Your arteries are responsible for carrying blood around your body and away from your heart. Your veins are responsible for taking this blood back to your heart. Inside these veins are valves, which prevent blood from flowing back down through the veins.
But what happens when there are issues with this process?
Blood can start to pool in your legs and veins because it’s not flowing back to your heart as it should. This is known as venous reflux disease (or venous insufficiency/ vein disease).
The good news is, venous reflux disease isn’t uncommon, and it isn’t benign. Treatment programs work to relieve your symptoms and, if possible, correct whatever’s causing the abnormality in your veins.
Let’s take a look at what is vein reflux disease, its causes, and what treatments are available.
What is Venous Reflux Disease?
The term “venous reflex” refers to how the blood abnormally backs up in your veins. This back up creates a problem that contributes toward vascular disease. In normal circulation, your veins carry the oxygen-depleted blood back to the lungs to re-oxygenate it before taking it back to the heart.
To work against gravity, this venous blood flows through your body by an action that takes place in your calf muscles. The valves open up to allow this blood to be pushed toward the heart. However, when this blood starts to build up, these valves shut to prevent any reflux.
That’s why venous reflux is also responsible for creating the symptoms people get when they have chronic vascular insufficiency (CVI). This causes changes in the texture and color around the ankles and legs. It also contributes to swelling in the ankles and legs (edema), and varicose veins.
The Causes of Venous Reflux
There are a number of factors that can result in venous reflux, including a blood disorder or injury that causes blood clots that damage the valves or veins. This includes peripheral artery disease (PAD), a condition that results in less blood flow in the legs due to a buildup of fatty materials, plaque, and cholesterol.
Equally, when a patient suffers from deep vein thrombosis (DVT), deep vein reflux can occur, which means blood clots form in one or several of your deep veins – normally in your legs.The obstruction caused in DVT can lead to valve damage, which, in turn, causes venous insufficiency. Around 30% of people who develop DVT will suffer from chronic venous insufficiency within 10 years.
Alternatively, superficial vein reflux, which can cause varicose veins, spider veins (telangiectasias), and small reddish veins (reticular veins), tends to occur as you grow older. The natural aging process weakens the vein valves and walls, sometimes causing clots in superficial veins (smaller veins nearer the surface of your skin) that lead to superficial vein reflux.
The Symptoms of Venous Reflux
There are a number of symptoms that may indicate venous reflux disease, including:
- Edema – swelling of the ankles or legs
- Leg cramps
- Pain that eases when you raise your legs but gets worse when you stand up
- Itchy legs
- Throbbing, aching, or a heavy sensation in your legs
- Weak legs
- Varicose veins
- Reticular veins
- Leg ulcers
- Changes in skin color – particularly near your ankles
- Thickened skin, particularly on your ankles or legs
- Tight sensations in your calves
When a patient isn’t presenting some of these symptoms but is concerned about the aesthetic look of their varicose veins, the doctor may only carry out a physical examination.
However, whatever your symptoms, the doctors will choose the right treatment plan for you after your consultation, putting together a tailored strategy that’s specific to your unique needs.
What Is Your Venous Reflux Risk Factor
The venous reflux patient demographic places certain people at a higher risk of developing venous insufficiency than others. Key risk factors include:
- A family history of varicose veins, or if you’re suffering from varicose veins yourself
- Deep vein thrombosis
- A sedentary lifestyle
- Long periods of sitting or standing
- Female gender
- Injury to the ankle or leg
20% of adults may be affected by CVI, with 40% of women over 50 and 20% of men having significant problems with the veins in their legs. Approximately 20-25 million Americans suffer from varicose veins with women being far more likely to suffer from spider veins.
Getting a Diagnosis of Venous Reflux
To assess whether or not you have venous insufficiency, your doctor will carry out a physical examination and will also go through your medical history with you. They’ll make note of any changes to the texture, color, or temperature of your skin, while also looking for spider veins and varicose veins along with any ulcerations or edema to your legs.
Your doctor will assess how efficiently your circulatory system is working by checking pulses at numerous different places.
Then, to accurately determine what’s causing the problem, they may want to do some further tests, which includes an ultrasound that creates an image of the structure of your veins and the blood flow within them. Sonographers (the specialists who conduct these ultrasounds) will evaluate everything thoroughly with your doctor before proceeding with your treatment.
Various Venous Reflux Treatment
How you’re treated will depend on a variety of factors, including your health history and status and the reason why this condition has occurred. Other factors that will influence your doctor’s decision, include:
- Your age
- Your symptoms
- How tolerant you are of certain procedures and/or medications
- How severe your condition is and how they expect it to progress
- Your preference or opinion
Prescription Compression Stockings
These elastic stockings apply your lower leg and ankle with pressure which helps reduce leg swelling and improves blood flow. These stockings are available in a variety of different lengths and strengths so your doctor will determine which will be most effective for you.
Improving Blood Flow
As well as the above, your doctor may ask you to do what you can to improve the flow of blood in your legs. This means keeping them elevated as much as you can, exercising regularly, avoiding crossing your legs, and wearing compression stockings.
Endovenous Laser Therapy (EVLT)
EVLT doesn’t require surgery but is an FDA-approved treatment that permanently eliminates superficial venous insufficiency.
To carry this out, doctors use an ultrasound to guide a thin laser fiber into the affected vein. Once in position, laser energy is used to heat the area, which causes the inefficient vein to seal. This means that, straight away, other healthy veins are taking the blood back to your heart, with the unused vein eventually being reabsorbed into your body.
The number of procedures required will depend on how many veins are diseased. However, each procedure should only last approximately 15 minutes. You’ll also be provided with a local anesthesia (like you get when you visit the dentist) to prevent any potential discomfort while the procedure is being carried out.
And due to the minimally-invasive nature of EVLT, you should be able to return to your day-to-day activities straight afterward, going back to work if required, too.
Often used when the case of venous reflux has advanced to a certain level, this involves injecting a chemical into the affected vein to scar it and prevent it from carrying blood. Blood will return to your heart through healthy veins and your body will eventually absorb the scarred vein(s). This procedure can be used on small- to medium-sized veins.
Sometimes, in conjunction with treatments like EVLT, sclerotherapy, and compression stockings, complementary therapies may be required. These can include certain exercises that you do at home or temporary medications like diuretics, anticoagulants, and pentoxifylline (Trental).
Diuretics utilize your kidneys to remove excess fluid from your body, anticoagulants help thin your blood, and Trental works to improve how your blood flows around your body. The latter may be used alongside compression stockings to speed up the healing process of your leg ulcers. Ulcers can also be healed using aspirin.
Ways of Preventing Venous Reflux Disease
If you are at risk of developing venous insufficiency, there are a number of things you can do to decrease this risk. This includes not smoking, exercising regularly, moving around frequently, especially when you’re sitting or standing for long periods of time, and maintaining a healthy weight.
You should also be on the lookout for any of the aforementioned symptoms. If you’re concerned about anything, contact your doctor straight away. In some cases, symptoms for this condition may be likened to other conditions, which is why it’s highly recommended that you schedule a consultation to receive a proper diagnosis from your doctor.
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