In our modern world, this problem is very acute and widespread among both men and women.We will try to find out the causes, predisposing factors, and also talk about treatment methods and medications used for varicose veins.
Varicose veins are a disease of the veins characterized by their enlargement, change in shape and reduction in elasticity.Most often, the superficial veins of the lower extremities, the venous plexus of the rectum (hemorrhoids), the veins of the collar system and the spermatic cord are affected.
Predisposing factors
Conditions that contribute to difficulty in the flow of blood through the venous system, including:
- long periods of systematic standing linked to professional activities (waiters, pharmacists, hairdressers, salespeople, etc.);
- compression of the pelvic veins by the pregnant uterus;
- congestion of the pelvic veins, for example with chronic constipation, sedentary work;
- congenital weakness of the vein wall and insufficiency of the venous valves;
- surgical intervention (arteriovenous bypass);
- hormonal imbalance (menopause, estrogen intake);
- overweight.
It is important that the true causes of varicose veins are not known.This disease is progressive in nature and refers to irreversible changes in venous vessels.
If we talk about varicose veins of the lower limbs, it is also an aesthetic problem in women.Dilated veins appear visible or swell under the skin in the form of twisted cords or knots (varicose veins).Their skin is thinned and easily damaged, due to a violation of its nutrition.First, dark brown or brown spots appear on the skin, then the veins twist and lift the skin.Over time, if the skin is not properly nourished, trophic ulcers can form.Varicose veins are almost always accompanied by swelling of the extremities, which appears towards the end of the day.This condition leads to rapid fatigue of the legs when walking, a feeling of heaviness and pain in the legs, which intensify in the evening.In the absence of proper treatment, the disease progresses and swelling of the extremities intensifies.Due to the slowdown in blood flow, inflammatory processes may occur in the dilated veins, leading to their blockage.
So, the stages of varicose veins:
- 1 “heavy” leg syndrome;
- 2 persistent swellings develop, accompanied by altered pigmentation of the skin and stagnant dermatitis;
- 3 trophic ulcers appear.
Symptoms of varicose veins of the lower limbs
- rapid fatigue of the legs when walking;
- cramps at night;
- feeling of heaviness in the legs;
- pain in legs, worse in the evening;
- tension in the legs;
- fast heartbeat and shortness of breath.These symptoms occur when the load on the heart muscle increases due to blood deposition in the venous bed.
Let's consider when varicose veins are localized in other organs:
Esophageal varices
Esophageal varices are characterized by tortuosity and saccular outgrowths of blood vessels.The cause of the disease is portal hypertension.
Events:
- inflammation of the esophagus;
- burning, belching;
- anemia;
- difficulty swallowing.
Complications such as severe bleeding from the veins may develop.The patient develops vomiting blood, hypotension, tachycardia and impaired consciousness.
Varicose veins of the uterus
Reasons:
- increased physical activity;
- chronic constipation;
- pregnancy;
- take hormonal contraceptives;
- developmental abnormalities;
- abortions.
Symptoms include pain in the lower abdomen and menstrual irregularities.Infertility is a dangerous complication.
Lip varicose veins
It most often occurs during the second month of pregnancy.Predisposing factors are the presence of pelvic venous thrombosis or congenital angiodysplasia.
Events:
- dilated veins of the vulva;
- scratches on the skin and swelling;
- bursting pain in perineum.
The development of acute thrombophlebitis and rupture of a damaged vessel are possible.
Pelvic varicose veins
At the initial stage, this is manifested by persistent pain in the lower abdomen.There are several variants of the course of this form of the disease:
- varicose veins of the perineum and vulva;
- Pelvic venous congestion: pain during sexual intercourse, dysmenorrhea, difficulty urinating.
Clinical manifestations of pathology are observed in 30% of women during pregnancy.This disease is observed exclusively in women.
Spermatic cord varicose veins (varicocele)
Due to varicose veins of the spermatic cord, venous outflow from the testicles is disturbed.Patients notice persistent pain in the scrotum and erectile dysfunction.When examining the testicles, dilated superficial veins and asymmetry of the scrotum are visible.
Reasons:
- increased physical activity;
- congenital connective tissue deficiency;
- tumors of the retroperitoneum or pelvis.
Possible complications as the disease progresses are spermatogenesis leading to infertility.
Varicose dermatitis
This disease manifests itself as thinning and itching of the skin over the affected veins.In places of inflammation, dark or light spots and peeling appear.The main location of venous dermatitis is the lower leg and the ankle joint area.The danger is that patients scratch the itchy areas and the pathological process spreads to healthy tissues.If you do not seek treatment, the inflammation turns into varicose eczema.
Varicose eczema
The inflammation is persistent with periods of remission and relapse.Skin lesions are difficult to treat even after venectomy.Due to impaired skin microcirculation, the liquid part of the blood passes through the walls of the affected vessels.Areas of swelling and oozing appear in the area above the varicose vein.
