Battling Buerger’s Disease. You are a former smoker. You used to… | by Natasha Allen | Dec, 2023

You are a former smoker. You used to smoke a pack a day. You have pounding pain on your big toe on your right foot. It is riddled with dark red, blue and green veins. You could have Buerger’s disease.

Buerger’s disease is characterized by a combination of inflammation and clots in the arteries and veins that disrupt blood flow in the arms and legs.

The disease usually affects men between the ages 20 and 40. It’s more common in the Middle East and the Far East.

The cause of Buerger’s disease isn’t clear but it is strongly associated with smoking. Some research indicates that arsenic poisoning may play a role in the disease.

There is probably an impaired immune response that leads to the development of the disease. This condition, which is also called thromboangiitis obliterans, consists of blockages in the small and medium-size arteries of the arms and legs and can lead to gangrene, and, frequently, to a loss of a limb.

The first symptom of Buerger’s often is a lack of blood circulation to a section of the lower leg and localized gangrene in the toes.

On a positive note, Buerger’s disease was widely diagnosed in the United States early in this century, but the number of cases has declined drastically, while many cases continue to be seen in other parts of the world.

But smoking is almost always found in Buerger’s patients. When the patient quits smoking, the vessel inflammation and circulation deficit stops. In time, new vessels might sprout to serve the previously deprived tissue, and symptoms subside.

People with Buerger’s can also have arteriosclerosis. Buerger’s disease is a rare condition that inflames the arteries and the veins in the arms and legs. Blood vessels swell, reducing blood flow and eventually blocking blood to form clots.

When that happens, tissue damage occurs, followed by an infection and/or gangrene.

Symptoms include pain that comes and goes in your legs and feet or your arms and hands; a pain that 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); and painful, open sores on your fingers and toes.

In the case of stubborn smokers, Buerger’s disease can cause death.

According to the Cleveland Clinic, some complications of Buerger’s disease include:

§ Stroke.

§ Heart attack.

§ Transient ischemic attack.

§ Removal of toes or fingers (amputation).

§ Issues with blood vessels in your intestines.

§ Problems with your nervous system.

To diagnose Buerger’s disease, your healthcare provider will take a complete medical history, physical examination, vascular (blood vessel) tests and urine test.

Your provider will perform other tests such as an ultrasound, an ankle-brachial index, computed tomography (CT), angiogram and magnetic resonance angiogram (MRA).

There are some medicines that are useful in treating Buerger’s disease including:

§ Vasodilators, like calcium channel blockers, to make blood flow smoother.

§ Medicines to prevent inflammation.

§ Analgesics to help with pain and ulcer healing.

§ Anticoagulants to prevent blood clots.

§ Antibiotics for ulcers.

You may experience relief from Buerger’s disease symptoms with exercise; arm and leg compression therapy; surgery for pain or better blood flow; stimulation of your spinal cord; and removal of fingers or toes when an infection or gangrene occurs.

There is no cure for Buerger’s disease. The best way to prevent the disease from spreading is to stop smoking. About 50 percent of the people with Buerger’s disease who keep using tobacco end up having to get a finger or toe removed. People with the condition who quit smoking hardly ever need an amputation.

If you suspect you have Buerger’s disease, contact your provider right away and quit smoking.

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