VARICOSE VEINS

What Are Varicose Veins?

Varicose veins are superficial engorged and convoluted veins that appear around the calves and thighs.
They are unsightly and very common although not a cause for concern in most people. Varicose veins can also appear in any part of the body, when veins around the anus become varicose, they are called Haemorrhoids.

Normally blood flows through the arteries down the legs and returns back up the legs through the veins.
The deep veins carry most of the blood to the heart whereas the less important superficial veins can become varicose. These veins contain valves, which should allow the blood to flow upwards toward the heart by the action of the muscles movements of the legs. Sometimes these valves are damaged, the veins are dilated and the blood pooled back forming the varicosities in these veins. Naturally gravity plays a part in making these veins look engorged and convoluted with prolonged standing or walking and the temporary relief is lying down or raising the legs up.

What are the causes?

Genetics -
A history of varicose veins in the family. Varicose and spider veins can be associated with hereditary factors. About a fifth of the population have varicose veins

Deep veins thrombosis -
Occasionally the deep veins of the legs may be involved due to thrombophlebits (Inflammation of the deep veins)

Occupations or hobbies. -
Activities that require prolonged standing in occupation such as - nurses, sales assistants, waitresses, teachers or flight attendants…

Pregnancy or menopause. -
Hormonal changes during pregnancy, menstruation or menopause may be contributory factor. The female hormones tend to relax the vein walls allowing the blood to pool back in the legs.

Obesity. -
Overweight people are more likely to get varicose veins due to the added pressure on the legs veins.

Age. -
Varicose veins appear gradually and tend to affect the over 30 and can get worse over the years.

Precautions to relieve and prevent varicose veins.

Avoid standing for long periods at a time. Shift your weight from one leg to the other frequently if your job or hobby requires you to stand for a long time.

Keep your weight down through proper dieting.

Keep fit through exercising regularly.

Do not cross your legs while sitting down as this prevents the flow of blood in your legs.

Elevate your legs while resting to ease the back flow of blood to your heart.
Avoid salty foods to prevent swelling in the legs.

Wear elastic support stockings or crepe bandage to ease pain or prevent swelling of the legs.

In long car journeys stop and take a walk every hour or so. Get up and walk around in long haul flights.

Signs and Symptoms
The symptoms may be present before varicose appear. However the signs and symptoms may include:

• Legs feeling heavy and achy with or without throbbing and burning sensation. Swelling and cramp in the lower legs. Prolonged sitting or standing tends to make your legs feel worse.
• Superficial distended veins visible under the skin of your legs.
• Discoloration of skin around the ankles.
• The distended veins feel itchy.
• Skin ulceration around the ankles, which represent a severe form of vascular disease and require immediate medical or surgical attention.

Occasionally, the deep veins within your legs are involved. In such cases, your limbs may swell considerably. Any sudden leg swelling that may or may not be accompanied by pain and redness needs urgent medical attention, as it may indicate a blood clot (DVT).
If you are concerned about how your veins look and feel after taking precautionary measures and the conditions are getting worse then you should see your doctor. If your legs look bad with the distended veins and you are not having any symptoms, your veins can be taken out or treated cosmetically.

Diagnosis

When you consult your doctor, he will examine your legs while you are standing to detect for swelling and to see if the swelling goes down while you are lying flat with you legs elevated. He will also ask you to describe the ache and pain in your legs. An ultrasound test may be required to see if there is evidence of a blood clot. The skin around your ankles will be examined for discolouration due to ulceration. Some further tests may be performed.

Complications

It is sometimes possible to develop very painful ulcers on the skin near the varicose veins, especially around the ankles. Discolouring of the skin usually precedes the development of an ulcer, which may be caused by long term oedema (waterlogging) of these tissues around the affected veins.

Treatment Options

There are several options in treating varicose veins. The most common procedure is surgery or sclerotherapy. These procedures may be used alone or in combination.

Surgery - The veins can be removed by a process known as "stripping", a procedure in which a thin flexible wire or plastic is passed into the damaged vein at the ankle or knee level and removed through a small incision at the groin. The incision at the groin is fairly small about 2 to 3cm long. The smaller tributaries of these veins may be removed by different techniques, using of vein hook or avulsion method without leaving any scars.