In our modern world, this problem is very acute and widespread in both men and women.We will try to understand the causes, predisposing factors, as well as talk about treatment methods and drugs used for varicose veins.
Varicose veins are a disease of the veins, characterized by their expansion, change in shape and decrease in their elasticity.The superficial veins of the lower extremities, the venous plexus of the rectum (hemorrhoids), the veins of the collar and the spermatic cord are most often affected.
Predisposing factors
Conditions that contribute to difficulty in the flow of blood through the venous system, namely:
- systematic long standing periods 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 that the true causes of varicose veins are not known.This disease has a progressive nature and refers to irreversible changes in the venous vessels.
If we talk about varicose veins of the lower limbs, this is also a cosmetic problem for women.Varicose veins appear visible or swollen under the skin in the form of twisted ligaments or knots (varicose veins).The skin on them is thin and easily damaged, the reason being 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 form.Varicose veins are almost always accompanied by swelling of the limbs, 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 increase in the evening.In the absence of appropriate treatment, the disease progresses and the swelling of the limbs increases.Due to the slowing of the blood flow in the varicose veins, inflammatory processes can occur, which leads to their blockage.
So, the stages of varicose veins:
- 1 syndrome of "heavy" legs;
- 2 persistent swelling develops, accompanied by impaired skin pigmentation and stagnant dermatitis;
- 3 trophic ulcers appear.
Symptoms of varicose veins of the lower extremities
- quick leg fatigue when walking;
- cramps at night;
- feeling of heaviness in the legs;
- pain in the legs, worse in the evening;
- tension in the legs;
- fast heart rate 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 look at when varicose veins are localized in other organs:
Varicose veins of the esophagus
Varicose veins of the esophagus are characterized by distortion and pouch-like growths of the blood vessels.The cause of the disease is portal hypertension.
Manifestations:
- inflammation of the esophagus;
- burning, belching;
- anemia;
- difficulty swallowing.
Complications such as significant bleeding from the veins can develop.The patient develops vomiting of blood, hypotension, tachycardia and impaired consciousness.
Varicose veins of the uterus
Reasons:
- increased physical activity;
- chronic constipation;
- pregnancy;
- taking hormonal contraceptives;
- developmental abnormalities;
- abortions.
Symptoms include lower abdominal pain and menstrual irregularities.A dangerous complication is infertility.
Varicose veins of the labia
It is most common 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;
- radiating pain in perineum.
Development of acute thrombophlebitis and rupture of a damaged vessel is possible.
Varicose veins of the small pelvis
In the initial stage, it manifests itself as a nagging 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 intercourse, dysmenorrhea, difficulty urinating.
Clinical manifestations of the 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 varicose veins of the spermatic cord, the venous outflow from the testicles is impaired.Patients note unpleasant pain in the scrotum and erectile dysfunction.Examination of the testicles showed dilated superficial veins and asymmetry of the scrotum.
Reasons:
- increased physical activity;
- congenital connective tissue deficiency;
- tumors in the retroperitoneum or pelvis.
Possible complications of disease progression are spermatogenesis leading to infertility.
Varicose dermatitis
This disease is manifested by thinning and itching of the skin over the affected veins.Dark or light spots and peeling appear in places of inflammation.The main localization of venous dermatitis is the lower leg and the area of the ankle joint.The danger is that patients scratch the itchy places and the pathological process spreads to the healthy tissue.If you do not resort to 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 veneectomy.Due to impaired microcirculation of the skin, the liquid part of the blood passes through the walls of the affected vessels.Edema and lacrimation appear in the area above the varicose veins.
Blisters with serous or serous-purulent content appear on the legs.When scratching, an infection develops in the wounds.Merging, small bubbles form papules.After the opening of the vesicle, crusts appear.The healing site is thinned and covered with scales.During the exacerbation period, the vesicles reappear.The progression of the pathology leads to the formation of trophic ulcers.
Spider veins
Spider veins - telangiectasias.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.Basically, it is not a separate disease, but rather 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 networkit can be located on the legs, face or buttocks.On the face, the manifestations of the vascular network are called rosacea.
Reasons:
- disorders of the rheological properties of blood;
- arterial hypertension;
- diseases of the digestive system;
- the effect of low temperatures on the skin of the face in a special way;
- when drinking alcohol.
A common cause of rosacea in women is hormonal changes and is eliminated by laser coagulation.
For varicose veins, preventive measures are of great importance:
- using comfortable shoes and loose underwear;
- if there is a predisposing factor or disease in the initial stage, then it is necessary to limit or eliminate static loads and prolonged standing;
- moderate physical activity;
- intake of vitamins: C, E, PP;
- balanced diet.
Of course, in the modern world it is impossible to follow the recommendations to limit or eliminate static loads and stay on the feet for long periods of 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.
