Choosing the “right” doctor is sometimes difficult. No, you all know that an ophthalmologist treats your eyes, if children are sick, you go to a pediatrician, and all your problems are required to be solved by a doctor at a local clinic. The therapist, of course. But what if the problem is quite narrow, and you simply don’t want to go first to a therapist, then for an examination, and as a result receive a referral to another specialist and again wait in line, all this time, without solving the treatment issue? There is an exit.
You must be able to immediately, at the first symptoms, choose a specialist who will reduce your ordeal in queues to a minimum. Or maybe it will cancel them altogether. For example, we will try to resolve the issue with varicose veins and find out which doctor deals closely with this pathology.
The branch of medical science that studies varicose veins is called phlebology. Hence the name of the doctor’s specialty – phlebologist. Phlebologists undergo a narrow specialization in venous pathologies. Their responsibilities include not only examining your legs for disease, but also the ability to carry out diagnostics using sophisticated medical equipment.
A professional phlebologist is well versed in the methods of treating varicose veins and performs minimally invasive interventions for therapeutic purposes. For example, phlebologists at the Baltic Vein Clinic successfully use the latest world developments to treat varicose veins. Most of the surgeries they perform are same-day surgeries. That is, after a single visit to such a doctor, you will be able to part with varicose veins forever.
Video interview with phlebologist of the Baltic Vein Clinic Vladislav Semenyuk in “Morning News”:
In difficult situations, if phlebological care is not enough for the patient, the doctor can resort to the help of colleagues. These are doctors who also deal with blood vessels, but in a slightly different way. Let's conduct a short educational program that will help you understand the many incomprehensible names of medical professions.
Doctors of the following specializations work closely with phlebologists:
Find out from this article whether there is a danger of removing varicose veins on the legs and should you be afraid of it?
Surgeon is the general name for a specialist who performs treatment through surgery. The surgeon performs operations on internal organs and eliminates the consequences of injuries. Depending on the area of application, the name of the specialization changes:
This is only a small part of surgical specializations. You can continue them for a long time. Angiosurgeons, unlike ordinary surgeons, do not perform abdominal and other operations, but are often present at them if masterly interventions on blood vessels are needed. Varicose veins, atherosclerotic lesions - all this is the work of an angiosurgeon.
Varicose veins can become complicated. Trophic disorders often appear on a person’s legs – ulcers that threaten to deprive the patient of mobility. Here, not only phlebologists get down to business, although their role is leading, but vascular surgeons, physiotherapists, and dermatologists also get involved.
A doctor with the title angiologist is rare in the vastness of the former USSR. But in the USA and some European countries there is such a specialization. Angiologists can safely be called related to phlebologists, with the difference that in their work they give preference to medicinal and conservative treatment of varicose veins.
There are many doctors who deal with blood vessels. This is understandable, because the human vascular system is huge, and if a failure occurs in one part of it, the entire body will suffer.
Perhaps this is the stage of varicose veins when you won’t even have to resort to minimally invasive intervention. Compression will be prescribed, physical treatment, mechanical lymphatic drainage will be done - you’ll see, you’ll manage without surgery! Agree, this is more attractive than racking your brains over choosing the right doctor.
Varicose veins are a serious disease that occurs quite often these days. There are many reasons for the pathology, including hereditary predisposition, increased stress on the legs, and poor lifestyle. If varicose veins are not treated, they can cause thrombosis, ulcers, and even limb amputation.
To prevent your legs from spinning, you need to go to the hospital at the first signs of pathology. Symptoms of varicose veins include swelling, cramps, and visible spider veins.
On the threshold of a medical institution, the first question pops up on its own. Why do varicose veins occur, which doctor treats them? Let's try to give a complete answer to this question.
At the reception desk you can easily find the working hours of the following doctors:
Each doctor has his own narrow specialization, but by combining all the symptoms and examinations, they will be able to provide the highest quality assistance in treating the disease.
Often, in the presence of varicose veins, additional diseases are added to the main disease. It can be:
You can’t do this without the help of dermatologists and physiotherapists. They will familiarize themselves with the primary doctor’s prescriptions and supplement them with their own, which will include ointments to moisturize the skin and procedures to improve blood outflow and circulation in the extremities.
It is important to take care of your health and respond to any changes that occur in the body. When they appear, you need to contact a therapist and get an appointment for urine and blood tests, which can give a more specific picture of the course of the disease.
You should rush to see a therapist who can cure the disease if you have the following symptoms:
It is important to pay attention to the fact that even if the veins are not yet visible, but the symptoms are already present, you still need to come to see a doctor. After passing all the required number of tests, the therapist refers the patient to a phlebologist for further treatment.
Situations often arise when the disease is at such a stage of progression that conservative treatment methods are no longer able to help. In this situation, a surgeon comes to the aid of the phlebologist.
The main specialist who deals with varicose veins, but to get to him, you need to visit a therapist.
This doctor is consulted for surgical treatment of varicose veins. He prescribes additional tests and studies that will show the possibility of surgery.
It is not an ordinary surgeon who begins the surgical intervention, but an angiosurgeon. He works with veins, arteries, lymph nodes and performs operations on them. Their responsibilities include not only carrying out planned interventions, but also providing assistance in cases of injuries in which blood vessels are damaged.
After a certain period of time that the patient spends in the hospital, it is necessary to return to the clinic and see a phlebologist. The doctor is obliged to evaluate the work done and tell the person about the necessary measures to prevent the disease, which may include medication support and the use of various procedures.
In our country, an angiologist (a doctor who treats blood vessels) is extremely rare, but in the United States this position is very popular. Their main task is medicinal and conservative treatment of varicose veins.
Many people are not even going to go to the hospital, even the symptoms of the disease are already very pronounced. The reasons for this are fear. It constrains a person and he cannot decide to seek help when the disease is at an early stage and can be prevented. They do not know which doctor to contact for varicose veins and what needs to be done first.
