Disease information

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Venous disease of the inferior members.

The notion of venous disease of the inferior members expresses the set of hemodinámicas disturbances at sanguineous level that appears when an operation of the venous system takes place badly. This pathology, predominantly feminine (2 / 3 women in front of 1 / 3 men) is very frequent, since it reaches approximately to 40 % of the population of the developed countries.

Frequently it is pronounced with the appearance of discreet edema in the inferior members, accompanied by a sensation of slowness of legs. Also it can appear by a superficial chronic venous éstasis that can go of the simple varicosidad (arborescencia of very small red and blue intradérmicas veins) to the complex variz.

The complications of the venous disease can be of type:

Circulatory: varicose trombosis or periplexia,

• Trófico: angiodérmica and varicose ulcer.

1. The veins.

The veins are tubular structures that the return assures the blood to the heart. Like all the conductive glasses, they are protected by cells of endotelio, but they are different from other glasses in which they have, of specific form, you fold internal that corresponds to valves. These valves facilitate the circulation from the the most elevated most inferior zone to, preventing than the blood flows back towards the feet. The system to valvular allows the vein to fight against the hydrostatic pressure and the force of the gravity. The wall of a vein has a thickness smaller twice than the one of the artery.

It is formed by a weave specialized in the containment and made up of:

• smooth muscular Cells,

• elastic Fibers,

• Fibers of colágeno and specific proteoglicanos.

2. The venous system.

The venous system of the inferior members contains two networks schematically:

• deep a venous network and a superficial venous network.

Deep the venous network is the one that surrounds to the arteries. It is surrounded by the muscular mass. This network drains 90 % of the venous blood of the inferior members.

The superficial venous network is visible under the skin, is bad prote'ge'e and outside the muscle. She does not assure the return the blood more than in 10 %, and is the cause of several venous diseases of the inferior members. This network is compound essentially of internal and external safenas veins. The superficial venous network is united to the deep veins by the armor - piercing veins that are in charge to drain the blood of the surface towards the deepest zones.

3. The venous circulation.

The venous circulation is governed by two types of mechanisms: the called mechanisms passive and, by the active opposition, mechanisms.

The passive mechanisms.

The return of the venous blood is determined by the pressure differential between the periphery and the heart (right auricle) The venous pressure depends on several factors:

The arterial pressure.

It is the impulse of the arterial blood that entails the mobilization of the venous blood. The arterial system is bound to the venous system by the capillaries. When the degree of opening of the hair arterioles increases, the venous pressure increases vice versa and.

The hydrostatic pressure.

The passage of "knocked down" position, where the hydrostatic pressure is the same one in all the sides, to "the raised" position imposes to the veins of the inferior members great variations of pressure. The process is limited by two factors:

• the colágeno of the venous weave, that assures a structure to him maintenance,

• the capacity of the valves to close itself, and that divide the blood column. If it appears an excessive pressure, the valves end up losing their functionality. Before an injury to valvular, the process also worsens by the creation of a compensating superior pressure in the immediately inferior part to the damaged valve.

The peripheral tissue pressure.

This pressure is related to the contraction of muscles of the inferior members that, when compressing the deep veins, impel the blood towards the heart. The gradient of pressure between the surface and the depth explains the passage of the blood of the superficial veins towards the deep veins.

The venous aspiration.

The aspiration of the venous blood must to the conjunction of two processes:

• the contraction of the right ventricle that creates a depression in the right auricle,

• the intratorácica negative pressure.

The active mechanisms.

The veins are not only a set of túbulos in charge to lead the blood towards the cardiac cavities. Also are walls equipped with contractibilidad. The venous weave contains active elements: smooth muscular fibers that allow the vein to reduce or to increase their caliber. These fibers are compound of smooth muscular cells regulated by adrenérgicas completions. These completions release noradrenaline that causes, by activation of the receivers, a contraction of the smooth muscle. Noradrenaline at venous level is a vasoconstrictor. Other transmitters can affect to the vasomotilidad inhibiting or stimulating the liberation of this noradrenaline by the nervous completion.

