What Is Buerger's Disease: Causes and Treatment Methods?

What Is Buerger's Disease?

Body tissues are nourished through the transport of nutrients and the supply of oxygen. After nutrients are taken orally, they are broken down by the digestive system into their building blocks. They are then absorbed in the intestine and enter the bloodstream. Blood is the main carrier in the body and carries nutrients, oxygen and other necessary substances. Blood pumped from the heart is carried to tissues and organs through arteries. These arteries branch into the smallest blood vessels known as capillaries. Here, an exchange of substances takes place between the blood and the tissues. While oxygen and nutrients pass into the tissues through the capillaries, waste products and carbon dioxide are removed by passing from the tissue cells into the blood. In this way, blood and nutrients are carried to the tissues through the circulatory system, the tissues are nourished and metabolic needs are met.

Buerger's Syndrome, also known as thromboangiitis obliterans (TAO), is a vascular disease characterized by inflammation of the peripheral arteries. As a result of Buerger's disease, narrowing or even blockages can occur in the blood vessels of your hands and feet. This condition results in insufficient blood flow, especially when you actively use your limbs. Buerger's syndrome can reduce a person's quality of life and, in advanced cases, may be accompanied by ulcers (sores) on the fingers and toes. Less commonly, Buerger's disease can cause a decrease in blood flow to the heart, brain or abdomen.

Although the exact cause of Buerger's Syndrome is not known, the use of tobacco products such as cigarettes may be the main triggering factor in the development of the disease. Individuals who smoke may show an impaired immune system response. Inflammation resulting from the immune system response can cause the artery wall to thicken and narrow. A narrowed vessel can lead to clot formation. At the same time, the amount of blood passing through the vessel decreases. This condition affects tissue nutrition and can lead to pain, tissue wounds, ulcers and sometimes death of tissues (gangrene). Buerger's disease is first encountered in the feet. Pain usually begins in the affected areas within a short time, and this may then result in damage to body tissues close to the area where the symptom develops.

What Are the Causes and Risk Factors of Buerger's Disease?

Buerger's disease occurs due to inflamed blood vessels. There are some conditions that increase the risk of blood vessel inflammation or blockage. These can generally be summarized as follows:

Age: As in most diseases, age is an important factor that increases the risk of Buerger's syndrome. Symptoms usually begin at age 35 or older. However, it is an important risk factor for both sexes, especially for men aged 20-45 who use tobacco products heavily.

Sex: Buerger's syndrome is more common in men than in women.

Use of tobacco products: This is one of the most important risk factors for the disease. Smoking, chewing, or rolling your own cigarettes all increase the risk of developing the disease over time.

Diabetes: A patient who does not have good blood sugar control and does not pay attention to their diet may develop fatty deposits in their blood vessels. This affects blood flow in the vessels and causes Buerger's syndrome.

Atherosclerosis: Conditions such as physical inactivity and unhealthy nutrition can cause plaque buildup in the arteries and lead to Buerger's syndrome.

Autoimmune Diseases: Although rare, in cases where the immune system overreacts, the body may attack healthy body cells.

What Are the Symptoms of Buerger's Disease?

Buerger's disease has some distinct symptoms. These mainly result from tissues not receiving sufficient oxygen due to narrowing that develops in the blood vessels. The symptoms observed may vary depending on the type and severity of the disease, its location, or how much it restricts blood flow. In Buerger's syndrome, usually 2 or more limbs are affected. In general, the symptoms of Buerger's syndrome are as follows:

Blue or red color changes in the skin of the fingers or toes

Pallor (paleness) of the limbs

Painful sores developing on the hands and fingers

Burning or tingling sensation in the soles or hands

Pain in the legs, ankles or joint areas while walking, or intermittent need to limp

Fingers and toes that feel cold to the touch (Raynaud's syndrome)

Skin changes generally occurring in the upper and lower extremities

In severe cases of Buerger's syndrome, i.e., when only very small amounts of oxygen can reach the tissues, death of tissues may occur. This condition is called gangrene, and if not treated, infection may develop. For this reason, it is beneficial to be informed about the symptoms of the disease, take them seriously and go to an emergency department immediately.

What Are the Diagnostic Methods for Buerger's Disease?