Blisters with serous or serous-purulent content appear on the legs.Scratching causes an infection to develop in the wounds.As they coalesce, small bubbles form papules.After opening the vesicle, crusts appear.The healing site is thinned and covered with scales.During the period of exacerbation, vesicles reappear.The progression of the pathology leads to the formation of trophic ulcers.
Spider Veins
Spider veins - telangiectasia.Characterized by damage and expansion of small subcutaneous vessels.They appear on the skin as a network of purple or red blood vessels.In general, it is not a separate disease, but rather a cosmetic defect.
Reasons:
- venous insufficiency;
- connective tissue diseases;
- pathologies of the hepatobiliary system;
- use of hormonal drugs;
- diseases of the endocrine system.
Vascular networkcan be localized on the legs, face or buttocks area.On the face, manifestations of the vascular network are called rosacea.
Reasons:
- violations of the rheological properties of blood;
- high blood pressure;
- diseases of the digestive system;
- the impact of low temperatures on the skin of the face in a special way;
- while drinking alcohol.
Hormonal changes are a common cause of rosacea in women and are eliminated by laser coagulation.
For varicose veins, preventive measures are of great importance:
- use of comfortable shoes and loose underwear;
- if there is a predisposing factor or disease at the initial stage, then it is necessary to limit or eliminate static loads and prolonged standing;
- moderate physical activity;
- take vitamins: C, E, PP;
- balanced diet.
Of course, in the modern world it is impossible to follow recommendations to limit or eliminate static loads and standing for long periods of time.Therefore, it is necessary to resort to short gymnastics during the day and use massage services.It is also mandatory to wear elastic bandages and compression clothing.
Diagnosis
A comprehensive diagnosis is carried out using laboratory methods of examining blood and urine (detection of reflux in the saphenous veins, functional tests) and ultrasound examinations: duplex or triplex ultrasound;X-ray contrast venography;magnetic resonance venography;Multispiral angiography with contrast.
Treatment
After receiving the diagnostic results, the phlebologist (angiosurgeon) makes a decision on the use of treatment methods - surgery or conservative therapy.
When affecting the vessels of the lower extremities, use:
- surgical intervention, for example phleboectomy – removal of a specific vein;
- sclerosing therapy;
- conservative treatment.
Systemic drug therapy
- Antibiotics.(prescribed in the presence of inflammatory processes and trophic ulcers;
- Antiseptics;
- Phleboprotectors;
- Tissue regeneration stimulators;
- Anticoagulants;
- Topical steroids (prescribed for trophic ulcers);
- Externally - drugs containing heparin.
In this article we will dwell in detail on phleboprotectors and external agents used against varicose veins.
Phleboprotectants (Phlebotonics) are a group of medications used to treat venous insufficiency.They increase blood circulation, thereby normalizing vascular permeability, relieving swelling and eliminating the feeling of heaviness.It is important to use them in the early stages of the disease or to prevent exacerbations;for progressive forms, several courses are prescribed in different groups.
Review of medications used for varicose veins.
A natural remedy based on red vine leaf extract.Able to protect the walls of blood vessels and capillaries, improving their elasticity, normalizes vascular permeability.
The product provides enhanced protection of blood vessel walls and capillaries.The drug relieves swelling and prevents its recurrence, as it blocks the permeability of water, proteins and plasma through the walls of blood vessels, allowing their natural density to be restored.
Indicated for:
- prevention and symptomatic treatment of chronic venous insufficiency;
- swelling of the lower limbs;
- with sensations of heaviness and fatigue in the lower limbs.
Contraindicated:
- people suffering from allergies to any of the components of the composition.
Take 1 capsule upon waking up.The doctor may increase the dosage to 2 capsules.
Diosmin
The medicine is available in tablet form and is sold without a doctor's prescription.Refers to venotonic and angioprotective agents.Diosmin increases the tone of the veins, reduces venous stagnation, improves the permeability and microcirculation of capillaries.Has an anti-edematous effect.
Indicated for:
- varicose veins in the extremities and pelvis;
- complex therapy of hemorrhoids;
- signs of venous insufficiency, lymphatic flow disorders.
Contraindicated:
- with hypersensitivity to components;
- children and adolescents up to 18 years old.
Side effects may include mild digestive upset and headache.Take 1 tablet in the morning.The duration of treatment can be quite long, but generally does not exceed 2 months.
Troxerutinrelieves swelling, normalizes microcirculation and strengthens the walls of blood vessels.Has anti-inflammatory and antioxidant effects.
Indicated for:
- chronic venous insufficiency, at any stage of the disease;
- varicose veins;
- superficial thrombophlebitis;
- periphlebitis, phlebothrombosis;
- varicose dermatitis;
- post-thrombotic syndrome;
- hemorrhoids;
- post-traumatic edema and hematoma;
- bleeding diathesis with increased capillary permeability;
- as a prophylactic after venous surgery.
Troxerutin is used in combination with ascorbic acid to enhance its effects after vein surgery.
