Vena varicose veins

Varicose veins on the lower legs are usually asymptomatic in humans. Often the only problem with this pathology is an aesthetic defect in the foot caused by prominent superficial veins. In this case, the disease may be accompanied by pain or increased sensitivity of the skin of the feet. Depending on the severity of the disease, patients are offered non -drug, drug or surgical treatment. Read more about the first symptoms of varicose veins, the nature of its course and effective methods of treatment and prevention, read our material.

What is this

Varicose veins are a pathology that is only experienced by the general public. Animals do not have this problem, indicating that the disease is associated with upright posture. When a person reaches his feet, the main part of the circulating blood begins to lie below the level of the heart. In this case, all conditions are created for the blood to circulate more severely in the opposite direction, leading to stagnation.

According to statistics, some disorders of the venous system are observed in 80% of people in developed countries. Moreover, more and more often, the same problem is found in people at a young age. Most likely, one of the reasons why varicose veins "become younger" is an inactive lifestyle, which only contributes to stagnation.

Interestingly, in the age group under 20 years, varicose veins on the lower legs occur with equal frequency in men and women. However, after the age of 20, women begin to dominate the morbidity structure. This is due to pregnancy and childbirth, which are serious factors in the development of venous diseases.

Characteristics, causes and mechanisms of varicose vein development

The exact cause for the development of varicose veins on the lower part of the leg is still unknown. Currently, it is believed that the disease is caused by a congenital or acquired venous valve device of the lower extremities.

For unobstructed ascending blood flow through the veins, well -coordinated venous valve work is necessary. This valve is only open for blood flowing upwards. However, with valve defects, a partial decreased blood flow is also possible. This is how venous insufficiency develops, indicated by edema, leg muscle spasm and expansion of the venous ducts.

Leukocytes may also be involved in the pathogenesis of varicose vein development. This issue is currently being actively studied. It is assumed that with prolonged accumulation of leukocytes in the vessel tissue (in particular, in the area of the valve apparatus), the inflammatory process develops, spreading along the venous bed.

Because venous valves are subjected to constant mechanical stress, inflammation develops particularly rapidly in the area of the venous valve apparatus.

Now a large number of people in developed countries lead an inactive lifestyle. But why doesn’t everyone have varicose veins? Consider the main risk factors that contribute to the onset of this pathology:

• Hereditary factors. . . Despite the fact that specific hereditary mechanisms associated with the development of varicose veins have not been established, most experts agree on the presence of such factors. At the same time, there is a heavy counter -argument about heredity in the development of varicose veins. For example, this is the prevalence of varicose veins among ethnic Africans and African immigrants leaving to live in the United States. If the prevalence of varicose veins among inactive Africans is about 0. 5%, then among immigrants this figure reaches 20%. These figures suggest that hereditary factors are, at least, not the only ones in the development of the disease, and, most likely, do not occur.
• Obesity. . . People who are overweight and obese are at risk. It is important to note that obesity contributes to varicose veins both due to increased pressure on the vessels, and associated with the risk of other diseases affecting the vessels (diabetes mellitus, hypertension, etc. ).
• Pregnancy. . . This is one of the most obvious factors in the development of varicose veins on the lower legs. In this case, the main risk factor is an increase in the amount of circulating blood, as well as compression of the retroperitoneal vein by the developing fetus in the uterus. According to epidemiological studies, second and subsequent pregnancies lead to a significant increase in the likelihood of developing varicose veins. After the first pregnancy, the chances of varicose veins in the legs remain low.
• Hormonal imbalances. . . Hormones are involved in the pathogenesis of most diseases. These pathologies include varicose veins. This problem is especially true for women who take hormonal contraceptives, as well as those who use hormone replacement therapy for the treatment of certain diseases (e. g. , osteoporosis) or during the premenopausal period. It has been established that female sex hormones (in particular, estrogen and progesterone) reduce vascular tone and destroy collagen fibers. Thus, the vein wall is pathologically dilated.
• Way of life. . . A person’s lifestyle has a huge influence on the course of the disease. An inactive lifestyle, as well as work associated with prolonged standing or sitting (e. g. , security guards, drivers, office workers, service workers, etc. ) contribute to the development of varicose veins. You should also pay attention to nutrition. Lack of adequate amounts of vegetables and fruits in the diet worsens the condition of the walls of blood vessels.

