more information, see Pain in the calf - what are some indications that I have a thrombosis?
Varicose veins
Varicose veins stand out due to their sack-shaped, widened appearance and their wavy course. The superficial leg veins are affected by the changes and are unattractive.
But in addition to the aesthetic aspects, the varicose veins also go along with it
- evening ankle edema,
- Fatigue / tension / heaviness in the legs and
- nocturnal foot and calf cramps
hand in hand. Typically, symptoms are worse in the evening and can be relieved by walking a lot.
The exact cause of the development of the varicose veins is unclear.
Please also read our article on this Varicose veins.
itching
The itching is caused by the changes in the skin and the accumulation of metabolic products. Due to the poorer blood evacuation, the oxygen supply is poor and metabolic products, e.g. must be broken down in the liver, cannot be removed from the leg, or removed too slowly. This promotes inflammation of the skin, which also leads to itching.
therapy
In general, therapy for all venous disorders consists of compressing the legs using elastic bandages or stockings.
It is also recommended that you walk a lot and stand or sit little. These measures improve the transport of blood from the legs to the heart.
In dangerous venous thrombosis, the blood clot (thrombus) is removed through a small surgical procedure or with the help of a catheter. Furthermore, the blood is used for at least five days Heparin diluted. Furthermore, compression treatment with bandages or stockings should be carried out for a period of at least three months.
After successful treatment, the cause of the thrombosis must be searched for and this should be treated - e.g. Smoking and the use of contraceptives can lead to thrombosis in young women. Here it would be advisable to stop smoking or switch to another method of contraception.
Even with a freshly developed phlebitis, the affected veins can be freed of blood clots that arise due to the inflammation with a small prick. Varicose veins can be removed during an operation or closed with laser therapy.
When do I need an operation?
With varicose veins, the veins can be surgically removed. An intervention can be considered if the symptoms are severe, e.g. frequently recurring inflammation of the veins.
Surgery is particularly useful if thrombi (blood clots) keep forming in the veins.
But varicose vein surgery can also be performed for purely aesthetic reasons. Surgical removal of the varicose veins is only possible if the deep leg veins are healthy.
In about 5% of varicose veins, however, the deep leg veins are damaged and cannot transport the blood sufficiently to the heart. In this case, surgery is contraindicated.
Also read our article: Remove varicose veins - when do you have to resort to surgery?
Which medications can help?
Drug therapy does not play a major role in venous diseases. If the other therapeutic measures against edema are not effective enough, edema protective agents can be taken.
Medicines made from natural medicinal plants are more interesting. These do not usually require a prescription and must be paid for yourself. Horse chestnut extract, butcher's broom root and extracts of red vine leaves are recommended here.
Since drugs from natural plants can interact with other drugs, the attending physician should be informed about their use.
Which home remedies can help?
The most important thing is to keep your legs moving. That means walking a lot or doing sports. When walking, the muscles that support the transport of blood in the veins are activated. When sitting and standing, it is advisable to change positions regularly and not cross your legs.
On the other hand, putting your legs up has a positive effect. Flat, comfortable shoes are also recommended. Showering your legs with cold water or drinking a pub can relieve symptoms. Other helpful measures are curd wrapping or weight reduction if you are overweight. However, saunas should be avoided. An ointment for external use can also be made from chestnuts.
You might also be interested in: Home remedies for circulatory disorders
Can a venous disease be curable?
The symptoms and discomfort associated with venous disease can often be treated.
However, the underlying changes in the structure of the veins cannot be reversed. Phlebitis can heal completely, but if the veins are changed there is a risk that inflammation will recur. However, this can also be successfully counteracted through consistent treatment.
Which doctor treats the venous disease?
As a rule, the family doctor can treat the venous disease, only in certain cases does the person concerned have to see another doctor.
In the case of an acute thrombosis, the patient has to go to a hospital and is treated there by an angiologist (doctor who specializes in vascular diseases) or a vascular surgeon. The surgical removal of varicose veins is also carried out by a vascular surgeon.
Venous Disorders During Pregnancy
Varicose veins and weak veins occur frequently during pregnancy. The reason for this is that the veins have to work harder during pregnancy.
The blood volume increases and the changed hormonal balance causes the veins to widen, which means that the venous valves can no longer close completely. The weight gain also increases the pressure on the leg veins, which increases the risk of water retention. Almost every second woman is affected. During the second pregnancy the risk of water retention is increased.
Vein problems should be monitored by the doctor. Pregnancy also increases the risk of dangerous leg vein thrombosis, which is why a doctor should be consulted if there is pain in the legs.
To prevent varicose veins, the same measures can be taken as for the other venous diseases: wearing compression stockings, exercise and sports, avoiding long periods of standing and sitting, drinking enough, putting your legs up, pubs and wearing flat shoes.
You might also be interested in: Thrombosis in Pregnancy.
Open legs from venous disease
In the case of severe venous insufficiency, the supply of oxygen to the legs is so poor that wounds can hardly heal and the skin tends to open up. One speaks here in the technical language of ulcus cruris venosum.
The therapy is relatively difficult, as the vacancies prove to be very resistant due to the insufficient supply. Dead skin parts must be surgically removed. The vacancies are treated with a compression bandage. If it does not heal, plastic surgery can be performed.
For details, see Open legs due to a venous disease - venous leg ulcer.
