Veins

Apr 7, 2012 , Kateřina Hudecová

zily.jpg - kopie
zily.jpg - kopie
Veins are blood vessels, which have a role to carry blood to the heart. They are formed by the pooling of capillaries and are then joined to form larger branches. The venous system may be affected by a number of diseases. The most common of vein diseases are probably varicose veins and hemorrhoids.

Veins

Veins, Latin vena, are a tubular system belonging to blood vessels. They are an important part of our blood stream because as well as arteries they participate in the transport of blood in the human body. However, unlike arteries they carry deoxygenated blood from the body to the heart.

Function of veins

The venous system starts with small veins, called venules, which follow after the capillaries. These veins further pool together, widen and form larger veins until they finally merge into two large veins, the superior and inferior vena cava. These large veins carry deoxygenated blood and flow into the right atrium of the heart. Superior vena cava collects blood from the head, neck and upper limbs, inferior vena cava then from other parts of the body, i.e. from the trunk, pelvis and lower extremities. The exception is the heart, which has its own blood supply and deoxygenated blood is transported by coronary veins into the right atrium.

Diseases of veins

Vein diseases are most often located in the lower extremities. The blood from the lower extremities is drained by two venous systems, deep and superficial venous systems, which are connected by the so-called perforating veins. In them blood normally flows in the direction from the superficial to the deep veins. Deep veins are located between muscles, whereas superficial veins, as the name implies, are under the skin. It is necessary that the blood flows through the veins upwards towards the heart, against gravity. Therefore, the veins of the lower limbs are equipped with valves that prevent backflow of blood. The most common venous diseases include varicose veins, deep vein thrombosis, phlebitis and besides the legs also hemorrhoids.

Varicose veins

Varicose veins belong among the most common diseases of the venous system, usually in the lower limbs.

  • The nature of the formation of varicose veins is swelling of the venous wall. Consequently, venous valves are damaged, do not contract properly and are not able to provide adequate blood flow. Valves are also damaged in the perforating veins and the blood from the deep veins starts to overload the superficial system, which is not adapted to this. Blood in the veins starts to accumulate and often blood clots are formed in these areas as well and blood flow is impaired. This can happen due to genetics, or due to pregnancy and female sex hormones.
  • Symptoms of varicose veins include swelling, tightness and pain in the feet. Typically, these symptoms occur in the evening. As a result of blood circulation disorders in the legs, typical skin changes such as pigmentation or itchy skin occur. Also, there are night cramps. This increases the risk of varicose ulcers and reduces the ability of healing.
  • Varicose veins by themselves are not life-threatening. However, they may lead to the development of a number of complications. These are chronic venous insufficiency, phlebitis, varicose veins rupture, eczema and varicose ulcers.
  • Diagnosis of varicose veins is not too difficult because of their visibility on the surface of the lower extremities. To confirm the diagnosis of varicose veins functional tests are used, which consist in the gradual constricting of the limbs and monitoring their refilling after releasing the tourniquet. The main investigative method is duplex ultrasonography, which gives us information about the veins, their swelling or pathological blood flow.
  • The treatment of varicose veins may be conservative, laser, surgical or sclerotherapy. Conservative treatment is the first choice and its basis is wearing compression stockings to prevent swelling of veins and also reduces pain. Furthermore, lifestyle measures are recommended, which involve a diet rich in fiber and vitamins, frequent walking and standing limitations. Also the treatment of varicose veins includes vasoprotectives, i.e. drugs that reinforce the venous wall and also improve the outflow of blood from the lower extremities. The surgery involves the removal of the damaged part of the veins. Sclerotherapy is an effective method of treatment, where the damaged vein is injected with a substance causing congestion of the vein and thus putting it out of order. During laser removal of varicose veins is a laser fiber introduced through the inguinal vein into the damaged area and the vein is sealed from the inside.

Deep vein thrombosis

Deep vein thrombosis is a blood clot formed in the deep veins of the legs. This results in a partial or complete impairment of blood flow.

  • Deep vein thrombosis predispositions are conditions such as coagulation disorders, immobilization, smoking, prolonged standing or sitting, cancer, surgery, trauma, infection, or hormonal contraception.
  • Symptoms of deep vein thrombosis include swelling, pain, increased filling of superficial veins in the lower limbs, or bluish limbs.
  • Complications of deep vein thrombosis are particularly dangerous because a thrombus can break loose and cause pulmonary embolism. Additionally, venous hypertension and venous insufficiency can occur.
  • The treatment of deep vein thrombosis consists of administrating medication against blood clotting. In the case that is for various reasons not possible a so-called caval filter is introduced in to the inferior vena cava. It is an umbrella-shaped filter, which is usually introduced into the inferior vena cava and is used to capture blood clots or their fragments.

Vein inflammation

Inflammation of the veins or phlebitis is a disease that mainly affects the superficial veins of the lower extremities. Phlebitis occurs most frequently in the area of varicose veins, due to the accumulation of blood. Phlebitis is manifested by a painful, reddish and warm stripe that follows the course of the vessel. Also the vein affected by inflammation is hard on palpation. Phlebitis may occur after injecting the vein. Sometimes the patient may also suffer from temperatures. If pain occurs in a location other than the affected vein, or there is an onset of swelling, it is necessary to think about the risk of pulmonary embolism. In this case, it is absolutely necessary to visit a doctor immediately, but better a vascular clinic. For therapy it is necessary to wear compression stockings and avoid walking. For the vein affected by inflammation cold compresses are applied and ointments with heparin are also used to prevent blood clotting.

Hemorrhoids

Hemorrhoids are knot-like swelled veins in the lower part of the rectum and the anal canal. This is a very common disease that affects about 70% of people over the age of thirty years and more often affects men.

  • The nature of hemorrhoid formation lies in the fact that the mucous membrane of the rectum is not firmly fixed to the submucosa and such a mucosa comes outwards. On this surface, blood vessels change and swell. Here blood accumulates and therefore we are talking about hemorrhoids.
  • Risk factors of hemorrhoids are partially determined by genetics, but to a large extent can be influenced by lifestyle. Development of hemorrhoids can be caused by improper diet, lack of exercise and a sedentary way of life, but also due to some sports, such as cycling or riding a horse. A negative effect on the formation of hemorrhoids also has diarrhea that irritates the mucous membranes.
  • There are two main types of hemorrhoids, internal and external hemorrhoids. Manifestations of internal hemorrhoids include bleeding during or after defecation. It is usually accompanied with relief. Mostly after emptying the surface of the stool is covered by bright red blood. Blood from hemorrhoids can also absorb. In this case remains an empty skin pouch, which may be again filled with blood and form a new hemorrhoid. External hemorrhoids are located on the outer surface of the anus. They have the form of pouch-like swelled vessels; they are soft, painless and visible to the naked eye. Usually they do not bleed. Problems occur when the drain of accumulated blood is blocked, most often during excessive pushing of the stool. In this case, the accumulated blood coagulates and the hemorrhoid begins to interfere in this area and it is painful. In most cases these hemorrhoids must be surgically removed.
  • Diagnosis of hemorrhoids is done using a proctoscope. It is a tube which is inserted into the rectum of the patient and the doctor may detect internal hemorrhoids. Even if hemorrhoids are detected, it is necessary to proceed further with the examination to rule out other possible sources of bleeding, such as tumors of the intestine.
  • Treatment of hemorrhoids can be conservative, which involves a change in lifestyle and a diet with higher fiber content. Further the treatment may be outpatient, it is a painless removal of the hemorrhoid and the patient can go home immediately after the procedure. In severe cases, surgical treatment is recommended, that must be done under general or epidural anesthesia.

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