In our modern world, this problem is very acute and widespread in both men and women.We will try to find out the causes, predisposing factors, and we will also talk about treatment methods and drugs used for varicose veins.
Varicose veins are a disease of veins characterized by their enlargement, change in shape and decrease in elasticity.The most commonly affected are the superficial veins of the lower extremities, the venous plexus of the rectum (hemorrhoids), the veins of the cervical system and the spermatic cord.
Predisposing factors
Conditions that contribute to impaired blood flow through the venous system, namely:
- systematic long periods of standing on your feet associated with professional activities (waiters, pharmacists, hairdressers, sellers, etc.);
- compression of the pelvic veins by the pregnant uterus;
- congestion in the veins of the pelvis, for example, with chronic constipation, sedentary work;
- congenital weakness of the venous wall and insufficiency of the venous valves;
- surgical intervention (arteriovenous bypass);
- hormonal imbalance (menopause, estrogen intake);
- overweight.
It is important not to know the true causes of varicose veins.This disease is progressive in nature and refers to irreversible changes in the venous vessels.
If we talk about varicose veins of the lower extremities, it is also a cosmetic problem for women.Varicose veins are visible or swollen under the skin in the form of twisted cords or knots (varicose veins).The skin on them is thin and easily damaged, and the reason is a violation of its nutrition.First, dark brown or brown spots appear on the skin, then the veins twist and raise the skin.Over time, if the skin is not properly nourished, trophic ulcers can occur.Varicose veins are almost always accompanied by swelling of the extremities, which occurs towards the end of the day.This condition leads to rapid leg fatigue when walking, a feeling of heaviness and pain in the legs, which intensify in the evening hours.In the absence of appropriate treatment, the disease progresses and the swelling of the extremities increases.Due to the slowing down of blood flow, inflammatory processes can occur in varicose veins, which leads to their clogging.
So, the stages of varicose veins:
- 1 syndrome of "heavy" legs;
- 2 permanent swelling develops, accompanied by damaged skin pigmentation and stagnant dermatitis;
- 3 trophic ulcers appear.
Symptoms of varicose veins of the lower extremities
- rapid leg fatigue when walking;
- cramps at night;
- feeling of heaviness in the legs;
- leg pain, 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 the deposition of blood in the venous bed.
Let's consider when varicose veins are localized in other organs:
Varicose veins of the esophagus
Varicose veins of the esophagus are characterized by curvature and bag-like outgrowths of blood vessels.The cause of the disease is portal hypertension.
Manifestations:
- inflammation of the esophagus;
- burning, belching;
- anemia;
- difficulty swallowing.
Complications such as significant venous bleeding may develop.Blood vomiting, hypotension, tachycardia and loss of consciousness occur in the patient.
Dilated uterine veins
Reasons:
- increased physical activity;
- chronic constipation;
- pregnancy;
- taking hormonal contraceptives;
- developmental anomalies;
- abortions.
Symptoms include lower abdominal pain and menstrual irregularities.A dangerous complication is infertility.
Varicose veins of the labia
It most often occurs in the second month of pregnancy.Predisposing factors are the presence of pelvic vein thrombosis or congenital angiodysplasia.
Manifestations:
- varicose veins of the vulva;
- skin scratching and swelling;
- shooting pain in perineum.
The development of acute thrombophlebitis and rupture of the damaged vessel is possible.
Dilated pelvic veins
In the initial stage, it manifests itself as a nagging pain in the lower part of the stomach.There are several variants of the course of this form of the disease:
- dilated 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.
Dilated veins of the spermatic cord (varicocele)
Due to dilated veins of the spermatic cord, the venous outflow from the testicles is disturbed.Patients notice excruciating pain in the scrotum and erectile dysfunction.When examined in the area of the testicles, dilated superficial veins and asymmetry of the scrotum are visible.
Reasons:
- increased physical activity;
- congenital lack of connective tissue;
- tumors in the retroperitoneum or pelvis.
Possible complications as the disease progresses are spermatogenesis leading to infertility.
Varicose dermatitis
This disease is manifested by thinning and itching of the skin above the affected veins.In places of inflammation, dark or light spots and peeling appear.The main localization of venous dermatitis is the lower leg and ankle area.The danger is that patients scratch the itchy areas and the pathological process spreads to healthy tissue.If treatment is not resorted to, the inflammation turns into varicose eczema.
