Varicose Veins | |
 Varicose veins are dilated tortuous superficial veins in the legs. They can also occur in the male scrotum where they are called a varicocele and in the anorectal area where they produce haemorrhoids. The cause of varicose veins in the leg is unknown. They are thought to be due to a genetic or inherited weakness in the wall of blood vessels but another theory is that they are associated with disease of the lower bowel due to the low roughage diet of modern western society, resulting in increased pressure in the abdomen and resistance to blood flow returning to the heart. Females, and particularly women who have borne children, appear to suffer from varicose veins more than men. Constrictive clothing, increased weight, prolonged standing or sitting with crossed legs can be aggravating factors. Varicose veins have also been linked with the oestrogens of oral contraceptives. Secondary superficial varicose veins can also appear following inflammation and obstruction to deeper veins in the legs. Most varicose veins are present below the knee. Some people suffer no symptoms from severe varicose veins while others have severe symptoms from apparently very minor veins. The commonest symptoms are aching and heaviness. Aching can be described as a dull heavy bursting sensation which becomes worse as the day progresses. Cramps and itching can be experienced and there can be cosmetic disfigurement. Complications include dry scaly skin over the veins, breakdown of the skin causing an ulcer or bleeding - which is usually due to a bump or other minor trauma. Non surgical treatment consists of proper fitting elastic stockings which generally should only extend up to the knee although satisfactory full length pantyhose type stockings are now available and can be used if suitable. Prolonged sitting with crossed legs or standing should be kept to minimum. Tight garters should not be worn. Walking is good for the legs and cycling exercises with legs elevated is to be encouraged. Elastic support, periodic elevation of the legs and exercise relieve the symptoms to a varying extent in most cases of varicose veins. Injection of veins with a sclerosing solution followed by elastic pressure bandages for 3 to 6 weeks can give excellent short term relief. It is best used in veins below the knees which are small and superficial. Removal of veins by surgical stripping is reserved for when symptoms are severe, if the veins are large, even if symptoms are absent, or with the occurrence of complications such as ulceration, bleeding of inflammation. Surgery is also indicated for cosmetic reasons. After operation, early walking will be encouraged but elastic bandages will have to be worn for 6 weeks and later on superficial veins may still have to be injected. |
