Buerger’s Disease

An uncommon condition that affects the arteries and veins in the arms and legs is called Buerger's disease. Your blood vessels enlarge and become irritated with thromboangiitis obliterans, or Buerger's disease, and they may get clogged by blood clots (thrombi).

The skin tissues are eventually harmed or destroyed, which increases the risk of infection and gangrene. Buerger's disease often manifests initially in your hands and feet before spreading to more extensive portions of your arms and legs.

Almost everyone with Buerger's illness smokes cigarettes or uses chewing tobacco or another tobacco product. The only method to stop Buerger's disease is to quit using cigarettes in any form. Amputation of a whole or a portion of a limb may occasionally be required for individuals who don't give up.

Buerger’s Disease: Causes

It is unclear what specifically causes Buerger's illness. Smoking contributes to the onset of Buerger's disease, although it is unclear how. The lining of your blood vessels may get irritated by substances in tobacco, producing swelling.

The condition may be inherited in certain people, according to experts. The disease may also be brought on by an autoimmune reaction, in which the body's immune system unintentionally targets healthy tissue.

Buerger’s Disease: Symptoms

The major symptoms include −

• Numbness or tingling in the hands or feet.

• Hands or feet with a crimson, blue, or pale color.

• You may experience intermittent pain in your hands, arms, or legs. When you cease using your hands or feet to do an activity (claudication), or while you're at rest, the discomfort may subside.

• A vein immediately below the skin's surface experiencing inflammation (due to a blood clot in the vein).

• Pallid hands and feet (Raynaud's phenomenon) when exposed to cold.

• Your fingers and toes have throbbing open sores.

Blood flow to your arms and legs will diminish as Buerger's illness progresses. This is brought on by obstructions that hinder blood flow to the tips of your fingers and toes. Without blood, tissues lack the oxygen and nutrients required for survival.

This may result in the death of the skin and tissue on the tips of your fingers and toes (gangrene). Black or blue skin, numbness in the afflicted finger or toe, and an unpleasant odor from the affected area are all indications of gangrene. A severe disease called gangrene typically necessitates amputating the afflicted finger or toe.

Buerger’s Disease: Risk Factors

The major risk factors include −

Nicotine Usage

Smoking cigarettes significantly raises your chance of developing Buerger's illness. Yet, anybody who uses tobacco, including those who smoke cigars and chew tobacco, is susceptible to Buerger's disease.

The greatest risk of developing Buerger's disease may be among individuals who smoke more than a pack and a half of cigarettes each day and hand-rolled cigarettes made from raw tobacco. In regions of the Mediterranean, Middle East, and Asia where heavy smoking is most prevalent, Buerger's disease rates are greatest.

Persistent Gum Disease

Although the cause of this association is not fully understood, long-term gum infection has been associated with the onset of Buerger's disease.

Age and Gender

Males are considerably more likely than females to have Buerger's disease. Yet, this discrepancy could be explained by men smoking more often than women. Those under the age of 45 are frequently the ones who initially develop the condition.

Buerger’s Disease: Diagnosis

Although no test can definitively determine if you have Buerger's disease, your doctor will probably request testing to either confirm the suspicion of Buerger's disease based on your signs and symptoms or to rule out other more prevalent disorders.

Testing could involve the following −

A Blood Test

Other illnesses that can cause comparable signs and symptoms may be ruled out by blood tests to check for specific chemicals. Blood tests, for instance, can be used to rule out diabetes, blood-clotting problems, and autoimmune illnesses like lupus and scleroderma.

Allen's Examination

To assess blood flow through the arteries supplying blood to your hands, your doctor could do a quick test known as Allen's test. Making a tight fist during Allen's test causes the blood in your hand to flow out. Your hand loses its natural hue when your doctor applies pressure to the arteries on each side of your wrist to limit the flow of blood back into your hand.

The doctor will then relieve the pressure on one artery at a time when you open your hand. The speed at which the color returns to your hand might provide a broad clue as to the condition of your arteries. An issue, such as Buerger's disease, may be indicated by slow blood flow into your hand.

Angiogram

Your arteries' health may be seen with the use of angiography. CT or MRI scans can be used to perform an angiography without any physical contact. Alternatively, a catheter can be inserted into an artery to do the procedure. A specific dye is injected into the artery during this treatment, and you then go through a series of quick X-rays. Any arterial obstructions are made more visible in the photographs by the dye.

Even if you don't have symptoms or signs of Buerger's disease in all of your limbs, your doctor may request angiograms of your arms and legs. Even though you might not have symptoms in your other limbs, Buerger's disease nearly usually affects more than one leg, thus this test may identify it even if you don't have signs or symptoms.

Buerger’s Disease: Treatment

Although there is no cure for Buerger's disease, giving up all tobacco products is the most effective strategy to slow the progression of the condition. A few smokes a day might make the condition worse.

To help you stop smoking and reduce the swelling in your blood vessels, your doctor might offer advice and pharmaceutical recommendations. Because nicotine replacement medications include nicotine, which stimulates Buerger's disease, you should stay away from them. You can utilize items that don't contain nicotine.

A residential smoking cessation program is an additional choice. In these programs, you spend a certain number of days or weeks at a treatment center, which is occasionally a hospital.

• Drugs to widen blood arteries, increase blood flow, or dissolve blood clots

• Compression is applied just sometimes to your arms and legs to improve blood flow to your extremities.

• Stimulating the spinal cord

• Amputation in the event of infection or gangrene

Buerger’s Disease: Prevention

Almost all individuals with Buerger's illness have used tobacco in some capacity, most notably cigarettes. It's crucial to stop using cigarettes if you want to avoid Buerger's illness.

It might be challenging to stop smoking. You've undoubtedly attempted to stop smoking in the past if you're like most smokers. Retrying is never too late. Ask your doctor for advice on effective quitting methods.

Conclusion

An unidentified medical disorder with a strong relation to tobacco addiction is known as Buerger's Disease. Although few randomized clinical trials are investigating the efficacy of alternative therapy, they are nevertheless significant because surgical revascularization is typically not an option. The cornerstone of management today is the full cessation of all cigarette usage.