All you need to know about Buerger’s disease: A preventable vascular threat tied to tobacco use
Thromboangiitis obliterans (Buerger’s disease) is an inflammatory condition affecting small blood vessels, primarily in smokers. It causes pain, reduced circulation, and can lead to gangrene. Symptoms include limb pain, weak pulses, and ulcers. Diagnosis involves vascular tests. Quitting tobacco, proper foot care, exercises, and lifestyle changes are essential for management.
Definition and Demographics Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is an inflammatory disease that can block the blood vessels in the hands and the feet. It is commonly seen in men, especially in the young and the middle aged. One of the key etiological factors is smoking and tobacco chewing, as it is almost exclusively seen in people who use products that contain nicotine.(Image: Canva)
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Initial Sites and Risk Factors More often than not, it begins in the lower limbs (first in one then in the other). Hormonal influence, familial nature, and hypersensitivity to cigarettes are probable causes for the development of Buerger’s disease. People who have frequent feet injuries and poor hygiene are also more susceptible.(Image: Canva)
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Effect of Smoking When a person smokes, carbon dioxide and nicotinic acid enter the body, and lead to inflammation of the arteries. Eventually, artery, vein and nerve may all become involved. Due to the involvement of nerves, the person may experience pain even while resting. Initially collaterals develop to compensate for the blockage.(Image: Canva)
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Disease Progression If the affected individual does not stop smoking, the disease progresses into the collaterals as well, thus leading to decompensatory peripheral vascular diseases. The limb eventually becomes devoid of oxygen, thus leading to ulceration and death of the tissues, that is, gangrene.(Image: Canva)
Symptoms and Co-morbidities There may be intermittent pain while walking, which can progress to pain when one is resting. The pulses that are ordinarily palpable in the foot become feeble, or absent altogether. If the person has some co-morbidities, like diabetes mellitus, it can worsen the ulceration and lead to gangrene faster.
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Investigations Blood tests may be done as a workup to finding the diagnosis. The haemoglobin levels, ultrasound Doppler to check the arteries, blood sugar levels to check for diabetes mellitus and ultrasound abdomen may be done to see for any block in the aorta. In some cases, a sample tissue of the affected artery, vein or nerve may be taken.(Image: Canva)
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Tobacco Cessation The first advice will always be to quit smoking. This can be initiated by letting your family and friends know that you will not be smoking. Seeking help from a psychologist, and keeping yourself busy has also been recommended. It has also been noticed that avoiding alcohol or coffee, or any drink that you usually link with tobacco can help.(Image: Canva)
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Improving Circulation Caring for your limbs is also a vital part of the treatment. Keeping the head end of the bed raised and the foot end of the bed lowered has been known to improve circulation. Buerger’s exercise may also be recommended which involves alternatively elevating and lowering the legs, each for two minutes, for several times in one cycle.(Image: Canva)
Limb Care Chiropody, or the treatment of legs, is essential. You must avoid frequently exposing your feet to extremes of temperatures, like too cold to warm. You should be wary of even minor trauma, like nail paring or excess pressure at the pressure points in the feet. Oiling of feet can help in preventing dryness and must be done regularly.(Image: Canva)
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Footwear Modifications Your feet need utmost care in this disease, and you should carefully select your footwear, lest you harm them. You may be asked to wear socks with your footwear to avoid further damage, and raising the heels of your shoes by about two centimetres can reduce the workload of your calf muscles, thus improving pain.(Image: Canva)
Rajeshwaari Kalla is a freelance health and wellness writer