The serotonin, histamina, angiotensina II and prostaglandins B1 and F2 have a vasoconstrictor effect. It agrees to consider that during a too important venous contraction, takes place an exudation of liquid at hair level due to the compensating vasodilatación of the arterioles. The prostaglandins present A1, A2, E2 and I2 in the inflammation, have an inhibiting effect on the venous smooth muscle and therefore, they cause a vasodilatación.


The organization of the venous system is, from a functional point of view, an adaptation model to fight against the force of the gravity. At the same time, he is one of the great weak points, since this complex and multifactorial regulation can be unbalanced easily.

We are going to see the different mechanisms that cause the appearance of the venous disease.


The vertical position adopted by the human being makes undergo considerable pressures to the venous network of the inferior members. He is undeniable that remaining of immovable foot and during long time favors and aggravates the venous insufficiency. It is stated very frequently in people who work during all the day of foot.

On the other hand, some studies have returned to bring to light the relation between long permanence On guard seated and the presence from varices. In the third - world countries and East, it is stated that the varicosidad is rare. The western ones sleep an average of 8 hours, 8 hours of foot work or seated and 8 hours seated in a chair or a sofa relax. Therefore, during 16 hours it is in a position that does not favor the correct venous circulation. The Japanese also relax 8 hours but walking, cycling or seated in the ground, he is to say that the Japanese are 16 hours On guard favorable. Therefore, the position seated in a doubled chair, legs, seems to favor the appearance of venous diseases.

Muscular exercise.

To walk improvement the operation of the venous system of the inferior members. The frequent muscular contractions assure a better sanguineous drainage and in addition, they develop a network of collateral veins apt to suplementar a deficient containment. To make physical exercise of continued form is a protective factor of the venous disease; on the contrary, the sedentarismo is an aggravating factor.


Thus, with the changes of temperature vasomotores phenomena are observed venous level. These variations of section of the vein must to the thermal sensitivity of the nervous completions of smooth the muscular cells. The cold causes a vasocontricción by increase of the affinity of noradrenaline by its receivers.

By an inverse process, during the exhibition to the heat, a vasodilatación takes place. The heating by the ground, sobrewarmed up means, a solar exhibition or too important thermal amplitude favor the sanguineous éstasis and the installation of the venous disease. The sensation of heavy legs, edema and the varices are agravated by the heat. The frequency of functional problems of the venous insufficiency is much greater in summer.

Hormonal factors.

The statistics are clear: the venous disease in front of affects to two women a man. As it is obvious east done is in narrow relation with the hormonal phenomena. The estrogens or, more concretely, the variation of their levels can affect the venous wall, which explains that the puberty, the menstrual cycle, the pregnancy and the premenopause are responsible for an accentuation of the venous distension. In addition, the way of feminine life, normally more sedentary, often associated to a more static work, makes that the woman reunites enough more unfavorable elements, propitious to develop a venous insufficiency.


It seems to be that the hereditary factor also can influence in the appearance of venous diseases. He is dificil to attribute ésto to the inheritance in case single, since, often, individuals of a same family have nutritional habits and similar hygiene of life. If one were inheritance, the races and the ethnic groups would be due to mark to significant differences between.

Surveys epidemiologists have tried to demonstrate this, therefore a study made by Brizzio in an India community of a native town of Argentina, demonstrates affirmative results in that sense. In the group of pure Indians, no had varices. In the group of racially mixed Indians most presented / displayed pictures of venous anomalies. In this specific case, the mestization has been the person in charge of the appearance of the varicose disease.

It is possible to be spoken of genetic weakness of the conjuntivo weave or rather question is hereditary degenerations of endotelio? La is open still today.

Free radicals.

At the moment one knows that after a chronic circulatory insufficiency, the alterations produced at level of the venous weave can have to the action of free radicals. Let us remember that the free radicals are unstable molecules that have a free electron and that tend to become stabilized, mainly after numerous physiological oxidativas reactions.

The free radicals act on lipids causing their oxidation. The oxidativa alteration of nutritional lipids is well - known for a long time: it causes a modification of the scent and the flavor (rancid) A similar phenomenon takes place on lipids of the alive organisms, mainly on which they constitute biological membranes. The free radicals are the origin of a great number of structural and functional attacks of cellular membranes. At level of the endoteliales cells, these anomalies are translated, at a first moment, problems of the permeability, people in charge of the plasmática flight (edema interstitial) Later, the action repels on the valves, with increase of the fragility and destruction in case of elevation of the venous pressure.

