Venous reflux disease is a serious condition more commonly known as chronic venous insufficiency (CVI). This article explains what chronic venous insufficiency is, how it is caused, its common symptoms and what kinds of treatment are currently available for patients who are afflicted by it.
What is Venous Reflux Disease and Why Does it Happen?
As we walk, the blood in our lower extremities is pumped from the superficial or outer veins upwards and inwards into the deep venous system and then up the major, deep veins towards the heart. When the blood stops flowing, valves in the vein walls close to prevent the blood from returning or ‘refluxing’ back down towards the feet and the skin. Any back-flow of blood in normal veins normally closes normal valves. However, these valves are often defective and do not adequately perform their role normally for people with CVI.
The valvular incompetence behind chronic venous insufficiency may have different causes. Inflammation of the vein (phlebitis) can damage the valves and their ability to work properly as can the presence of blood clots (thrombosis). These common causes often lead to CVI evolving to include a post-phlebitic or post-thrombotic syndrome, respectively. However, congenital valve malformation is also a common contributor to the condition, which is often familial and hereditary. However, there are other causes of CVI- like conditions that increase venous pressure in pelvic veins. CVI normally affects the superficial venous system but can also involve the deep venous system or the perforating or communicating veins connecting the two systems.
Sometimes, it is not the valves themselves but the vein walls that are at the root of the problem because of chronic distention. Veins can be naturally weak in some individuals whereas others can be weakened or dilated by the effects of hormones- for example hormones released during pregnancy, or chronic back-pressure. When the vein walls become over-distended, the valves are unable to meet in the center or co-apt and blood refluxes through the gap. Over time, the veins become increasingly distended and deformed perpetuating the disease and leading to the characteristic unsightly appearance of varicose veins. Venous reflux disease is most common in people over 50 years of age while other risk factors include heredity, long regular periods of standing or sitting, obesity and smoking.
The Symptoms of Venous Reflux Disease
Aside from the aforementioned appearance of varicose veins, there are a number of symptoms associated with CVI. Many patients report feeling ache, particularly after walking or standing, with this pain often resolving once the limb is elevated (reducing blood pressure in the veins). Instead of, or in addition to ache, sufferers may experience heat, itchiness, tenderness or general discomfort in the affected leg. There may be color changes, particularly near the ankles with a flare of veins, and later in the course of the disease, the skin often becomes hardened, swollen and shows increased pigmentation (lipodermatosclerosis).
Conditions that cause the pressure to rise in the lower extremity veins chronically can also, over time, cause capillaries and venules to distend and get congested causing back-pressure and stasis, increasing the risk of leg ulcers which are slow to heal owing to the impaired blood flow in the region leading to ischemia.
How Can Venous Reflux Disease be treated?
The treatment of CVI will involve both alleviating the symptoms and tackling the underlying problem. Graduated compression of the lower extremity, using specially designed compression stockings (offered free with every Spring of Youth consult), will help to normalize the venous pressure within veins and, in addition, patients will be advised to elevate their legs as often as possible. Leg ulcers will need to be properly dressed and monitored in addition to the limb being compressed. Regurgitant, damaged and unsightly veins can often be ablated (closed) and some removed without complications. A few of the modern methods by which veins in the superficial venous system can be managed include heat or laser ablation (whereby the energy from a laser, or heat source, is introduced via a tiny catheter) and injection sclerotherapy (involving the injection of small amounts of a safe substance). In both cases, the vein will eventually atrophy and shrivel-up naturally and disappear.
If you are troubled by varicose veins, spider veins or other unsightly cosmetic issues, Mississippi vein specialists invite you to explore the options open to you via the Spring of Youth Medical Group. Please call us on (228) 875-0885 or visit www.springofyouthmedical.com