Post-thrombotic Syndrome

Post-thrombotic Syndrome

People who suffer from deep vein thrombosis are in danger of developing post-thrombotic syndrome, also known as venous stress disorder or postphlebitic syndrome.

Deep vein thrombosis is a condition which occurs when a clot is formed inside a deep vein. This is most common in the legs, but it is not limited to them. It starts with pain, warmth, changes in skin color and swelling. Deep vein thrombosis can cause several other conditions, including life-threatening ones such as pulmonary embolism.

Post-thrombotic Syndrome symptoms and diagnosis

Having in mind that the condition most often affects legs, it is not very easy to diagnose, despite symptoms which are more than obvious. This is so due to the fact that the most common symptoms that accompany post-thrombotic syndrome are very similar to the symptoms that come with several other conditions.

The most notable symptoms include pain which can range from aches to cramps, itching, eczema, heaviness, tingling, varicose veins (veins which have become bigger than normal and sometimes twisted), skin color changes (red or brown) and dryness, formation of ulcers and swelling.

Another issue which hampers diagnosis attempts is the fact that symptoms can vary between different patients. A symptom which can be very severe for one patient can be completely non-existent for another. Symptoms can also change severity over time.

However, all symptoms which accompany post-thrombotic syndrome have been shown to worsen if patients spend a long time walking or standing. ON the other hand, rest reduces the symptoms, especially if the affected leg is elevated.

The pain and other symptoms can affect everyday life of patients significantly.

Diagnosing post-thrombotic syndrome usually starts with the acknowledgement of deep vein thrombosis in the patient’s medical history. After this the symptoms are observed a procedure called lower limbs venous ultrasonography needs to be performed. It is not invasive and carries no risks. Ultrasound technology is used to determine the pathology, physiology and anatomy of veins. When used for post-thrombotic syndrome its purpose is to give information on the location of the blood clots and the degree to which they obstruct the flow.

Another problem with the diagnosis is that there needs to pass several months before the diagnoses of deep vein thrombosis and post-thrombotic syndrome. The symptoms are very similar and the time gap is needed to make sure that the observed symptoms do not come from deep vein thrombosis only.

Post-thrombotic Syndrome causes

Inflammation plays a big role in the development of post-thrombotic syndrome. However, the entire process is far from clear at the moment. It is thought that venous valves get damaged by the thrombus and that this is also a contributing factor. An increase of the pressure inside veins and capillaries leads to venous hypertension which then causes ruptures of smaller veins closer to the surface. Other results of this occurrence include an increase in tissue permeability and subcutaneous hemorrhage. All of these things lead to the mentioned symptoms including changes in skin color, swelling, pain and creation of ulcers.

Post-thrombotic Syndrome Causes
Post-thrombotic Syndrome Causes
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Obesity is hardly a cause to post-thrombotic syndrome, but it is definitely true that obese people suffer from post-thrombotic syndrome more often. The same goes with age, since most patients are 60 or more years old.

If deep vein thrombosis symptoms persist long after the initial diagnosis and treatment, the patient is very likely to be suffering from post-thrombotic syndrome.

Treatment and prevention of post-thrombotic syndrome

Preventing deep vein thrombosis is the best way of preventing post-thrombotic syndrome. Other prevention solutions include electrostimulation, compression stockings and anticoagulant drugs.
A novel treatment method is catheter thrombolysis which is used to destroy a blood clot.

Leg needs to be elevated for most treatment methods. Various forms of pain and inflammation treatment are also necessary, as is taking care of wounds for patients who have ulcers.
However, most NSAIDs, opioids and painkillers cause serious problems with their side effects, interactions with other forms of treatment and habituation issues. They are almost never a viable long-term solution and drugs which cause excessive bleeding should not be taken in order to manage post-thrombotic syndrome induced pain.

This is why solutions such as palmitoylethanolamide (PEA) are necessary. It is pharmaceutical grade palmitoylethanolamide, a fatty acid which is naturally created in the body to deal with pain and inflammation.
PEA affects numerous receptors inside the body either by binding to them directly, or through substances such as anandamide. These receptors are PPAR-alpha, CB1, CB2, GPR55, GPR119 and TRPV1. This enables PEA to calm any inflamed cells and bring them back to their natural healthy state.

Inflammation is inevitably connected with pain and PEA works as a great pain-reliever by inhibiting COX-2 and iNOS expression and influx of neutrophils. This reduces the feeling of pain. However, PEA does not only reduce the feeling of pain, but it also treats the underlying inflammation which plays a big role in post-thrombotic syndrome. This is how PEA works against the cause and symptoms at the same time.

Unlike other pain-killing solutions, PEA has no overdose level or side effects. This means that it is perfect for prolonged use, while its inflammation calming properties make it a viable option for prevention as well. Having in mind that many deep vein thrombosis patients later develop post-thrombotic syndrome, PEA should be used for prevention and deep vein thrombosis recovery.

Lastly, if you are using any other drugs, you can safely take PEA. And this goes for painkillers as well.