Most often people are afraid of:
Now you can easily decide which doctor to see for varicose veins, overcome your fear and boldly begin to fight the disease. It is important to remember that if you consult a specialist in a timely manner and carry out preventive measures, you can avoid many of the problems that varicose veins bring with you.
Varicose veins are not such a rare disease that you don’t know which specialist deals with it. But due to the fact that few people go to the clinic when spider veins or nagging pain appear, people do not know which doctor treats varicose veins on the legs. Therefore, some prefer to go first to a therapist so that he can refer them to a specialist, while others boldly take a ticket to a surgeon, believing that he is a generalist doctor. So which doctor should you consult with varicose veins?
Varicose veins are a disease of blood vessels, which involves their swelling (expansion) and thinning. Surgeon (from the ancient Greek “I work with my hands”) is a fairly general name for doctors whose competence includes surgical treatment. Surgeons include dentists, urologists, gynecologists, cardiologists and other specialized specialists.
With varicose veins at a protracted stage, surgical treatment (vein excision or removal) may also be required, so it is logical to call such a specialist a vascular surgeon. But not every clinic has such doctors. The problem of shortage of personnel is especially acute in regional medical institutions, so when asked which doctor to go to for varicose veins, the receptionist may simply give you a ticket to see a surgeon, in the absence of other specialists.
Due to the fact that varicose veins and other types of venous insufficiency have recently become a serious problem, new specialties have appeared in medical institutes. Thus, those who wish can study to become a phlebologist - a doctor who deals exclusively with veins (from the Greek phlebos - vein).
Phlebologists are often called vascular therapists because they study the causes of varicose veins, clearly know the symptoms of the disease and can make a more correct diagnosis and prescribe treatment. Often, a phlebologist is also a surgeon in order to be able not only to carry out therapeutic treatment, but also, if necessary, to be able to perform surgical intervention. Such a specialist clearly knows the differences between the two types of surgical treatment of varicose veins.
If everything is now clear with the phlebologist, and this word no longer raises questions, all that remains is to figure out who an angiologist is. He is also a doctor who treats varicose veins. But is his competence different from that of a phlebologist?
An angiologist (from the Greek angio - “vessel”) is a broader specialist who deals with vessels (veins, arteries and capillaries). He knows everything about blood and lymphatic vessels, their structure and functioning, knows how to recognize pathological conditions and determine their causes, understands numerous methods of prevention, diagnosis and treatment of arteries, veins and capillaries.
Another specific doctor for varicose veins is an angiosurgeon. This is the same angiologist, but qualified to perform surgery. But usually experienced vein specialists are generalists. Therefore, the angiologist can consult the patient and subsequently perform surgery on him.
We have determined which doctor treats varicose veins. Now let's look at the methods that a phlebologist or angiologist can use to determine the degree of development of varicose veins.
After making a diagnosis, the phlebologist chooses methods for treating varicose veins:
It turns out that to the question, what is the name of the doctor who treats varicose veins, three answers can be given at once: phlebologist, angiologist and vascular surgeon. The first one must be addressed a priori, because This is a vein specialist. If there is no such doctor, you can go to an angiologist, because... he also treats blood vessels. If there are no such specialists in your region of residence, you can contact a vascular or regular surgeon. He will be able to determine the advanced state of the disease and, in extreme cases, will refer you to a more specialized specialist in another city.
Varicose veins are a common disease that affects more than half of the world's inhabitants. But despite this, few potential patients know which doctor treats varicose veins. When faced with a problem such as pain and a feeling of heaviness in the legs, the appearance of spider veins, you need to contact a doctor who has several medical specialties: phlebology, vascular surgery, angiology.
This is a specialist who studies the physiological and anatomical features of normal and pathological changes in blood flow, as well as the clinical manifestations of diseases of the lower extremities.
If we generally discuss the symptoms associated with diseases for which phlebology is responsible, we can highlight the main signals that require special attention:
Important! The specialist’s task is to analyze the individual characteristics of each patient and draw conclusions based on such data, as well as determine the most effective recommendations regarding the required treatment and rehabilitation of varicose veins.
After a visual examination of the affected limbs, the phlebologist uses modern technical procedures, which determine a more accurate diagnosis and the location of a blood clot along the entire length of the vein:
Important! In individual cases, blood plasma tests are sometimes prescribed.
This specialist treats diseases that affect the veins by disrupting the general blood flow. Varicose veins are a more common reason for seeking help from a phlebologist. In addition, this specialist treats:
Important! Patients who have a hereditary predisposition to varicose veins should periodically visit a phlebologist to promptly detect the disease at an early stage and receive adequate treatment.
You also need to follow all the requirements and recommendations given by the doctor to prevent further progression of the disease. Typically these are the following tips:
There are difficult situations when the help of a phlebologist is not enough for a patient. Then colleagues who also deal with blood vessels, but in a different way, are involved in further treatment.
These specialists perform operations on veins, arteries and lymph nodes. Surgically, they treat not only chronic pathologies, but also provide prompt emergency care for traumatic vascular lesions.
Vascular surgeons are most often visited by people with an advanced form of the disease. After the examination results, the specialist may prescribe the following procedures:
Important! Many vascular surgeons propose to restore damaged vessels using gravitational surgery.
Varicose veins often lead to complications. On the patient’s legs, places with impaired trophism form - ulcers, which can even lead a person to immobility. In this case, you need to involve angiologists first.
These are specialists who carry out diagnosis, treatment and preventive measures for complications of venous, arterial and lymphatic vessels.
The angiologist treats patients using short-pulse electroanalgesia, compression and sclerotherapy. The treatment process also includes:
There is another specialty - angiosurgery. Such a specialist performs operations to eliminate dead veins, removes venous networks from the legs, and also carries out procedures related to the correction of damaged areas.
