Phlebitis: Symptoms, Causes, And Treatment

During pregnancy, women are not infrequently plagued by phlebitis. Among other things, this has to do with the varicose veins that many pregnant women develop in the course of pregnancy. You should take action against this inflammation, medically known as thrombophlebitis when you notice the first signs.

In this article you will learn all about the defensive measures – but do not worry, the worst medical application to cure phlebitis is limited to anti-inflammatory ointment and anti-inflammatory drugs and usually brings quick healing.

Phlebitis: What Is It Actually And Who Is Affected?

An inflammation of the vein is called thrombophlebitis by medical experts. Thrombophlebitis is not just inflammation, as the German term seems to imply. This reaction of the body to noxious stimuli would be limited to redness, swelling, warmth in the area of inflammation, and perhaps a little pain and restriction of function.

These would disappear without consequence once the inflammation was made to subside, for example, by anti-inflammatory ointment. There is more to thrombophlebitis: Phlebitis is an inflammation of the venous vessels caused by (tiny) blood clots in the veins.

However, this usually produces further blood clots in the veins, so the inflammation is virtually self-heating. Such blood clots are called thrombosis by physicians, and untreated thrombosis can have dire consequences.

All this happens under the skin, in a largely sealed-off area that is difficult to access for therapies such as anti-inflammatory ointment. After a more detailed explanation of the causes of phlebitis, you will understand why phlebitis must be approached from all sides.

This approach from all sides is called vein care – and it is important for the rest of your life, not only during pregnancy. Because the details of this vein care are so often neglected in today’s life, vein diseases are quite common in the German population.

Only about 10% of Germans have completely normal veins, 59% show slight changes in the leg veins, 14% have varicose veins in larger veins. Pregnancy then also increases the risk of thrombosis by 5 to 10 times.

Causes Of Phlebitis During Pregnancy

If acute superficial thrombophlebitis is so common, there must be causes that affect many people. In fact, first of all, the basis is the so-called Virchow triad, which describes various physical changes, weaknesses, damage.

Altered Or Damaged Vein Vessel Walls

Normally, the inner wall of the blood vessels in a vein (the endothelium) is perfectly smooth. The small clots that continually form in almost any flowing blood slide along this smooth inner wall until they could be dissolved by the body.

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Injuries and inflammatory processes can make the inner walls of the vessels rough. The mini-clots that are constantly formed and constantly dissolved in the course of blood clot regulation can stick to rough spots.

This is the starting point for the development of a noticeable thrombosis: More clots remain attached to the stuck “minithrombus” until eventually the vessel is completely clogged and blood can no longer flow.

Changes In Blood Flow Velocity

Mini-clots form more often when blood flows unevenly and/or more slowly. Blood flow slows down regularly in some parts of the body: where large arteries divide into two smaller ones, this leads to turbulence at the dividing point and thus to thrombi more often.

However, the flow rate can also be further reduced by physical weaknesses and damage.

Changes In Blood Viscosity (Blood Thickness)

Normally thin blood flows more easily than thickened blood, pretty logical, right? It forms fewer mini-clots and also flows more easily past the few normal, unavoidable mini-clots.

Thicker or less flowable blood is caused, for example, by a lack of fluids. Too dry air in the home, not drinking enough, sweating more for some time can be enough; but other causes can also contribute to thickening.

Such an initial situation often leads to varicose veins during pregnancy, here the main cause of phlebitis.

This Is Why Varicose Veins Promote Phlebitis

Varicose veins are a common side effect of pregnancy. Actually, they are unpleasant enough in themselves. But varicose veins also favor the development of thrombophlebitis, especially phlebitis in the leg.

During pregnancy, hormones are released that initiate important body changes for the baby. Besides, these hormones also cause some confusion in the body.

Among other things, these hormones cause the walls of the vessels in the leg veins to become more elastic. In addition, the total blood volume increases by about 20 percent at the beginning of pregnancy.

Soon the baby is also pressing on the pelvic area, and in the last three months of pregnancy even directly on the abdominal vein (which makes it even more difficult for blood to return to the heart).

So the veins have to do a lot more during pregnancy than ever before. This is why it is quite common for the blood to back up and pool in the veins until they become knotty.

This is the varicose vein, which gets its name from the Old High German “krimpfan” (to bend). However, the slowed blood flow also has an irritating effect on the veins, which not infrequently leads to phlebitis.

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During pregnancy, 25 to 50% of women develop phlebitis, and the risk increases with the number of pregnancies.

Other Causes Of Phlebitis

All other causes of damaged veins can, of course, contribute to the development of phlebitis during pregnancy. These other causes primarily include:

  • Poor diet with too few nutrients.
  • Too little exercise.
  • Too little fluid intake through food and drink.
  • Small skin lesions that allow bacteria to enter a vein.
  • Bacterial causes after intravenous injection/infusion.
  • An indwelling intravenous catheter (left in the vein too long).
  • Slowed blood flow due to heart failure or bed confinement.
  • Underlying inflammatory diseases such as intestinal inflammation, rheumatism, chronic autoinflammatory diseases.
  • Injuries to the vein wall.
  • Increased blood clotting after surgery.
  • Tumor diseases.
  • Genetic predisposition.

How To Recognize Phlebitis

If the blood is prevented from flowing by thrombi (clots), you will notice this by increasingly unpleasant bodily reactions.

Now that you know what is going on in the body when thrombophlebitis develops, you have a good chance of noticing the first signs of phlebitis:

First Signs

Sensitive women can sometimes sense very early when phlebitis is developing in the leg. The following early signs may be noticeable:

  • The skin on the leg appears to be under tension.
  • Even tensing the leg muscles is somehow uncomfortable.
  • Individual areas of skin seem warmer than others.
  • Swollen legs.

