Review of medications for varicose veins

In our modern world, this problem is very acute and widespread in both men and women.We will try to find out the causes, predisposing factors, as well as talk about treatment methods and medications used for varicose veins.

Varicose veins are a disease of the veins that is characterized by their enlargement, change in shape and reduction of their elasticity.The superficial veins of the lower extremities, the venous plexus of the rectum (hemorrhoids), the veins of the jugular system and the spermatic cord are most often affected.

Predisposing factors

Conditions that contribute to difficulty in blood flow through the venous system, namely:

• long systematic periods of standing connected with professional activities (waiters, pharmacists, hairdressers, sellers, etc.);
• compression of the pelvic veins by the pregnant uterus;
• congestion in the pelvic veins, for example, with chronic constipation, sedentary work;
• congenital weakness of the venous wall and insufficiency of venous valves;
• surgical intervention (arteriovenous bypass);
• hormonal imbalance (menopause, estrogen intake);
• overweight.

It is important that the true causes of varicose veins are not known.This disease is progressive in nature and refers to irreversible changes in the venous vessels.

If we talk about varicose veins of the lower extremities, it is also a cosmetic problem for women.Varicose veins appear visible or bulge under the skin in the form of twisted cords or knots (varicose veins).Their skin thins and is easily damaged, the reason is the violation of its nutrition.Initially, dark brown or brown spots appear on the skin, then the veins twist and raise the skin.Over time, if the skin is not properly nourished, trophic ulcers can form.Varicose veins are almost always accompanied by swelling of the extremities, which appear at the end of the day.This condition leads to rapid fatigue of the legs while walking, a feeling of heaviness and pain in the legs, which intensifies in the evening.In the absence of proper treatment, the disease progresses and the swelling of the extremities intensifies.Due to the slowing down of blood flow, inflammatory processes can occur in dilated veins, leading to their blockage.

Thus, the stages of varicose veins:

• 1 "heavy legs" syndrome;
• 2 continuous swelling develops, accompanied by damaged skin pigmentation and stagnant dermatitis;
• 3 trophic ulcers appear.

Symptoms of varicose veins of the lower extremities

• rapid leg fatigue while walking;
• cramps at night;
• feeling of heaviness in the legs;
• pain in the legs, getting worse in the evening;
• tension in legs;
• fast heart rate and shortness of breath.These symptoms appear when the load on the heart muscle increases due to the deposition of blood in the venous bed.

Let's consider when varicose veins are located in other organs:

Varicose veins of the esophagus

Esophageal varicose veins are characterized by twisting and saccular growth of blood vessels.The cause of the disease is portal hypertension.

Manifestations:

• inflammation of the esophagus;
• burning, belching;
• anemia;
• difficulty in swallowing.

Complications such as significant bleeding from the veins may develop.The patient develops vomiting blood, hypotension, tachycardia and impaired consciousness.

Uterine varicose veins

Reasons:

• increased physical activity;
• chronic constipation;
• pregnancy;
• taking hormonal contraceptives;
• developmental anomalies;
• abortions.

Symptoms include lower abdominal pain and menstrual irregularities.A dangerous complication is infertility.

Varicose veins of the labia

It most often appears in the second month of pregnancy.Predisposing factors are the presence of pelvic vein thrombosis or congenital angiodysplasia.

Manifestations:

• dilated veins of the vulva;
• skin itching and swelling;
• bursting pain in perineum.

The development of acute thrombophlebitis and rupture of a damaged vessel is possible.

Varicose veins of the pelvis

In the initial stage, it manifests itself as an annoying pain in the lower part of the abdomen.There are several variants of the course of this form of the disease:

• varicose veins of the perineum and vulva;
• Pelvic venous congestion: pain during intercourse, dysmenorrhea, difficulty urinating.

Clinical manifestations of the pathology are observed in 30% of women during pregnancy.This disease is observed exclusively in women.

Varicose veins of the spermatic cord (varicocele)

Due to varicose veins of the spermatic cord, the venous flow from the testicles is interrupted.Patients notice nagging pain in the scrotum and erectile dysfunction.When examined in the testicular area, dilated superficial veins and asymmetry of the scrotum are visible.

Reasons:

• increased physical activity;
• congenital lack of connective tissue;
• tumors in the retroperitoneum or pelvis.

Possible complications as the disease progresses are spermatogenesis leading to infertility.

Varicose dermatitis

This disease is manifested by thinning and itching of the skin over the affected veins.Dark or light-colored spots and skin appear in places of inflammation.The main localization of venous dermatitis is the lower part of the leg and the ankle joint.The risk is that patients scratch the itchy areas and the pathological process spreads to healthy tissues.If you do not resort to treatment, the inflammation turns into varicose eczema.

Varicose eczema

Inflammation is continuous with periods of remission and relapse.Skin lesions are difficult to treat even after venectomy.Due to damaged microcirculation of the skin, the liquid part of the blood passes through the walls of the affected vessels.Areas of swelling and weeping appear in the area above the varicose veins.

