Buerger's disease is an uncommon artery and vein disease of the arms and legs. Buerger's disease, also known as thromboangiitis obliterans, causes your blood arteries to become inflamed, swollen, and potentially obstructed by blood clots (thrombi).
This eventually causes skin tissue damage or destruction, which can lead to infection and gangrene. Buerger's disease generally begins in the hands and feet and can progress to affect wider portions of the arms and legs.
Almost everyone with Buerger's illness smokes or uses other kinds of tobacco, such as chewing tobacco. The only method to stop Buerger's disease is to cease using all types of tobacco. Amputation of all or part of a limb is occasionally required for people who refuse to quit.
WHAT ARE THE SYMPTOMS OF BUERGER'S DISEASE?
Symptoms of Buerger's disease include:
- Numbness or tingling in the hands or feet.
- Hands and feet that are pale, reddish, or blue in color.
- Pain in your legs and feet, as well as your arms and hands, that comes and goes. This discomfort may develop when using your hands or feet and subsides when you cease doing so (claudication) or when you are at rest.
- Inflammation of a vein at the skin's surface (due to a blood clot in the vein).
- When exposed to cold, the fingers and toes appear pale (Raynaud's phenomenon).
- Open sores on your fingers and toes that are painful.
WHAT ARE THE CAUSES OF BUERGER'S DISEASE?
Buerger's disease has an unknown etiology. While it is obvious that tobacco use contributes to the development of Buerger's disease, it is unclear how. Tobacco compounds are considered to irritate the lining of your blood vessels, causing them to enlarge.
Some people may have a hereditary susceptibility to the condition, according to experts. It's also conceivable that the condition is triggered by an autoimmune reaction, in which the body's immune system assaults healthy tissue by mistake.
WHAT ARE THE RISK FACTORS FOR BUERGER'S DISEASE?
Tobacco consumption
Cigarette smoking dramatically raises your chances of developing Buerger's disease. Buerger's disease, on the other hand, can affect anyone who uses tobacco, including cigars and chewing tobacco.
People who smoke hand-rolled cigarettes made from raw tobacco, as well as those who smoke more than a pack and a half of cigarettes each day, are at the highest risk of developing Buerger's disease. Buerger's disease is more frequent in the Mediterranean, Middle East, and Asia, where heavy smoking is prevalent.
Chronic gum disease
Long-term gum infection has been associated to the development of Buerger's disease, while the explanation for this association is unknown.
Sex
Buerger's disease affects much more men than women. This disparity, however, may be related to men's greater smoking rates.
Age
People under the age of 45 are more likely to get the condition.
WHAT ARE THE COMPLICATIONS OF BUERGER'S DISEASE?
Blood flow to your arms and legs declines as Buerger's disease develops. This is because blockages make it difficult for blood to reach the tips of your fingers and toes. Tissues that do not receive blood do not obtain the oxygen and nutrients that they require to thrive.
This might result in the death of the skin and tissue on the tips of your fingers and toes (gangrene). Gangrene symptoms include black or blue skin, loss of sensation in the afflicted finger or toe, and a foul odor emanating from the affected region. Gangrene is a severe disease that typically necessitates the amputation of the afflicted finger or toe.
HOW IS BUERGER'S DISEASE DIAGNOSED?
While no tests can definitively determine if you have Buerger's disease, your doctor will almost certainly request testing to rule out other more prevalent disorders or confirm suspicion of Buerger's disease based on your signs and symptoms. Among the possible tests are:
Blood tests
Blood testing for certain chemicals can rule out other illnesses that generate similar signs and symptoms. Blood testing, for example, can aid in the diagnosis of autoimmune illnesses such as scleroderma or lupus, blood-clotting problems, and diabetes.
The Allen's test
To examine blood flow through the arteries delivering blood to your hands, your doctor may perform a simple test called the Allen's test. You create a tight fist in the Allen's test, which pushes the blood out of your hand. Your doctor applies pressure to the arteries on each side of your wrist to delay the flow of blood back into your hand, causing the color of your hand to fade.