Treatment of such serious venous diseases as thrombosis, thrombophlebitis, varicose veins should be trusted only to an experienced and highly qualified doctor. When contacting a phlebologist, it is extremely important to find out the following about him:
This is not the entire list that you should pay attention to when looking for a good phlebologist with whom you can go for an appointment without any doubt. It would be ideal if the specialist has completed advanced training courses, has an academic degree and scientific publications.
Which doctor treats hemorrhoids? This question arises for every person faced with the symptoms of such a delicate and unpleasant disease.
At first, patients are embarrassed to contact a specialist, since it is not customary to tell either family or even professional doctors about hemorrhoidal disease.
Meanwhile, delaying treatment can lead to worsening of the condition, increased symptoms and the development of complications. That is why proctology patients need to know which doctor to go to with hemorrhoids and what awaits them during the treatment process.
In the initial stages, varicose hemorrhoidal veins practically do not bother patients, occasionally reminding themselves of drops of blood on toilet paper, itching sensations, and discomfort in the rectal canal.
Most often, those patients who experience severe signs of the disease come to see doctors:
Moreover, before visiting the proctology office, patients themselves try to get rid of hemorrhoids by using suppositories and ointments. However, their choice is not always verified and corresponds to the characteristics of the pathological process.
A patient’s visit during an exacerbation makes it much more difficult to carry out diagnostic procedures, since most hardware examinations are prohibited due to:
In such a situation, the doctor treating acute hemorrhoids initially relieves the symptoms of exacerbation, and only then prescribes the necessary diagnostic procedures and therapeutic or surgical measures.
That is why, at the first signs of varicose hemorrhoidal veins, it is necessary not to self-medicate, but to consult a specialist who will determine all the nuances of further treatment.
So, it is necessary to treat hemorrhoidal disease in order to prevent possible worsening of the condition and the occurrence of various negative consequences. All that remains is to understand who to contact if unpleasant symptoms develop.
A doctor who professionally treats hemorrhoids is called a proctologist, or coloproctologist. There is an opinion among patients that the latter is dealing with something else - for example, more serious conditions. However, this point of view is largely erroneous.
Proctologist and coloproctologist are names of the same medical profession. In the late 90s, the Russian Ministry of Health brought the name of the specialization “proctology” into line with international standards.
Since that time, it has been customary to call the science and field of medicine that deals with the study and treatment of diseases of the colon, anal canal and pararectal area proctology.
Accordingly, a specialist involved in the diagnosis and treatment of these pathological conditions, including those specializing in hemorrhoids, can equally likely be called a proctologist or a coloproctologist.
In general, the responsibilities of a proctologist, who can work both in a clinic and a specialized medical institution, are the same. In accordance with job descriptions, a physician must:
In each patient, the course of the disease differs in the provoking factor, severity of symptoms, and the presence/absence of contraindications. That's why you need to take an individual approach.
A few words need to be said about the proctologist who performs the duties of a surgeon. This is a more subtle specialization that places serious demands on the doctor.
Patients are usually sent to the surgical department only when conservative methods of therapy have not brought the desired results, and the person’s well-being begins to rapidly deteriorate.
Thus, to the question of which doctor treats complicated hemorrhoids in the last stages of the pathological process, there is only one answer - a proctologist surgeon. The expert objectively assesses the patient’s condition and chooses the most preferable surgical treatment method.
A specialist, taking into account the complexity of the case and the stage of hemorrhoidal disease, can perform the following activities:
Many patients living in the outback are worried that it is not always possible to contact a proctologist, since such specialized specialists are not available in every clinic.
If hemorrhoids develop, which doctor should I contact? This will depend on the staffing level of a particular medical institution. The patient can use the services of the following doctors:
The patient's appointment should begin with the collection and study of anamnestic data. A coloproctologist or other specialist needs to listen to the patient’s complaints, understand when the initial signs appeared and in what ways the person tried to eliminate the disease before going to the doctor.
In addition, the physician needs to identify the factors that provoke hemorrhoidal disease, and then, if possible, eliminate them from the patient’s life.
Hemorrhoids in men and women usually occur in the same way, but the triggers may be different. Thus, it is more common for a man to abuse alcohol and lift weights, while a woman is more likely to suffer from the disease during pregnancy and childbirth.
Then the doctor conducts a visual examination, which is especially informative for external hemorrhoids. You can also detect internal cavernous formations that have come out.
But with internal hemorrhoids, the nodules are located deep in the rectal canal, which is why they cannot be detected during a standard examination, unless, of course, they begin to fall out of the rectum.
In such a situation, the doctor uses the palpation method. Wearing gloves, the proctologist feels the walls of the rectal canal. With severe hemorrhoids, the nodules become dense and increased in size, so they can be easily detected by digital examination.
To clarify the diagnosis (and varicose anal veins are not the only disease accompanied by pain and bleeding from the rectum), a more in-depth, instrumental study is required.
These examination methods include:
So, now it’s clear which doctor treats hemorrhoids. All that remains is to figure out what you should take with you to the proctology office.
First of all, you will need to capture:
In case of aggravated hemorrhoids or at the last stage of the disease (when the process has started), you should prepare for hospitalization. Therefore, the patient should take with him things (clothing, hygiene items) that may be needed in the ward.
It is best not to eat anything before your appointment, as the doctor may send you for a blood test.
The choice of the preferred treatment regimen is influenced by several important conditions. So, the doctor will be guided by certain factors, including:
At the very beginning of the disease, only conservative therapy is used. The specialist prescribes venotonics that eliminate vascular weakness, local medications - rectal suppositories, ointments and creams.
A qualified doctor will not base a therapeutic course on dubious drugs that have not been licensed. In addition, the doctor will try to avoid referral for surgery.
The proctologist will also recommend eliminating “provocateurs”: it is important to maintain an optimal diet and hygiene measures, increase physical activity (within reasonable limits), reduce body weight, etc.
