Thrombophlebitis Definition, Reason, Symptoms, Treatment & Prevention
Definition
Thrombophlebitis is a disease of the blood vessels characterized by an inflammatory process in the veins, especially in the lower leg area. Thrombophlebitis is often preceded by a blood clot that blocks a blood vessel or is medically referred to as a thrombosis.
Based on its location, thrombophlebitis is divided into two, namely:
- Superficial thrombophlebitis, namely thrombophlebitis that occurs in veins located near the skin.
- Deep vein thrombosis ( deep vein thrombosis/DVT ), which is thrombophlebitis that occurs in the deep muscles as a result of thrombosis.
Thrombophlebitis is often found together with DVT. Studies find that an estimated one in 1000 adults in the world experience this disease. Generally this disease is found in people aged 60 years and over, and is more experienced by women.
Symptom
Thrombophlebitis most often occurs in the lower limbs. Usually, only one limb is affected. Unless the sufferer has a severe blood clotting disorder, thrombophlebitis can occur in both legs simultaneously.
In patients with thrombophlebitis, the legs will look reddish, and feel harder and warmer. In addition, the legs are swollen and painful when moved.
If the type of thrombophlebitis that occurs is superficial thrombophlebitis, sometimes you can see dilation of blood vessels under the skin that looks like bluish twisty lines that are painful to the touch.
The dangerous thing about thrombophlebitis is the complications that can occur, namely pulmonary embolism and post phlebitis syndrome as follows:
- Pulmonary embolism is a condition where a blood clot blocks a pulmonary artery. Usually, these blood clots come from thrombophlebitis and DVT in a loose leg.
Pulmonary embolism will cause the lungs to not get blood flow. As a result, the sufferer will have severe shortness of breath and may die if he does not immediately receive proper treatment.
- Postphlebilitis syndrome is a long-term complication of thrombophlebitis and DVT which is characterized by pain or heaviness in the limbs when moved.
Reason
Thrombophlebitis and DVT can be caused by three main things, namely:
- There is an injury to the veins, for example due to a broken leg or due to surgery.
- Blood disorders such as thrombophilia.
- Lying down for a long time, for example if you are undergoing treatment at the hospital.
In addition, the following conditions also make a person susceptible to thrombophlebitis:
- Being sedentary for a long time, for example when traveling by plane or train
- Have varicose veins in the leg area
- Have a heart pacemaker or catheter, such as an IV line in a large blood vessel
- Dehydration
- Pregnant or have recently given birth
- Suffering from cancer
- Taking hormonal drugs, such as birth control pills or implants
Diagnosis
In the early stages, the doctor will conduct a thorough interview and complete a physical examination from head to toe. Next, several additional checks will be needed such as:
- Blood tests to see if the blood is thick (hypercoagulation) by checking activated partial thromboplastin time (aPTT), prothrombin time (PT), D-dimer, protein C, protein S, antithrombin, anticardiolipin, and so on.
- A duplex ultrasound examination should also be done to see if there are blood clots in the veins.
If a complication in the form of a pulmonary embolism is suspected, a chest X-ray, scintigraphy, or pulmonary venography will be required.
Treatment
Because thrombophlebitis often occurs as a result of DVT, treatment for DVT is mandatory. Treatment is in the form of giving anticoagulants (a type of blood thinner) to destroy blood clots that occur.
Types of anticoagulants that can be given include heparin, low molecular weight heparin, or fondaparinux. In addition, non-steroidal anti-inflammatory drugs such as ibuprofen will also be given to reduce pain and inflammation.
If the blood clot that is blocking the blood vessel is very large and is not effectively treated with anticoagulants, then surgical removal of the blood clot sometimes needs to be done.
Prevention
To prevent thrombophlebitis and DVT, there are several things you can do, namely:
- Do physical activity (brisk walking, jogging, swimming, climbing stairs) at least five times a week, for 30 minutes each time.
- If you have to be in a sitting position for long periods of time, avoid folding your legs and feet. Do regular stretching every 1-2 hours.
- Wear loose clothing.
- Drink 1.5-2 liters of water per day to prevent dehydration.