Varicosities – Dilatation of Veins

Elongated, dilated, tortuous, twisted superficial veins are termed varicose veins. These occur due to the rapid filling of the superficial veins due to incompetent valves in the venous system.

Sometimes the valves may be absent since birth, though rarely. Due to such valves, the blood flows backwards causing backpressure and dilatation. Idiopathic cases are also known.

Such condition may occur in all age groups but young women are more affected. People affected commonly are the one’s whose work demands long-standing hours such as teachers, conductors, traffic policemen etc. Varicosities are also commonly seen in women with many children (multipara) and can cause severe complications in them.

Most commonly affected part is leg. But these may affect the oesophageal, haemorrhoidal, and upper limb veins even. These may even occur in pregnancy (on the vulva) and in abdominal tumours.

There are two types of varicose veins; primary and secondary. Primary varicose veins are due to incompetent valves alone and may be inherited. Most varicose veins are primary. Secondary varicose veins may be due to some obstruction of venous outflow (such as in pregnancy, pelvic tumour etc), valvular destruction and high blood flow or pressure (fistulae).

Most common symptoms are aching sensation and tiredness in the whole lower limb (especially the calves). There are disfiguring effects on the skin including dilated visible veins, pigmentation, eczema and ulceration. Slight swelling of the ankles at the end of the day is also common.

Though always symptomatic, there may be asymptomatic cases with features such as leg cramps, heaviness and itching in legs, leg aching, tiredness, fatigue and pain in lower extremities. The symptoms may worsen during menses.

Varicose veins are often mistaken as arthritis or peripheral neuritis. Diagnosis is confirmed by clinically inspection through various tests.

Treatment may be conservative or surgical. The patient should wear stockings, avoid long standing, walk regularly, lose weight (if obese) and never sit with legs hanging down.

Surgery may be done in severe cases or in complications. But surgery can never cure or prevent the development of varicosities and the procedure may have to be repeated after some years.