Clear Symptoms

These symptoms become more obvious as the phlebitis progresses:

  • The affected area hurts when pressure is applied.
  • The affected area is swollen, red and warm.
  • The corresponding vein segment is hardened, often you can feel a rough vein strand.
  • If you tense the leg muscles, this causes pain.

The Dangers Of Phlebitis

Venous inflammation can develop into damage that goes beyond the immediate impairment: Small blood clots are usually already involved in the development of phlebitis.

These can develop into a dangerous thrombosis if the phlebitis is not treated in time with anti-inflammatory ointment and the other measures described below.

In addition, superficial phlebitis can spread to the deep veins of the leg. While the superficial venous system drains blood from the skin and subcutaneous tissue, the deep veins carry blood to the heart and lungs.

Deep vein thrombosis can therefore lead to serious complications: When a blood clot breaks loose from a deep vein, it is carried with the blood to the heart and then to the lungs. If it clogs a blood vessel there, this is known as a pulmonary embolism – a life-threatening condition.

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These complications always affect only a small proportion of affected patients – but the risk is there and must be ruled out. In addition, phlebitis may never get better by doing nothing; phlebitis should therefore not be taken lightly and always belongs in medical treatment:

Acting Instead Of Worrying: Therapy For Phlebitis

First Aid

If you suspect that you are developing signs of phlebitis – you can start doing something about it immediately.

Move as much as possible until you come to the doctor. This doesn’t mean an ambitious sports program, but rather steady, even movement in an upright posture: going for a walk, dancing around the house to nice music, cycling, taking the stairs instead of the elevator.

But don’t forget to relax thoroughly every now and then during a period of increased mobility. If you put your legs up, this will also counteract phlebitis.

When Is A Visit To The Doctor Necessary?

The next step is to go to the doctor. As soon as possible, already at early signs.

The first point of contact is the family doctor. However, the general practitioner is not always sufficiently equipped with the equipment necessary for a reliable diagnosis. He or she will then refer you to an appropriately experienced internist, angiologist, physician with the additional title of phlebologist, or the special consultation hours of a clinic.

If you wish to contact the specialist immediately, you can usually do so. Information on health insurance tariffs, which initially provide for obligatory visits to the family doctor.

If diseases such as rheumatism or or consequences of therapeutic effects such as an indwelling catheter could be involved in the development of thrombophlebitis, it may be necessary to consult the physician responsible for these treatments.

Medical Diagnosis And Treatment

The physician must first rule out all risks in the direction of deep vein thrombosis; this may require various diagnostic steps. Then he will prescribe a compression bandage or compression stockings.

This is the first and most important pillar of therapy because compression is very effective in helping the disturbed tissue to heal. Compression stockings are not easy to put on, especially during pregnancy.

You should nevertheless put them on consistently every morning, because the pressure helps the vascular valves to close better, thus preventing blood stasis. The doctor will advise you to move a lot (with and without compression stockings).

More than before, because you most likely would not have developed phlebitis in your leg if you had walked around enough. This movement is not only very important for healing but also the best protection against the spread of thrombophlebitis to the deep venous system.

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You will also receive a prescription for an anti-inflammatory ointment. This anti-inflammatory ointment supports healing in several ways: the doctor will choose an anti-inflammatory ointment that is cooling at the same time, which promotes healing and is pleasant.

If you massage the anti-inflammatory ointment well when applying it, you will also give your legs a pleasant massage. Depending on how advanced the thrombophlebitis is, the doctor may prescribe anticoagulants, which also act somewhat as anti-inflammatory drugs.

Pain usually goes down enough when you apply the anti-inflammatory ointment. If not, the doctor can prescribe painkillers from the group of NSAIDs (non-steroidal anti-inflammatory drugs).

Again, these are also anti-inflammatory drugs that work against the inflammation to about the same extent as the anti-inflammatory ointment. If the doctor is consulted in good time and his instructions are followed consistently, superficial phlebitis usually heals quickly and without complications.

Vein Care For Healthy Veins

There are plenty of measures to keep the veins fit during and after pregnancy. These help to combat existing phlebitis and prevent further phlebitis, but are also just generally healthy:

  • Keep legs in shape: Lots of walking and lying down, little sitting and standing (3L-3S rule), focus on endurance.
  • If sitting or standing cannot be avoided, do foot gymnastics every now and then, move your toes and form them into claws.
  • Raise your legs more often, both sitting and lying down.
  • Replace high heels with comfortable, flat shoes.
  • Walk barefoot as often as possible.
  • Reduce excess weight.
  • Drink enough fluids, especially water or unsweetened teas.
  • Avoid overheating when sunbathing, taking a bath in the tub or using hot water bottles or heating pads.
  • Regularly shower your legs with cool to cold water.
  • Standing too long, walking too little? If you get heavy legs, you can always apply an anti-inflammatory ointment.
  • Calf compresses with curd or vinegar can also work wonders for tired veins.
  • Varicose veins should be treated as soon as they appear, because they are not only an aesthetic problem.

In the course of treating your phlebitis, you may have learned that you may carry a genetic predisposition to phlebitis. Even then, the above measures can usually prevent further phlebitis without the need for anti-inflammatory drugs.

Another prerequisite for a healthy life without phlebitis is that you observe your body carefully enough and, in case of doubt, always seek medical treatment in time.

Observation can usually be combined well with body care measures. You should treat yourself to such body care measures very often, especially during pregnancy: During this time, thorough all-around care is one of the most beautiful and important duties of the expectant mother.

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