Symptoms
Characteristic symptoms of phlebitis are the classic signs of inflammation, which can be observed in all inflamed tissues: The affected area is reddened, overheated, painful. Under certain circumstances, a hardened venous strand may be palpable. These signs are known as calor, dolor, rubor, tumor (lat.
color, painfulness, warmth, hardening). In the case of phlebitis, there is usually no swelling or oedema of the affected areas of the body. Such an inflammatory reaction may be accompanied by fever. However, this happens rather rarely.
Diagnosis
The diagnosis of phlebitis is made either by the clinical picture or by an ultrasound examination. Reddening and painful progressions on the basis of the leg veins give rise to the suspicion of thrombophlebitis. Venous inflammation must always be distinguished from so-called phlebothrombosis, i.e. deep vein thrombosis, which often affects leg and pelvic veins.
This is manifested by swelling of one leg, which can be painful under stress and at rest. A distinction must also be made between deep vein thrombosis and erysipelas, the infection of a wound by bacteria. Erysipelas, which is usually caused by streptococci, is when bacteria can penetrate through small injuries to the skin, with a clearly defined redness and high fever.
Affected persons appear limp, tired and exhausted. If no clear picture emerges after a detailed questioning of the patient and physical examination, a special form of ultrasound examination can be used. In this examination, which is called duplex sonography, the flow rate of the blood in the veins is assessed and a possibly existing thrombus in a deep leg or pelvic vein can be detected, which indicates phlebothrombosis and prevents superficial phlebitis.
Therapy of phlebitis
So what to do if phlebitis becomes noticeable? The therapy consists first of all in alleviating the symptoms of the disease as quickly as possible in order to provide relief for the patient: anti-inflammatory and/or anticoagulant ointments act locally and are applied to the affected skin areas (cf. Ointment).
The part of the body that is affected should also be well cooled. This simple measure quickly and effectively relieves the pain caused by the inflammation. In addition, the attending physician prescribes stronger or less strong pain medication as required by the patient.
However, these should only be taken in case of strong, acute pain and not without reason. The most important and most effective measure for the treatment of acute superficial thrombophlebitis is long walks or plenty of exercise. Patients suffering from phlebitis in the area of the leg veins should walk as much as possible.
Long periods of standing should be avoided.In addition, one can consider the purchase of support stockings, which show very effective results especially in the case of an existing varicose vein condition. A good education about possibilities to avoid a recurrence of the event as well as (if available) a removal/treatment of the cause of the phlebitis are obligatory. If the phlebitis has not existed for a long time (less than 7 days) and large clots are palpable in the vessel, a doctor can additionally try to remove the thrombi by piercing the vein.
The further treatment then proceeds as described above. Patients often experience immediate pain relief through the removal of the clot. If a bacterial infection seems likely to be the cause of phlebitis (e.g. phlebitis associated with high fever or after known contamination of a wound), antibiotic therapy is administered in addition to symptomatic therapy.
If possible, this is then carried out in tablet form and not to burden additional veins via an infusion system and an intravenous cannula. Unfortunately, this is not possible in every case. Because phlebitis usually occurs in a limited area, local therapy is also sensible and possible.
The problem of thrombophlebitis superficialis is superficial, i.e. relatively close to the surface of the skin. This is another reason why the inflammation can be treated very well with ointments whose active ingredients penetrate the skin from the outside. There are several possibilities for ointment therapy of phlebitis: firstly, the cause of the pain, i.e. the inflammation, can be treated.
For this purpose, anti-inflammatory (antiphlogistic) ointments such as Voltaren® are used. Another possibility is to treat the blood clotting disorder associated with phlebitis. The aim is to dissolve any blood clot that may have caused the inflammation and to prevent the formation of further thrombi due to the inflammation.
Ointments that slow down the blood clotting process can be used for this purpose. Ointments containing heparin, for example, are frequently used. Applied directly to the skin as a cream, this ingredient still acts at the affected area, but no longer in the entire body circulation as after a heparin injection.
If a severe coagulation disorder is the cause of frequently recurring phlebitis, on the other hand, one should consider injecting heparin. In addition to the general medical measures, which usually already allow for a successful treatment of phlebitis, there are also some homeopathic approaches to treat this type of inflammation. Here, homeopathic medications called Arnica in different dilutions (potentiation) are mainly used.
As a rule of thumb one should stick to a dosage of “5 globules three times a day”. In addition, a treatment attempt with Echinacea or Mercurius Solub H is often suitable. In order to choose the right homeopathic substance, some accompanying symptoms that are present should be taken into account. For example, a different homeopathic medication may be appropriate for certain accompanying symptoms.