Stage of varicose veins in the lower part of the leg

Currently, several classifications of varicose veins on the lower extremities are used. The international classification of CEAP, adopted in 1994, is considered generally accepted. CEAP is an abbreviation, where each letter corresponds to the name of the classification category:

• C (Clinical)- clinical class of the disease (type of veins affected, the presence of pigmentation, eczema, trophic ulcers).
• E (Etiology)- etiology of the disease (congenital, primary, secondary).
• A (Anatomy)- localization of pathological anatomy (shallow or perforated veins).
• P (Pathophysiology)- type of disorder (venous reflux, obstruction, or a combination of both).

The course of the disease occurs in six stages:

• Level zero. . . The earliest stage of varicose veins, in which even a doctor can not confirm the diagnosis with certainty. At this stage, there are no outward signs of the disease. Ultrasound diagnostics does not indicate the presence of pathology. At the same time, a person at level zero worries about symptoms such as swelling, a feeling of heaviness in the legs, as well as cramps, which indicate the presence of problems with blood vessels.
• First stage. . . Already in the first stage of the disease, spider veins appear on the surface of the skin of the feet, the diameter of which is less than 1 millimeter. Medium -sized veins can increase in diameter up to 3 mm. At this stage, the doctor is not always able to make a correct diagnosis, because the presence of such an asterisk does not always indicate a varicose vein.
• The second level. . . At this stage, veins can appear and disappear depending on the condition. For example, veins appear clearly after prolonged sitting, standing, or lifting heavy objects. The diameter of the varicose veins at this stage is 3 mm or more. Blood clots often form in the second stage.
• The third level. . . If in the previous stage of the disease swelling of the feet appears and disappears, then in the third stage the edema becomes permanent. The worst leg swelling is in the evening.
• Fourth rank. . . At this stage, significant trophic changes occur. In particular, tissue nutrition is disrupted near the affected veins. Patients experience changes in the skin such as lipodermatosclerosis (inflammation of the subcutaneous fatty tissue), eczema, as well as darkening or discoloration of the skin. For the fourth stage of the disease, pigment changes are characteristic. For example, the skin in the affected duct area may turn brown as well as black, indicating the concentration of pigment in this area. The opposite situation is also possible, when, due to pathological processes, the pigment does not enter the affected area, which leads to the appearance of pale skin color. If at this stage the varicose veins are not treated, then the problem will only worsen with the appearance of further trophic ulcers.
• Fifth rank. . . At this stage of the disease, in addition to the above symptoms, trophic ulcers also appear, which heal quickly. If you do not take any steps for treatment, then ulcers will appear again and again.
• Sixth level. . . Trophic ulcers that do not heal appear. In the affected area, the temperature rises significantly, and pus may ooze from the wound.

You should not wait for the development of the last stage - you should go to the doctor for a second to register and keep track of the dynamics of the disease. Sometimes the symptoms improve on their own, and sometimes they develop quickly. Therefore, it is important to monitor the situation to take timely action.