The muscular cells of the venous wall, can present / display morphologic and physiological anomalies produced by the free radicals giving rise to an abnormal conjuntivo weave, that does not assure its mechanical properties correctly. The oxidation of lipids of membranes also can have consequences in other structures that are not the cellular membrane. Thus, the lipids of oxidized membranes form peroxides, being known the malonil - dialdehído one (M. D. A.

This M. D. A. carrier of two free radicals, is able to act on protéicas molecules and to modify their structures. It has the property to establish a cross - sectional bridge between proteins. This bridge affects so much to the D. N. A. as to colágeno and elastina fibers, being able to alter its functional characteristics. Thus, the different weaves implied in the venous return are disorganized of progressive form by the free radicals.

After this review, we see with greater thoroughness three clinical forms susceptible to be dealt with Fitoterapia:

Beginning of a venous insufficiency,


• Hemorroides.


The varices are irregular and permanent expansions of the superficial veins. The appearance of a variz is the testimony of an precise inefficiency of the apparatus to valvular. It is translated by the passage of the blood, to crosscurrent, of the venous deep axes, towards the affected superficial vein with distension.

At first, most of the varices remains located and painless. Later, if the disease worsens, groupings with a little attractive aspect can form. Some forms very extended can have their origin in a disease that would be to diagnose.

Biological balance.

The biological balance will study the sanguineous coagulation. The evolution of the reológicas disturbances in the varicose disease is of a considerable importance then recent studies have demonstrated that, very frequently, the people with varices undergo a modification in certain sanguineous parameters. Thus, the venous circulatory flow, is diminished strongly in the case of the pathological veins (varicose expansions) then it simultaneously appears a eritrocital aggregation that an increase of plasmática viscosity. This notion is fundamental for the understanding and the treatment of the varicose disease.

Venous Doppler.

The extremeone of the veins allows to need the diagnosis insufficiency to valvular, to investigate the incontinentes armor - piercing veins and to demonstrate a possible deep trombosis.


The flebografía allows to visualize the venous network when an intervention is anticipated.

The varicose disease can have a repercussion that goes beyond the aesthetic plane and be translated in important organic signs:

• Periflebitis, with local pain and inflammation of the conjuntivo weave that surrounds the vein.

• varicose, pruriginoso Eczema, accompanied by a cutaneous pigmentación and edema in the ankle.

• varicose Ulcer, is a loss of substance of the cutaneous coating. This injury, that has little tendency to the healing, is located generally on the distal part of the legs.

These evolved states need a esclerosante or surgical treatment.


1. Esclerosante treatment.

The esclerosante treatment sets out to suppress the superficial venous ebb tide. It consists of the introduction in a variz of a chemical agent creating at local level an inflammation that has like indirect effect a total or partial retraction of the wall.

Theoretically, all variz could be esclerosada. Nevertheless, in some zones it is contraindicated (subpúbicas veins, inner or outer veins of the foot) The sclerosis can approximately deal with a 90% varices. But the danger of recidivism in the case of the voluminous varices exists, reason why he is more justifiable, in this case, the surgery. The esclerosante treatment goes accompanied of a preventive medical treatment to space the evolutionary accesses or to delay the aggressive treatments.

2. Surgical treatment.

Operation of varices consists of evenaje (stripping) that can be short, and to stop themselves in the knee, or length, and to follow until the ankle. In general this one is the last resource, only resorts to him once it has failed the farmacológico treatment.

The results are good approximately in a 80% of the cases, with the condition for having resorted to the postoperative sclerosis of the small residual varices and to the taking of venotónicos regularly.

3. Fitoterapia.

The fitoterapia can be prescribed with good results:

In the "prevaricose syndrome" (all the signs of the venous suffering are present when not yet they have appeared the varices)

• For the varices of the pregnancy.

• In the painful accesses of the varicose disease.

• Like complementary treatment of the sclerosis or the surgery.

Plants adapted for this disease.




Chestnut tree of Indians.

Red grapevine.



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