Contraindicated:
- with hypersensitivity;
- peptic ulcer of the stomach and duodenum;
- chronic gastritis (in the acute phase).
Not suitable for minors, pregnant women in the first trimester or breastfeeding.The medicine Troxerutin should not be used in case of gastrointestinal problems.At the active stage of combating the disease, 1 capsule is prescribed with meals three times a day.To maintain the effectiveness of the treatment, the product is applied twice a day.
Rutosidehas anti-inflammatory effects and combats swelling and heaviness in the legs.The peculiarity of the drug is that it acts with blood cells, thereby promoting permeability.Thus, the medicine against varicose veins helps fight against venous microthrombosis.
Indicated for:
- chronic venous insufficiency;
- postphlebitic syndrome;
- trophic disorders of varicose veins, trophic ulcers;
- hemorrhoids (pain, exudation, itching and bleeding);
- venous insufficiency and hemorrhoids during pregnancy, from the second trimester.
Contraindicated:
- during pregnancy, for a period of 1 to 3 months.
The capsules are used 2 to 3 times a day, one at a time.
TribenosideAvailable in the form of dragees and capsules.It has anti-edematous and anti-inflammatory effect, improves vascular permeability.
Indicated for:
- varicose veins of the lower extremities, including the second and subsequent stages;
- symptoms of CVI, namely: lymphostasis, blood stagnation, feeling of pain, heaviness, distension in the calves, especially in the evening;
- phlebitis, periphlebitis, postoperative period;
- trophic ulcers;
- hemorrhoids in chronic and acute phases.
Contraindicated:
- pregnant women 4 to 12 months and breastfeeding women.
The capsules are taken twice a day at regular intervals.
Diosmin with hesperidin,The medicine is available in the form of film-coated tablets, available without a doctor's prescription.The main active ingredients are diosmin and hesperidin.They belong to the group of venotonic substances and angioprotective drugs.They help restore the tone of the vein walls and improve blood circulation in the veins, normalize the functioning of the valves.
Directions for use:
- hemorrhoids;
- varicose veins of the extremities and pelvis;
- chronic venous insufficiency, including trophic ulcers.
The drug is contraindicated in case of allergic reactions to the components and during breastfeeding.Side effects include only mild dyspepsia and rash.The drug is indicated for complex and regular use.
External remedies for the complex treatment of varicose veins
Ointments and gels are used as external agents.First of all, it is necessary to provide an anti-inflammatory and analgesic effect;for these purposes, nonsteroidal anti-inflammatory drugs are used, as well as general steroids.
Non-steroidal anti-inflammatory drugs (NSAIDs):
- Ketorolac;
- Ketoprofen;
- Ibuprofen;
- Nimesulide gel;
- Diclofenac;
All of them have a powerful anti-inflammatory effect, eliminate pain, discomfort and heaviness.are used 1-3 times a day, depending on the stage of the disease, with circular massage actions.Contraindicated in the presence of trophic ulcers and open wounds.
Steroid drugs are used in special cases.If NSAIDs are ineffective.
Prednisolone and its analogues.Inflammation and pain are relieved and local tissue nutrition is improved.It is not used in large quantities due to the possibility of causing widespread side effects.
Relieve swelling:
Corticosteroid medications are used.Restore normal blood flow in legs with varicose veins, by stimulating the contraction of the vascular walls:
- Troxerutin;
- Diosmin;
- Rutoside.
External narrowly analgesic drugs are rarely used, due to their limited action, they do not eliminate the cause, but act on the symptoms:
- Diclofenac;
- Ketoprofen.
Heparin-containing medications contain corticosteroids in addition to heparin.
Complex ointments used for varicose veins of the legs
These drugs have a systemic effect:
- Heparin sodium (used to relieve swelling, pain, improve local blood flow, prevent the formation of blood clots. It has a rapid therapeutic effect: it is obtained on the second or third day of use).
- Troxerutin.It relieves pain, swelling, inflammation, normalizes the condition of the veins, ensures adequate venous-lymphatic drainage and prevents the formation of blood clots.
- Escin.Prescribed in the early stages of varicose veins of the legs, in later stages it is almost ineffective.It is of plant origin.
Basic principles of therapy with external drugs:
- do not self-medicate, but seek help from a phlebologist;
- strictly follow the instructions for use;
- analyze the treatment effectiveness result 10 days after the treatment date.
However, even with the combined use of tablets and ointments, gels for external use, one should not count on a quick result, it all depends on the course of the disease, its stage and the presence of concomitant diseases.
In conclusion, I would like to emphasize that medications for varicose veins in various places are not able to completely stop the disease and prevent complications.At the early stage of the disease, venotonic and angioprotective drugs help to normalize blood flow in the lower extremities, thereby eliminating symptoms such as swelling, leg fatigue and varicosities, protruding tortuous superficial veins.All these medications constitute only part of the treatment, directly linked to lifestyle and diet.In progressive stages, microsurgical and minimally invasive interventions are indicated while taking medications that improve treatment results.