Diagnosis
Comprehensive diagnosis is carried out using laboratory methods for blood and urine testing (detection of reflux in the saphenous veins, functional tests) and ultrasound examinations: ultrasound duplex or triplex scanning;X-ray contrast venography;magnetic resonance venography;multispiral contrast-enhanced computed angiography.
Treatment
After receiving the results of the diagnostics, the phlebologist (angio-surgeon) decides 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 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 - heparin-containing drugs.
In this article, we will dwell in detail on phleboprotectors and external means used for varicose veins.
Phleboprotectors (phlebotonics) are a group of drugs used in venous insufficiency.They increase blood circulation, thereby normalizing vascular patency, relieving swelling and removing 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 courses of treatment are prescribed in different groups.
Overview of medications used for varicose veins.
Natural remedy based on red grape leaf extract.Able to protect the walls of blood vessels and capillaries, improving their elasticity, normalizes vascular permeability.
The product is characterized by improved protection of the walls of blood vessels 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, achieving the restoration of their natural density.
Shown for:
- prevention and symptomatic treatment of chronic venous insufficiency;
- swelling of the lower limbs;
- with a feeling of heaviness and weariness in the lower limbs.
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 the form of tablets and is sold without a prescription.It refers to venotonic and angioprotective agents.Diosmin increases the tone of the veins, reduces venous congestion, improves the permeability and microcirculation of the capillaries.It has an anti-edematous effect.
Shown for:
- varicose veins of the limbs and pelvis;
- complex therapy of hemorrhoids;
- signs of venous insufficiency, disorders of lymphatic flow.
Contraindicated:
- with hypersensitivity to the components;
- children and adolescents up to 18 years.
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 more than 2 months.
Troxerutinrelieves edema, normalizes microcirculation and strengthens the walls of blood vessels.It has an anti-inflammatory, antioxidant effect.
Shown for:
- chronic venous insufficiency at any stage of the disease;
- varicose veins;
- superficial thrombophlebitis;
- periphlebitis, phlebothrombosis;
- varicose dermatitis;
- postthrombotic syndrome;
- hemorrhoids;
- post-traumatic edema and hematomas;
- hemorrhagic diathesis with increased capillary permeability;
- as prophylaxis after vein surgery.
Troxerutin is used in combination with ascorbic acid to enhance the effect after venous 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 nursing mothers.The drug Troxerutin should not be used if there are problems with the gastrointestinal tract.In the active stage of the fight against the disease, 1 capsule is prescribed together with meals three times a day.To maintain the effectiveness of the treatment, the product is applied twice a day.
Rutosidehas 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 patency.Thus, the drug for varicose veins helps in the fight against venous microthrombosis.
Shown for:
- chronic venous insufficiency;
- postphlebitic syndrome;
- trophic disorders in varicose veins, trophic ulcers;
- hemorrhoids (pain, exudation, itching and bleeding);
- venous insufficiency and hemorrhoids during pregnancy, starting from the second trimester.
Contraindicated:
- during pregnancy, for a period of 1 to 3 months.
Capsules are used 2-3 times a day, one at a time.
TribenosideIt is available in the form of dragees and capsules.It has an anti-edematous, anti-inflammatory effect, improves vascular permeability.
Shown for:
- varicose veins of the lower extremities, including in the second and subsequent stages;
- symptoms of CVI, namely: lymphostasis, blood stagnation, feeling of pain, heaviness, swelling in the calf area, especially in the evening;
- phlebitis, periphlebitis, postoperative period;
- trophic ulcers;
- hemorrhoids in chronic and acute phase.
Contraindicated:
- pregnant women aged 4-12 months and lactating women.
The capsules are taken 2 times a day at regular intervals.
diosmin with hesperidin,The drug is available in the form of film-coated tablets and is available without a 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 functioning of the valves.
Indications for use:
- hemorrhoids;
- varicose veins of the limbs 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 means for complex treatment of varicose veins
Ointments and gels are used as external means.First of all, it is necessary to provide an anti-inflammatory and analgesic effect;non-steroidal 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 powerful anti-inflammatory effect, remove 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 generalized side effects.
Swelling Relief:
Drugs based on corticosteroids are used.Restoration of normal blood flow in the legs with varicose veins by stimulating the contraction of the vascular walls:
- Troxerutin;
- diosmin;
- Rutoside.
Analgesic external drugs are rarely used narrowly, due to their limited effect, they do not eliminate the cause, but work with the symptoms:
- Diclofenac;
- Ketoprofen.
Heparin-containing medicines 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 effectiveness after 10 days from the date 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 progression 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 places are not able to completely stop the disease and prevent complications.In the early stage of the disease, venotonic and angioprotective drugs help to normalize blood flow in the lower extremities, eliminating symptoms such as swelling, fatigue of the legs and cobwebs, prominent curved superficial veins.All these drugs are only part of the treatment, which is directly related to lifestyle and nutrition.In advanced stages, microsurgical and minimally invasive interventions are indicated, while taking drugs that improve treatment results.