Buergers Disease - Symptoms and Treatment

Buerger's disease is an acute inflammation and thrombosis (clotting) of arteries and veins of the hands and feet. The obstruction of blood vessels in the hands and feet reduces the availability of blood to the tissues, causes pain and eventually damages or destroys the tissue. It often leads skin ulcerations and gangrene of fingers and toes. Buerger's disease is rare in the United States, but is more common in the Middle East and Far East. Buerger's disease most commonly affects men between ages 20 and 40, though it's becoming more common in women. 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 may ultimately be necessary. In most cases, the first symptom is extreme pain of the lower arms and legs while at rest. Affected individuals may also experience cramping in the legs when they walk that, in rare cases, may cause limping (claudication). In addition, affected individuals may have sores (ulcers) on the extremities, numbness and tingling and a lack of normal blood flow to the fingers and/or toes when exposed to cold temperatures (Raynaud's phenomenon), and/or inflammation and clotting of certain veins (thrombophlebitis). In severe cases, individuals with Buerger's disease may exhibit tissue death (gangrene) of affected limbs.

Buerger's disease, also called thromboangiitis obliterans, is a rare disease of the arteries and veins in the arms and legs. The cause of this disease remains unknown. The vascular lesions (inside the walls of the blood vessels) appear to be inflammatory, but the actual cause for Buerger's has been the topic of much speculation. Immunologic, toxic, and infectious causes have been postulated. Many of the patients who suffer from this disease are smokers which has lead to the implication that nicotine as at least an exacerbating factor for Buerger's disease. Males are affected more frequently than females in a ratio of approximately 75 to 1. Incidence of this disease is approximately 7 or 8 cases per 100,000 in the general population. The typical patient with Buerger's disease is a young male who smokes cigarettes and presents with the signs and symptoms of peripheral vascular disease. The lower extremities are most commonly affected and patients will often complain of coldness of the limbs. The upper extremities can be involved in up to 70% of patients with Buerger's and patients will often have symptoms of Raynaud's disease. Patients will also have their cholesterol checked in addition to a glucose tolerance test (diabetes screen) to exclude atherosclerosis, a more common cause of vascular occlusive disease. Treatment includes strict avoidance of any tobacco products. A surgical procedure to sever the sympathetic nerves (autonomic nerves) has also been used. Prognosis for life is good but amputation of the lower extremities is common in advanced disease.

Causes of Buergers Disease

Common Causes of Buergers Disease :

• Buerger's Disease is also known as thromboangiitis obliterans and its precise cause is unknown.
• This leads to the signs and symptoms of Buerger's disease, beginning with pain and weakness in your fingers and toes and advancing to other parts of your arms and legs.
• Most patients with Buerger's are heavy smokers, but some cases occur in patients who smoke "moderately"; others have been reported in users of smokeless tobacco.
• Thromboangiitis obliterans (Buerger's disease) is caused by vasculitis, which is an inflammation (irritation with presence of extra immune cells) of blood vessels
• It almost always affects men aged 20 to 40 years old who have a history of smoking or chewing tobacco.

Symptoms of Buergers Disease

Some common Symptoms of Buergers Disease :

• Swelling in your feet and hands.
• Open sores on your fingers and toes.
• Usually the patient has symptoms in both hands or in both feet, but not necessarily equally.
• In some, the foot or hand may be pale and cold, while others may have reddened skin.
• The patient may also have numbness, a burning sensation, or pain in the affected limb.
• All of the symptoms are due to the lack of circulation.
• The pulse in the wrist foot and elbow may be decreased or absent.

Treatment of Buergers Disease

• The main treatment is to STOP SMOKING immediately.  If the patient keeps smoking, then the disease will continue to proceed and become more severe.
• If infections or ulcers develop, they must be treated very quickly and aggressively to prevent spreading.
• Once the patient stops smoking, then taking good care of the hands and feet is very important.
• In some people with the disease, they may need to have some of the nerves cut (sympathectomy) to help relieve the spasming of the blood vessel, and also to help relieve some of the pain.
• Physical exercise.
• Avoidance of cold environments .
• Surgery to cut the nerves in the affected area (surgical sympathectomy) to control pain.
• Low cholesterol diet.
• Sympathectomy.