Read about this blood vessel disease that limits blood flow, especially to your hands and feet. Quitting smoking is the best treatment for this condition.
Buerger's disease is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease — also called thromboangiitis obliterans — your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi).
This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs.
Virtually everyone diagnosed with Buerger's disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger's disease. For those who don't quit, amputation of all or part of a limb is sometimes necessary.
Buerger's disease symptoms include:
See your doctor if you think you may have signs or symptoms of Buerger's disease.
The exact cause of Buerger's disease is unknown. While tobacco use clearly plays a role in the development of Buerger's disease, it's not clear how it does so. It's thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell.
Experts suspect that some people may have a genetic predisposition to the disease. It's also possible that the disease is caused by an autoimmune response in which the body's immune system mistakenly attacks healthy tissue.
Cigarette smoking greatly increases your risk of Buerger's disease. But Buerger's disease can occur in people who use any form of tobacco, including cigars and chewing tobacco.
People who smoke hand-rolled cigarettes using raw tobacco and those who smoke more than a pack and half of cigarettes a day may have the greatest risk of Buerger's disease. The rates of Buerger's disease are highest in areas of the Mediterranean, Middle East and Asia where heavy smoking is most common.
Long-term infection of the gums has been linked to the development of Buerger's disease, though the reason for this connection isn't yet clear.
Buerger's disease is far more common in males than in females. However, this difference may be linked to higher rates of smoking in men.
The disease often first appears in people less than 45 years old.
If Buerger's disease worsens, blood flow to your arms and legs decreases. This is due to blockages that make it hard for blood to reach the tips of your fingers and toes. Tissues that don't receive blood don't get the oxygen and nutrients they need to survive.
This can cause the skin and tissue on the ends of your fingers and toes to die (gangrene). Signs and symptoms of gangrene include black or blue skin, a loss of feeling in the affected finger or toe, and a foul smell from the affected area. Gangrene is a serious condition that usually requires amputation of the affected finger or toe.
Virtually everyone who has Buerger's disease has used tobacco in some form, most prominently cigarettes. To prevent Buerger's disease, it's important to not use tobacco.
Quitting smoking can be hard. If you're like most people who smoke, you've probably tried to quit in the past. It's never too late to try again. Talk to your doctor about strategies to help you quit.
While no tests can confirm whether you have Buerger's disease, your doctor will likely order tests to rule out other more common conditions or confirm suspicion of Buerger's disease brought on by your signs and symptoms. Tests may include:
Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out autoimmune diseases such as scleroderma or lupus, blood-clotting disorders, and diabetes.
Your doctor may perform a simple test called the Allen's test to check blood flow through the arteries carrying blood to your hands. In the Allen's test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color.
Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Buerger's disease.
An angiogram helps to see the condition of your arteries. An angiogram can be done non-invasively with the use of CT or MRI scans.
Or it may be done by threading a catheter into an artery. During this procedure, a special dye is injected into the artery, after which you undergo a series of rapid X-rays. The dye helps make any artery blockages easier to see on the images.
Your doctor may order angiograms of both your arms and your legs — even if you don't have signs and symptoms of Buerger's disease in all of your limbs. Buerger's disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage.
Although no treatment can cure Buerger's disease, the most effective way to stop the disease from getting worse is to quit using all tobacco products. Even a few cigarettes a day can worsen the disease.
Your doctor can counsel you and recommend medications to help you stop smoking and stop the swelling in your blood vessels. You'll need to avoid nicotine replacement products because they supply nicotine, which activates Buerger's disease. There are non-nicotine products that you can use.
Another option is a residential smoking cessation program. In these programs, you stay at a treatment facility, sometimes a hospital, for a set number of days or weeks. During that time you participate in daily counseling sessions and other activities to help you deal with the cravings for cigarettes and to help you learn to live tobacco-free.
Other treatment approaches exist for Buerger's disease, but are less effective than quitting smoking. Options include:
There are a number of things you can do on your own to help improve your symptoms, such as:
Infection prevention. Low blood flow to your extremities means your body can't resist infection as easily. Small cuts and scrapes can easily turn into serious infections.
Clean any cut with soap and water, apply antibiotic ointment, and cover it with a clean bandage. Keep an eye on any cuts or scrapes to make sure they're healing. If they get worse or heal slowly, see your doctor promptly.
You're likely to start by seeing your family doctor or primary care provider, who may eventually refer you to someone who specializes in blood vessel diseases (vascular specialist).
To make the most of your appointment, come prepared with information and questions for your doctor.
Some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
Your doctor may ask:
April 7th, 2021