BUERGER'S DISEASE

General Information

DEFINITION--Blockage of small and medium arteries--usually in the legs and feet--from inflammation of blood vessels. This causes clot formation. Cigarette-smoking is a very important factor in developing this disease. It is extremely rare among non-smokers.

BODY PARTS INVOLVED--Arteries (and sometimes veins) in the extremities.

SEX OR AGE MOST AFFECTED--Both sexes, but most common in cigarette-smoking men between ages 20 and 40.

SIGNS & SYMPTOMS

• Intermittent pain in the instep or the leg when exercising. The pain improves with rest.
• Pain, blueness, heat and tingling in the legs when exposed to cold.
• Painful ulcers on the toes and fingertips (sometimes).

CAUSES--Unknown, but the disease is probably triggered by nicotine. Cigarette-smoking causes blood-vessel spasms, leading to obstruction of the essential blood vessels in the extremities.

RISK INCREASES WITH

• Collagen disease or atherosclerosis.
• Stress.
• Cold weather.
• Family history of Buerger's disease.

HOW TO PREVENT

• Don't smoke.
• Avoid exposure to the cold. This also causes blood vessels to constrict and deprives extremities of a normal blood supply.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as ultrasound, plethysmography to help detect decreased circulation in the peripheral vessels and arteriography to locate lesions (See Glossary for all).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Surgery (sympathectomy) to cut sympathetic nerves to the area (sometimes).

POSSIBLE COMPLICATIONS

• Fingertip ulcerations.
• Muscle atrophy.
• Gangrene in the foot or leg caused by a loss of blood supply. This may result in amputation.

PROBABLE OUTCOME--This condition is currently considered incurable. However, symptoms can be controlled for a while, but the disease causes increasing disability--especially if amputation is necessary. Life expectancy is reduced. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Other measures are rarely successful if smoking continues, so stop smoking.
• Avoid exposure to the cold. Wear warm footwear and gloves.
• Clip nails carefully to avoid injuring the skin.
• Wear well-fitting shoes and cotton or wool socks. Don't wear socks made of synthetic material.
• Insert soft padding in your shoes to protect your feet.
• Don't go barefoot outdoors.
• Counseling may be recommended to help with lifestyle changes required to cope with the restrictions of the disease.

MEDICATION--Your doctor may prescribe vasodilator drugs, but they are usually useless if you continue smoking.

ACTIVITY--Avoid cold weather, but stay active. Begin a conditioning program to become as physically fit as possible.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of Buerger's disease.
• Uncontrollable pain begins.
• Ulcers develop on your toes or feet.