Varicose veins of the 2nd degree develop if a person missed the first symptoms of the disease, such as swelling, leg fatigue, and spider veins. The disease is common among both women and men over the age of 30. If left untreated, the disease can lead to serious problems. Blood clots and congestion in the blood vessels may appear as complications. What symptoms of grade 2 varicose veins are observed in patients, and how is this pathology treated?
Unlike when a person has varicose veins of the 1st degree (then the disease is practically invisible), varicose veins of the 2nd degree begin to make themselves felt.
Symptoms may include:
If you observe the following signs, be sure to consult a doctor:
All these changes increase the risk of developing thrombophlebitis.
The longer the disease progresses, the more difficult it is to treat:
If there are many affected areas, a more serious operation is used.
Any degree of varicose veins can also be treated with traditional methods in combination with medications. You will not be able to completely get rid of the pathology using these methods, but it is possible to speed up the restoration of blood vessels with their help.
In addition, traditional methods of treating varicose veins of the 2nd degree include:
Now let's take a closer look at some of them:
Any even very high-quality treatment does not guarantee that blood circulation in the extremities will be completely restored.
That is why it is very important to follow the rules of rehabilitation after treatment, which will help restore the circulatory system:
With any degree of varicose veins, you should not eat baked goods and confectionery products. In addition, all carbonated drinks, alcohol, strong tea and coffee are prohibited.
If varicose veins develop, heavy physical activity and prolonged standing on your feet are prohibited.
For prevention, you can use a set of exercises that will help maintain the tone of the veins:
To fully prevent varicose veins at home, it is necessary to use a contrast shower. This is an alternate dousing with cold and hot water. Due to the change in temperature, the walls of blood vessels are strengthened.
A contrast shower should be taken daily in the morning and before bed. It is not necessary to make either very hot or very cold water. The temperature should be such that the body is comfortable.
It is not recommended to use medications to prevent varicose veins without a doctor’s prescription. As a rule, oral tablets are prescribed only in cases of complications or in the initial stages of the disease.
Some of the safest and most common means are:
In pharmacies you can purchase many external products for the prevention of varicose veins. You need to choose those drugs that contain leech extract, heparin, menthol and essential oils.
The application of external products is combined with massage. Massaging the limbs helps prevent congestion and improve blood circulation.
Timely measures taken to prevent the development of complications of varicose veins can stop the development of complications. If you do nothing, grade 3 varicose veins develop very quickly.
According to estimates by specialists from the Russian National Research Medical University named after N.I. Pirogov, more than 50% of the world's population have a disease called varicose veins.
The disease is a process in which peripheral veins swell and become visible under the skin . Having increased in volume, they are drawn into knots, which disrupts the functions of the valve apparatus. Blood cannot circulate at a normal pace, and venous pressure increases, stretching blood vessels that are unable to process excess fluid.
Varicose veins are a disease with which not only modern medicine is familiar. Even the ancient Byzantines suffered from this disease .
Judging by their interest in the disease and the developed methods to combat it (specially treated bandages were used for treatment), varicose veins were already a fairly common disease at that time.
Most often, varicose veins are found in women . This is due to constantly changing hormonal levels. Men, although in smaller numbers, also visit the office of a phlebologist, a specialist who studies the structure and function of veins.
The system by which it is customary to qualify the stages of the disease includes 6 degrees of disease development:
The stages of the disease depend not only on its neglect, but also on other external and internal factors, so let’s consider the main ones:
It is important that scientists have also identified a hereditary predisposition to this disease. Accordingly, there is a possibility that a patient who adheres to a healthy lifestyle may have varicose veins.
If symptoms of the disease occur, you must immediately contact a specialist , without delaying or leading the disease to surgical intervention.
You should avoid accumulating excess weight and a sedentary lifestyle, move more, engage in active sports, and spend more time in nature. Clothing must be comfortable and meet criteria that ensure safe wearing.