Blisters with serous or serous-purulent content appear on the legs.During the itching, an infection develops in the wound.Joining together, small blisters form papules.After the opening of the vesicle, crusts appear.The healing site is thinned and covered with scales.During the period of deterioration, the vesicles appear again.The progress of the pathology leads to the formation of trophic ulcers.

Spider veins

Spider veins - telangiectasia.It is characterized by damage and dilation of small subcutaneous vessels.They appear on the skin as a purple or red network of blood vessels.In general, it is not a specific disease, but rather acts as a cosmetic defect.

Reasons:

• venous insufficiency;
• connective tissue diseases;
• pathologies of the hepatobiliary system;
• use of hormonal drugs;
• diseases of the endocrine system.

Vascular networkit can be located in the area of the legs, face or buttocks.On the face, manifestations of the vascular network are called rosacea.

Reasons:

• violation of the rheological properties of blood;
• arterial hypertension;
• diseases of the digestive system;
• the impact of low temperatures on the skin of the face in particular;
• when you drink alcohol.

A common cause of rosacea in women is hormonal changes and is eliminated with laser coagulation.

For varicose veins, preventive measures are of great importance:

• the use of comfortable shoes and indoor shoes that do not tighten;
• if there is a predisposing factor or disease in the initial stage, then it is necessary to limit or eliminate static loads and prolonged standing;
• moderate physical activity;
• intake of vitamins: C, E, PP;
• balanced diet.

Of course, in the modern world, it is impossible to follow the recommendations for limiting or eliminating static loads and standing for long periods of time, so it is necessary to turn to short gymnastics during the day, as well as use massage services.It is also mandatory to wear elastic bandages and compression garments.

Diagnosing

A comprehensive diagnosis is carried out using laboratory methods for the examination of blood and urine (detection of reflux in the saphenous veins, functional tests) and ultrasound examinations: duplex or triplex ultrasound scanning;X-ray contrast venography;magnetic resonance venography;multispiral computed angiography with contrast.

Treatment

After receiving the diagnostic results, the phlebologist (angiosurgeon) makes a decision on the use of treatment methods - surgery or conservative therapy.

When touching the vessels of the lower extremities, use:

• surgical intervention, for example, phleboectomy - removal of a specific vein;
• sclerosing therapy;
• conservative treatment.

Systemic drug therapy

1. Antibiotics.(it is described in the presence of inflammatory processes and trophic ulcers;
2. Antiseptics;
3. Phleboprotectors;
4. Stimulators of tissue regeneration;
5. Anticoagulants;
6. Local steroids (prescribed for trophic ulcers);
7. Externally - drugs containing heparin.

In this article, we will dwell in detail on phleboprotectors and external agents used for varicose veins.

Phleboprotectors (phlebotonics) are a group of medications used for venous insufficiency.They increase blood circulation, thereby normalizing vascular permeability, relieving swelling and eliminating the feeling of heaviness.It is important to use them in the initial stages of the disease or to prevent exacerbations;for progressive forms, several treatment courses are prescribed in different groups.

Review of medications used for varicose veins.

A natural remedy based on the extract of red grape leaves.Able to protect the walls of blood vessels and capillaries, improving their elasticity, normalizes vascular permeability.

The product contains improved protection of the walls of blood vessels and capillaries.The drug relieves swelling and prevents its recurrence, as it blocks the permeability of water, proteins and plasma through the walls of blood vessels, achieving the restoration of their natural density.

Indicated for:

• prevention and symptomatic treatment of chronic venous insufficiency;
• swelling of the lower extremities;
• with a feeling of heaviness and fatigue in the lower extremities.

Contraindicated:

• people suffering from allergies to one of the ingredients in the composition.

Take 1 capsule after waking up.The doctor can increase the dose to 2 capsules.

Diosmin

The drug is available in tablet form and is sold without a doctor's prescription.Refers to venotonic and angioprotective agents.Diosmin increases the tone of the veins, reduces venous stagnation, improves capillary permeability and microcirculation.It has an anti-edematous effect.

Indicated for:

• varicose veins in the limbs and pelvis;
• complex therapy of hemorrhoids;
• signs of venous insufficiency, disorders of lymphatic flow.

Contraindicated:

• with hypersensitivity to the components;
• children and adolescents up to 18 years old.

Side effects may include mild digestive upset and headache.Take 1 tablet in the morning.The course of treatment can be quite long, but usually no more than 2 months.

Troxerutinrelieves swelling, normalizes microcirculation and strengthens the walls of blood vessels.It has anti-inflammatory, antioxidant effects.

Indicated for:

• chronic venous insufficiency, at any stage of the disease;
• varicose veins;
• superficial thrombophlebitis;
• periphlebitis, phlebotrombosis;
• varicose dermatitis;
• postthrombotic syndrome;
• hemorrhoids;
• edema and post-traumatic hematoma;
• hemorrhagic diathesis with increased capillary permeability;
• as a prophylactic tool after vein surgery.

Troxerutin is used in combination with ascorbic acid to increase its effects after venous surgery.

