About buerger's disease

What is buerger\'s disease?

Buerger's disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi).

This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs.

Virtually everyone diagnosed with Buerger's disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger's disease. For those who don't quit, amputation of all or part of a limb is sometimes necessary.



What are the symptoms for buerger\'s disease?

Buerger's disease symptoms include:

  • Pain that may come and go in your legs and feet or in your arms and hands. This Pain may occur when you use your hands or feet and eases when you stop that activity (claudication), or when you're at rest
  • Inflammation along a vein just below the skin's surface (due to a blood clot in the vein)
  • Fingers and toes that turn pale when exposed to cold (Raynaud's phenomenon)
  • Painful open Sores on your fingers and toes

When to see a doctor

See your doctor if you think you may have signs or symptoms of Buerger's disease.



What are the causes for buerger\'s disease?

The exact cause of Buerger's disease is unknown. While tobacco use clearly plays a role in the development of Buerger's disease, it's not clear how it does so.

Experts suspect that some people may have a genetic predisposition to the disease. It's also possible that the disease is caused by an autoimmune response in which the body's immune system mistakenly attacks healthy tissue.



What are the treatments for buerger\'s disease?

Smoking cessation

Although no treatment can cure Buerger's disease, the most effective way to halt the disease's progress is to quit using all tobacco products. Even a few cigarettes a day can worsen the disease.

Your doctor can counsel you and recommend medications to help you stop smoking and stop the swelling in your blood vessels. You'll need to avoid nicotine replacement products because they supply nicotine, which activates Buerger's disease; there are non-nicotine products that you can use. If the disease is still active, your doctor may check your urine for the presence of nicotine to see if you're still smoking.

Another option is a residential smoking cessation program. In these programs, you stay at a treatment facility, sometimes a hospital, for a set number of days or weeks. During that time you participate in daily counseling sessions and other activities to help you deal with the cravings for cigarettes and to help you learn to live tobacco-free.

Other treatments

Other treatment approaches exist but are less effective. Options include:

  • Medications to dilate blood vessels, improve blood flow or dissolve blood clots
  • Intermittent compression of the arms and legs to increase blood flow to your extremities
  • Spinal cord stimulation
  • Surgery to cut the nerves to the affected area (surgical sympathectomy) to control pain and increase blood flow, although this procedure is controversial and long-term results haven't been well-studied
  • Medications to stimulate growth of new blood vessels (therapeutic angiogenesis), an approach that is considered experimental
  • Amputation, if infection or gangrene occurs



What are the risk factors for buerger\'s disease?

Tobacco use

Cigarette smoking greatly increases your risk of Buerger's disease. But Buerger's disease can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco may have the greatest risk of Buerger's disease.

It isn't clear how tobacco use increases your risk of Buerger's disease, but virtually everyone diagnosed with Buerger's disease uses tobacco. It's thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. The rates of Buerger's disease are highest in areas of the Mediterranean, Middle East and Asia where heavy smoking is most common.

Chronic gum disease

Long-term infection of the gums also is linked to the development of Buerger's disease.

Sex

Buerger's disease is far more common in males than in females. However, this difference may be linked to higher rates of smoking in men.

Age

The disease often first appears in people less than 45 years old.



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