Phlebitis
What is Phlebitis?
There are two main versions of Phlebitis (fle-BYE-tis). Superficial and deep vein thrombophlebitis (DVT). The main one associated with varicose veins is superficial Phlebitis. Phlebitis means inflammation of a vein. Thrombophlebitis is the term used when a blood clot in the vein causes the inflammation. Thrombophlebitis usually occurs in leg veins, but it may occur in an arm. The thrombus (clot) in the vein causes pain and irritation and may block blood flow in the veins. Phlebitis can occur in both the surface (superficial) or deep veins.
Superficial phlebitis affects veins on the skin surface. The condition is rarely serious and, with the right treatment can usually be corrected quickly. As in the case of diagnosing varicose and spider veins the proper medical evaluation is necessary to determine what type of Phylebitis a person may be suffering from.
What Causes Phlebitis?
Some of the more common causes of phlebitis are:
- Trauma or injury to the leg which weakens the veins
- Long periods of inactivity – sitting or laying for long periods of time, such as, long driving or flying
- Insertion of intravenous catheters (IV) in hospitals, or IV induced phlebitis
- Long rest period after surgery (post-operative period), especially orthopedic procedures
- Prolonged immobility, as in hospitalized or bed-ridden patients
- Severe varicose veins
- Underlying cancers or clotting disorders
- Intravenous drug use
- Smoking
- Taking Oral Contraceptives (i.e. Birth Control Pills)
- Pregnancy
As you will notice by the description of common causes, some of these are also the same as what are common causes of varicose veins.
Symptoms of Phlebitis
Warmth, tenderness, redness, and swelling along the course of the vein is highly suggestive of superficial phlebitis or thrombophlebitis.
- Swelling of the veins
- Swelling, redness, and/or tightness of skin around the vein
- Fever
- Burning or uncomfortable feeling around the vein
Other Testing Methods for Phlebitis
D-dimer is a blood test that can indicate phlebitis. This is a chemical that is released by blood clots when they start to degrade. A normal D-dimer makes the diagnosis of thrombophlebitis unlikely. The limitation of this test is its lack of specificity, meaning that an elevated D-dime level can be seen in other conditions including recent surgery, fall, pregnancy, or an underlying cancer.
Conditions that mimic phlebitis include lymphangitis (swelling and inflammation of lymph nodes) or cellulitis (superficial skin infection), insect bites, can be distinguished by obtaining a careful medical history and physical examination by a physician. Sometimes, a biopsy of the skin may be required to establish the definite diagnosis.
How is Phlebitis Treated?
Treatment of superficial phlebitis may depend on the location, extent, symptoms, and underlying medical conditions.
As with any medical condition the proper diagnosis is key. The diagnosis of superficial phlebitis can be made based on a physical examination. An ultrasound scan of the area can help determine the severity of the condition.
Deep venous thrombophlebitis (DVT) is also best determined by an ultrasound scan. If deep venous thrombophlebitis is suspected or diagnosed, or if its risk of developing is considerable, then anti-coagulation medication (blood thinners) may be necessary. A thrombophlebitis may take weeks to months to recover.
In general, superficial phlebitis of the upper and lower extremities can be treated by applying warm compresses, elevation of the involved extremity, encouraging (walking), taking a oral anti-inflammatory medications [ibuprofen (Motrin, Advil). Topical anti-inflammatory medications may also be helpful, such as diclofenac gel. External compression with fitted compression stockings is also a recommended for patients with superficial phlebitis of the legs.