What is chronic venous insufficiency and how is treatment

Chronic venous insufficiency is a very common disease, more frequent in women and the elderly, which is characterized by the inability to maintain a balance between the blood flow that reaches the lower limbs and its return, being usually caused by the malfunction of the existing valves in the veins, and may also be associated with obstruction of the venous flow.

Depending on the severity, this disease can be quite disabling, due to the appearance of symptoms, such as heaviness and pain in the legs, swelling, tingling, itching, skin manifestations, among others.

Treatment depends on the severity of the disease and can be performed with medication administration, use of compression stockings and in some cases, it may be necessary to resort to surgery.

What are the signs and symptoms

The most common symptoms that can manifest in people with venous insufficiency are heaviness and pain in the affected limb, itching, tiredness, night cramps and tingling.

In addition, some characteristic signs of chronic venous insufficiency are the appearance of spider veins, varicose veins, swelling and skin pigmentation.

Possible causes

Venous insufficiency is caused by the malfunction of the valves that are present along the veins, which are responsible for the return of blood back to the heart, and may also be associated with obstruction of the venous flow.

When they work correctly, these valves open in an upward direction, allowing the blood to rise, and close soon afterwards, to prevent the blood from flowing down again. In people with venous insufficiency, the valves lose the ability to close completely, allowing the venous blood to reflux to the extremities, leading to an increase in pressure in the legs, due to the action of gravity and the occurrence of swelling.

What are the risk factors

The cases in which there is a greater risk of suffering from venous insufficiency are:

• Pregnancy and use of oral contraceptives, which can worsen chronic venous disease, as estrogens increase venous permeability and progesterone promotes dilation; Obesity; Permanence for long periods of standing; Sedentary life; Family history of varicose veins or chronic venous insufficiency; Previous history of trauma to the affected lower limb; History of thrombophlebitis.

What is the diagnosis

Generally, the diagnosis consists of an assessment of personal and family medical history, assessment of associated risk factors and analysis of the presence of other diseases and duration of symptoms. A physical examination is also performed to detect signs such as hyperpigmentation, presence of varicose veins, swelling, eczema or active or healed ulcers, for example.

In addition, the doctor can also use diagnostic methods, such as eco-color doppler, which is the main method of evaluation after clinical examination, which allows the detection of malfunction of venous valves or chronic obstruction. A technique called venous plethysmography can also be used, which can be used as a complementary quantitative test to assess the degree of impairment of venous function.

When the diagnosis is not conclusive, it may be necessary to resort to an invasive examination, called phlebography.

What to avoid

In order to avoid or alleviate the symptoms and to prevent the disease from worsening, the person should avoid standing for many hours or staying in hot places for a long time, avoid a sedentary lifestyle, prolonged sun exposure, hot baths, saunas and avoid wearing heels or too shallow shoes.

How the treatment is done

Treatment will depend on the severity of the disease and consists of the use of compression or elastic stockings, which promote the resorption of the edema and prevent its formation, decrease the venous caliber and increase the flow speed, reducing blood reflux when the person is standing. Find out how compression stockings work.

In addition, the doctor can also prescribe venotonic remedies, such as hesperidin and diosmin, for example, mainly to relieve symptoms and decrease the inflammatory process of the valves. These remedies increase venous tone, decreasing capillary permeability and act on the wall and venous valves, preventing venous reflux. They also promote an improvement in lymphatic flow and have an anti-inflammatory action.

In some cases it may be necessary to perform sclerotherapy, if the person has spider veins and surgery, if he has varicose veins, in order to prevent the progression of the disease.

For the treatment to be more effective, the person must maintain a healthy weight, elevate the feet, whenever seated, avoid standing and standing and perform physical exercise.