What are they?
Varicose veins represent enlargement and elongation of veins on the surface of the body with associated failure of the valves in them. This is the commonest abnormality of the veins.
Varicose veins are predominantly seen in the lower limbs, but may occur in several other sites. Varicose veins affecting the surface veins of the leg are extremely common in most Western countries especially in females, and the incidence increases with age.
The cause of varicose veins is unknown but possible predisposing factors include genetic factors, prolonged standing, tumours in the pelvis compressing the veins, pregnancy, ageing and obesity.
What are the symptoms?
Uncomplicated varicose veins are seldom symptomatic. Increased fatigue, aching or burning sensation or leg pains on standing for brief periods are the commonest symptoms. The pains may be localized over the enlarged veins. Symptoms are worst towards the end of the day when there may be some swelling of the ankle. This usually subsides when the legs are elevated.
The severity of the symptoms, however, is not necessarily correlated with the degree of development of the varices, patients with minimal veins occasionally complaining of severe symptoms.
When complicated, varicose veins may present with itching associated with skin infection, ulcerations, bleeding or leg swelling that refuses to subside.
What treatment works?
Supporting elastic stockings may be applied preferably to both thigh and leg; in the absence of stockings, elastic bandages similarly applied may be used. Weight loss is also important. Patients who are obese are also encouraged to lose weight.
These conservative methods are non-curative and may be used in elderly patients unfit for surgery or those who refuse it. They are also useful in women with moderately developed varicose veins who are pregnant or are desirous of having more children. These individuals are encouraged to
Chemical irritating agents can be directly injected into the veins to close them down. These can be used alone for small varicose veins or after surgery for larger ones. In appropriately selected cases, the results of sclerotherapy are encouraging with minimal recurrence rate.
Surgery can be done for some major varicose veins. However, not all large ones can be safely treated with it.
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