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Learning About Buerger's Disease (Thromboangiitis Obliterans)

Blood vessels of the hand, showing healthy blood flow and blocked blood flow

What is Buerger's disease?

Buerger's disease (thromboangiitis obliterans) is a problem with the smaller blood vessels of the arms and legs. Inflammation, which is part of the body's immune response, happens in these blood vessels. That causes clumps of cells to form clots. The clots can reduce or block blood flow in the blood vessels. That makes it hard for blood and oxygen to reach the ends of your arms and legs.

The lack of blood and oxygen can damage the tissues in your fingers and toes, which can be very painful. In serious cases, the tissue might die.

What are the symptoms?

The most common symptoms are pain and a change of colour in the fingers and toes. The pain can occur both while you are active and when you rest, and it can be severe. You may have a reaction to cold that causes pain and numbness. Your skin may look purple or pale.

You may have painful ulcers (skin sores) on your fingers and toes. Unlike some other types of skin sores, these ulcers don't heal. They may lead to tissue death. This is called gangrene.

What causes it?

Smoking tobacco and using other forms of tobacco can lead to Buerger's disease. Almost all of the people who have this problem smoke or use tobacco. In rare cases, a person who doesn't use tobacco can get this problem.

How is it treated?

The goals of treating Buerger's disease are to relieve your symptoms, restore blood flow to your hands and feet, and prevent tissue damage. Stopping tobacco use is the only treatment that can relieve symptoms and keep the disease from getting worse. It can also lower the chance that tissue will be very damaged and need to be removed.

Your doctor may recommend other treatments to manage pain or help heal ulcers. For example, your doctor may prescribe medicine to try to relieve pain. You may also take medicine that can help prevent blood clots.

If the tissue damage on your fingers or toes is too severe, you may need to have the finger or toe amputated.

How can you care for yourself at home?

  • Don't smoke or use any other forms of tobacco. Tobacco can make the disease worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • If your doctor recommends it, get more exercise. This may improve blood flow. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least at least 2½ hours a week.
  • Take good care of your hands and feet.
    • Try to keep them warm.
    • Treat cuts and scrapes on your arms and legs right away. Poor blood flow prevents (or slows) quick healing of even small cuts or scrapes.
    • Avoid shoes that are too tight or that rub your feet.
    • Avoid socks or stockings that are tight enough to leave elastic-band marks on your legs. Tight socks can make this circulation problem worse.
    • Keep your hands and feet clean and moisturized to prevent drying and cracking.
    • Wear gloves to protect your fingers from injury.
    • Place cotton or lamb's wool between your toes to prevent rubbing and to absorb moisture.
    • If you have a sore on your hand or foot, keep it dry and cover it with a non-stick bandage until you see your doctor.
  • Don't sit or stand for long periods.
  • Don't cross your legs when you sit or lie down.
  • Avoid caffeine if your doctor recommends it. Caffeine can make your blood vessels narrow.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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