Varicose eczema
The inflammation is persistent with periods of remission and relapse.Skin lesions are difficult to heal even after venectomy.Due to disturbed microcirculation of the skin, the liquid part of the blood passes through the walls of the affected vessels.In the area above the varicose veins, swelling and weeping areas appear.
Blisters with serous or serous-purulent contents appear on the legs.When scratching the wounds, an infection develops.Small bubbles coalesce to form papules.After the opening of the vesicle, crusts appear.The healing site is thinned and covered with scales.In the period of exacerbation, vesicles appear again.The progression of the pathology leads to the formation of trophic ulcers.
Spider veins
Spider veins - telangiectasia.It is characterized by damage and expansion of small subcutaneous vessels.They appear on the skin as a purple or red network of blood vessels.In general, it is not a separate disease, but acts as a cosmetic defect.
Reasons:
- venous insufficiency;
- connective tissue diseases;
- pathologies of the hepatobiliary system;
- use of hormonal drugs;
- diseases of the endocrine system.
Vascular networkthey can be localized on the legs, face or buttocks.On the face, manifestations of the vascular network are called rosacea.
Reasons:
- violation of the rheological properties of blood;
- arterial hypertension;
- diseases of the digestive system;
- the impact of low temperatures on the skin of the face in a special way;
- when you drink alcohol.
Hormonal changes are a common cause of rosacea in women, and it is eliminated by laser coagulation.
Preventive measures are of great importance for varicose veins:
- using comfortable shoes and underwear that does not constrict;
- if there is a predisposing factor or disease in the initial phase, then it is necessary to limit or eliminate static loads and long-term standing;
- moderate physical activity;
- intake of vitamins: C, E, PP;
- a balanced diet.
Of course, in the modern world, it is impossible to follow the recommendations on limiting or eliminating static loads and staying on your feet for a long time, so it is necessary to resort to short gymnastics during the day, as well as use massage services.It is also mandatory to wear elastic bandages and compression clothing.
Diagnostics
Comprehensive diagnosis is carried out by laboratory methods for testing blood and urine (detection of reflux in saphenous veins, functional tests) and ultrasound examinations: ultrasound duplex or triplex scan;X-ray contrast venography;magnetic resonance venography;multispiral computerized 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 blood vessels of the lower extremities, use:
- surgical intervention, for example, phleboectomy - removal of a certain vein;
- sclerosing therapy;
- conservative treatment.
Systemic drug therapy
- Antibiotics.(prescribed in the presence of inflammatory processes and trophic ulcers;
- Antiseptics;
- Phleboprotectors;
- Stimulators of tissue regeneration;
- Anticoagulants;
- Topical steroids (prescribed for trophic ulcers);
- Externally - drugs containing heparin.
In this article, we will dwell in more detail on phleboprotectors and external means used for varicose veins.
Phleboprotectors (phlebotonics) are a group of drugs used for venous insufficiency.They increase blood circulation, which normalizes the patency of blood vessels, relieves swelling and eliminates the feeling of heaviness.It is important to use them in the initial stages of the disease or to prevent exacerbations;for progressive forms, several treatments in different groups are prescribed.
Overview of medications used for varicose veins.
Natural medicine based on red grape leaf extract.It can protect the walls of blood vessels and capillaries, improving their elasticity, normalizing vascular permeability.
The product has improved protection of the walls of blood vessels and capillaries.The drug relieves swelling and prevents its recurrence, because it blocks the permeability of water, proteins and plasma through the walls of blood vessels, achieving the restoration of their natural density.
Indicated for:
- prevention and symptomatic treatment of chronic venous insufficiency;
- swelling of the lower extremities;
- with a feeling of heaviness and fatigue in the lower extremities.
Contraindicated:
- people suffering from allergies to one of the components in the composition.
Take 1 capsule after waking up.The doctor may increase the dose to 2 capsules.
Diosmin
The drug is available in tablet form and is sold without a prescription.It refers to venotonics and angioprotective agents.Diosmin increases the tone of veins, reduces venous stagnation, improves capillary permeability and microcirculation.It has an anti-edematous effect.
Indicated for:
- varicose veins on 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 of age.
Side effects may include mild indigestion and headache.Take 1 tablet in the morning.The course of treatment can be quite long, but usually no longer than 2 months.