For varicose veins, it is best to give the legs an elevated position, in which case the pressure on the vessels will decrease and the swelling will disappear . A contrast shower also helps improve blood circulation and, thereby, facilitates the passage of blood through the vessels.
As with any other disease, you should not put off going to the doctor if you have varicose veins. Early diagnosis increases the chances of successful rehabilitation and a speedy recovery.
I analyze the evidence base for all drugs for the treatment of first-degree varicose veins and chronic venous insufficiency (CVI). How to treat varicose veins at the first stage based on evidence-based medicine.
In this article I do not touch upon compression hosiery, since pre-varicose vein syndrome is not accompanied by compression treatment, but I will definitely prepare material about it later.
We will talk about all active ingredients for the treatment of the initial stage of varicose veins, having the following ATC classification: C05 - Angioprotectors > C05B - Drugs used for varicose veins, C05C - Capillary stabilizing agents
Brief report on the evidence base. Details in the article
My sources are the medical libraries Pubmed and Cochrane. There is decent material about evidence-based medicine and international databases from neurologist N. Zhukov, which provides answers to all questions about searching for medical information.
Why do I need this : research on medications has more than once saved me from unnecessary expenses in pharmacies and, on the contrary, convinced me of the feasibility of the prescribed treatment. First of all, I do this for myself, I have the time and desire for this. But not everyone can do this kind of work, so I’m sharing my experience here. So let's get started.
Chronic venous insufficiency (hereinafter referred to as CVI) is usually treated according to symptoms, since the causes of varicose veins, strictly speaking, are unknown. Most often they blame a sedentary lifestyle and genetic predisposition, pregnancy, excess weight, and diabetes.
At the first cosmetic problems and slight discomfort, treatment should be started. This is the only way to avoid progression of the disease and further surgery (at least it will delay invasive treatment by a lot).
There are several active ingredients that relieve symptoms. Everything that is available in pharmaceuticals is exclusively symptomatic treatment, working in tandem with lifestyle correction.
CVI and varicose veins at an early stage are treated with the following substances:
Let's look at each active substance. Below I “in a nutshell” provide information about them, links to clinical trials and a list of drugs that contain these substances. I will also try to calculate the approximate cost of the course of treatment. This will be useful if you need to compare analogues and generics. My list is relevant for drugs registered in Ukraine, and their trade name and packaging design may differ from Russian and Belarusian ones.
A group of the most popular substances used to treat first-degree varicose veins. Flavonoids give color to plant skins, are involved in photosynthesis, apoptosis (“suicide” of damaged and mutated cells) and seed germination. They accumulate in large quantities in citrus peel, onions, cocoa, and green tea. Bioavailability from products is very high.
Spoiler: extremely low efficiency.
Not registered as a medicinal product. Rutosides stand out as a separate group . In worldwide practice, rutin, rutoside, monoxerutin and troxerutin are used to relieve edema before and after venous surgery, to reduce, and I quote: “subjective symptoms in patients with chronic venous insufficiency.”
The best-selling drugs based on rutosides
Routines have a slight inhibitory effect on oxidative metabolism in affected veins. Its anti-edematous effect has been proven. The problem lies in the monstrous dosages .
A Cochrane meta-review on rutin and its derivatives was conducted in 2015 (1). Clinical trials of the drugs Relvene® (France), Venoruton® (Switzerland) and Paroven® (UK) were considered - evidence of the effectiveness of these drugs is questionable.
To get the effect, you need to take 4 grams of rutin per day - 26 tablets of Ascorutin. This does not fit in with the therapeutic doses in the medications available to us (Ascorutin - maximum 150 mg per day). In a normal diet, we consume at least 2 grams of flavonoids with plant foods, which makes taking them in dietary supplements unnecessary.
