Review of medications for varicose veins.

In our modern world, this problem is very serious and widespread in both men and women.We will try to find out the causes, predisposing factors, and also 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 decrease in elasticity.Most often, the superficial veins of the lower extremities, the venous plexus of the rectum (hemorrhoids), the veins of the collar system and the spermatic cord are affected.

Predisposing factors

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

• systematic long periods of standing associated with professional activities (waiters, pharmacists, hairdressers, salespeople, etc.);
• compression of the pelvic veins by the pregnant uterus;
• congestion in the veins of the pelvis, for example, with chronic constipation, sedentary work;
• congenital weakness of the venous wall and insufficiency of the 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 venous vessels.

If we talk about varicose veins of the lower extremities, it is also an aesthetic problem for women.Dilated veins appear visible or swell under the skin in the form of twisted cords or nodules (varicose veins).Their skin becomes thin and easily damaged due to a violation of its nutrition.First, dark brown or brown spots appear on the skin, then the veins twist and lift 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 appears towards the end of the day.This condition causes rapid fatigue of the legs when walking, a feeling of heaviness and pain in the legs, which intensifies at night.In the absence of adequate treatment, the disease progresses and swelling of the extremities intensifies.Due to the slowdown in blood flow, inflammatory processes can occur in the dilated veins, leading to their obstruction.

Thus, the stages of varicose veins:

• 1 “heavy” legs syndrome;
• 2 persistent swelling develops, accompanied by altered skin pigmentation and stagnant dermatitis;
• 3 trophic ulcers appear.

Symptoms of varicose veins of the lower extremities.

• rapid leg fatigue when walking;
• cramps at night;
• feeling of heaviness in the legs;
• pain in the legs, which worsens at night;
• tension in the legs;
• rapid heartbeat and difficulty breathing.These symptoms occur 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.

Varicose veins of the esophagus are characterized by tortuosity and saccular growths of blood vessels.The cause of the disease is portal hypertension.

Manifestations:

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

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

Varicose veins of the uterus.

Reasons:

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

Symptoms include pain in the lower abdomen and menstrual irregularities.A dangerous complication is infertility.

Varicose veins of the lips

It occurs most frequently 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 scratching and swelling;
• stabbing pain in the 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 persistent pain in the lower 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 sexual intercourse, dysmenorrhea, difficulty urinating.

The 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 of the testicles is disturbed.Patients notice persistent pain in the scrotum and erectile dysfunction.When examined in the area of the testicles, dilated superficial veins and asymmetry of the scrotum are seen.

Reasons:

• increased physical activity;
• congenital connective tissue deficiency;
• 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.In places of inflammation, spots and peeling of dark or light colors appear.The main localization of venous dermatitis is the lower leg and ankle joint area.The danger is that patients scratch the itchy areas and the pathological process spreads to healthy tissue.If treatment is not used, the inflammation turns into varicose eczema.

varicose eczema

The inflammation is persistent with periods of remission and relapse.Skin lesions are difficult to treat even after venectomy.Due to a violation of skin microcirculation, the liquid part of the blood passes through the walls of the affected vessels.Areas of swelling and suppuration appear in the area above the varicose vein.

Blisters with serous or serous-purulent content appear on the legs.When scratching, an infection develops in the wounds.The small bubbles that merge form papules.After opening the gallbladder, scabs appear.The healing site becomes thin and covered with scales.During the exacerbation period, vesicles appear again.The progression of pathology leads to the formation of trophic ulcers.

spider veins

Spider veins: telangiectasias.Characterized by damage and expansion of small subcutaneous vessels.They appear on the skin as a network of purple or red blood vessels.In general, this is not a separate 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 on the legs, face or buttock area.On the face, manifestations of the vascular network are called rosacea.

Reasons:

• violations of the rheological properties of blood;
• arterial hypertension;
• diseases of the digestive system;
• the impact of low temperatures on facial skin in a special way;
• when drinking alcohol.

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

For varicose veins, preventive measures are of great importance:

• wearing comfortable shoes and underwear that does not constrict;
• if there is a predisposing factor or disease at the initial stage, then it is necessary to limit or eliminate static loads and prolonged stay;
• moderate physical activity;
• taking vitamins: C, E, PP;
• balanced diet.

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

Diagnosis

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

Treatment

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

When affecting 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.(prescribed in the presence of inflammatory processes and trophic ulcers;
2. Antiseptics;
3. Phleboprotectors;
4. Tissue regeneration stimulators;
5. Anticoagulants;
6. Topical steroids (prescribed for trophic ulcers);
7. Externally: medications 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 courses of treatment are prescribed in different groups.

Review of medications used for varicose veins.

Natural remedy based on red vine leaf extract.Able to protect the walls of blood vessels and capillaries, improving their elasticity, normalizing vascular permeability.

The product features 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, restoring 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 components of the composition.

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

Diosmina

The medication is available in tablet form and is sold without a prescription.Refers to venotonic and angioprotective agents.Diosmin increases the tone of the veins, reduces venous stagnation, improves the permeability and microcirculation of capillaries.It has an antiedematous effect.

Indicated for:

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

Contraindicated:

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

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 and antioxidant effects.

Indicated for:

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

Troxerutin is used in combination with ascorbic acid to enhance 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 stage of the fight against the disease, 1 capsule is prescribed 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 combats swelling and heaviness in the legs.The peculiarity of the drug is that it acts with blood cells, promoting permeability.Thus, the medicine for varicose veins helps fight against venous microthrombosis.

Indicated for:

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

Contraindicated:

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

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

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

Indicated for:

• varicose veins of the lower extremities, including in the second stage and later;
• symptoms of CVI, namely: lymphostasis, blood stagnation, a feeling of pain, heaviness, distension in the calf area, especially at night;
• phlebitis, periphlebitis, postoperative;
• trophic ulcers;
• hemorrhoids in chronic and acute phases.

Contraindicated:

• pregnant women from 4 to 12 months and lactating women.

The capsules are taken 2 times a day at regular intervals.

diosmin with hesperidin,The medication is available in the form of film-coated tablets, available without a prescription.The main active ingredients are diosmin with hesperidin.They belong to the group of venotonic substances and angioprotective drugs.They help restore the tone of the venous walls and improve 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 components and during lactation.Side effects include only mild dyspepsia 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 provide 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.They 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.

Steroids are used in special cases.If NSAIDs are ineffective.

Prednisolone and its analogues.Inflammation and pain are relieved and nutrition of local tissues is improved.It is not used in large quantities due to the possibility of causing widespread side effects.

Relieve swelling:

Corticosteroid-based medications are used.Restore normal blood flow in the legs with varicose veins, stimulating the contraction of the vascular walls:

• troxerutin;
• Diosmina;
• Rutoside.

Strictly analgesic external medications are rarely used;Due to their limited action, they do not eliminate the cause, but act on 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 flow and 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 veno-lymphatic drainage and prevents the formation of blood clots.
• Escin.It is 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 external drug therapy:

• do not self-medicate, seek help from 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, one should not count on a quick result, it all depends on the progression of the disease, its stage and the presence of concomitant diseases.

In conclusion, I would like to note that medications for varicose veins in various places cannot completely stop the disease and prevent complications.In the early stages of the disease, venotonic and angioprotective drugs help to normalize blood flow in the lower extremities, eliminating symptoms such as swelling, fatigue in the legs and spider veins, tortuous and protruding 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.