Can varicose veins be prevented?

09 August 2016


What research is available regarding varicose veins? Why does it happen and can you prevent it? Is there any research that indicates dietary influence on venuous function?


We put this to Naked Scientist Chris Smith...

Chris - Right well, what is a varicose vein? This is common; about half of men and half of women are destined to get varicose veins. The evidence is women will get them slightly younger than men. They are bulges or dilatations in the veins often seen in the legs, and the reason for this is the pressure is greatest in veins in you longest part of your body and your dependent tissues.

So, if you imagine yourself standing up, you've got all of the mass of the blood in that column of blood vessel, which goes from your big toe right the back up to your heart, pushing down on your veins. Veins aid the return of the blood to the heart because they have valves in them and those valves allow one way flow. And every time you contract a muscle you squeeze the vein, and this applies a pressure to the blood and it pushes blood through the valve, and it moves it back up to the heart.

Now eventually, some of those valves fail a bit and so, instead of there being a short segment of water pressure pushing down on each segment of the vein, you can end up with a long column of water pushing down on one bit at the bottom of the vein. So the pressure on the wall of that vein can become quite high and it leads to that segment of the vein beginning to stretch or dilate and become torturous, and you often see this happening on the lower limb because that's where the pressure is highest.

We know that they tend to be more common in people who gain weight. We know that pregnancy is a risk factor, probably because you gain a bit of weight but you also have more pressure on your venous system. We also know that family history seems to play a role. If you have a family history of people getting varicose veins, especially at a younger age, you are more likely to succumb to them yourself, but that's not a given.

How can we treat them? Well, you can stop them happening in the first place up to a point if you minimise your risk factors. You can minimise your body mass index, which is a big risk.

Kat - Does putting your feet up a lot help?

Chris - It doesn't really seem to, no. There's not really any evidence that being lazy does help. Probably because you gain weight and so one thing begets the other.

The other thing you can do though is have surgery, and what you do is a strip of the vein and looks pretty nasty and it is pretty nasty. What you do - and I've done this operation - you take someone, hopefully anesthetized and asleep; it would be very painful if you didn't have them asleep. You thread a cannula up from the bottom of the vein right up to where it joins the vein at the top of the leg, and it's got a big bulge on the end of this cannula. This big thing - it looks a bit like a mini torpedo and once it's come out of the end of the vein you then yank back and strip out the whole of the vein all the way back along it's course.

Kat - Ewww!

Chris - And rip it all out. And you rely on the blood then finding other routes back up inside the body and that's called a stripping. And also the little ones, the little perforators, you do a multiple stab through the skin and whip them out and they just thrombose off. If they are a big problem you don't have to resort to surgery. What people sometimes do is wear those stockings called TED or thromboembolic deterrent stockings which are elastic stockings and they apply pressure across the wall of the vein, stopping the vein stretching and dilating. But, unfortunately, not everything improves with age and your risk of varicose veins is one of them.

Sorry Kat.

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