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What is Buerger’s Disease / Thromboangiitis Obliterans?

Buerger’s Disease or Thromboangiitis Obliterans

Thromboangiitis Obliternas or Buerger's Disease affecting the great toe
Buerger’s Disease affecting the great toe

Buerger’s Disease is a reasonably rare condition in which the small blood vessels of the hands and feet are occluded (or blocked) by inflammation of the vessels.  This inflammation is called vasculitis.  The reduced flow of blood will cause pain in the short term.  If it continues for a long enough period, patches of skin and other tissues in the hands and feet can become damaged or die. It can affect the palms and soles of the feet as well as the digits.

This condition afflicts ~ 60 people in 100,000 people, the majority being males aged 20 to 40 who use tobacco. Only 10 % of sufferers are female and children are rarely affected.

Symptoms of Buerger’s Disease include the extremities being cold, painful and of altered colour, appearing pallid, blue or red during an episode.  The pain is of a burning or buzzing nature and is usually quite severe.  It  may occur at rest or with activity but is often triggered by cold or emotional stress.  It is usual that more than one extremity is affected.

Examination of the areas affected by Thromboangiitis Obliterans may show enlarged blood vessels, poor pulses and skin damage similar to frostbite or ulcers. Blood tests may be done to exclude other autoimmune diseases and occasionally a biopsy of the blood vessel may be required to confirm the diagnosis.

There is no cure for Buerger’s disease. The aim of treatment is to reduce the severity of symptoms, specifically to deter amputation. Tobacco must be avoided under all circumstances and exposure to cold should be limited. During an episode, the application of moderate warmth and moving the part gently may increase circulation. Care should be taken not to expose the area to very hot conditions – submerging the feet in a bucket of boiling water will cause further injury. Some drugs that dilate the vessels (including Aspirin) may be useful in treating the condition and a sympathectomy (cutting the sympathetic nerve to the area) can reduce pain. Amputation can become necessary if large areas of tissue die or if severe infection takes hold.  Always seek medical assistance early if it is clear that something is going wrong.

Symptoms of Thromboangiitis Obliterans may disappear if the person stops tobacco use.

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