If drug treatment does not help, the doctor prescribes minimally invasive surgical techniques, among which the following methods are especially popular:
In the case of severe forms of proctological disease and complications, serious operations are prescribed - open or closed hemorrhoidectomy. However, they are used less and less often, since they are characterized by high trauma.
Sometimes patients, even after visiting a proctologist, do not notice any visible improvements. Varicose veins continue to bother you, and signs of complications begin to appear.
This can happen for reasons such as:
The question of what is the name of the doctor who helps with hemorrhoids is really relevant. An experienced proctologist will determine the degree and type of disease, detect complications and select the correct methods of therapy.
Self-medication is a dangerous and unproductive path. It’s easier to trust doctors and forget about negative symptoms than to fight pain and bleeding from the rectum on your own.
Varicose veins in women are most often associated with heaviness in the legs, enlarged veins in the calves and discomfort when sitting or walking for long periods of time. Few people know that varicose veins also occur in the pelvis, which causes considerable discomfort to the fair sex and significantly limits their quality of life.
In this article we will look at the disease, talk about treatment and, most importantly, about the prevention of this disease.
Pelvic varicose veins in women (PVVV) is a complex medical problem. Many cases of successful treatment of this chronic disease have been described. However, URVMT is often not diagnosed. With this disease, there is a high probability of diagnostic errors, especially at its early stage.
HRVMT is caused by two main reasons:
1. Obstruction of the veins of the pelvic organs (ovaries, tubes, uterus), causing an increase in pressure in the underlying areas and their expansion.
2. Blockage of large venous trunks, in which an extensive network of “bypass” (collateral) venous outflow pathways develops with their expansion.
ARVMT occurs more and more often with age. So, it can be detected in 20% of girls aged 17 years. In perimenopausal women (45 – 50 years old), the incidence of ARVMT is already 80%.
80% of all cases of URVMT are dilatation of the ovarian veins. Very rarely (1%) varicose veins of the broad ligament of the uterus are observed.
The basis of ARVMT is connective tissue dysplasia. This is a violation of the structure and function of connective tissue throughout the body. It is manifested by the weakness of the elements connecting cells in all tissues. One of the consequences of connective tissue dysplasia is weakness of the vascular walls, especially in vessels with a small amount of muscle tissue, that is, in the veins. The cause of the development of connective tissue dysplasia is considered to be adverse effects of the fetus during pregnancy and environmental pollution.
ARVMT occurs under the influence of the following provoking factors:
- long periods of standing or sitting during professional activities; hard physical labor;
- frequent use of interrupted coitus as a method of contraception, anorgasmia;
- frequent pregnancies and childbirths;
- many gynecological diseases, for example, endometriosis, salpingitis, ovarian diseases, backward bending of the uterus (retroflexio);
- menstrual irregularities, increased estrogen levels; It is possible that hormone replacement therapy and hormonal contraception play a certain negative role.
The most common symptom of ARVMT is chronic pain in the lower abdomen. Most often they are aching, pulling, and “give” to the lower back and groin area. In half of the patients, pain intensifies before menstruation. Pain can be provoked by prolonged sitting or standing, or heavy physical activity. Sometimes the cause of increased pain is sexual intercourse.
Many women notice increased discharge from the genital tract for no reason. Painful menstruation and premenstrual syndrome are common.
One of the manifestations of ARVMT is pain in the perineal area. Urinary disorders may occur.
Upon examination, you can see varicose veins on the thighs, buttocks, and perineum.
The main method for diagnosing ARVMT is Doppler ultrasound of the pelvic veins. In this test, the veins are visualized using ultrasound. The screen shows dilated, tortuous veins of the small pelvis, the speed of blood flow in them decreases. Signs of venous valve dysfunction are determined.
An informative method for diagnosing URVMT is transuterine venography. This is a study of veins associated with their filling with a contrast agent, clearly visible on an x-ray. The result is a series of images of veins, where collaterals, dilated veins, places of thrombosis, and the condition of the valves are visible. The method is contraindicated in case of iodine intolerance (part of the contrast agent) and pregnancy.
If ARVMT is suspected, laparoscopy is performed: examination of the pelvic cavity using an endoscope through a small puncture in the abdominal wall.
The most informative study is considered to be selective oophorography: an X-ray examination of the ovarian veins using contrast.
For the purpose of differential diagnosis with other diseases of the pelvic organs, computed tomography can be performed.
It is necessary to carry out a differential diagnosis with diseases such as inflammation of the appendages, endometriosis, uterine prolapse, postoperative neuropathies, inflammation of the large intestine or bladder, radiculitis, and pathology of the hip joints.
VRVT therapy is aimed at achieving the following goals:
1. Termination of reverse blood flow through the veins of the ovaries.
2. Normalization of vein tone, improvement of blood supply to tissues.
3. Relief of symptoms: pain, bleeding, and so on.
Treatment of ARVMT includes two main components:
1. A course of medication during an exacerbation.
2. Constant use of physical therapy to prevent relapses.
In drug therapy, the main role is played by venotonic drugs (improving the tone of the veins) in combination with angioplatelet agents (preventing the formation of blood clots in the veins). Pentoxifylline is also indicated.
A modern venotonic drug is Phlebodia 600 (diosmin). It can also be prescribed during the 2nd – 3rd trimester of pregnancy. Diosmin reduces the distensibility of veins, reduces the severity of blood stagnation in them, improves lymph outflow and helps relieve swelling. It normalizes microcirculation in tissues, improving their blood supply. Phlebodia 600 also has an anti-inflammatory effect.
Take this medicine 1 tablet in the morning on an empty stomach for up to 4 months.
If repeated courses of venotonic drugs are ineffective, surgical treatment is possible.
