Varicose

Varicose veins: causes, symptoms, treatment and prevention

According to statistics published on the website of General Surgery Clinic Medical Faculty Rnrmu them. Pirogov, varicose veins affect more than half the world's population.Every Tuesday AiF Health explains what signs may indicate that you have time to see a doctor. This week we tell what varicose veins, as it is diagnosed, treated, and what to do to stay healthy legs.Some people with the responsibility spits on this issue - and live to venous ulcers. A part - is interested in treatment and prevention, so that by applying a small force to secure healthy feet, ready to run, swimming, mountain climbing and other pleasures of life. It is the second category of people we have prepared a large-scale popular narrative of varicose veins and its treatment.Start with a small anatomical digression: as you know, the blood moves through our body in two circles - big and small. Initiates heart of this movement: it contracts rhythmically, pushing the blood through the aorta, arteries, blood vessels ... From top to bottom, the feet, the blood moves with enthusiasm - thanks to gravity. But before reaching the feet, she had to turn around and go through the veins in the opposite way - up. And this is problematic.


In order for this process was made possible, provided the valves in the veins to blood passed in only one direction - up. Driving is about what is happening: the heart pushes blood through the vessels, that goes up and the valve is fixed at a certain level until the next heartbeat.Furthermore, to move the blood up helps not only the heart but also the leg muscles. If the muscles contract and relax on a regular basis (for example, provide its owner with an energetic walk on rough terrain), the blood vessels are exposed to compressed-relaxation - and the blood vigorously pushed up from the valve to the valve. This happens in a healthy body without varicose veins of the legs.If Vienna has expanded, the valves to ensure the normal outflow of blood from the legs, longer link up. Between them, a gap - and the blood flow slows down. The worse the blood circulation, the more stretched Vienna. The circle is closed!

Heredity plus ...
Doctors believe that the main reason for the development of varicose veins - hereditary. If your parents or grandparents have varicose veins, you can pass this trouble to you. And it does not matter on the feet or elsewhere were veins from your ancestors: the disease can be localized in the groin, in the anal area (yes, it's hemorrhoids) - if there is a gene that provides a weak venous wall, it may sooner or later to express themselves. 

Amiran Demur, phlebologist surgeon, physician ultrasound diagnosis Vein Center: 

For the diagnosis of varicose veins of the legs there are a few tools. The simplest of them - Doppler: it gives a definite answer, have varicose veins or not. It can be done at the primary suspect in the veins. The gold standard in the diagnosis of varicose veins - a duplex ultrasound scan (USDS). It combines the capabilities of ultrasound and Doppler studies. With USDS you can see the speed of blood flow, the diameter of the vein valves and evaluate the work of the state of the vascular walls. Accordingly, if the results of medical examination in varicose veins there is no doubt we can do without Doppler and immediately go to USDS. 

But even the weakest of the venous wall can not stretch out, if for no reason. The beginning and the speed of development of the disease depends on the adversities that you are putting your feet.

These include a fixed way of life, the need to sit for 6-8 hours a day (the computer in your car, and so on. D.), Increased physical activity (need to lift and drag of gravity), wearing high heels, the reluctance to engage in his own body, and although I would occasionally drop in to the doctor-phlebologist. 

The extent of the disease 

The international scientific community has agreed to systematize the varicose veins, called CEAP (Clinical Etiology Anatomy Pathology) - on the basis of it, there are 6 stages of varicose veins. If left untreated varicose veins, do not take care of their feet and not to engage in prevention, and regularly exposed legs above adverse effects, it can be fast enough to go through all six stages and was in the hospital between life, death, and saving the surgeon's scalpel.Stage 0 - the mysterious condition in which a person complains of symptoms characteristic varices (swelling, heaviness, or pain in the legs, night cramps), but neither the eye nor the results of any investigations veins can not be detected. 

Stage 1 - on his feet visible vascular "asterisk" or vascular grid, plus sometimes overcome the above symptoms.Step 2 - If on the previous stages in the scientific community there are still controversial - whether to call these manifestations of varicose or not, the second stage begins, so to speak, the "real" varices. At this stage, you are able to find themselves at increased bluish veins or nodules that may grow after a long sitting at the computer or walking in high heels. From this stage, the formation of blood clots. 

Stage 3 - all the symptoms described above are supplemented by regular edema, which is particularly noticeable at the end of the day. In the morning, he may disappear, but resumed again in the evening.Step 4 - start trophic (ie, associated with a lack of power) changes in the extremities: due to the excessive accumulation of skin pigment may acquire abnormal color - from dark brown to black. In addition, it is developing skin inflammation - redness, from small to large weeping lesions. Over time possible atrophy of the skin, which is characterized by white, slightly sink areas. All these troubles lead to the formation of trophic ulcers.Stage 5 - all of the above symptoms plus healed trophic ulcer.Step 6 - active actions, unhealed trophic ulcer.

What do I have?  

