Venous insufficiency

Venous insufficiency is a condition where the flow of blood through the veins is inadequate, causing blood to pool in the legs. Remember, your arteries carry blood from your heart out to the rest of your body, like your legs. Your veins collect this blood and carry it back to the heart to be pumped again. One-way valves in the veins stop the blood from flowing backward. When the veins have trouble sending blood from the limbs to the heart, it’s known as venous insufficiency. In this condition, blood doesn’t flow back to the heart properly, causing blood to pool in the veins in your lower legs.

Causes

The most common causes of venous insufficiency are a history of blood clots and varicose veins. When forward flow through the valves in the veins is obstructed when there is a blood clot, blood builds up below the clot, which can lead to venous insufficiency. In varicose veins, the valves are often missing or not functioning and blood leaks back through these damaged valves. In some cases, weakness in the leg muscles that squeeze blood forward can also contribute to venous insufficiency.

According to The University of Chicago Medical Center, venous insufficiency is more common in women than in men, occurring in women between 40 and 49 and in men between 70 and 79. Other risk factors for venous insufficiency include blood clots, varicose veins, obesity, pregnancy, smoking, cancer, muscle weakness, leg injury or trauma, swelling of a superficial vein (phlebitis), family history of venous insufficiency, and inactivity (sitting or standing for long periods of time without moving can cause high blood pressure in the leg veins and increase your risk).

Symptoms

Symptoms of venous insufficiency may include swelling of the legs or ankles (edema), pain that gets worse when you stand and gets better when you raise your legs, leg cramps, aching, throbbing, or a feeling of heaviness in your legs, itchy legs, weak legs, thickening of the skin on your legs or ankles, skin that is changing color, especially around the ankles, leg ulcers, varicose veins, or a feeling of tightness in your calves.

Diagnosis

If you have any of these symptoms, you can visit your primary physician, podiatrist or vascular surgeon. A physical examination will be done and a complete medical history will be taken to figure out if you have venous insufficiency. There may be some imaging tests ordered to pinpoint the source of the problem. These tests may include a venogram or a duplex ultrasound. Venogram is when the doctor puts an intravenous (IV) contrast dye into your veins allowing them to see the veins better. Duplex ultrasound tests the speed and direction of blood flow in the veins.

Treatment

Treatment will depend on many factors, including the reason for the condition, health status and history. Other factors the doctor will consider are the symptoms, age, how bad the condition is, and how well you can tolerate medications or procedures recommended.

The most common treatment for venous insufficiency is wearing prescription compression stockings. These special elastic stockings apply pressure at the ankle and lower leg. They help improve blood flow and can reduce leg swelling and other symptoms you may be experiencing. Compression stockings come in a range of prescription strengths, different lengths and different materials. Your doctor will help you decide the best type of compression stocking for your treatment.

Other treatment

Improve blood flow by keeping your legs elevated whenever possible, wear compression stockings to apply pressure to lower legs, and walking and exercising regularly. It is important to never cross your legs when seated because this decreases blood flow to the leg.

Medications

There are also a number of medications that may help those suffering from venous insufficiency including diuretics – medications that draw out extra fluid from your body by urinating; anticoagulants – medications that thin the blood; and medications that help improve blood flow such as Trental and Daflon, which can decrease swelling in the veins and pain in the legs.

Surgery

For more serious cases of venous insufficiency, surgery may be required. You may need to see a vascular surgeon who may perform surgery to repair veins or valves, remove (stripping) the damaged vein, sclerotherapy, endoscopic, bypass or laser surgery. Most of these surgeries may be done as an outpatient procedure.

Prevention

If you have a family history of venous insufficiency, here are some steps you can take to lessen your chances of developing this condition: Don’t sit or stand in one position for long periods of time — get up and move around frequently, at least five to 10 minutes every hour; don’t smoke – and if you do smoke, quit now. Get regular exercise, like walking and maintain a healthy body weight.

• For more information on foot conditions, visit www.apma.org, healthcentral.com, or email us at foothealth242@gmail.com. To see a podiatrist, visit Bahamas Foot Centre, Rosetta Street, or telephone 325-2996 for an appointment at Bahamas Surgical Associates Centre, Hilltop Medical, or call 394-5820 for an appointment. You can also visit Lucayan Medical Centre in Freeport, Grand Bahama, or telephone 373-7400 for an appointment.

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