Of the 1,474 studies on rutosides reviewed by Cochrane, only 15 met the guidelines. According to the cumulative results of these trials, rutin and its derivatives lead to modest improvements in some symptoms of CVI and the first stage of varicose veins (pain, heavy leg syndrome, tingling, swelling).
Addition 02/14/2018: All numbered links are uploaded to Google Drive separately, since articles with so many links have problems with ranking in search engines. Search for full texts using the sci-hub service. Thanks for understanding!
A 2016 review of 66 included studies of the evidence base for phlebotonics found that the most commonly used agents to treat stage 1 varicose veins relieve swelling, cramps, and paresthesia (tingling), but are inferior to compression (2).
A few particularly revealing clinical trials:
The doctor diagnoses grade 2 varicose veins when a person comes in quite late, having lost sight of all the symptoms - swelling, leg fatigue, characteristic pain, stars. The valve apparatus in the veins noticeably weakens. The outflow of blood is noticeably impaired, swelling becomes constant, patients no longer know what to do at home, how to get rid of the disease. After all, it becomes quite serious that often among men of military age the question becomes urgent: will they be accepted into the army with varicose veins? Indeed, when diagnosing stage 2 varicose veins, the army is contraindicated for a person.
Stages of varicose veins
Varicose veins of degree 2 are determined by the following characteristics:
With grade 2 varicose veins, changes in the veins are noticeable even to the eye. The lesions affect not only the lower legs, but are noticeable above the knees. The venous network and stars become noticeable even under fatty deposits. Nodularity of the peripheral veins appears. Such changes increase the risk of thrombophlebitis. It is during this period that most patients with varicose veins turn to a phlebologist. You can get a consultation with a phlebologist on our website.
Treatment should be started immediately when the first stars are detected.
Treatment of grade 2 varicose veins is a serious, multi-component and rather long process. The number and list of procedures depends on individual characteristics. Folk remedies for varicose veins are used as a significant addition, if, of course, we are talking about medicinal herbs, essential oils, and not about dubious charlatan methods like miraculous magnets and urine therapy.
The main goal of the process is to normalize the functioning of blood vessels.
Treatment methods for grade 2 varicose veins can be divided into:
Varicose veins 2 degrees Before and After treatment
Tablets or capsules prescribed by a phlebologist should have a venotonic and angioprotective effect. It is necessary to raise the tone of the veins, making them less extensible. Only with this approach does swelling subside and pain subside. Drug treatment of varicose veins of the legs will not allow the development of trophic ulcers and thrombophlebitis, this is especially important in the hot season.
For local treatment of affected veins in the legs, ointments, creams and gels with anti-inflammatory medications and blood thinners are used.
Treatment is complemented by procedures from the folk arsenal and the mandatory use of compression underwear (stockings and tights), which in some cases can be replaced with an elastic bandage. With varicose veins of the 2nd degree, it is still possible to achieve success without surgical intervention (Read more about varicose veins without surgery here)
Non-surgical treatment methods have recently included hirudotherapy. Thanks to hirudin, you can reduce blood viscosity and improve circulation in affected vessels.
In some cases, even with grade 2 varicose veins, conservative treatment may exhaust itself. In such cases, it is necessary to prescribe surgical intervention - phlebectomy, which involves removing the affected areas of the veins. Such surgery can be invasive, even if done under endoscopic guidance, and requires a long recovery period. The operation is performed under general anesthesia in a hospital setting.
In modern medicine, less invasive methods are used, formally related to surgery:
Microphlebectomy can be performed even in an outpatient setting, but is usually done in a hospital because it requires several days of recovery. In this case, the patient literally gets off with small bruises, because... To remove the affected areas of the vein, they are grabbed with a special hook through a tiny incision in the skin.
Sclerotherapy or sclerotherapy is a method of “gluing” small vessels that appear as stars. By means of a regular injection, a foaming substance is injected into the vein, literally soldering the damaged walls. Anesthesia is not required for this intervention; the whole process takes a maximum of a quarter of an hour.