There are many procedures through which a vein can be extended to "destroy": seal, solder, remove. We will describe the most common:1. Sclerotherapy - this procedure allows you to "glue" the little vials, for example, eliminate the so-called "stars". The vessel by injection (i.e., a simple injection) is injected substance vein wall are glued together. Over time glued Vienna cord forms and dissolves. The procedure is done without anesthesia and takes 5 to 15 minutes.2.Laser coagulation - with this procedure, you can solder the larger vessels. It is under local anesthesia: a light guide is introduced into the vein through which laser radiation is allowed. It heats the blood cells - and they "brew" vessel. In the future, it is the case with sclerotherapy, dissipated.After the treatment for a month is necessary to protect yourself, do not lift weights, do not walk in high heels. Plus, this will have to wear compression stockings 1st or 2nd class (by a doctor). Therefore, most of these activities are recommended in the cold season, when the actual jersey to wear. 

A bit of prevention 

If you carefully read the section about the causes of varicose veins, you know that it is necessary for the prevention of: the movement! If you work in an office or drive a car for 6-8 hours, at least once an hour arrange a break, get up, walk around the room for coffee (tea, just so), or walking down the street. There is no way to walk - stand on the ground and rolls from heel to toe and back.If possible, wear compression stockings if your doctor is appointed. If it's hot and jersey causes aversion, replace it with an evening electromyostimulation procedure. To do this, buy a small pharmacy apparatik - neuromuscular stimulator.Lying in front of TV, fasten the terminal unit to spawn - and relax. The device will send an electrical discharge to the muscles, and the muscles will shrink. 

An hour or two of such procedures, and the sensations in the legs become lighter and joys.If you go on a long journey, in the course of flight do self-massage of shins: tapping, pinching, rubbing help the blood circulate, eliminate stagnation.Do not get carried away with high heels.If life is not without heels in joy, then wear them in the office, and when you come to me on the street shoes with guideshoe (or vice versa - depending on where you want to shine). And know that heels in 7 and 10 cm on the eye look about the same, and the damage is less than 7-inch.If possible, end the morning shower contrasting douches. If you pour cold water on the whole body is difficult, it is possible to arrange a douche feet - so you learn the basics of tempering and toniziruete vessels.In general, pay attention to the legs - and preventive measures, it may save you from having to "glue" veins.

 Amiran Demur, phlebologist surgeon, physician ultrasound diagnosis Vein Center:

Treatment of varicose veins depends on the extent of the disease. In 0-1 stages appointed so-called "basic treatment". It includes phlebotropic drugs, tones and strengthens the venous wall. They are prescribed as the interior in the form of tablets or for topical use - mainly in the form of gels. Plus, the patient is advised to wear compression stockings class 1 support in particularly troubled times for the veins (during exercise, long-haul flights during the forced sedentary work, and so on. D.). In the 1-2 th stage is combined with the basic treatment procedures can eliminate varicose veins. With a small expansion this can be sclerotherapy or laser photocoagulation. Larger vessels may have to be removed - this operation is called "fleboektomiya." Many patients ask, why do it if the veins do not interfere with life. Besides the fact that varicose veins can progress, there are other complications, blood clots, phlebitis, thrombophlebitis. But clots are known to pose a serious danger from plugging the vessel to a pulmonary thromboembolism limb (in the latter case, the detached clot with blood enters the pulmonary artery, blocking it, and stops the blood supply to the lung, which can lead to death). 

Truth or fiction? 

- If you have varicose veins of the legs, then this can not be overlooked. While nothing can be seen, there is no threat to health. 

No. In practice, doctors Phlebology there are times when a person comes to the reception with minimal complaints of heaviness in the legs and on the results of the study had found an invisible eye varices requiring treatment.

Of course, this is the exception rather than the rule, but regular annual preventive examination surgeon or phlebologist needs everyone who watched at home in the family-varikoznikov sufferers. 

- C varices can be overcome by using ointments and tablets. 

No. Conservative treatment (ie, treatment with a variety of medications prescribed by the doctor) does not resolve the existing veins. If Vienna has expanded, with the help of a gel or ointment to her original form is not returned.Phlebotropic formulations - i.e. drugs, tonics venous wall - in the form of tablets or gels for topical use administered to prevent further progression of the disease.It is treated as varices only by procedures gluing or sealed vein (or removing this same vein - in the extreme case). Furthermore flebotonikov topical ointments can use cooling - they cause vessels to contract and thus give them tone. 

If there is time and effort, you can replace this ointment contrast cool shower or bath for the feet - the effect is the same.

- If you have varicose veins, you can not go to a fitness club and do at the gym.  

No. Of course, it all depends on the degree of varicose veins. If you get any trophic changes in the limbs, the exercises have to be postponed. But 2-3rd stages of varicose veins exercise can be quite useful.

Before going to the gym you have to go to the phlebologist and use it to pick up compression stockings, which you will be engaged. In addition, the doctor will tell you about the limitations in the power load - exactly what you in your condition should not be done.