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Varicose Veins: Causes, Symptoms, Diagnosis And Treatment

Varicose veins, also known as varicoses, are enlarged, swollen and twisted veins that most commonly affect the legs. It is estimated that around 25 per cent of adults are affected by varicose veins [1] and the condition is most common in women.

What Causes Varicose Veins [2]

The arteries in our body carry blood from the heart to the rest of the tissues and the veins return blood from the rest of the body to your heart, so that there is blood recirculation.

The veins have one-way valves, which means the blood can travel only in one direction. If the veins are damaged and not working properly, the blood can flow backwards. This leads to the accumulation of blood in the veins rather than travelling to the heart. This, in turn, causes the veins to stretch, twist and become enlarged and swollen.

The veins which are farthest away from the heart are most affected, like the legs. This is due to the gravity that makes it difficult for the blood to flow back to the heart.

Symptoms Of Varicose Veins [3]

  • Aching pain and discomfort
  • Dark purple or blue coloured veins
  • Veins that are enlarged and swollen
  • Burning, throbbing or muscle cramps in the legs
  • Extreme pain after sitting or standing for a long time
  • Skin discolouration around a varicose vein.

Risk Factors Of Varicose Veins

  • Age - As you age, you are more likely to experience varicose veins because ageing causes wear and tear on the valves in your veins [4] .
  • Gender - Women have higher chances of developing this condition, mostly due to the hormonal changes that occur during pregnancy, premenstruation or menopause. Also, taking birth control pills can increase the risk of varicose veins too [5] .
  • Family history - If your family members have varicose veins, you are more likely to have them too [6] .
  • Obesity - Being obese puts added pressure on the veins [7]
  • Pregnancy - When a woman is pregnant, the volume of blood in your body increases, which can cause swollen veins in your legs [8] .
  • Standing or sitting for longer periods - If you are standing or sitting for longer periods, the blood is unable to flow well causing varicose veins [9] .

Complications Of Varicose Veins [10]

  • Ulcers
  • Blood clots
  • Bleeding

Diagnosis Of Varicose Veins [11]

To diagnose varicose veins, the doctor will physically examine you and check your legs for swelling. The doctor then recommends some diagnostic tests which include the following:

  • Doppler test - An ultrasound scan is done to check how your blood is flowing in the veins and it also checks for blood clots in the veins.
  • Colour duplex ultrasound scan - This test shows the colour images of the structure of veins to find any abnormalities in the veins.

Treatment Of Varicose Veins

Self-care and compression stockings are the treatment procedures for varicose veins. And if the condition doesn't improve with these treatment procedures, the doctor will suggest the following treatment options:

  • Sclerotherapy - A solution, generally a salt solution, is injected directly into the vein. It causes the veins to scar, forcing the blood to travel through healthier veins. The scarred vein is reabsorbed into the local tissue and eventually, it fades [12] .
  • Laser treatment - This treatment procedure is used to close off small varicose veins and it slowly fades and disappears [13] .
  • Ambulatory phlebectomy - The smaller veins are removed through a series of tiny skin punctures [14] .
  • Catheter-assisted procedures - A thin tube (catheter) is inserted into a large vein and the catheter tip is heated up using either radiofrequency or laser energy. While the catheter is pulled out, the heat destroys the vein causing it to collapse [15] .
  • High ligation and vein stripping - This surgical procedure involves drawing the veins through a small incision in the skin to prevent pooling of the blood [16] .
View Article References
  1. [1] Callam, M. J. (1994). Epidemiology of varicose veins.British journal of surgery,81(2), 167-173.
  2. [2] Tisi P. V. (2011). Varicose veins.BMJ clinical evidence,2011, 0212.
  3. [3] Bradbury, A., Evans, C., Allan, P., Lee, A., Ruckley, C. V., & Fowkes, F. G. (1999). What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey.BMJ (Clinical research ed.),318(7180), 353-356.
  4. [4] Brand, F. N., Dannenberg, A. L., Abbott, R. D., & Kannel, W. B. (1988). The epidemiology of varicose veins: the Framingham Study.American journal of preventive medicine,4(2), 96-101.
  5. [5] Criqui, M. H., Jamosmos, M., Fronek, A., Denenberg, J. O., Langer, R. D., Bergan, J., & Golomb, B. A. (2003). Chronic venous disease in an ethnically diverse population: the San Diego Population Study.American journal of epidemiology,158(5), 448-456.
  6. [6] Scott, T. E., LaMorte, W. W., Gorin, D. R., & Menzoian, J. O. (1995). Risk factors for chronic venous insufficiency: a dual case-control study.Journal of vascular surgery,22(5), 622-628.
  7. [7] Seidell, J. C., Bakx, K. C., Deurenberg, P., van den Hoogen, H. J., Hautvast, J. G., & Stijnen, T. (1986). Overweight and chronic illness—a retrospective cohort study, with a follow-up of 6-17 years, in men and women of initially 20-50 years of age.Journal of chronic diseases,39(8), 585-593.
  8. [8] Dindelli, M., Parazzini, F., Basellini, A., Rabaiotti, E., Corsi, G., Ferrari, A., & Parazzini, F. (1993). Risk factors for varicose disease before and during pregnancy.Angiology,44(5), 361-367.
  9. [9] Abramson, J. H., Hopp, C., & Epstein, L. M. (1981). The epidemiology of varicose veins. A survey in western Jerusalem.Journal of Epidemiology & Community Health,35(3), 213-217.
  10. [10] Campbell B. (2006). Varicose veins and their management.BMJ (Clinical research ed.),333(7562), 287-292.
  11. [11] Marsden, G., Perry, M., Kelley, K., & Davies, A. H. (2013). Diagnosis and management of varicose veins in the legs: summary of NICE guidance.Bmj,347, f4279.
  12. [12] Subbarao, N. T., Aradhya, S. S., & Veerabhadrappa, N. H. (2013). Sclerotherapy in the management of varicose veins and its dermatological complications.Indian Journal of Dermatology, Venereology, and Leprology,79(3), 383.
  13. [13] Medical Advisory Secretariat (2010). Endovascular laser therapy for varicose veins: an evidence-based analysis.Ontario health technology assessment series,10(6), 1-92.
  14. [14] Belramman, A., Bootun, R., Lane, T., & Davies, A. H. (2019). Foam sclerotherapy versus ambulatory phlebectomy for the treatment of varicose vein tributaries: study protocol for a randomised controlled trial.Trials,20(1), 392.
  15. [15] Paravastu, S. C. V., Horne, M., & Dodd, P. D. F. (2016). Endovenous ablation therapy (laser or radiofrequency) or foam sclerotherapy versus conventional surgical repair for short saphenous varicose veins.Cochrane Database of Systematic Reviews, (11).
  16. [16] Zhao, Z. Y., Zhang, X. J., Li, J. H., & Huang, M. (2015). Comparison of high ligation and stripping of the great saphenous vein combined with foam sclerotherapy versus conventional surgery for the treatment of superficial venous varicosities of the lower extremity.International journal of clinical and experimental medicine,8(5), 7843-7848.
Read more about: causes symptoms diagnosis treatment
Story first published: Friday, December 6, 2019, 17:23 [IST]
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