Laser coagulation or ablation allows even larger veins to be “soldered together.” It has to be done under anesthesia, albeit local. A light guide is inserted into the vessel and the blood is heated with radiation, which seals the vessel, which will later resolve, and the vein will remain intact. As a variation, laser photocoagulation, which allows you to remove rosacea on the face, is done without anesthesia.
Radiofrequency obliteration is borrowed from cardiology. It is also a minimally invasive method. Very similar to sclerotherapy, but without the injection of chemicals.
After surgery, even a minimally invasive one, you should wear compression stockings and follow all recommended preventive measures. After the completion of the rehabilitation period, you can resume sports training.
Varicose veins are a disease characterized by dilation of superficial veins up to 3 millimeters or more. It is characterized not only by its high prevalence, but also by the fact that most patients learn about the disease already having varicose veins of the 2nd degree, when varicose nodes become noticeable. A survey conducted among 3,000 people showed that 62% had pathology of the veins of the lower extremities, while only 18% knew about their disease.
The main factor in the development of varicose veins is a congenital change in the ratio between collagen and elastin of the venous wall. It is known that if one of the parents has varicose veins, the probability of its occurrence is 60% for men and 25% for women. If both parents have varicose veins, the risk of its occurrence increases to 90%.
Today, the CEAP classification is accepted in the medical community.
For everyday needs, the first part of this classification is sufficient:
Manifestations of grade 2 varicose veins can be divided into subjective and objective.
Subjective manifestations are not much different from those that appeared at the previous stages. These are complaints of dull, aching pain and heaviness in the calf muscles, cramps at night, burning in the legs, and rapid fatigue. Complaints intensify in the evening, especially if you had to stand or sit for a long time during the day. In women they often become stronger the day before or during menstruation. After a walk or lying down, subjective manifestations decrease.
An objective sign of grade 2 varicose veins is the appearance of areas of altered veins: “varicose nodes” with a diameter of more than 3 mm . This is precisely the diagnostic criterion.
In the treatment of grade 2 varicose veins, there are several areas:
One of the main principles of treating varicose veins is the creation of constant compression, which allows you to maintain the elasticity of the veins, restoring their functions. Most often, compression hosiery is used for this.
Medical knitwear is divided into 4 compression classes. For limited forms of grade 2 varicose veins, class I is sufficient; if the pathology affects several veins or their extended sections, class II compression should be used.
At stage 2 varicose veins, pharmacotherapy alone cannot reverse the disease, returning the venous walls to their original state. But it helps eliminate swelling and pain, enhances the effect of compression hosiery and prevents complications of varicose veins characteristic of later clinical stages.
Medicines can be either oral or topical.
Oral drug therapy for varicose veins is based on phleboprotectors - biologically active substances of natural or synthetic origin that have the ability to tone the venous wall.
Phlebotonics are prescribed in case of subjective manifestations of the disease, reducing or completely eliminating them. Their effectiveness for the prevention of varicose veins with an existing predisposition has not been proven.
They also reduce swelling, improve microcirculation, protect vein valves and reduce inflammation.
The effectiveness of drugs containing heparin or non-steroidal anti-inflammatory drugs directly depends on the concentration of the active substances. Therefore, products containing 500-1000 IU of heparin per 1 g are considered effective.
Local remedies help to quickly relieve subjective symptoms, but are ineffective as an independent remedy for the treatment of grade 2 varicose veins. It is imperative to combine them with compression therapy.
Contraindications for the use of local dosage forms are violation of the integrity of the skin.
Despite the fact that formally this technique is not an operation, only a surgeon or angiosurgeon who has received additional training in phlebology and has a permanent practice has the right to perform it.
Sclerotherapy is more effective in the early stages of varicose veins (telangiectasia and reticular veins), but it is rarely used in the presence of local varicose nodes located on the tributaries of the main veins. Another condition is the absence of reflux (backflow of blood) through the main and perforating (connecting the subcutaneous and deep) veins.
