Varicose Veins

Basically, 'varicose' means abnormally dilated or swollen. Varicose veins, therefore, are so distended that they can be seen as knotty bulges just under the surface of the skin.

To understand how unsightly varicose veins occur, it helps to look closely at the venous, or vein system. This is a complex, but highly efficient network which regulates the flow of blood round the body.

Veins have valves in them which allow the blood to pass only in one direction. Each valve consists of two pouches which lie flat against the internal wall of the vein when the blood is flowing in the right direction but which open out to meet and block the passage when the blood tries to flow backwards. The legs have the greatest number of valves, followed by the arms; the internal organs have only a few.

You can see where the valves are simply by rubbing your finger along a large vein in the arm or leg in the opposite direction to the blood flow. Little swellings will appear above each valve.

The veins have thinner walls than arteries, although their diameter is greater, to allow for the more leisurely flow of blood. The thinner walls, however, enable them to contract much more easily if less blood comes their way to keep the blood flowing properly. There is an imperceptible and continuous squeezing of the veins by muscles all over the body which keeps the blood flowing from valve to valve.

There are many more veins than arteries. Generally there are two veins working with each artery, except, strangely, with the largest artery which is 'partnered' by just one vein. The whole body is threaded with an intricate network of veins which collect blood from different areas of the body and drain it into other areas,

The legs are each served by one large vein the inferior vena cava. which is connected to two iliac veins. These collect blood from the abdomen and legs. The superficial veins drain into the external saphenous vein on the back of the leg and the internal saphenous veins which run from the instep up the inside of the leg and thigh. The system connected with the internal saphenous vein is the one that causes all the trouble, being especially liable to swell and become varicose.

The blood in the veins is blue because it does not contain oxygen. Oxygen is carried by haemoglobin. If there is no oxygen in your blood the haemoglobin turns blue, The veins are generally nearer the surface than the arteries so the blue blood is easily seen through the A This is why the term 'blue blooded' is synonymous with the old European aristocracy. They led a sheltered, indoor life for the most part, and their veins therefore, showed more clearly through their pale, thin skinned hands, arms and necks giving the blue impression. The peasants and labourers, on the other hand, had rough, darkened skin because of their strenuous outdoor life.

Blood flow is stepped up with temperature and with exercise, so the veins have to expand to cope with the increase and to help the body maintain a reasonable temperature. Veins are nearer the surface and so you can see the swelling more easily, particularly in the veins on the back of the hands,

Because the blood flow in the veins in certain parts of the body can become very sluggish and because veins have weaker walls than arteries, they are particularly prone to disorders and inflammation.

The commonest of these is varicose veins. It is estimated that these occur in one woman out of two and one man in four over the age of 40, although they can occur in much younger people. Usually they are trivial, medically speaking, and many people never feel the need to have them treated. Sometimes, however, they are painful and usually they look ugly. Many women have them treated for purely cosmetic reasons.

It is the superficial saphenous veins near the surface of the leg which are usually affected. What happens is that the valves fail to work properly, causing the blood to stagnate and the vein wall around the valve to swell. These swellings stand out as unsightly, knobbly protuberances on the skin's surface. There are many causes of varicose veins. Often the condition is hereditary. Some people are born with veins which are thinner walled and weaker than others.

There are, however, many jobs which put people at greater than average risk of developing varicose veins. The danger comes in occupations which involve long periods of standing still when the muscular contractions. of the legs are not properly at work to keep the blood flowing smoothly. Hairdressers, shop assistants and barmaids are particularly at risk. For men, dentistry is a particularly vulnerable profession. The housewife could be in danger if she spent long hours standing still at the ironing board. But, as every housewife

Bathing your legs and feet in warm water stimulates the circulation of the blood, relieves pressure which builds up and reduces the likelihood of swelling veins.

knows, her job also involves a great deal of moving about so she would rarely suffer from varicose veins in this way. Sometimes after long waits in shopping lines or at bus stops, a housewife may experience a feeling of tiredness or throbbing in her legs and even swelling about the ankles.

Even the slightest movement of the legs helps the blood flow, so if you do have to stand for a long time, it is a good idea just to flex your toes occasionally, or shift your weight from your toes to your heel or vice versa. A few minutes' rest with your feet up (ideally above the heart level) should relieve the pressure on the veins of your legs and quickly restore them to normal. It is important to remember that varicose veins do not point to anything very serious. Regular exercise will help to make sure that your blood keeps moving.

In addition to the knotty bumps, symptoms of varicose veins include a feeling of weariness and tiredness in the legs and swollen ankles. In severe cases the valve failure can lead to a 'waterlogged' skin which is discoloured because of continuous leakage of small amounts of blood and fluid from the blood vessels. These areas can become very itchy and are prone to ulcers even after the smallest injury. The vein can also become inflamed, a condition known as phlebitis.

Pregnancy can be a contributory cause, although the condition frequently disappears after the baby is born. Constipation, too, puts pressure on the venous system by partially blocking veins in the pelvic area.

The veins affected by varicosities are generally not the deep ones in the leg, but the saphenous veins near the surface of the skin. This means that they are easily accessible for simple surgery or they can be blocked by injecting an irritant which encourages the vein walls to collapse and stick together or blocks them with a blood clot. These artificial clots are not dangerous because they adhere firmly to the vein's walls.

