2023-04-25 06:24:23
What is phlebitis?
Phlebitis refers to the formation of a caillot de sang – or thrombus – in a vein, most often at the level of the legs. Phlebitis can be superficial or deep.
“The superficial phlebitis is the mildest form : it affects a superficial vein which generally becomes painful and palpable” describes the phlebologist.
The deep phlebitis is much more seriousbecause it obstructs a vein of larger caliber located within the muscle.
Dr M. Sica angiologist phlebologist: The main risk of deep thrombosis is that the clot breaks away from the venous wall and arrives, via the circulation of the deep venous system, as far as the lungs.
Without proper treatment, pulmonary embolism can lead to the risk of death.
Superficial phlebitis is manifested by a inflammation of the affected vein : the skin becomes red at its location, and the area is hot and very sensitive to the touch. The vein appears hardened under the skin, and is therefore no longer flexible like a normal vein.
phlebitis deep meanwhile, causes a dull pain in the affected area (generally thigh or calf) associated with a swelling (oedema) and usually a feeling of warmth in the leg.
What are the causes of phlebitis?
The most important risk factors for thrombosis are:
- A prolonged immobilization,
- A fracture with plaster cast which compresses the leg or a intervention chirurgicale that interfere with blood clotting,
- And long plane trip,
- And hormone treatment : some hormone replacement therapy for menopause (TSH) or some older generation estrogen-progestogen pills,
- A severe dehydration,
- A chronic inflammatory disease,
- Aobesity and a sedentary lifestyle important, which aggravate blood stagnation,
- The tobacco,
What foods thin the blood?
If it is difficult to say that certain foods thin the blood, it is obvious that diet plays an important role in the occurrence of cardiovascular diseases. The foods to put on the menu to prevent venous insufficiency are:
- THE foods rich in Omega 3 : oily fish (herring, salmon, mackerel …), oleaginous fruits (almonds, hazelnuts, walnuts …) and certain vegetable oils (walnuts, rapeseed, grapeseed …).
- THE alliaceae : garlic, onion, shallot, leeks … are known to stimulate the heart and promote blood circulation,
- THE colorful, antioxidant-rich fruits and vegetables : polyphenols, flavonols, flavonoids, which would be the most effective in strengthening the walls of blood vessels.
“Although a balanced diet is essential for cardiovascular health, we can hardly say, however, that applying these dietary rules prevents a person prone to thrombosis from being affected” concedes the specialist, who recalls, however, that one of the most important risk factors is overweight and a sedentary lifestyle favoring stagnation of blood in the veins.
Phlebitis, thrombosis, pulmonary embolism: What foods should be avoided for good blood circulation?
People prone to deep vein thrombosis and at risk of pulmonary embolism are generally put on preventive anticoagulant treatment, anti-vitamin K (AVK) for example, or new molecules.
Raphaël Gruman, dietitian nutritionist: The main dietary rule to apply for people on anti-vitamin K, is to limit the consumption of foods rich in vitamin K, which could interfere with their treatment and promote the formation of clots.
Vitamin K is mainly found in: leafy vegetables (especially spinach and parsley), seaweed, cruciferous vegetables (broccoli, kale, cauliflower, Brussels sprouts, radish, turnip…), rapeseed and soy oils. It can be noted that in general, the greener a plant is, the more vitamin K it contains.
These foods are not to be eliminated, but must be limited, during treatment, to a maximum of one serving per day.
Can we make phlebitis under anticoagulant?
It is practically impossible to have phlebitis under anticoagulant treatment. “The only risks are in the event of prescription with insufficient dosage or poor compliance with treatment by the patient” reassures the angiologist.
What prevention for phlebitis?
Thrombosis prevention involves limiting risk factors:
- Fight against sedentary lifestyle, while avoiding violent sports or sports likely to expose to micro-traumas. Conversely, the most suitable sports are: daily walking, swimming, cycling, yoga, pilates…
- Limit, as far as possible, long-haul flights et wear compression stockings, socks or tights during the journey,
- Monitor your diet to control weight,
- Avoid crossing your legs while sitting
- Limit the wearing of high heels which slow down venous return,
- Avoid wearing pants that are too tight,
- Reduce tobacco for smokers.
“In addition, when the patient is considered “at risk”, the doctor can prescribe a thrombophilia assessment by blood sample, to detect a possible hereditary genetic anomaly” indicates the specialist.
How to sleep to avoid phlebitis?
To improve venous return and limit the risk of phlebitis during the night, it is advisable to elevate the legs with a wedge of 10 centimeters high at the foot of the bed.
Treatment: how to treat phlebitis?
The treatment of phlebitis differs depending on whether it is superficial or deep.
Superficial phlebitis
The management of superficial phlebitis requires that the cause be identified beforehand.
“For example, if the thrombosis is due to hormonal contraception, the patient can be offered to put an IUD” explains Dr. Sica.
Then an echo-Doppler assessment makes it possible to precisely locate the location of the thrombus in order to assess the risks of the thrombosis becoming deep. If the risks are high, preventive treatment with low-dose anticoagulants can be considered.
If the phlebitis is superficial, with no risk of progressing, local treatment with an anti-inflammatory cream is recommended, and the wearing of compression stockings.
Deep phlebitis: which drugs?
In case of deep phlebitis, the first-line treatment is injection, subcutaneously, of a curative dose of heparin-type anticoagulant. The dose is calculated according to the weight of the patient and the injections are generally given by a nurse at home for a ten days. They are intended for prevent the clot from extending into the vein and migrating to the lungs.
After the injections, the anticoagulant treatment (AVK or new molecule) is offered orally in curative doses, for a period ranging from two months to more than a year.
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