Varicose
Veins
In our
circulatory system, arteries are the major blood vessels which carry and
distribute oxygenated blood throughout the body with its branches arterioles
and capillaries. Capillaries are most permeable for transportation of nutrients
and oxygen from blood to tissues.
These
capillaries, after diversification, tend to unite again to form venules. These
venules unite further to form smaller veins which again unite to form large
veins. Veins are blood vessels which collect and carry deoxygenated blood
towards heart for recharging oxygen. The two largest veins of our body are the
superior vena cava (which collects impure blood from the upper part of the
body) and the inferior vena cava (which collects and carries impure blood from
the lower part of the body i.e. from the legs and abdomen). If veins gets
swollen or distended, they are medically called ‘varicose veins’.
Varic is a Latin word which stands for swollen. Varix is meant for an enlarged
tortuous vein. Varicose is the condition where varix is present, which means
that it is not a disease by itself but it can occur in many cases/diseases due
to obstruction or other reasons.
Pathophysiology
Veins can distend 6 times more than arteries. Veins usually hold/retain
about 70 per cent of the total blood volume whereas only 30 per cent is held by
arteries. Veins wall are usually thin and can accommodate any amount of blood
with distension, but they can collapse readily being empty. They are usually
guarded by a pair of valves (non-return valves).
This prevents
back flow. Normally, the flow in the veins is guided by a muscular pump which
works as passive pump whereas artery has speed delivery with heart systolic
pump. The pressure of flow in artery is 120mg of Hg during systole which drops
slowly during distribution i.e. with arteries (70), arterioles (40),
capillaries (30), venules (15) and veins (0-15). Since there is no pressure to
direct flow, the activeness of local muscle is needed for pumping the blood
towards the heart. If it is not there, pooling of blood will be there. This is
the main reason for mild puffiness of the body especially in the extremities
which can be seen after sleep.
One can
notice this with the tightness of the finger ring in the morning which becomes
loose after some work.
Also, there are three types of veins. They are superficial veins, deep veins,
and perforating veins (that connect superficial and deep veins). Varicose veins
usually occur in superficial veins since it lacks muscular support and
pressure. This can be seen in elderly people when their skin loses its texture
and also in people who work out in gyms (temporarily) when they act to show the
muscle bulkiness with contractions. Here blood from deep veins takes
alternative route through superficial veins due to strong muscular contractions
which totally compress the deep veins.
Even though varicosity can occur anywhere in the body, the commonest part that
often suffers is the leg (calf muscle area). This is because gravitational
force endures more pressure in the veins of legs due to the erect posture of
the human being. Varicosity occurs on two occasions, one, due to lack of
muscular pump, and another, due to valve incompetence/damage due to diseases.
As blood tend to pool in veins, veins get enlarged to become varicose veins.
Commonly
suspected CAUSES for development of varicosity
Pressure in the blood vessels may be due to
- Obstruction
- Physiological –
Pregnancy & delivery can cause temporary increase of venous pressure
to cause varicose veins.
- Pathological – Liver
and portal vein disorders, pelvic tumours, circulatory disorders, cancer,
etc., can cause obstruction and thus varicose veins
- Erect posture of man
– from four-legged animals, by evolution, human beings attained the erect
posture. This has also been considered as a major susceptible factor for
development of varicose veins in the leg due to gravitational force.
- Hereditary –
Varicose veins seem to run in families
- Habit of alcohol,
sedentary life and drugs can also cause varicose veins
- Obesity, hormonal
changes at menopause or under birth control pills
Incidences
Varicose
veins are commonly seen in females especially in pregnant women. It may occur
in one or both sides. It is also commonly seen in elderly persons, when their
skin and muscles become more relaxed. Otherwise, sufferers are mostly
occupational i.e.
- Long sitting
travellers – drivers
- Long standing workers
– policeman, salesman/woman
- Sedentary workers
SYMPTOMS
Most of the time, varicose veins remain
without any symptom other than cosmetic distress. The presentation of varicose
veins symptoms usually varies from place to place and also with its intensity.
Commonly,
- Distention of veins
– worm-like or spider-like enlarged veins seen over the skin
- Discolouration and
itching over and nearby distended veins
- Swelling in inner
aspect of ankle
- Heavy and tight /
lightning / throbbing pain in the affected leg(s)
- Occasional numbness
and tiredness due to blood (de-oxygenated) pooling
Even though,
varicose veins are not a serious disorder, they need proper care to avoid
developing complications.