The best method is artificial occlusion (embolization) of the ovarian veins. It is performed using a special sclerosing agent, which is injected through a thin catheter under X-ray control. This intervention is low-traumatic and effective.
If such intervention is not possible, surgical removal of the affected veins is performed.
Symptomatic treatment is the use of non-steroidal anti-inflammatory drugs for pain.
The most popular folk remedies for varicose veins are horse chestnut, dandelion root, and kombucha (chaga). Infusions and pharmaceutical tinctures of these remedies prepared in different ways normalize venous tone. They can be used to treat varicose veins not only of the lower extremities, but also of the pelvis.
1. Normalization of working conditions with the exception of long periods of sitting or standing. Industrial gymnastics, regular breaks from work. Avoid heavy physical activity and heavy lifting.
2. Normalization of stool, relief from constipation. The diet should contain more vegetable fiber and vegetable oil. Quitting alcohol and smoking. Exclusion from the diet of spicy and salty foods.
3. Daily ascending contrast shower on the perineal area.
4. Exercises in a lying position with legs raised (“bicycle”, “birch tree”, “scissors”).
5. Breathing exercises: slow breathing using the abdominal muscles.
6. Wearing special medical tights of compression class II.
7. Prophylactic administration of venotonic drugs in courses 3–4 times a year.
Treatment is considered effective in cases where the symptoms of the disease cease, venous outflow improves according to instrumental studies, and the patient’s quality of life improves.
If the diagnosis has already been established, it is better to be treated by a phlebologist - a specialist in vein diseases. If a woman does not know the cause of constant pain in the lower abdomen, consultation with a gynecologist is recommended. In case of difficulties, an examination is carried out by a neurologist or urologist. The qualifications of the radiology and ultrasound diagnostics doctor play an important role in recognizing the disease. Treatment involves a specialist in physical therapy, a physiotherapist, a nutritionist, and in some cases a vascular surgeon.
Cardiovascular diseases are a real scourge of modern man. And those who consider the most serious of them to be purely myocardial infarction or stroke are deeply mistaken. Even a disease such as phlebitis can cause irreparable damage to the human body. What kind of disease is this, and how does it manifest itself?
Phlebitis affects important blood vessels such as veins. With it, the walls of blood vessels become inflamed and gradually collapse. Most often, this term refers to phlebitis of the lower extremities - one of the most common forms of this disease, which most often develops when the legs are affected by varicose veins. Also, inflammation of the veins often occurs against the background of any infection that has entered the body. In this case, the causative agent of phlebitis is microbes that provoke irritation of the walls of blood vessels, or any other pathogenic microflora.
There is a classification of forms of this disease, depending on the location of the inflammatory process. According to this classification, there are:
There are two categories of disease progression. So, there is acute and chronic phlebitis . They differ primarily in symptoms:
Phlebitis is also classified according to the objects affected. That is, according to the types of vessels that are susceptible to the disease.
So, if we are talking about phlebitis of the superficial veins, then it is easier to diagnose - it can manifest itself in the form of compactions similar to protrusions of subcutaneous fat . located along the vein bed.
In the case when the lesion affects vessels located deep (and most often it is phlebitis of the deep veins of the lower extremities), a person may not pay attention to symptoms such as pain in the limbs, low temperature for quite a long time, because in addition to phlebitis, these can be manifestations anything, even chronic fatigue.
In general, this disease affects both men and women equally. It is not clearly linked to the patient’s age: of course, over time, the risk of development increases due to the general deterioration of blood vessels, but since the main trigger is infection and varicose veins, young people can also be susceptible to it.
The most common form of this disease is, without a doubt, thrombophlebitis. As well as the most dangerous: blood clots formed at the site of inflammation - thrombi - can break off, block the pulmonary artery and lead to death . In addition to the main causes of occurrence, such a disease manifests itself in the case of weak vascular tone, as well as increased blood viscosity. Often, ordinary acute phlebitis of the deep veins develops into this form.
Cerebral phlebitis is a form of disease that affects the blood vessels of the brain. The cause of such inflammation is almost always an infection. Another form of this disease, localized on the human head, is phlebitis on the face. Its cause may be purulent inflammation - an abscess, phlegmon, resulting from some kind of infection.
Post-injection phlebitis with vein thrombosis
Post-injection phlebitis is a separate category, since it occurs solely as a reaction to the administered medication. This may be purely mechanical irritation of the vein walls, or it may also be inflammation as a result of the chemical properties of the injected substance. In particular, this so-called cubital phlebitis is sometimes used for the benefit of medicine: during the sclerotherapy procedure, an irritating reagent is deliberately introduced into the vessel, which provokes the development of this disease, and, as a result, gluing of the vessel walls.
Migrating phlebitis is a long-term form of inflammation. At the same time, superficial phlebitis affects the veins of the upper and lower extremities, periodically manifesting itself in relapses. Young men are most often affected by this form of the disease. Often, in addition to the veins, inflammation also affects the arteries.
Phlebitis of the collar vein is another common disease of this kind. It covers the largest of the veins of the abdominal cavity. In another way it is also called pylephlebitis.
Some of the reasons why phlebitis of various kinds may occur have already been indicated in the description, however, in order to systematize the main ones, we present them in a complete list:
Now that the main causes have been classified, we should take a closer look at the symptoms of this disease. And in the case of phlebitis, it can be quite varied.
They vary depending on the type of disease.
With superficial phlebitis in its acute form, the signs of the disease are quite easy to identify. For example, if we are talking about phlebitis of a vein in the arm, then it will become painful. There will be constant tension in this place. In addition, in the area where the affected vessel lies, the skin will turn red and become hot. In addition to these visual signs, the main symptoms of phlebitis are elevated body temperature, general weakness, and dizziness. In its chronic form, the clinical picture will not be so bright and will appear exclusively during periods of exacerbations, however, weakness and fever may persist during periods of remission.
