What Is Venous Reflux?
Venous reflux, also known as chronic venous insufficiency (CVI), is a condition where the valves in the veins of your legs don’t function properly. These valves are meant to ensure blood flows back towards the heart. When they malfunction, blood can flow backward (ie reflux) and pool in the leg veins. This can manifest as a wide spectrum of signs and symptoms.
Signs and Symptoms
Common signs and symptoms of venous reflux include:
- Swelling in the legs or ankles
- Spider and reticular veins
- Varicose veins (bulging, enlarged veins)
- Heavy, restless legs
- Aching, throbbing, or cramping pain in the legs
- Itchy or irritated skin
- Brownish skin discoloration around the legs and ankles
- Ulcers or open sores, typically around the ankle region
Causes
Venous reflux can occur in both men and women, but more frequently in women. Most of the time, this is age-related. The wear and tear associated with aging leads to weakening of the vein walls.
It is also fairly common to have a family history of venous problems and varicose veins.
In women, pregnancy is a major causative factor. Hormonal changes associated with pregnancy results in the relaxation of vein walls and an increased volume of blood in the veins. As the baby grows, the expanding uterus puts pressure on the pelvic veins draining the legs. These combine to cause added pressure and blood pooling in the leg veins.
Other causes include:
- Obesity
- Lack of physical activity
- Extended periods of standing or sitting (most of the time work-related)
Diagnosis
Your vascular surgeon will examine your legs and may perform an ultrasound to see how the blood is flowing in your veins. This non-invasive test provides a clear evaluation of the condition of your veins- allowing the diagnosis of the extent, and presence/absence of reflux.
In certain cases, a CT (Computed Tomography) scan of your abdomen may be indicated to evaluate for compression of your pelvic veins.
Treatment Options
The main objective of treatment is to reduce the backflow of blood down the diseased veins, and hence improve blood flow in the affected veins. Think of diseased veins as a congested highway with traffic backing up into the exit points. Treatment options include:
- Compression Stockings: These specially designed stockings gently squeeze the legs, acting as a pump to help blood flow upwards. Compression stockings are graded by the amount of pressure they exert. Higher grades of compression require prior assessment and fitting by a medical professional, to prevent inadvertent injury from improper use.
- Lifestyle Changes: Regular exercise, weight management, and avoiding long periods of standing can help.
- Medications: Certain medications may be prescribed to address your symptoms. They are generally not effective, as venous reflux is a mechanical issue.
- Minimally Invasive Procedures: This is currently the first line option for contemporary treatment of venous reflux. Modalities include Sclerotherapy, Radiofrequency Ablation (ClosureFast™),VenaSeal (medical glue), and Clarivein (pharmacomechanical ablation). Most have excellent results, and your surgeon will determine the most suitable modality after a thorough assessment.
- Surgery: In more severe cases, conventional surgery may be necessary. This consists of vein stripping via an incision along the groin.
Prevention and Management
Early diagnosis and treatment is a key factor in preventing your symptoms from progressing. Regular monitoring by healthcare providers specializing in vascular health, lifestyle changes, and medical interventions where necessary, can significantly reduce the risk of disease progression and more serious symptoms.
If you have any concerns about these potential complications or your specific condition, feel free to reach out for a comprehensive evaluation. Individualized care is essential in preventing and managing the complications associated with venous reflux.
Conclusion
Venous reflux can be manageable with appropriate care. If you have any symptoms or concerns, please do not hesitate to reach out. We’re here to help you understand and manage your condition and provide you with the best possible care.
This information is provided as a general guideline and should not replace professional medical advice. Always consult with your healthcare provider for personalized recommendations.
FAQ about Venous Reflux
Our veins have small, one-way valves that keep blood flowing towards our heart. Sometimes, these valves can become weakened or damaged, and they don’t close properly. When this happens, blood can flow backward and pool in the veins, and this condition is what we call venous reflux.
It often occurs in the legs and can lead to symptoms like pain, swelling, and varicose veins. Dr. Lim has extensive experience in managing this condition and will work with you to find the most effective treatment options to manage any discomfort or complications.
Varicose veins and venous reflux are related, but they aren’t quite the same thing. Venous reflux is the underlying condition where, as we mentioned, the blood flows backward due to faulty valves and pools in the veins. When this happens, it can cause the veins near the surface of the skin to become swollen, twisted, and visible, and these are what we call varicose veins. So, you can think of varicose veins as a possible symptom or result of venous reflux.
Dr. Lim can help clarify any concerns or queries you have about these conditions and discuss potential treatments if you’re experiencing discomfort or other issues.
Varicose veins are enlarged, twisted veins that are visible under the surface of the skin. They often appear in the legs and can cause discomfort, pain, or swelling.
Spider veins are smaller, more superficial veins that often appear as blue, purple, or red lines on the skin surface. They are typically not painful but can be cosmetically bothersome to some individuals.
Several factors contribute to the development of varicose and spider veins, including age, genetics, hormonal changes, pregnancy, obesity, and prolonged periods of standing or sitting.
