Management

Aethiologies

Factors responsible for varicose vein disease:

• Heredity 2/3 of patients have positive familial history. In African Americans the risk of varicose vein diseases are much less because of the number of vein wall valves that is much more in African Americans.

• Female/ male ratio is 2/1 in some countries, this is an hormonal effect. Use of oral contraceptives, estrogen and progesterone increase the risk

• Obesity :varicose veins disease risk increase   about 20% in obesity

• Pregnancy:  during the first trimester hormonal changes are responsible .  During the last trimester fetal growth and compression of inferior vena cava by enlarged fetus is a predisposing factor for varicose vein disease during pregnancy.

• Prolonged sitting or standing as in barbers, nurses, operating room staffs,sales people, flight attendants, waitress/waiter, teachers, postal workers, factory workers, surgeons.

• Loss of vein elasticity with aging and menopause

• Phlebitis: a previous history of phlebitis  Increase the risk of varicose veins by damaging vein wall valves

• Sunburns :are an important risk factor for varicose vein disease.

• Drugs : aspirin, anticoagulants, pain killers, insulin

• Other risk factors: Smoking , alcohol,  hypertension, diabetes

Homocysteine: A recently identified risk factor, homocysteine is an amino acid that promotes coronary artery disease, stroke, and DVT by encouraging clot formation and impairing the ability of damaged vessels to heal themselves. High homocysteine levels are associated with a deficiency of folic acid and vitamins B₁₂ and B₆. There may also be a genetic component. Eating lots of green leafy vegetables, citrus fruit, and grains, and taking a daily multivitamin high in folate may improve your odds.

Steps to Prevent Varicose  Veins

• Avoid  prolonged sitting or prolonged standing.

• Giving your legs a break  periodically during the day.

• Move around, walk, work the muscles pump in your  calves

• Elevate your  legs during rest.  This  allow a greater gravitational downward flow of blood

• Ask your physician about the benefit of wearing a  compression stocking to prevent swelling. The trick to compression therapy is  simple, you must apply the compression BEFORE your feet hit the ground in the  morning.

• Maintain normal weight to take unnecessary pressure off the veins

• Pay attention to salt  amounts in your meals

• Walking is a very good exercise for preventing varicose vein disease.

• Avoid direct sunlight to minimize vasodilation and swelling.Pay attention to sun burns do not stay a long time in sunshine and use sun block creams

• Avoid tight clothing which can restrict circulation.

• Avoid Excess alcohol and smoking

• Wear flat or low-heeled shoes to work calf muscles and prevent discomfort

• Exercise to improve blood circulation

Cafer Abbasoğlu
jan 2007