In the acute form of phlebitis of the deep veins, for example, if we consider phlebitis of the legs in the area of the inguinal veins, the following symptoms are characteristic: swelling at the site of inflammation, hyperthermia of this part of the body, pain. But the color of the skin, in contrast to the surface form, becomes milky white.
Pylephlebitis is usually accompanied by symptoms of purulent intoxication of the abdominal cavity: weakness, headache, yellowness of the whites of the eyes and skin, vomiting and sharp cutting pain on the right side under the ribs. It can develop from an acute form to a chronic one, and cause kidney and liver failure.
The cerebral form is characterized by such signs of phlebitis as headache, increased blood pressure, and weakness.
When diagnosing one of the forms of this disease, the doctor often prescribes a set of therapeutic measures to the patient.
In general, treatment of phlebitis is carried out using conservative methods - that is, with medication, using physiotherapeutic procedures, preventive measures and adherence to a certain lifestyle.
In the case of treatment of mild phlebitis of the superficial veins, in particular phlebitis of the upper extremities, formed as a result of catheterization or needle punctures, only anesthetic procedures are required. If the cause of the disease is an infection, the basis of treatment will be measures to eliminate it from the body, and only then eliminate the consequences of inflammation of the vein walls.
Most often, such treatment is carried out on an outpatient basis, that is, at home. But in particularly advanced cases of deep vein phlebitis, or progressive thrombophlebitis, hospitalization may be required for complex therapy.
What does it mean to treat phlebitis conservatively? This concept includes a number of purposes, in particular:
In addition to general prescriptions for the treatment of individual cases of phlebitis, the doctor must prescribe prophylaxis to the patient in order to avoid a recurrence of this disease in the future.
First and foremost on the list of things that will help a person avoid phlebitis is a healthy lifestyle. Compliance with it significantly reduces the risk of developing the disease. In addition, you should also give up a sedentary lifestyle and spend more time outdoors.
In case of predisposition to varicose veins, to prevent phlebitis, it is worth conducting courses of treatment with ointments containing heparin .
Another means of preventing phlebitis is monitoring the correct placement of IVs, intravenous injections and avoiding mechanical injuries to the veins. Also, for prevention, treatment of pustular diseases, inflammatory processes, and infections of various kinds should be started in a timely manner. To prevent thrombophlebitis, under the supervision of a doctor, you should also monitor your blood viscosity, for which you should be examined by a phlebologist at least once a year.
In general, to summarize, the following points can be drawn:
Inflammation of the vein walls is an extremely unpleasant, but fortunately treatable disease. If you do not start its course and promptly contact a specialist of the appropriate profile - a phlebologist - it will not cause too serious harm to the body, will not become an obstacle to the patient’s high quality of life, and will quickly heal with the help of fairly simple measures.
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12/07/2014 | Author admin
Hemorrhoids are a fairly common disease, although many of our compatriots prefer not to disclose such delicate details from their lives and do not even go to the doctor because they are “ashamed.” Statistics show that all segments of the population suffer from it - from small children to pensioners. Some to a greater extent, some to a lesser extent (for example, 40% of all patients are men over 40 years old). But the disease brings nothing but unpleasant sensations to everyone without exception. Therefore, it is impossible not to think about the disease (it reminds itself of itself every time a person visits the toilet).
If the mother definitely takes the child to the doctor (having suspected something is wrong, and children usually do not suffer in silence, but complain at the first symptoms), then it is sometimes very difficult to force an adult to go to the doctor. He becomes ashamed (what kind of intimate place should he show to a stranger!), and is afraid that he will need painful procedures or even a complex operation... Is this a familiar situation? But in vain! Firstly, you should know that often the doctor treats hemorrhoids exclusively with the help of local agents (especially when the situation is “fresh”, that is, you came in on time), and this does not hurt at all! Secondly, all modern diagnostic methods do not cause significant discomfort. You will experience much more unpleasant sensations when you delay your visit to the doctor and find yourself completely “accidentally” on the operating table with stage 3-4 of the disease and severe bleeding. Thirdly, your “hemorrhoids” may not be hemorrhoids at all (but a cancerous tumor, for example), so delay is fraught not only with loss of health, but also of life!
In our article we will look at hemorrhoids from all sides: which doctor treats the disease, how he does it, and also lightly touch on such a topic as the significance of the science of “Coloproctology”.
You probably have hemorrhoids: which doctor should you go to? How can he help you? Let's look at these questions in this section. It happens that a person would seem happy to go to a medical professional, but he doesn’t know which one... Hence the complexes: it’s embarrassing to ask someone for advice, but there’s no longer enough strength to endure. It turns out to be a vicious circle, the chains of which we will now help you break!
If you want the most complete help, then this is the doctor for you: a doctor who treats hemorrhoids quickly and at a professional level, who has experience in this particular specialization. And, most importantly, to whom you are not ashamed to turn, since for him this disease is from the category of ordinary! As many have already guessed, we are talking about a proctologist.
It is the coloproctologist who treats hemorrhoids of any stage. He conducts an examination, if necessary, prescribes additional examinations, analyzes the situation, and ultimately prescribes effective treatment. After recovery, the patient needs to visit this doctor from time to time so as not to miss the onset of relapse of the disease (so-called relapses, which sometimes occur after 3-5 years).
We have already received the answer to the question of which doctor treats hemorrhoids, now let’s talk about what he needs to study before starting work.
Previously, this science was called “Proctology”, but in 1997 it was officially renamed “Coloproctology”. Its main direction is the study of scientific methodology on how to treat all kinds of diseases of the colon (one of which is hemorrhoids).
To become a proctologist, a student must receive a basic higher education in the specialty “Surgery” or “General Medicine”. At the same time, he undergoes residency (or graduate school, internship) in his main profession, and then professional retraining (a course of study in the specialty “Coloproctology”).
