Buerger’s Disease

Alternative Nane:Thromboangiitis obliterans

Definition:
Buerger’s disease is a rare disease of the arteries and veins in the arms and legs.In this disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger’s disease usually first shows in the hands and feet and may eventually affect larger areas of your arms and legs.

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Buerger’s disease is rare in the United States, but is more common in the Middle East and Far East. Buerger’s disease usually affects men younger than 40 years of age, though it’s becoming more common in women.

Virtually everyone diagnosed with Buerger’s disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger’s disease. For those who don’t quit, amputation of all or part of a limb may be necess

Symptoms:
The following are the symptoms of Buerger’s:
•Intermittent leg pains
•Leg numbness
•Leg tingling
•Leg burning
•Leg paresthesias
•Foot pains
•Leg pain worse with exertion
•Foot pain worse with exertion
•Foot paresthesias
•Foot numbness
•Foot tingling
•Foot burning
•Cold feet
•Foot discoloration
•Poor leg circulation
•Poor hand circulation – in some less common cases
•Severe pain in extremities at rest
•Insomnia
•Sensation of cold at extremities
•Cold hypersensibility
•Sudden sweating
•Dyshidrosis
•Ulceration of extremities
•Gangrene of extremities
•Blood vessel inflammation
•Blood vessel thrombosis
•Rest pain
•Unremitting ischemic ulcerations
•Gangrene of the digits of hands and feet

The lack of sufficient blood flow to the hands and feet leads to the development of tissue ischemia and sores or lesions. This can eventually lead to the death (necrosis) of affected tissues and gangrene, which may require removal of the dead tissues or amputation in the most severe cases.

Buerger’s disease can mimic or occur in conjunction with a condition called Raynaud’s phenomenon. Symptoms of Raynaud’s phenomenon include a change in color of the affected fingers and toes. The fingers and toes may appear pale, grey or bluish (cyanosis). The hands and feet may feel very cold and there may also be pain, throbbing, burning or numbness….more about Buerger’s disease »

Causes:
The precise cause of Buerger’s disease is unknown.
It’s believed that in genetically susceptible individuals, smoking triggers an autoimmune response that causes the inflammation. The symptoms occur as a result of inadequate blood supply to the tissues.

Diagnosis:
Patient history and physical examination strongly suggest Buerger’s disease.
The condition is characterized by swelling in the arteries and veins of the arms and legs. The cells that cause the inflammation and swelling — and eventually blood clots — form in the vessels leading to your hands and feet and block the blood flow to those parts of your body.

Reduced blood flow means that the skin tissue in your hands and feet doesn’t get adequate oxygen and nutrients. This leads to the signs and symptoms of Buerger’s disease, beginning with pain and weakness in your fingers and toes and spreading to other parts of your arms and legs.

While no tests can confirm whether you have Buerger’s disease, your doctor will likely order tests to rule out other more common conditions or confirm suspicion of Buerger’s disease brought on by your signs and symptoms.

Tests may include:

Blood tests
Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out scleroderma, lupus, blood-clotting disorders and diabetes, along with other diseases and conditions.

The Allen’s test
Your doctor may perform a simple test called the Allen’s test to check blood flow through the arteries carrying blood to your hands. In the Allen’s test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color. Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Buerger’s disease.

Angiogram
An angiogram, also called an arteriogram, helps doctors see the condition of your arteries. A special dye is injected into an artery, after which you undergo

X-rays or other imaging tests. The dye helps to delineate any artery blockages that show up on the images. Your doctor may order angiograms of both your arms and your legs — even if you don’t have signs and symptoms of Buerger’s disease in all of your limbs. Buerger’s disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage.

* Doppler ultrasonography to show diminished circulation in the peripheral vessels

* plethysmography to help detect decreased circulation in the peripheral vessels

Risk Factors:

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Tobacco use
Cigarette smoking greatly increases your risk of Buerger’s disease. Heavy cigarette smokers (people who smoke one and a half packs a day or more) are most likely to develop Buerger’s disease, though it can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco may have the greatest risk of Buerger’s disease.

It isn’t clear how tobacco use increases your risk of Buerger’s disease, but virtually everyone diagnosed with Buerger’s disease uses tobacco. It’s thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. Rates of Buerger’s disease are highest in areas of the Middle

East and Far East where heavy smoking is most common.

Although secondhand smoke isn’t thought to be a major risk factor for Buerger’s disease, if you’re diagnosed, you should stay away from people who are

Smoking. Secondhand smoke could worsen your condition.

Chronic gum disease :Long-term infection of the gums is also associated with the development of Buerger’s disease.

Treatment:
The only effective treatment for Buerger’s disease is to quit smoking (smoking cessation) and to abstain from the use of all tobacco products, such as chewing tobacco. At this time, there are no medications that are effective in treating Buerger’s disease.

If an affected individual continues to smoke, they’re likely to have toes and/or fingers amputated. Infections should be treated promptly.

Smoking cessation is a challenging process and requires a multifaceted approach to be successful. For optimal results with smoking cessation, it is recommended that a smoker consults with a health care provider prior to quitting. Smoking cessation can include a combination of nicotine replacement therapy to minimize the nicotine cravings associated with nicotine withdrawal, and participation in a smoking cessation support group, such as Freedom From Smoking (http://www.ffsonline.org/ ) or Nicotine Anonymous (http://www.nicotine-anonymous.org).

Lifestyle & Home Remedies:
Take care of your fingers and toes if you have Buerger’s disease. Check the skin on your arms and legs daily for cuts and scrapes, keeping in mind that if you’ve lost feeling to a finger or toe you may not feel, for example, a cut when it happens. Keep your fingers and toes protected and avoid exposing them to cold.

Low blood flow to your extremities means your body can’t resist infection as easily. Small cuts and scrapes can easily turn into serious infections. Clean any cut with water, apply antibiotic ointment and cover it with a clean bandage. Keep an eye on any cuts or scrapes to make sure they’re healing. If they get worse or heal slowly, see your doctor promptly.

Visit your dentist regularly to keep your gums and teeth in good health and avoid gum disease, which in its chronic form is associated with Buerger’s disease.
Prognosis: The disease is progressive in patients who do not stop smoking. Areas with gangrene must be removed surgically.

Prevention:
Quit using tobacco in any form
Virtually everyone who has Buerger’s disease has used tobacco in some form, most prominently cigarettes. To prevent Buerger’s disease, it’s important to not use tobacco.

Quitting smoking can be hard. If you’re like most people who smoke, you’ve probably tried to quit in the past, but haven’t been successful. It’s never too late to try again. Talk to your doctor about strategies to help you quit.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.wrongdiagnosis.com/b/buergers_disease/intro.htm
http://edition.cnn.com/HEALTH/library/buergers-disease/DS00807.html
http://www.mayoclinic.com/health/buergers-disease/DS00807
http://www.bbc.co.uk/health/physical_health/conditions/buergher1.shtml

Buerger’s Disease

http://modernmedicalguide.com/buergers-disease/

http://indiahealthtour.com/treatments/vascular/buerger-disease-thromboangiitis-obliterans-treatment-india.html

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