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VARICES,
CAPILLARY VESSELS, ULCERS
What are varicose veins?
The term varix means dilatation, tortousity. A varix is then a dilatation
of the vein that assumes a tortuous aspect; varices very often form
a network. (Network of varices)
Varices are more or less visible depending on their position. Why
do varices form?
There are three hypotheses:
-
A modification of the veins' walls does not allow the valves to
work properly. In this case the disease gets progressively worst.
-
A modification of the valves followed by a deterioration of the
walls
-
More frequently, a combination of the two previous causes.
Are varices hereditary?
A real hereditary is not proved, but the cases seem to confirm a familiarity.
How do varices reveal themselves?
In the first stage: swelling heaviness, heat, tiredness of legs and
feet. These problems are more accentuated in spring and summer and for
most of women in the pre-menstrual time.
In the second stage: varicose veins and capillary vessels appear. The
clinic picture gets worst. Complications, such as thrombophlebitis,
often followed by hypodermitis (inflammation of the subcutaneous tissue)
or by lymphagitis (inflammation of the lymphatic vessels), can arise.
If the disease is not treated in the initial stage, worse damages of
the tissues, ulcers (that represent the last stage of the chronic venous
failure) appear.
Therefore the disease must be treated in the earlier stages, instead
of attending further complications.
What is chronic venous insufficiency?
It is a more complex disease caused by the simultaneous dysfunction
of the deep vein and the superficial veins as well as the perforant
ones. The disease is often confused with simple varix problem, that
in truth represent one of the most common effects. The chronic venous
insufficiency can evolve itself becoming an untreatable disease. Patients
in this stage even if are defined untreatable they can be treated and
cured.
What are capillary vessels (spider veins)?
The telangiectasias, this is the scientific term for spider veins the
capillary vessels, are thin reddish and bluish venules located between
the skin layer. This problem pertains almost completely to females;
they occur on the thighs in 40% of the cases. Rarely they can bring
burning and itching, and mainly in the pre-menstrual period.
What is the cause?
In most cases these small varices appear without a certain cause, i.e.
without problems related to blood circulation and often when varicose
veins are not present. On the other hand it has been observed a familiar
predisposition and that pregnancies and contusion trauma (such as to
violent massages) favor their appearance.
Only in a very small percentage (15%) talangectasias occur in association
with varicose veins, but in one third of the cases it is possible to
individuate an insufficiency of superficial veins not yet clinically
evident.
In which way are telangiectasias treated?
Sclerotherapy (injection of sclerosing solution directly into the veins)
is the elective method to treat telangiectasias.
Bluish vessels must be carefully treated, in order not to cause damages
(lesions, wounds) or dark spots on the skin. Thin and resistant reddish
telangiectasias are the most difficult to treat. To optimize the results
complementary therapies, such as laser therapy and ozone therapy, are
suggested.
In several cases the effects of the scleroterapy last during the years.
Sometimes additional scleroterapies are needed.
Is
the pill indicated when you suffer of vein problems?
Modern oral contraceptives have a low hormone dosage. Therefore it shouldn't
cause vein problems nor increase the appearance of telangiectasias,
if taken for a brief period.
Some studies, although, prove that patients who use oral contraceptives
have a greater risk of telangiectasias. In truth the pill reproduces
a hormonal state similar to pregnancy. Consequently the assumption should
be preceded by an accurate clinic and hemodynamic study and by analyses
targeted to identify eventual factors of risk.
If telangiectasias increase when treated with hestro-progestenics, hormone
treatment must be suspended. Even in this case there is no general formula.
Therefore a specialist should be always consulted.
What is a thrombophlebitis?
Thrombophlebitis is an inflammation of the veins accompanied by the
formation of a blood clot and by a painful swelling and rush of the
skin, easily recognizable. In some cases the thrombus can increase and
extend to inner veins (deep venous thrombosis). More rarely a fragment
of the thrombus can break off and reach the lungs. In this case we talk
about "pulmonary thromboembolism", that represents a great
risk.
If the thrombophlebitis is cured during initial stages, the risks are
at minimum level and a complete recovery is possible.
What are the causes of thrombophlebitis?
Dilatation of the veins causes a venous stasis. The stasis is the principal
responsible factor of thrombophlebitis occurrence. In many cases a thrombofilia
can follow to the stasis. A trauma can determine thrombophlebitis also
in the veins of healthy people. In addition, there are other risk factors,
such as: obesity, pregnancy, surgical operations, smoke, alcohol, intravenous
injection, infective and neoplastic diseases and immobilization.
Should you rest in bed in case of thrombophlebitis?
Absolutely not. Several years ago it was thought that bed rest was necessary.
Today it has been shown that the main cause of thrombophlebitis is stasis,
therefore it is very important to walk as soon as possible with elastic
bandage or elastic stockings that must be prescribed by a specialist.
What is an ulcer?
An ulcer is a lesion of the skin comparable to a more or less profound
sore. Venous ulcers are generally localized in the inner side of ankles.
We have to take into account that we can improve our appearance, but
we can not transform completely our body according to TV models.
Varices and pregnancy relationships
The pregnancy represents a high-risk time for patients suffering of
varicose diseases. The hormonal modifications (increase of the estrogens
and progesterones) and the increase of the uterus volume cause a venous
stasis from the first days of pregnancy. During the pregnancy, diffuse
venous dilatations located close to the main venous systems can often
be observed. As soon as the baby is born, a reduction of these veins
is observed.
Moreover during the pregnancy the risk of thrombophlebitis increases.
It is therefore suggested:
- to consult a vein specialist
- to carefully study one's own venous circulation
-
to perform the tests of the blood coagulation
- to repeat step 1 to 3 every three months
It is also very important to wear elastic pantyhose
and to assume all the prescripted drugs.
Moreover a diet rich in fibers (vegetables and fruit) and poor in sugar
and fat is warmly recommended. A normal physical activity is always
suggested, but not when contra-indicated by the obstetrician.
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