After the end of the training period, the future coloproctologist takes a qualification test and receives a certificate (certificate or certificate). Then he has the right to get to work - treating people for diseases associated with problems in the colon.
It is believed that this is one of the most specific and difficult professions of a doctor, because he must have the skills of a surgeon, a therapist, and an anesthesiologist at the same time. In addition, he is a highly specialized doctor who understands the anatomy of the rectum and can diagnose any diseases that develop in it.
A doctor who treats hemorrhoids and other rectal diseases may have a varied job.
If a doctor works in an outpatient department, then he:
If this is a doctor working in a hospital, then he:
Any doctor who treats hemorrhoids should always competently advise the patient on all issues related to his health. After all, a correctly made diagnosis in combination with clear and understandable recommendations given to the patient is the key to a person’s quick recovery!
What is important for such a doctor? Like a doctor of any profile, he needs to have high intelligence, logic, and ideally know the terminology and all information related to human anatomy.
At the same time, a good and respected proctologist, whom people completely trust (and therefore are not afraid to go to an appointment), additionally has significant experience (the more, the better), radiates positive energy and has a strong desire to help people. These are the doctors who become the most famous professionals in their field!
Some people are interested in which doctor to contact for hemorrhoids if there are no proctologists in the local clinic?
This is a fairly common situation, since there are not so many experienced professionals (this is the specifics of the work, alas). Most doctors work either in hospitals or in private clinics. If you need to go to the hospital only as a last resort (when you have advanced hemorrhoids), and you cannot afford a paid consultation, then you can go to the following specialists:
Of course, visiting a proctologist will give the best results, but in extreme cases you can always contact other doctors. They are all familiar with human anatomy and can give good recommendations.
We have already found out what the name of the doctor who treats hemorrhoids is (this can be either a coloproctologist or another specialist - a surgeon, therapist, gynecologist). Now let's talk about how he does it.
A classic specialist who works in an official medical institution uses exclusively approved diagnostic and treatment methods. He acts professionally and does not experiment on his patients.
In modern medicine, there are many ways to cure hemorrhoids without resorting to folk remedies (the effectiveness of which has not been proven by scientific research).
A responsible proctologist will first try to cure hemorrhoids of stages 1-2 without aggressive influence, exclusively with the help of medications. To do this, he usually uses:
Local medications can also be used for more advanced stages of hemorrhoids, but then they will be used as additional therapy - for pain relief and relief of irritation.
If medications do not help (the characteristics of the body play a role here, as well as the ability of tissues and blood vessels to regenerate), more radical measures are used - minimally invasive methods (stage 2-3 hemorrhoids, the proctologist will immediately begin to treat with more effective methods):
Each method has its own characteristics. But all of them are truly highly effective (more than 90% of patients report complete recovery)!
This treatment is recognized throughout the world as low-traumatic and safe. That is why it is chosen by those who do not want to go under the surgeon’s knife, but want to get rid of the problem once and for all. The only disadvantages of such methods are the high cost of the procedure and possible relapse after 3-5 years. But they are easily compensated by other advantages:
Which doctor treats hemorrhoids of the last, fourth stage? Of course, a proctologist-surgeon. He performs surgery (hemorrhoidectomy) when a person has no chance of recovery using any of the above methods.
The last stage is characterized by serious changes in the patient’s body. Thus, secondary infections and other concomitant diseases can be added to ordinary hemorrhoids, which significantly complicate the entire treatment process. If you do not react in time, everything can end very badly (even death, for example, from massive bleeding or blood poisoning).
As a rule, such people already have difficulty moving, they have complicated hemorrhoids: which doctor they see is no longer so important - the main thing is that he saves the person. You definitely can’t do this without a scalpel!
The operation has one great advantage - after it the patient does not experience relapses.
But you should not immediately ask the proctologist for surgical intervention: the operation is carried out only according to compelling indicators. For example, if a patient develops anemia due to bleeding, if there is a risk of thrombosis, and also if a person has an acute attack with pain and signs of secondary infection.
30 Nov 2014, 05:08, author: admin
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Thrombosis is the formation of blood clots in the lumen of a vessel; venous and arterial thrombosis are distinguished. Taking into account the topic of the site, we will talk about venous thrombosis.
Typically, the term thrombophlebitis refers to superficial vein thrombosis, and the terms thrombosis and phlebothrombosis refer to deep vein thrombosis.
Blood clots can form in any veins - veins of the upper and lower extremities, veins of the abdominal cavity, etc.
In order for a blood clot to form in a vein, a number of conditions or factors are necessary. In the classical version, there are three factors that contribute to thrombus formation ( Virchow's triad ).
- hypercoagulable state (increased coagulability). There are many reasons for increased blood clotting - surgery on any part of the body, pregnancy, childbirth, diabetes, excess dietary fat, oral contraceptives, dehydration, genetic factors (rare), etc.
- injury to the inner wall of the vessel (endothelium) . The vascular wall can be injured during the installation of a venous catheter, injection into a vein (due to this, thrombosis is very common in drug addicts who inject into the veins of the legs, in the groin), injuries, during radiation therapy, chemotherapy, etc.
- slowing down blood flow . It can be observed in various conditions - varicose veins, pregnancy, obesity, immobilization of a limb (for example, when wearing a cast after fractures), heart failure, forced sedentary position of the body (for example, during long air travel), compression of veins by tumors, etc.
Thrombosis can occur due to the action of one factor or a combination of them. For example, in case of a fracture of the leg bones, all three factors can be involved - increased coagulability in the case of extensive hemorrhages in the area of injury, damage to the vascular wall as a result of a mechanical shock, and a slowdown in blood flow as a result of wearing a cast.
Most often, thrombosis occurs in the veins of the lower extremities. This is due to the fact that stagnation most often occurs in these veins (obesity, varicose veins, edema, etc.).