During sclerotherapy, a solution is injected into the dilated section of the vein, causing the formation of a blood clot, which is subsequently replaced by connective tissue, turning the section of the vein into a fibrous cord.
Sclerotherapy is contraindicated in:
Complications with sclerotherapy are rare. It can be:
Or removal of the affected vein. Classic method of surgical treatment of varicose veins.
The indication for surgical treatment of grade 2 varicose veins is reflux in the superficial veins. If it is not there, surgery for grade 2 varicose veins is not necessary and you can limit yourself to conservative methods.
Contraindications to phlebectomy:
A laser (endovasal laser obliteration) or a source of electromagnetic oscillations in the radiofrequency range (radiofrequency ablation) is inserted into the affected vein under ultrasound guidance. They damage the vessel wall, which leads to its “gluing” and, subsequently, fibrosis. This is a modern alternative to surgery - minimally traumatic and safe. Thermal obliteration can be performed on an outpatient basis.
The indications and contraindications for this intervention are the same as for the “classical” surgical technique.
There is an opinion that varicose veins are localized in the legs - calves, knees, ankles. This opinion is only partly true - yes, 70% of cases occur in the lower extremities.
But there are also more dangerous localizations - this is the rectum (hemorrhoids) and the esophagus - the development of the disease in these places is more difficult to diagnose, and therefore it is more dangerous.
If you prevent the development of the disease at the initial stage, you can delay the development of varicose veins for many years.
How not to miss the initial stage of this disease, and what treatment methods for varicose veins and the degree of the disease exist? Let's figure it out.
Why do varicose veins occur? As a rule, due to increased physical activity (subject to genetic predisposition), due to an incorrect lifestyle .
A weak venous wall is the main enemy, and this property of the body is most often inherited. So the main reason is, by and large, heredity . Both men and women can get sick. Although, according to statistics, women's blood vessels are weaker, and they suffer from varicose veins more often than men.
Signs of varicose veins of the first degree:
If you notice these symptoms, don’t delay , your health depends on you.
Treatment for varicose veins of the 1st degree is as follows: take a course of venotonics, reduce the load on the lower extremities, do not sit “crosswise”, buy and wear compression stockings or tights, give your legs a contrast shower. With competent behavior you will delay the development of the disease for many years .
What grade 1 varicose veins look like, photo below:
As the disease progresses, the patient will experience more and more pain, a constant pulling sensation in the knee area .
If grade 2 varicose veins of the esophagus are detected, the person will not be able to eat normally and will constantly suffer from heartburn and pain in the chest area . By the way, many blame the heart and intercostal neuralgia for this - rarely does anyone know about the existence of esophageal varicose veins.
Is surgery necessary for stage 2 varicose veins? It is still possible to prevent the development of the disease without surgical intervention: you just need to not be lazy and regularly take care of your legs.
How to stop the development of the second stage of varicose veins of the lower extremities:
If all the measures described above do not help, and you feel a deterioration in your condition, do not hesitate. Today, there are effective modern methods for treating grade 2 varicose veins - ozone therapy and sclerotherapy .
Below you can see photos of grade 2 varicose veins:
If the patient honestly and regularly followed all the phlebologist’s instructions, but the disease still progressed to the terminal (decompensation) stage, then, alas, it’s a matter of heredity.
The patient can’t just run or jump, it hurts just to walk . Almost every day the lower extremities swell greatly ; impaired blood circulation causes improper distribution of water in the tissues of the body.
Now treatment is possible only through surgery . Phlebectomy, laser treatment, sclerotherapy - all these are paid, rather expensive interventions.
But if the patient wants to return to his previous standard of living, he will have to spend money and be patient. In the end, this is not the end of the world; after the operation, you will be able to move painlessly and enjoy life again.