Diagnosis
Nowadays
science has advanced in tremendous ways to diagnose the obstructions / blocks
(if any) in such a way that a simple 4 to 7 seconds x-ray exposure (CT coronary
angiogram) is enough to diagnose minute blocks in heart miniature blood
vessels. Regarding varicose veins, even a simple clinical examination with
tourniquet can give idea to fix the problem of the varicose vein. To rule out
blocks or valvular damage in a simple way, Doppler (ultrasound) study can be
done. For more specification, Venogram (angiography) or CT scan is advisable.
COMPLICATIONS
As varicose
veins tend to worsen over time, it usually needs care and support. Uncared-for
varicose veins can often cause recurrent infection/inflammation (phlebitis) and
pain in the affected veins. It can also lead to ulcer formation, necrosis and
gangrene. Also, as blood tends to pool for a long time, there comes the chances
for development of clot (deep vein thrombosis). It can go in circulation to
block blood vessels of the lungs or heart which can endanger life all of a
sudden.
PREVENTION & MANAGEMENT
Do’s
- Restrict salt intake
- Wear stockings or
crepe bandage (in the morning itself)
- Exercise moderately
(walking and cycling) to improve muscular pump and circulation
- Keep your legs
elevated during rest and sleep
- Take care of itching
and ulcer immediately
Avoid
- Standing or sitting
for a long time (sedentary habits)
- Crossing over the
legs
- Tight undergarments
- Alcohol and smoking
- Unnecessary drugs,
especially pain-killers (promotes water retention)
GENERAL TREATMENT
Mostly, no
one goes for medical treatment in the beginning unless cramps or pain develop.
If the problem is cosmetic, they will proceed for treatment even in the initial
period. Also, as many of the sufferer are reluctant to use stockings
continuously (due to cosmetic concern or discomfort), they opt for other
methods. Commonly, the advanced medical world uses chemicals to cauterise and
close blood vessels (sclerotherapy) or laser to burn the affected vessel(s). In
most advanced cases, vein stripping (surgical removal) is advised. Even though
there arises minor complications (pain, skin rash, scar, etc) with
chemical/laser treatment and surgical intervention, the major concern is that
the varicosity can recur in other/adjacent veins in the near future. Also,
nowadays, to rule out formation of clot (deep vein thrombosis) anti-coagulants
are also advised invariably.
Homeopathic
Approach
To avoid discomfort, pain, itching, ulceration, bleeding and unwanted progress
of the varicose veins, management and treatment should be taken accordingly, at
the earliest. Varicose veins usually tend to get worse over time and become
more persistent unless otherwise cared-for. Best of all the medicines is
elevation of the leg, exercise, rest, water and salt restricted diet, without
which no treatment will be helpful.
Any type of localised approach or treatment will usually suppress/mask the
complaint for the time being only. Wearing stockings or crepe bandage will
arrest further progress of distension or varicose veins, and it does not help
in reduction of the size of varicose veins. Also, one should be aware of
recurrences of varicose veins even after surgical intervention. This confirms
that the cause is not localised and it is the effect of internal circulatory or
other systemic diseases. So the cause must be analysed completely and treated
accordingly.
Homoeopathy medicines are very effective in management of varicose veins
without any painful interventions. But treatment should be started at the
earliest to cure it completely or otherwise, it can only be maintained.
Homeopathy medicines should be administered after proper analysis of the
disease (nature and origin) and sufferings. Homeopathy usually cares both for
the patient’s feelings as well as the disease symptoms.
Homeopathic medicines commonly used in cases of varicose veins are Acid flour,
Apis mel, Arnica, Bryonia, Calc carb, Calc flour, Capsicum, Carbo veg,
Causticum, Hamemelis, Hepa sulf, Lachesis, Lycopodium, Millefolium, Nux Vom,
Phosphorus, Pulsatilla, Sulphur, Thuja, Zincum met, etc. For infected varicose
veins, Acid flour, Ars alb, Belladonna, Hamamelis, Lachesis, Pyrogen, Vipera,
etc. These Medicines should be taken under the advice and diagnosis of a
qualified Homeopath.
for
new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
Clinic : +91-452-233-8833 |
E-mail: drcheena@gmail.com
(Disclaimer: The contents of this column are for informational
purpose only. The content is not intended to be a substitute for professional
healthcare advice, diagnosis, or treatment. Always seek the advice of
healthcare professional for any health problem or medical condition.)