Thrombosis of superficial and deep veins is distinguished.
attention! Deep vein thrombosis is dangerous due to the detachment of a blood clot and its migration into the pulmonary artery (pulmonary embolism), which most often leads to serious consequences or instant death!
Superficial veins are affected by thrombosis most often with varicose veins. Blockage of the vessel is accompanied by inflammation of the surrounding tissues. That is why the terms “ thrombophlebitis ” (phlebitis - inflammation of a vein), “ varicothrombophlebitis ” (inflammation of varicose veins) are used for this type of thrombosis.
Usually, in the area of varicose veins on the lower leg, pain and redness appear along the vein; in the area of redness, the vein itself is palpated as a dense, painful “cord”. There may be a slight increase in body temperature. In general, thrombophlebitis of the superficial veins is not dangerous; there is no detachment of a blood clot with pulmonary embolism (with the exception of inflammation of the great saphenous vein on the thigh and the small saphenous vein in the popliteal region, this will be discussed below). With adequate treatment, the inflammatory phenomena subside, and the patency of the veins is partially or completely restored over time.
The great saphenous vein (GSV) runs under the skin from the ankle joint along the inner surface of the leg to the inguinal fold. In the groin it flows into the deep femoral vein. That is why thrombophlebitis of the GSV is dangerous due to the transition of thrombosis from the superficial (GSV) to the deep (femoral) vein - ascending thrombophlebitis of the GSV . But thrombosis of the femoral vein is dangerous due to the detachment of a blood clot and pulmonary embolism. Therefore, if there are signs of GSV thrombosis (redness, pain along the inner surface of the thigh), you should urgently consult a surgeon or call an ambulance. Such patients are hospitalized and, if there is a threat of thrombosis spreading to the femoral vein, the GSV is ligated closer to the groin - this is a simple operation under local anesthesia.
A similar situation, but much less frequently, occurs with thrombophlebitis of the small saphenous vein (SSV) . It runs along the back of the leg and drains into the popliteal (deep) vein in the popliteal fossa.
The main therapeutic measures are reduced to elastic compression ( elastic bandage or compression hosiery ) and the prescription of medications.
Among the medications used are phlebotropic drugs (detralex, phlebodia), antiplatelet agents (thrombo-ass), anti-inflammatory drugs (Voltaren). Lyoton-gel is applied topically.
All patients require a venous ultrasound to exclude concomitant deep vein thrombosis and clarify the prevalence of superficial vein thrombophlebitis.
– a more severe illness, usually requiring the patient to stay in a hospital.
Thrombosis of the deep veins of the leg is distinguished . popliteal vein . femoral vein . iliofemoral (ileofemoral) thrombosis . Often there is damage to thrombosis of several sections (for example, the popliteal and femoral veins, deep veins of the leg and popliteal vein, etc.).
Deep vein thrombosis manifests itself primarily as swelling and moderate pain. Moreover, the higher the level of thrombosis, the more pronounced the edema. Thus, with thrombosis of the deep veins of the leg, there may be moderate swelling of the leg, sometimes the swelling is so insignificant that it is detected only when measuring the circumference of the leg (compared to the healthy leg). With thrombosis of the femoral or iliac (continuation of the femoral) veins, the entire leg, up to the groin, and in severe cases, the lower part of the abdominal wall swells.
In the photo - the left lower limb is cyanotic, thickened to the groin - deep vein thrombosis at the level of the iliofemoral segment (ileofemoral thrombosis).
Thrombosis, as a rule, is unilateral, so only one leg swells. Bilateral edema is observed with thrombosis of the inferior vena cava, deep vein thrombosis in both legs (which is quite rare).
Another symptom of thrombosis is pain . It is usually moderately expressed, pulling, sometimes bursting, is relatively constant in nature, and can intensify in a standing position. In case of deep vein thrombosis of the leg, the Homans, Lowenberg, Luvellubri, Meyer, Payra symptoms are positive.
With deep vein thrombosis, there may also be a slight increase in temperature, increased venous pattern, etc.
In almost all cases, deep vein thrombosis is treated in a hospital. An exception may be deep vein thrombosis of the leg, provided there is no threat of thromboembolism. The danger of thromboembolism can only be determined by ultrasound examination.
If deep vein thrombosis is suspected, the patient should be hospitalized immediately. In the hospital, an examination is carried out to clarify the prevalence of thrombosis, the degree of threat of pulmonary embolism, and treatment is started immediately.
Usually, drugs that reduce blood clotting (anticoagulants), antiplatelet agents, anti-inflammatory drugs, and phlebotropic agents are prescribed.
In case of massive thrombosis, in the early stages it is possible to carry out thrombolysis - the introduction of agents that “dissolve” thrombotic masses.
If there is a threat of thromboembolism, when the thrombus is attached to the wall of the vessel only by some part, and the tip of the thrombus “dangles” in the lumen of the vessel ( floating thrombus ), thromboembolism is prevented (installation of a vena cava filter, plication of the inferior vena cava, ligation of the femoral vein, etc. ).
The consequences of deep vein thrombosis vary. With a small thrombosis on the lower leg there may be no consequences. With massive thrombosis, especially “high” (at the level of the hip or above), swelling of the leg may persist for a long time, and in severe cases there may be trophic disorders, even the appearance of ulcers (post-thrombophlebitic disease ( ptfb )). Therefore, after deep vein thrombosis, the patient is prescribed treatment for a long time in the form of elastic compression (special stockings), indirect anticoagulants (warfarin under the control of blood clotting), and other drugs.
You should see a phlebologist for at least six months after thrombosis.
Occurs quite rarely. Almost never causes pulmonary embolism.
– basically the same as other venous thromboses. It may also develop as a complication of venous catheterization (cubital, subclavian catheter), sometimes arising as a result of prolonged compression or uncomfortable position of the upper limb (for example, during sleep).
– the same as other venous thromboses.