The commonest operation for varicose veins is 'stripping'. The vein is tied off at two places and the intervening swollen part literally stripped out en masse. Although the operation is a simple one, it does carry a very small risk of complications and involves a few days' stay in hospital. An increasing number of doctors are following the more modern injection techniques which seem just as effective and which are far quicker and cheaper to carry out.

The modern method is properly known as injection compression sclerotherapy and consists of a series of injectionsusually about seven in all. A small quantity of detergent like fluid known as a sclerosant is injected and causes the vein to collapse. The leg is tightly bandaged to accelerate the process. Injections are repeated each week until all the varicosities have subsided.

Many surgeons, however, still believe in the less sophisticated stripping operations. The reason for this may well be that exaggerated claims of a total 'cure' were made when injection techniques were first introduced. Neither surgery nor injection can 'cure' varicose veins because they do not attack the underlying causes. Unfortunately varicosities can reappear after either method, but weight control and regular exercise can help keep them at ease.

Phlebitis can be a cause for concern when it is associated with a blood clot in a larger, deeper vein. The clot can break away and pass through the heart to lodge in a branch of the main. artery, cutting off the blood supply to part of the lungs.

This blocking is called pulmonary embolism and is a major cause of unexpected death after surgical operations because the manipulation of organs during surgery, and the complete bed rest afterwards encourages the formation of clots, called thrombosis, in the veins nearby. For this reason, surgical patients are always given special exercises soon after their operation, to make sure there is no blood stagnation and clotting.

It has also been shown that oral contraceptives carry a tiny increased risk of blood clotting. They are not recommended for women with a family history of, or a tendency to, blood clotting disease. Normally, however, the blood clots formed in the veins are reabsorbed into the blood stream.

Haemorrhoids, commonly known as piles, are also a form of distended or varicose veins. Again this seems to be an evolutionary penalty, as the main cause of the trouble seems to be pressure from the abdominal muscles on the veins running up the lining of the rectum. The veins in this area are particularly prone to trouble. The muscles which keep the rectum closed interfere with circulation through the haemorrhoidal veins. It appears that hereditary factors play a part in this condition.

Doctors believe that some people's habits and diet make them more vulnerable. This ailment is especially common in men with sedentary jobs who do not take enough exercise and, because of the extra pressure, it is more likely to occur in men and women who are overweight. Piles are fairly common in the younger age groups, too.

Habitual constipation is a significant factor in this condition although it is unlikely to be the sole cause. The discomfort of haemorrhoids encourages constipation, so the two complaints aggravate each other in a particularly vicious circle. Sitting on a cold or damp surface or even a general chill can inflame already swollen veins and bring on what is commonly known as 'an attack of piles'. Women often suffer from piles during pregnancy although they usually recede after the child is born. '.

The risk of haemorrhoids can be reduced by sensible eating and a reasonable amount of regular exercise. Exercise helps carry the blood off the limbs and so prevent a build up of pressure in the veins. Obesity creates many other problems as well as piles, so it is important to keep to a well balanced diet to prevent you from gaining extra pounds. Constipation can be avoided by eating plenty of fruit and vegetables every day. Excessive alcoholic drinks and strong purgatives should be avoided because they can actually help to bring on the condition by irritating the delicate tissues.

One of the main symptoms of haemorrhoids is bleeding. Although there may be some discomfort and much embarrassment piles are rarely painful. But if they last a long time, even a small amount of blood lost each day can rob the body's supplies of iron and lead to anaemia, It is most important that you seek prompt medical advice about piles. In some cases the symptoms of piles are similar to more serious illnesses. It is best to be safe and comfortable rather than sick and sorry.

Small haemorrhoids can often be cured by suppositories designed to reduce congestion and by mild laxatives. Special ointments are available on the market to reduce itching and careful regular washing with warm water is always recommended by doctors. Soap, however, can act as an irritant.

For more serious cases, injection techniques or surgery are used. The injection method is slightly different from that used in the leg. Here, the irritant fluid is used to cause scarring around the haemorrhoid. In surgery the offending veins may be removed or isolated and tied off with ligatures.

Even broken veins are occasionally, seen on the face, especially around the nose, and on the back of the hands. These are caused by failure in the mechanism which controls the dilation or constriction of the blood vessels. Frequently this breakdown is caused by an excessive intake of alcohol although there are other causes, including the natural process of aging.

Alcohol makes the blood vessels expand particularly just beneath the skin's surface. When they dilate you become flushed and feel a rosy glow. If an individual were continually to drink to excess, the tiny capillary blood vessels would 'Jam' in the distended position. This in turn can create problems at the venous end of the capillary system by causing the tiny blood vessels to rupture and adding a fine tracery of broken vein, to the crimson hue.

Going from a hot atmosphere into the cold puts extra strain on the control mechanisms. So again 'moderation in all things' is the best method of prevention, There is as yet no cure for broken veins. It is often quite simple, however, for both men and women to disguise the offending vessels with special preparations should they prove embarrassing.

Generally, however, the veins function remarkably well in coping with all the pressures put upon them. Knowing even a little about how they work can show you how you can help them to perform their tasks more efficiently. The secret, as with all aspects of healthy living, lies in a commonsense approach to life enough but not too much of the right kinds of foods and regular, though not necessarily strenuous, exercise. Learn more about Veins.