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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for varicose veins

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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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Posted on Wed, 6 Aug 2014 in Elderly Problems
Question: Dr. XXXXXXX there is absolutely no evidence of prominent veins in my legs. zero varicose veins in evidence. However you may well be right about blown out valves in the veins. what is the test to check for distended valves? For the arrhythmia question - I have no perceptible arrhythmia - if it's there it us minute. The shortness of breath is only very occasional and very slight. I only really feel it when blood pressure rises sharply which is still very occasional. 


I am quite reticent at the idea of taking anti arrhythmia drugs at my very minor stage - I have drastically stepped up my intake if a wide range of arterial anti-oxidants (will list them and they are many and we'll researched for safety - eg. Simple things like grape seed extract, mega doses of vitamin C and CoEnzymeQ10). I am thinking of asking my GP to put me back on lisinopril hydrochlorothiazide which completely stabilized BP for many years. 


Please keep in mind that I have **kept my BP normal with no medicine** at all this past five years although I was in the second half of my fifties. So the thought of jumping into anti-arrythmia drugs wholesale seems like a very pharmaceutically aggressive approach at this early juncture.  


I omitted to mention one thing but it is significant. One quite good doctor I consulted privately gave me a whole body thermal scan, spotted the emerging venous condition in my right leg, and also spotted what he said was a malfunctioning pyloric valve, which I have since mostly confirmed as when I am nervous meals pass right through my small intestine and I get diarrhea. BTW I have had an iron gut all my life until the past 3-4 years. No colicky stomach at all and I can eat any amount of spicy food no problem. 


The clear corollary symptom is that my small intestine gets swollen with gas as the food passes right through the pyloric before proper intestinal breakdown. I have very minor distress from it BUT there is one very interesting corollary - both intestines are distending moderately - pushing up into the diaphragm and this doctor said the flow of blood from the heart is disrupted by this constant pressure, and that over the years my heart has "learned" to pump blood upward through other arteries.


I have to get more details on this but I can categorically confirm that my colon is acting exactly in line with the pyloric valve dysfunction. With long time passing with this condition, it could begin to stress the heart. When I exercise I don't so much feel that the heart can't take it, but rather the symptoms could well be that the trajectory of blood exiting the heart can't flow freely downward because the diaphragm is pressing upwards. All of this can cause the feeling of congestion. 


I also want to downplay the amount of SOB I experience - it does NOT come from exertion - it comes only *very slightly*, when my blood pressure is rising sharply and that seems almost always from stress (angiotensin).  BP has been very well behaved this past 5 yrs without medicine but I may well be getting to the point where my natural supplements protocol needs some extra help with that. I am very trim with almost no abdominal fat but my lower abdomen is always a bit distended which lends credence to this distended small intestine thesis. 


I am very grateful for the guidance you can offer as it will guide me to getting the proper tests to confirm all this. I think you are probably spot on about the veins in the lower legs - but I repeat there is almost zero sign of varicose veins - a few of the principal ones in the right leg are a bit more distended than the 1 MM. shorter left leg. I feel that the single most important thing here would be to test for and confirm that a distended small intestine is pushing up the diaphragm and putting a strain on the normal coursing of blood. That would be a strain on the arteries also! 


Belly has been moderately distended for years now while the rest of me is bordering on thin. Thank you for your advice thus far. You are far more engaged in deciphering my symptoms than my HO doctors who are more formula driven Wish you were in San XXXXXXX
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Answered by Dr. Prakash H Muddegowda 1 hour later
Brief Answer:
Get a color doppler done.

Detailed Answer:
Hi
Thanks for asking the query and glorious words.

Varicose veins can be confirmed by a "color Doppler study".
The most common cause of varicose vein is prolonged standing.
As you are finding skin changes, it will require treatment.
Elastic support compression stockings can be used.

Palpitations are usually seen immediately after exertion or emotional stress. As you are finding palpitation, other than these times, it could be most probably arrhythmia commonly (supra-ventricular tachycardia or SVT).
Most of the times, it is completely harmless or benign.
Treatment for palpitation is instituted when it is associated with lightheadedness or dizziness (which at present you do not have at present)

Judging by the clinical history, I would say your heart and other major organs are in good condition.
If you have high blood pressure now, you can get yourself started on any anti-hypertensive (avoid calcium channel blocker group). If not, continue with your regimen.
Without hypertension, if started, it could cause hypotension, dizziness and other unnecessary complications due to falling.

I do not however agree with small intestine bloating and compressing the vessels or the diaphragm. Bloating is very common and intestine has plenty of space to move around the abdomen. I would agree with your bloated stomach. But I would not agree with you it causing any other symptoms as you are perfectly normal other than possible varicose veins.

Continue your supplements and stay healthy.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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