Absolutnie nie! Coraz częściej problem wykrywamy u dzieci i młodych dorosłych. Wynika to z faktu, iż jeszcze 20 lat temu przyjmowaliśmy złe założenia odnośnie mechanizmu inicjowania niewydolności żylnej i nie badaliśmy układu żylnego jamy brzusznej i miednicy małej. To właśnie na tym poziomie w układzie żylnym występuje najwięcej anomalii i błędów anatomicznych, które już u rosnących dzieci doprowadzają do rozwoju niewydolności żylnej miednicy i wtórnej do niej niewydolności żylnej kończyn dolnych. Rozwój niewydolności żylnej przyspieszają obecnie aktywności siłowe, które są nadużywane przez młodszą część społeczeństwa. Kolejne czynniki ryzyka to deficyt ruchu, nadwaga oraz nadmiarowe przyjmowanie antykoncepcji hormonalnej, która maskuje objawy niewydolności żylnej miednicy u młodych kobiet. U młodych osób wczesne objawy są często bagatelizowane, co może prowadzić do szybkiego postępu choroby. Warto pamiętać, że im wcześniej rozpoczniemy leczenie, tym lepsze efekty możemy osiągnąć.

Compression therapy is the basis of prevention and supportive treatment in venous insufficiency. Regular wearing of compression products is recommended, especially in situations of increased risk (pregnancy, long standing, sitting, air travel over 4h). It should be remembered that stockings do not cure, but only support the venous system and slow down the development of the disease in patients suffering from venous disease. In pregnant women, they significantly reduce the symptoms and development of limbic venous insufficiency. We always strive to cure venous insufficiency, so that the patient only uses compression therapy in situations of increased leg strain and increased risk of venous thrombosis. The final decision on the timing and intensity of compression therapy depends on the severity of the disease and the recommendations of the attending physician.

Moderate physical activity is not only allowed, it is actually recommended! Walking, swimming, cycling or Nordic walking are particularly beneficial. Sports involving a lot of leg strain and sudden movements should be avoided. The worst for the veins, both in the abdominal cavity, pelvis and legs, are power exercises with heavy loads and strong inhalations. They very often contribute to the early occurrence of pelvic venous insufficiency and secondary venous insufficiency of the lower limbs. In this case, it is important to remember that excessive dilatation of the entire venous bed in the small pelvis is irreversible and often untreatable.

Yes, varicose veins in the lower limbs significantly increase the risk of developing deep vein thrombosis (DVT). In healthy veins, the blood flows smoothly; in varicose veins, there is constant venous stasis and slowed blood flow. It is in areas of venous stasis that blood clots most easily form. This is why it is so important to have regular phlebological checks with Doppler ultrasound assessment of the veins of the lower limbs, and to wear compression devices in situations of increased risk of thrombosis (long flights, car rides, immobilisation of the limb or periods of pregnancy and childbirth). Appropriate thromboprophylaxis before planned operations should also be remembered.

The first step should be a consultation with a phlebologist and a Doppler ultrasound examination of the veins of the lower limbs, small pelvis and abdominal cavity. Only a comprehensive assessment of our veins allows us to make a true diagnosis and treat the patient causally. Subsequently, a decision is made to deepen the diagnosis (MR venography or CT venography?). These examinations make it possible to assess the progression of the venous disease and to select an appropriate treatment method. Chronic use of pharmacotherapy and symptomatic 'treatment' of the veins in the legs are the most common errors in the treatment of venous insufficiency of the lower limbs.