Contraindicated:

• with hypersensitivity;
• peptic ulcer of the stomach and duodenum;
• chronic gastritis (in the acute phase).

Not suitable for minors, pregnant women in the first trimester or breastfeeding.The drug Troxerutin should not be used if there are problems with the gastrointestinal tract.In the active phase of the fight against the disease, 1 capsule is prescribed together with meals three times a day.To maintain the effectiveness of the treatment, the product is applied twice a day.

Rutosideit has anti-inflammatory effects and fights swelling and heaviness in the legs.The special feature of the drug is that it works with blood cells, promoting permeability.Thus, the drug for varicose veins helps in the fight against venous microthrombosis.

Indicated for:

• chronic venous insufficiency;
• postphlebitic syndrome;
• trophic disorders in varicose veins, trophic ulcers;
• hemorrhoids (pain, exudation, itching and bleeding);
• venous insufficiency and hemorrhoids during pregnancy, starting from the second trimester.

Contraindicated:

• during pregnancy, for a period of 1 to 3 months.

Capsules are used 2-3 times a day, one at a time.

TribenosideAvailable in the form of dragees and capsules.It has an anti-edematous, anti-inflammatory effect, improves vascular permeability.

Indicated for:

• varicose veins of the lower extremities, including in the second and subsequent stages;
• symptoms of CVI, namely: lymphostasis, blood stagnation, feeling of pain, heaviness, distention in the calf area, especially in the evening;
• phlebitis, periphlebitis, postoperative period;
• trophic ulcers;
• hemorrhoids in chronic and acute stages.

Contraindicated:

• pregnant women 4-12 months and lactating women.

Capsules are taken 2 times a day at regular intervals.

Diosmine with the Hesperides,The drug is available in the form of film-coated tablets, available without a doctor's prescription.The main active ingredients are diosmin and hesperidin.They belong to the group of venotonic substances and angioprotective drugs.They help restore the tone of the venous walls and improve the blood flow in the veins, normalize the functioning of the valves.

Indications for use:

• hemorrhoids;
• varicose veins of the extremities and pelvis;
• chronic venous insufficiency, including trophic ulcers.

The drug is contraindicated in case of allergic reactions to the ingredients and during breastfeeding.Side effects include only mild indigestion and skin rash.The drug is indicated for complex and course use.

External remedies for the complex treatment of varicose veins

Ointments and gels are used as external agents.First of all, it is necessary to ensure an anti-inflammatory and analgesic effect;non-steroidal anti-inflammatory drugs, as well as general steroid drugs, are used for these purposes.

Nonsteroidal anti-inflammatory drugs (NSAIDs):

• Ketorolac;
• Ketoprofen;
• Ibuprofen;
• Nimesulide gel;
• Diclofenac;

All of them have a powerful anti-inflammatory effect, eliminate pain, discomfort and heaviness.are used 1-3 times a day, depending on the stage of the disease, with circular massage actions.Contraindicated in the presence of trophic ulcers and open wounds.

Steroid drugs are used in special cases.If NSAIDs are ineffective.

Prednisolone and its analogues.Inflammation and pain are relieved and local tissue nutrition is improved.It is not used in large quantities because of the possibility of causing generalized side effects.

Swelling relief:

Drugs based on corticosteroids are used.Restoring normal blood circulation in the legs with varicose veins, stimulating the contraction of the vascular walls:

• Troxerutin;
• Diosmin;
• Rutoside.

External strictly analgesic drugs are rarely used, due to their limited action, they do not eliminate the cause, but work with the symptoms:

• Diclofenac;
• Ketoprofen.

Heparin-containing medications contain corticosteroids in addition to heparin.

Complex ointments used for varicose veins of the legs

These drugs have a systemic effect:

• Heparin sodium (used to relieve swelling, pain, improve local blood circulation, prevent the formation of blood clots. It has a rapid therapeutic effect: it is achieved on the second or third day of use).
• Troxerutin.It relieves pain, swelling, inflammation, normalizes the condition of the veins, ensures adequate venous-lymphatic drainage and prevents the formation of blood clots.
• Escin.Prescribed in the early stages of varicose veins of the legs, in the later stages it is almost ineffective.It is of plant origin.

Basic principles of therapy with external drugs:

• do not self-medicate, but seek the help of a phlebologist;
• strictly follow the instructions for use;
• analyze the result of treatment effectiveness after 10 days from the date of treatment.

However, even with the combined use of tablets and ointments, gels for external use, you should not count on a quick result, it all depends on the progress of the disease, its stage and the presence of concomitant diseases.

In conclusion, I would like to emphasize that medications for varicose veins in different countries are not able to completely stop the disease and prevent complications.In the early stage of the disease, venotonic and angioprotective medications help to normalize blood flow within the lower extremities, eliminating symptoms such as swelling, leg fatigue and spider veins, elongated tortuous superficial veins.All these medications are only part of the treatment, which is directly related to lifestyle and nutrition.In progressive stages, microsurgical and minimally invasive interventions are indicated while taking medications that improve treatment results.