What grade 3 varicose veins look like, photo below:
If varicose veins of the lower extremities are successfully operated on today, then with varicose veins of the esophagus (phlebectasia) the situation is more complicated .
Also, the trigger for the development of phlebectasia can be cirrhosis of the liver, hepatitis, fatty liver, the formation of blood clots or compression of the portal artery due to neoplasms.
Symptoms of the development of varicose veins of the esophagus of the 1st degree:
Diagnosis of phlebectasia can be done using ultrasound of the abdominal organs, as well as with an increase in hepatic bilirubin in laboratory tests (one of the signs). At an advanced stage, multiple erosions of the esophagus can be seen on an x-ray.
Well, if you have been informed of this diagnosis, do not panic, treatment is possible . You will have to take the same veinotonics as for varicose veins of the lower extremities, go on a special diet and wear a special bandage .
Modern treatment methods will also come to the rescue - sclerotherapy and ozone therapy .
And if you take preventive measures and treatment of the first stage of varicose veins, you can delay the onset of painful sensations for many years to come. The main thing is to identify the disease in time - the photos of the stages of varicose veins that are in the article will help you with this.
Treatment methods for the disease at different stages:
Every third woman and every tenth man in the world suffers from varicose veins, based on official WHO estimates. Experts attribute this to the fact that the disease has many provoking factors, and few patients seek help in a timely manner at the first stage of varicose veins. In total, phlebologists note 4 stages of development of varicose veins.
Most often, people turn to doctors when grade 2 varicose veins have already begun, since at the initial stage vascular pathology is practically asymptomatic. While the second stage is characterized by more pronounced manifestations, the presence of pain, causing anxiety and a desire to deal with problems. At the second stage of development, varicose veins of the lower extremities are still amenable to conservative treatment.
Varicose veins of the second degree are not an independent disease that occurs without cause. Any illness begins with provoking factors, and until a specialist discovers such factors, no way to solve the problem will be found. To do this, anamnesis is collected during a consultation with a phlebologist, as well as a comprehensive diagnosis in a clinic.
The most common causes of varicose veins are the following conditions:
In addition, a hereditary predisposition, when there are people in the family suffering from varicose veins, is considered a risk factor for the development of varicose veins. Knowing the reasons for the development of pathology, you can narrow the circle of people who are at risk for such a disease. It is much easier to prevent varicose veins than to try to cure them.
To determine the disease, you need to know what signs of second-degree varicose veins are expressed. Namely:
You can get rid of varicose veins at home! You just need to rub it in once a day at night.
As a rule, the symptoms of varicose veins in the second stage are more pronounced in the hot season, and you often feel heaviness and fatigue in your legs. In addition, pain, swelling and a feeling of fullness in the legs can occur even at rest. In this regard, people more often turn to doctors for help in the second stage, since the first stage manifests itself relatively unnoticed.
Treatment of varicose veins of the second stage of development begins with diagnostics, so that the specialist can identify the causes of the pathology, whether there are complications, and whether surgery is needed or whether conservative treatment will be sufficient. And if the first stage of varicose veins is treated with compression garments and preventive measures, then the second stage will need to be treated comprehensively.
There are several methods for treating varicose veins of the second stage of development:
After any of the listed methods for treating the second stage of varicose veins, the patient will need to wear compression garments for some time. Thanks to it, further stretching of the veins will be prevented, since the blood pressure will be evenly distributed throughout the lower extremities.
In the future, to consolidate the results of treatment for varicose veins of the second stage of development, it will be important for the patient to follow preventive measures. Doctors put forward a number of rules:
An alternative method for the prevention and treatment of varicose veins is hirudotherapy. Hirudotherapy sessions are carried out in specialized institutions with the help of a specialist. Take medicinal leeches and apply them to the affected areas. Leech saliva contains a special enzyme, hirudin, which thins the blood and improves blood circulation. Hirudotherapy is also an excellent prevention of thrombosis.