To diagnose Buerger's syndrome, your doctor will first perform a physical examination. Changes in skin color, which are among the symptoms of Buerger's syndrome, are checked at this stage, or you may be asked questions. Then, your family history is checked to understand your genetic predisposition. Subsequently, you will need to have a blood test to see changes in hormonal or blood findings. In addition, in some rare cases where the diagnosis cannot be clearly established, a biopsy of a blood vessel may be performed.

What are the imaging and laboratory methods used in the diagnosis of Buerger's disease? What are the treatment methods for Buerger's disease?

In general, the imaging and laboratory methods used in the diagnosis of Buerger's disease are as follows:

Ultrasound: Doppler ultrasound is used especially in the diagnosis and treatment of diseases affecting the heart and cardiovascular health. The procedure provides information about the direction and speed of blood flow in the vessels. Problems such as clots or narrowing in blood vessels affecting limbs such as the arms and legs, as well as organs, are identified.

Ankle-brachial index (ABI): With ABI, information can be obtained about the extent of narrowing in the vessel and whether the tissues are receiving sufficient oxygen. However, the exact location of the narrowing cannot be determined.

Computed tomography (CT): This is one of the imaging tests widely used in the healthcare sector. Like an X-ray, it shows the inside of your body. It differs from X-ray in terms of image quality and detail. Organs, blood vessels, muscles and bones are visualized in detail with computed tomography. In computed tomography, a type of fluid may be injected intravenously before the procedure to highlight certain areas of the body. This fluid is excreted from your body in urine within 24 hours.

Angiogram: This is an imaging option that provides imaging using X-rays. With this test, you can see how blood circulation is in a specific area of your body. Before the angiogram, a dye that the device can visualize is injected into your body. Your doctor will inform you about the points you should pay attention to before the angiogram procedure. For example, in the morning you should only choose clear liquids such as broth or tea for breakfast. Since a catheter needs to be inserted during the angiography procedure, local anesthesia is applied beforehand. However, it is not a frightening procedure and you will not feel any pain.

Magnetic resonance angiography (MRA): This is one of the non-invasive imaging methods that shows narrowing or blood flow in blood vessels. Depending on the type, it can provide 2D or 3D imaging. Unlike CT, you are not exposed to radiation during the procedure.

What Is the Follow-up and Recovery Process for Buerger's Disease?

There is no known treatment option with a definitive cure for Buerger's Syndrome. However, it has been determined that people with this disease generally experience improvements after quitting the use of tobacco products. Even smoking 1-2 cigarettes a day is sufficient for the disease to continue. Treatment methods other than this mainly focus on improving symptoms. The most preferred method for this is drug therapy. The drugs preferred in drug therapy also vary according to the problem.

Vasodilators or calcium channel blockers, to improve blood flow

Analgesics, to support pain or ulcer healing

Anticoagulants, to prevent blood clot formation

Antibiotics, used for ulcer treatment

In addition, some strategies used to alleviate symptoms caused by Buerger's disease and to improve quality of life include:

Stay active. The World Health Organization (WHO) recommends 150 minutes of walking per week.

Spinal cord stimulation therapies

Compression therapy applied to the arms and legs

Although not very often preferred by doctors, amputation of tissue that begins to damage other tissues and cannot be saved is also among the treatment options.

Risk Factors and Prevention of Buerger's Disease

The risk factors for Buerger's disease are generally age, sex and use of tobacco products. Among these, sex and age constitute non-modifiable risk factors. However, tobacco use is modifiable and is the biggest risk factor. For this reason, to prevent Buerger's disease, it is necessary to avoid all kinds of tobacco and drugs and to develop policies aimed at reducing tobacco products.

What Are the Possible Risk Factors and Influencing Factors of Buerger's Disease?

The possible and known risk factors for Buerger's Disease are as follows:

Diabetes

Cigarette or drug use

Sedentary lifestyle

Unhealthy nutrition

Age

Sex

What measures and lifestyle changes can be taken to prevent Buerger's Disease?

Buerger's disease is a condition in which there is insufficient blood flow to tissues due to narrowing or inflammation of the blood vessels. The first lifestyle change you need to make to prevent this is to quit tobacco product use, if you use them. Even nicotine patch therapy may play a role in activating the disease. Make sure you are active every day. The World Health Organization (WHO) recommends 150 minutes per week of low-intensity or 75 minutes of high-intensity activity for adults. Pay attention to your diet. Adopting a diet rich in vegetables and healthy fats may be protective for your vascular health.