After that, you open your hand and your doctor relieves pressure on one artery, then the other. The speed with which the color returns to your hand may provide a broad indicator of the health of your arteries. Slow blood flow into your hand might be an indication of a condition, such as Buerger's disease.
Angiogram
An angiography provides information about the status of your arteries. An angiography can be performed non-invasively using CT or MRI images.
Alternatively, a catheter can be inserted into an artery. A specific dye is injected into the artery during this treatment, followed by a series of fast X-rays. The dye aids in the visualization of any arterial blockages on the pictures.
Even if you don't have Buerger's disease in all of your limbs, your doctor may request angiograms of both your arms and legs. Because Buerger's disease almost invariably affects more than one limb, this test may detect early evidence of vascular damage even if you don't have symptoms in your other limbs.
WHAT ARE THE TREATMENTS FOR BUERGER'S DISEASE?
Quitting smoking
Although there is no cure for Buerger's disease, the most effective approach to prevent it from worsening is to cease smoking any tobacco products. Even a few smokes each day can exacerbate the condition.
Your doctor can counsel you and prescribe drugs to help you quit smoking and reduce blood vessel swelling. You should avoid nicotine replacement products since they include nicotine, which triggers Buerger's illness. There are non-nicotine options available.
A residential smoking cessation program is another possibility. You remain at a treatment center, sometimes a hospital, for a defined number of days or weeks in these programs. During that period, you will attend daily counseling sessions and other activities to help you deal with your cigarette cravings and learn to live tobacco-free.
Other treatments
Other therapy options for Buerger's disease exist, however they are less successful than stopping smoking. Among the options are:
Drugs that dilate blood arteries, enhance blood flow, or dissolve blood clots
Compressing your arms and legs intermittently to promote blood flow to your extremities.
Stimulation of the spinal cord
If infection or gangrene develops, amputation may be required.
Future treatment options
- Nerve surgery: Surgery to sever the nerves leading to the afflicted area (surgical sympathectomy) to decrease pain and boost blood flow, albeit this surgery is controversial and long-term benefits have not been well explored.
- Developing new blood vessels: Medications that induce the creation of new blood vessels (therapeutic angiogenesis), an experimental method
- Bosentan (Tracleer): This medicine has been authorized for the treatment of pulmonary hypertension. In brief tests of persons with Buerger's illness, the medication increased blood flow.
- Blood vessel procedure: A tiny catheter put into blood arteries may open them, restoring blood flow. Although this method, known as endovascular therapy, is not extensively utilized, it has the potential to be helpful.
HOME REMEDIES FOR BUERGER'S DISEASE
You can help improve your symptoms by doing the following things on your own:
- Exercise: Regular physical exercise can assist you in a variety of ways, including relieving some of the discomfort associated with Buerger's illness. Most days of the week, try to obtain at least 30 minutes of moderate aerobic activity, such as walking or riding.
- Skin care: If you have Buerger's disease, take care of your fingers and toes. Check the skin on your arms and legs for cuts and scrapes on a regular basis, keeping in mind that if you've lost sensation in a finger or toe, you may not notice a cut when it occurs. Keep your fingers and toes warm by not exposing them to the cold.
- Prevention of infection: Low blood supply to your extremities implies your body is less able to fight illness. Small cuts and scratches can quickly become dangerous illnesses.
Soap and rinse any cuts, apply antibiotic ointment, then wrap with a clean bandage. Keep an eye on any wounds or scrapes to ensure they heal properly. If they worsen or heal slowly, consult your doctor right away.
- Gum care: Visit your dentist on a regular basis to maintain your gums and teeth healthy and to avoid gum disease, which is connected to Buerger's disease in its chronic form.
- Avoiding the smoke of others: In addition to not smoking, it is critical to prevent secondhand smoke.