The word varicose is a derivative of the Latin word varix which means twisted. Therefore the term varicose vein implies that the vein has become twisted, but there is much more involved than this. The veins become lumpy, knotted and unsightly, they can be painful; can cause blood clots, skin damage and ulceration.
Veins are tubular structures made up of muscular and fibrous tissue; they should be constantly filled with blood travelling in one direction; towards the heart. They carry deoxygenated blood, and the only vein within the human body that transports oxygenated blood is the pulmonary vein which takes blood into the heart from the lungs.
The term varicose vein normally conjures up an image of gnarled and contorted structures within the legs, and this is in truth, where they are most likely to develop, however, they can occur in other areas of the body such as the oesophagus, the pelvic area and the rectum. A haemorrhoid is in fact a varicose vein.
Within the legs there are three main types of veins, superficial veins, deep veins and anastomosing veins, sometimes known as perforator veins, because they perforate the fascia that surrounds the muscles.
Superficial veins are found just below the skin surface, they are visible and it is these veins that are prone to varicosity. The saphenous and the anterior tibial veins fall into the category of superficial veins. The long saphenous vein is the longest vein in the human body; it begins in the foot and is situated along the inside of the leg to the groin. The short saphenous vein is located posterior to the calf muscle to behind the knee. The anterior tibial vein lies at the front of the leg between the knee and the foot. It is these veins that are most likely to become varicose.
Deep veins are situated below the skin’s surface and are not visible. They travel through muscles and varicosities do not arise within these veins.
Anastomosing veins transport the blood from the superficial veins to the deep veins. It is the valves within the anastomosing veins that ensure that the blood flows only one way. It is when these valves malfunction that blood is pushed back into the superficial veins, the blood then pools causing the onset of varicosity, if left untreated the blood mass causes the vein to lose its elasticity and an affected vein can become so dilated that the valves cannot close, and this exacerbates the condition.
Varicose veins within the oesophagus can be life threatening, and the condition occurs due to increased pressure within the anastomosing veins at the lower end of the oesophagus. The most common causes are cirrhosis of the liver and right side heart failure. If this continues untreated the varicose veins can rupture and cause a haemorrhage which may result in death.
Varicose veins are more likely to occur with an increase in age due to loss of vein elasticity. Lack of exercise and poor diet are also predisposing factors along with obesity and gravitational pull, as in standing for long periods which can cause blood pooling in the legs and pelvis.
Preventative measures include regular physical exercise to improve circulation, frequent elevation of the legs; this is especially important following long periods of standing, a nutritious diet and maintaining weight within normal limits for height and bone density.