While spider veins are generally harmless, varicose veins can sometimes lead to complications such as bleeding, blood clots, and ulcers. It is advisable to consult with a healthcare provider for diagnosis and treatment options.
Approximately half of the population has some form of venous disease while varicose veins affect one out of two people age 50 and older, and 15-25% of all adults. On average 18% of men and 25% of women develop varicose veins. Varicose veins are one of the most common venous issues affecting the world today.
Anyone can develop spider or varicose veins, but they are more common in those above 50 years old, females, individuals with a family history, and those with certain lifestyle factors like a high BMI, desk-bound work environments, or in occupations which require you to stand for long periods of time.
Here are some physical symptoms of varicose veins that make them easier to diagnose:
- Itchy or flaky skin around the affected vein, sometimes accompanied by a burning sensation,
- Feeling of heaviness or ache in the lower legs after standing or sitting for long periods of time (usually worse at end of day, with comparative relief in the morning),
- Muscle cramps or pain in the lower legs, and,
- Swelling around the ankles – the ankle area appears puffy and swollen, and the ankle bone may not be visible
Not all of these symptoms are present in the same person. However, if you fit the above description, or if you have one or more of these symptoms, it is likely you have varicose veins. These symptoms can take a toll on your quality of life, making it hard to do things like walking or even standing for long periods.
Fortunately, modern minimally-invasive surgical methods have made the treatment of varicose veins quick and easy. Feel free to reach out for a personalised assessment and consultation should you have any of the above concerns.
While not all people present with severe symptoms, varicose veins generally worsen over time. Initially, slight heaviness and discomfort in the affected leg will be felt. If untreated, this pain may increase and result in limitations in walking and cramping during the night. Eventually, varicose veins can lead to skin discolouration or open wounds (ulcers) around the ankles.
Your healthcare provider will usually diagnose these conditions based on a physical examination. Additional tests like ultrasound may be recommended to assess the presence of venous incompetency (reflux), and rule out other issues.
An ultrasound is the most common diagnostic test for varicose veins. Some patients may require a CT (Computed Tomography) scan of your abdomen may be indicated to evaluate for compression of your pelvic veins.
Treatment options may include lifestyle changes, compression stockings, minimally invasive procedures like sclerotherapy, radiofrequency ablation therapy, and surgical interventions like vein stripping.
Generally, spider veins are treated with less invasive methods like injection sclerotherapy or radiofrequency treatment. Spider veins usually require a few sessions of sclerotherapy to resolve.
Varicose veins may additionally require more extensive treatment like mini-stab avulsions (for removal) depending on their extent and severity.
Coverage varies by insurance provider and plan. It is essential to consult your insurance to determine what treatments are covered, especially since some treatments may be considered cosmetic.
Clinical results have been published documenting the success of Endovenous Radiofrequency Ablation, ClariVein and VenaSeal at above 90% and Sclerotherapy between 60-80%.
As with any medical treatment, each method has its own risks and benefits. Your surgeon will explore the most suitable treatment option, after a thorough assessment of your condition.
Sclerotherapy is commonly used to treat spider veins (small superficial veins) and has been used with safety and success since the 1930’s. This treatment is a non-surgical procedure, and can be performed in the outpatient clinic.
Using a very fine needle, a solution is injected into the vein. This solution causes the vein walls to stick together and eventually close. The obliterated vein is absorbed by the body over time.
Following sclerotherapy, there is very little to no downtime. Patients will be required to wear a compression stocking for the next week. They can return to work or carry on with normal activities straight away. Some patients may experience gentle bruising at the treated area, especially those with thin and lighter skin.
Patients should wait at least three months after pregnancy before being treated for venous insufficiency. Patients who have suppressed immune systems, deep vein thrombosis, and patients who are immobile (ie cannot walk or move around), are generally not good candidates for treatment and will require further evaluation to assess their suitability.
Recovery depends on the treatment method used. Minimally invasive treatments usually have shorter recovery times. Most patients will be able to walk on the same day after their surgery. Traditional open surgical treatments (eg open stripping of vein) may require a longer period for full recovery.
Yes. There is a possibility that new varicose or spider veins may develop over time even after successful treatment, particularly if underlying risk factors are not addressed. Risk of recurrence is usually around 5-10%.
This depends on the type of treatment you undergo. For minimally invasive treatments, most people can return to normal activities relatively quickly in a day or two. Vigorous exercise is usually not recommended till 2 weeks post-surgery. Traditional open surgical treatments may require a longer period for full recovery.
Most treatments aim to reduce the appearance and symptoms of varicose and spider veins significantly, but results can vary from person to person.
While many people seek treatment for cosmetic reasons, treatment can also alleviate symptoms like pain, swelling, and itching associated with varicose veins.
You can schedule a consultation by:
- Calling our clinic at +(65) 6694-2282,
- Leaving us a Whatsapp message +(65) 9727-0788,
- Emailing contact@drdarryllim.com, or
- Using our contact form [go to contact page]
During your first consultation, your vascular surgeon will examine your veins, discuss your symptoms, go over your medical history, and possibly recommend additional tests. A personalized treatment plan will then be discussed.