Troxerutinrelieves swelling, normalizes microcirculation and strengthens blood vessel walls.It has an anti-inflammatory, antioxidant effect.
Indicated for:
- chronic venous insufficiency, at any stage of the disease;
- varicose veins;
- superficial thrombophlebitis;
- periphlebitis, phlebotrombosis;
- varicose dermatitis;
- postthrombotic syndrome;
- hemorrhoids;
- post-traumatic edema and hematomas;
- hemorrhagic diathesis with increased capillary permeability;
- as a prophylactic agent after vein surgery.
Troxerutin is used in combination with ascorbic acid to improve the effect after vein surgery.
Contraindicated:
- with hypersensitivity;
- peptic ulcer of the stomach and duodenum;
- chronic gastritis (in the acute phase).
Not suitable for minors, first trimester pregnant or breastfeeding.Troxerutin should not be used if there are problems with the gastrointestinal tract.In the active phase of the fight against 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.
Rutosideshas an anti-inflammatory effect and fights swelling and heaviness in the legs.The peculiarity of the drug is that it works with blood cells, promoting permeability.Thus, the drug for varicose veins helps in the 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, starting from the second trimester.
Contraindicated:
- during pregnancy, in the period from 1 to 3 months.
Capsules are used 2-3 times a day, one at a time.
TribenosideAvailable in the form of dragees and capsules.It has an anti-edematous, anti-inflammatory effect, improves vascular permeability.
Indicated for:
- varicose veins of the lower extremities, including in the second and later stages;
- symptoms of CVI, namely: lymphostasis, blood stagnation, feeling of pain, heaviness, bloating in the calf area, especially in the evening;
- phlebitis, periphlebitis, postoperative period;
- trophic ulcers;
- hemorrhoids in chronic and acute phase.
Contraindicated:
- pregnant women from 4-12 months and nursing mothers.
Capsules are taken 2 times 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 with hesperidin.They belong to the group of venotonic substances and angioprotective drugs.They help to restore the tone of the venous walls and improve blood flow in the veins, normalizing the operation of the valves.
Indications 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 skin rash.The drug is indicated for complex and course use.
External drugs for the complex treatment of varicose veins
Ointments and gels are used as external means.First of all, it is necessary to ensure an anti-inflammatory and analgesic effect;nonsteroidal anti-inflammatory drugs, as well as general steroid drugs, are used for these purposes.
Non-steroidal anti-inflammatory drugs (NSAIDs):
- Ketorolac;
- Ketoprofen;
- Ibuprofen;
- nimesulide gel;
- Diclofenac;
All of them have a strong anti-inflammatory effect, relieve pain, discomfort and heaviness.they are used 1-3 times a day, depending on the stage of the disease, with circular massages.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 removed, and local tissue nutrition is improved.It is not used in large quantities due to the possibility of causing generalized side effects.
Swelling removal:
Medicines based on corticosteroids are used.Restoring normal blood flow in legs with varicose veins by stimulating the contraction of the vascular walls:
- Troxerutin;
- Diosmin;
- Rutosides.
Narrowly analgesic external drugs are rarely used, because of their limited effect they do not eliminate the cause, but they act on the symptoms:
- Diclofenac;
- Ketoprofen.
Medicines containing heparin 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 achieved 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.
- Aeschin.Prescribed in the early stages of varicose veins of the legs, in the later stages it is almost ineffective.It is of plant origin.
Basic principles of therapy with external drugs:
- do not self-medicate, but seek the help of a phlebologist;
- strictly follow the instructions for use;
- analyze the result of treatment efficiency after 10 days from the day of treatment.
However, even with the combined use of tablets and ointments, gels for external use, you should not count on a quick result, everything depends on the progress of the disease, its stage and the presence of concomitant diseases.
In conclusion, I would like to note that drugs for varicose veins in different locations are not able to completely stop the disease and prevent complications.In the early stages of the disease, venotonic and angioprotective drugs help to normalize blood flow in the lower extremities, eliminating symptoms such as swelling, leg fatigue and spider veins, protruding tortuous superficial veins.All these drugs are only part of the treatment, which is directly related to lifestyle and diet.In progressive stages, microsurgical and minimally invasive interventions are indicated along with medication that improves the outcome of treatment.