Varicose Veins

What Are Varicose Veins?

Varicose (VAR-i-kos) veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs. However, they also can form in other parts of your body.

Varicose veins are a common condition. They usually cause few signs or symptoms. In some cases, varicose veins may cause complications, such as mild to moderate pain, blood clots, or skin ulcers.

Overview

Veins are blood vessels that carry blood from your body’s tissues to your heart. The heart pumps the blood to your lungs to pick up oxygen. The oxygen-rich blood is then pumped out to your body through your arteries.

From your arteries, the blood flows through tiny blood vessels called capillaries, where it gives up its oxygen to the body’s tissues. Your blood then returns to your heart through your veins to pick up more oxygen.

Veins have one-way valves that help keep blood flowing toward your heart. If your valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell and can lead to varicose veins.

A number of factors may increase your risk for varicose veins. These include family history, age, gender, pregnancy, overweight or obesity, and lack of movement.

Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.

Outlook

Varicose veins usually don’t cause medical problems. If your varicose veins cause few signs and symptoms, your doctor may suggest simply making lifestyle changes.

In some cases, varicose veins can cause complications, such as pain, blood clots, or skin ulcers. If your condition is more severe, your doctor may recommend one or more medical procedures. Some people choose to have these procedures to improve the appearance of their varicose veins or to relieve pain.

A number of treatments are available for varicose veins that are quick and easy and don’t require a long recovery time.

National Heart Lung and Blood Institute

What Is Peripheral Arterial Disease?

Peripheral arterial disease (P.A.D.) occurs when plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.

When plaque builds up in arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.

P.A.D. usually affects the legs, but also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.

Normal Artery and Artery With Plaque Buildup

The illustration shows how P.A.D. can affect arteries in the legs. Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of the normal artery. Figure B shows an artery with plaque buildup that’s partially blocking blood flow. The inset image shows a cross-section of the narrowed artery.

Overview

Blocked blood flow to your legs can cause pain and numbness. It also can raise your risk of getting an infection in the affected limbs. It may be hard for your body to fight the infection.

If severe enough, blocked blood flow can cause tissue death (gangrene). In very serious cases, this can lead to leg amputation.

If you have leg pain when you walk or climb stairs, talk to your doctor. Sometimes older people think that leg pain is just a symptom of aging. However, the cause for the pain could be P.A.D. Tell your doctor if you're feeling pain in your legs and discuss whether you should be tested for P.A.D.

Smoking is the main risk factor for P.A.D. If you smoke or have a history of smoking, your risk for P.A.D. increases four times. Other factors, such as age and having certain diseases or conditions, also increase your risk.

Outlook

If you have P.A.D., your risk for coronary artery disease, heart attack, stroke, and transient ischemic attack (“mini-stroke”) is six to seven times greater than the risk for people who don’t have P.A.D. If you have heart disease, you have a 1 in 3 chance of having blocked leg arteries.

Although P.A.D. is serious, it’s treatable. If you have the disease, it’s important to see your doctor regularly and treat the underlying atherosclerosis.

P.A.D. treatment may slow or stop disease progress and reduce the risk of complications. Treatments include lifestyle changes, medicines, and surgery or procedures. Researchers continue to explore new therapies for P.A.D.

NIH

What are Hemorrhoids?

What are hemorrhoids?

The term hemorrhoids refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed.

Hemorrhoids may result from straining to move stool. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea, and anal intercourse.

Hemorrhoids are either inside the anus—internal—or under the skin around the anus—external.

What are the symptoms of hemorrhoids?

Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching, also called pruritus ani, have similar symptoms and are incorrectly referred to as hemorrhoids.

Hemorrhoids usually are not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days.

Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

How common are hemorrhoids?

Hemorrhoids are common in both men and women. About half of the population has hemorrhoids by age 50. Hemorrhoids are also common among pregnant women. The pressure of the fetus on the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.

How are hemorrhoids diagnosed?

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon, or sigmoid, with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

What is the treatment?

Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include:

• 
  tub baths several times a day in plain, warm water for about 10 minutes
• 
  application of a hemorrhoidal cream or suppository to the affected area for a limited time

Preventing the recurrence of hemorrhoids will require relieving the pressure and straining of constipation. Doctors will often recommend increasing fiber and fluids in the diet. Eating the right amount of fiber and drinking six to eight glasses of fluid—not alcohol—result in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding.

Good sources of fiber are fruits, vegetables, and whole grains. In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).

In some cases, hemorrhoids must be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue. The doctor will perform the procedure during an office or hospital visit.

A number of methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:

Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.

Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.

Infrared coagulation. A special device is used to burn hemorrhoidal tissue.

Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.

How are hemorrhoids prevented?

The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs. Exercise, including walking, and increased fiber in the diet help reduce constipation and straining by producing stools that are softer and easier to pass.

NIH

Abdominal Adhesions

What are abdominal adhesions?

Abdominal adhesions are bands of tissue that form between abdominal tissues and organs. Normally, internal tissues and organs have slippery surfaces, which allow them to shift easily as the body moves. Adhesions cause tissues and organs to stick together.

