Need to generate more awareness about varicose veins: Dr Virender Sheorain, Medanta

Gurgaon (Haryana): A senior specialist at Medanta The Medicity Hospital Gurgaon, Haryana, has said that people suffering from varicose veins should not ignore this problem, and therefore, should be made more aware of what it is and how it surfaces.

In a paper written on the subject, Dr. Virender Sheorain said, "If you notice deep red and blue veins on your legs; do not take them lightly as you may be suffering from varicose veins."

He said that varicose veins are the visible surface manifestations of an underlying problem with reverse venous flow, which is also termed venous insufficiency syndrome.

"These veins are formed when the valves of the superficial veins of the lower limbs get damaged. As a result, blood flow from the lower limbs to the heart is decreased resulting in retention of blood in the veins. It is most commonly found in legs, feet and particularly calves. Mild forms of venous insufficiency are merely uncomfortable, annoying, or cosmetically disfiguring, but severe venous disease can produce serious systemic consequences and can lead to loss of life or limb," Dr. Sheorain said.

Dr. Sheorain said varicose veins cannot be completely prevented, but added that there are many ways to improve vein health.

"Physical activity such as walking, cycling, jogging and swimming are great ways to improve circulation, by pumping blood up the leg against gravity. Graduated compression hose can also help improve circulation by preventing blood from pooling in the leg veins," he said.

He listed five symptoms of varicose veins:

· Bulging or stretching superficial leg veins

· Aching, throbbing or Night cramps in legs

· Heavy, tired, itching or restless legs

· Skin changes such as blackening of skin in legs

· For some people there is swelling of the ankles and feet.

Other factors that influence the onset of varicose veins are age, sex, genetics,obesity , and the position of your legs for longer periods.

"Ageing causes wear and tear of the veins and this causes improper functioning of the valves of the veins. It is known that women are the most affected by varicose veins. It is so since women are subjected to frequent hormonal changes. Pregnancy, pre menstruation, and menopause are some of the factors in women that influence varicose veins. Varicosities (varicose veins) are found in as many as 40 per cent pregnant women. Varicose veins could be inherited from your parents. People who are overweight might get varicose veins since they impart more pressure on the veins due to their weight. People who are working while standing for a longer time may experience varicose veins," Dr. Sheorain said.

People who stand for long-periods like policemen, army personnel, and sales staff in malls or professionals who sit for eight hours continuously can also suffer from this problem as well, he added.

"The major problem is that many people are not aware that they suffer from varicose veins. Awareness is lacking not only in patients but also in the medical fraternity. It is an under treated disease; more than 40 per cent of the Indian population suffers from it. If left untreated, it results in chronic venous insufficiency, venous ulcers, eczema, cosmetic disfigurement and systemic hypertension. Untreated and undiagnosed varicose veins result in pooling of the blood in the lower limbs, causing severe itching and burning sensation in the feet, sometimes-severe tiredness and psychological disturbances," he said.

As far as diagnosis is concerned, Dr. Sheorain said that a physical examination, mainly visual, by a qualified doctor such as vascular, endovascular and interventional specialist will decide whether or not a patient has varicose veins.

He said that such doctors would check a patient for signs of swelling. A patient could also be asked questions about the symptoms, whether any close relatives have/had varicose veins, and whether they are or have been pregnant. The physician may also ask the patient whether he/she has ever had any leg injury, such as a broken bone, and any history of deep vein thrombosis.

He added that color duplex ultrasound scans - this is Gold standard to diagnose varicose veins. It provides color images of the structure of veins, which helps the doctor identify any abnormalities. This test can also measure blood-flow speed.

"If the patient has no symptoms or discomfort and is not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms, treatment may be required to reduce pain and/or discomfort, address complications, such as leg ulcers, skin discoloration or swelling. Some patients may also want treatment for cosmetic reasons - they want to get rid of the "ugly" varicose veins," Dr. Sheorain said.

He also suggested the use of compression stockings to squeeze the patient's legs and improve circulation and added that these stockings must be worn properly.

Conventional surgical treatment and modern non-surgical treatment of varicose veins can be done, he said.

"Self-help would help you to prevent and complicate the varicose veins in you. Many self-help measures can be adopted to prevent varicose veins from getting worse," Dr. Sheorain said.