symptoms

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

• sick. . . This is an early sign of the disease. Since pain is a non -specific symptom, it is impossible to make a diagnosis based on these symptoms alone. With varicose veins on the lower part of the leg, the pain is often localized along the trunk of the vein.
• Foot in foot. . . Also applies to early symptoms, while the veins in the skin are not yet visible. Often, the feeling of heat is accompanied by throbbing pain.
• Muscle cramps and itching. . . Usually disturbed at night.
• Swelling in the legs. . . In the early stages of the disease, the swelling is small and temporary. As a rule, they appear in the evening and disappear in the morning. However, as the disease progresses, the severity increases and becomes permanent.
• Skin discoloration. . . As a rule, with varicose veins, the skin of the lower legs becomes darker. In the affected vein area, the skin turns brown. In the advanced stages of the disease, eczema and dermatitis appear. The terminal stage of varicose veins is characterized by the appearance of trophic ulcers. At first, this is an ulcer that heals, but then an unhealed wound forms.
• Vascular spiders. . . In the medical literature, such asterisks are called telangiectasias. In some people, varicose veins may be limited to spider veins, without progression to larger veins.
• Wide veins twisted. . . The most characteristic sign of varicose veins is twisted veins dilated on the surface of the foot.

In summer, the symptoms of varicose veins become more pronounced. This is due to the high ambient temperature, which already contributes to the expansion of the veins. Therefore, during the hottest time, from 10 am to 4 pm, it is better to be in a well -ventilated area.

When you see a doctor

You should see a doctor already at the first symptoms of the disease - pain, swelling, or the appearance of spider veins. Since the early stages of varicose veins are difficult to diagnose, they may initially be misdiagnosed. The patient should carefully monitor the condition of the foot and be constantly observed by a phlebologist.

Diagnostics

The diagnosis of varicose veins in the lower leg is reduced to the following activities:

• External examination of the skin of the feet;
• Doppler ultrasound;
• Duplex venous scanning;
• Phlebography.

Treatment features

Varicose veins on the lower legs are treated with conservative methods and surgery. Conservative treatment is reduced to the following activities:

• Drug therapy. . . This is the intake of medications that increase the tone of the venous wall. Also, patients are given drugs that reduce capillary permeability and improve blood microcirculation. If there is a risk of blood clots, then anticoagulants are also prescribed.
• Compression therapy. . . This is the wearing of special compression socks, which reduce the load on the feet. The benefit is that it is possible to distribute the load evenly, even with heavy physical effort. When using compression garments, congestion and swelling can be avoided.
• Rehabilitation gymnastics and lifestyle changes. . . Patients are advised to exercise to relieve tension in the legs. It is important to avoid sitting or standing for long periods of time. If you need to stand or sit for a long time at work, then you need to rest more often.

If conservative therapy of varicose veins does not bring the expected results, then a decision is made regarding surgical intervention. Often these are minimally invasive interventions, including:

• Sclerotherapy- introduction into the veins of material attached to the walls of the affected vessel. This treatment leads to reabsorption of the spider veins.
• Laser freezing- the introduction of laser light guide into the vein and the irradiation of the wall with a laser, which also leads to wall adhesion and further absorption of the vessel.
• Radio frequency ablation- attaching veins using high frequency currents.
• Phlebectomy- Removal of the affected vein, in which blood circulation has deteriorated by 90%.

In some countries, you can get surgery for free, under compulsory medical insurance. But it is not a fact that all types of compulsory insurance operations are provided everywhere. In any case, help will be provided, but it is necessary to know whether it will be a 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 prevent congestion in the veins.
• Run and exercise vigorously. . . With physical activity, it is important not to overdo it. If you have varicose veins, walking is definitely better than running.
• Unbalanced and unhealthy diet. . . You should leave out snacks, even if it seems that health permits. You should limit your intake of sweets, semi-finished products, as well as rich meat soups and smoked meats. But eating more vegetables and fruits is a good idea.
• Hot tub and shower. . . For people with vascular problems in the legs, overheated and prolonged water procedures are contraindicated.

Complications of varicose veins

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

Conclusion

Symptoms of varicose veins on the lower part of the legs, as a rule, do not appear immediately. Different people have different sets of manifestations. For example, sometimes with this pathology there is no edema or no local increase in temperature or pain. This does not mean that there is no disease at all. Timely visits to the doctor will slow the progression of the disease or even stop it, preventing the development of trophic changes.