The intestines are part of the digestive system. Abdominal adhesions can cause an intestinal obstruction.

Although most adhesions cause no symptoms or problems, others cause chronic abdominal or pelvic pain. Adhesions are also a major cause of intestinal obstruction and female infertility.

What causes abdominal adhesions?

Abdominal surgery is the most frequent cause of abdominal adhesions. Almost everyone who undergoes abdominal surgery develops adhesions; however, the risk is greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries. Adhesions can become larger and tighter as time passes, causing problems years after surgery.

Surgery-induced causes of abdominal adhesions include

tissue incisions, especially those involving internal organs
the handling of internal organs
the drying out of internal organs and tissues
contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches
blood or blood clots that were not rinsed out during surgery
A less common cause of abdominal adhesions is inflammation from sources not related to surgery, including

appendicitis—in particular, appendix rupture
radiation treatment for cancer
gynecological infections
abdominal infections
Rarely, abdominal adhesions form without apparent cause.

How can abdominal adhesions cause intestinal obstruction?

Abdominal adhesions can kink, twist, or pull the intestines out of place, causing an intestinal obstruction. An intestinal obstruction partially or completely restricts the movement of food or stool through the intestines. A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.

How can abdominal adhesions cause female infertility?

Abdominal adhesions cause female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Adhesions can kink, twist, or pull out of place the fallopian tubes, which carry eggs from the ovaries—where eggs are stored and released—to the uterus.

What are the symptoms of abdominal adhesions?

Although most abdominal adhesions go unnoticed, the most common symptom is chronic abdominal or pelvic pain. The pain often mimics that of other conditions, including appendicitis, endometriosis, and diverticulitis.

What are the symptoms of an intestinal obstruction?

Symptoms of an intestinal obstruction include

severe abdominal pain or cramping
vomiting
bloating
loud bowel sounds
swelling of the abdomen
inability to pass gas
constipation
A person with these symptoms should seek medical attention immediately.

How are abdominal adhesions and intestinal obstructions diagnosed?

No tests are available to diagnose adhesions, and adhesions cannot be seen through imaging techniques such as x rays or ultrasound. Most adhesions are found during exploratory surgery. An intestinal obstruction, however, can be seen through abdominal x rays, barium contrast studies—also called a lower GI series—and computerized tomography.

How are abdominal adhesions and intestinal obstructions treated?

Treatment for abdominal adhesions is usually not necessary, as most do not cause problems. Surgery is currently the only way to break adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional adhesions and is avoided when possible.

A complete intestinal obstruction usually requires immediate surgery. A partial obstruction can sometimes be relieved with a liquid or low-residue diet. A low-residue diet is high in dairy products, low in fiber, and more easily broken down into smaller particles by the digestive system.

Can abdominal adhesions be prevented?

Abdominal adhesions are difficult to prevent; however, surgical technique can minimize adhesions.

Laparoscopic surgery avoids opening up the abdomen with a large incision. Instead, the abdomen is inflated with gas while special surgical tools and a video camera are threaded through a few, small abdominal incisions. Inflating the abdomen gives the surgeon room to operate.

If a large abdominal incision is required, a special filmlike material (Seprafilm) can be inserted between organs or between the organs and the abdominal incision at the end of surgery. The filmlike material, which looks similar to wax paper, is absorbed by the body in about a week.

Other steps during surgery to reduce adhesion formation include using starch- and latex-free gloves, handling tissues and organs gently, shortening surgery time, and not allowing tissues to dry out.

Points to Remember

Abdominal adhesions are bands of tissue that form between abdominal tissues and organs, causing tissues and organs to stick together.
Although most adhesions cause no symptoms or problems, others cause chronic abdominal or pelvic pain, bowel obstruction, or female infertility.
Abdominal surgery is the most frequent cause of abdominal adhesions.
Abdominal adhesions can kink, twist, or pull the intestines out of place, causing an intestinal obstruction.
A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.
Abdominal adhesions cause female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place.
No tests are available to diagnose adhesions, and adhesions cannot be seen through imaging techniques such as x rays or ultrasound.
An intestinal obstruction can be seen through abdominal x rays, barium contrast studies—also called a lower GI series—and computerized tomography.
Surgery is currently the only way to break adhesions that cause pain, intestinal obstruction, or fertility problems.

NIH

Lung Transplantation

Lung transplantation is surgery to replace one or both diseased lungs with a healthy lung or lungs from a donor. During the operation, the surgeon makes a cut in the chest and removes the diseased lung. The surgeon then sews the new lung to the main blood vessels and air passage.

Your doctor may recommend a lung transplant if you have disease that cannot be controlled any other way. These diseases include

COPD (chronic obstructive pulmonary disease)

Cystic fibrosis

Idiopathic pulmonary fibrosis

Primary pulmonary hypertension

Complications of lung transplantation include rejection of the transplanted lung and infection.

MedlinePlus