Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage.
The disease is found worldwide and can affect people of any race and age group. However, it mainly affects Asian and Middle Eastern men between the ages of 40 and 45 who heavily use, or have heavily used, tobacco products, including chewing tobacco.
The specific cause of Buerger’s disease remains unknown. The risk for developing Buerger’s disease increases when you smoke heavily.
Scientists don’t know why tobacco smoke increases this risk, but the correlation between the two is well documented. According to the Mayo Clinic, almost everyone with Buerger’s disease uses tobacco.
Buerger’s disease begins by causing your arteries to swell and blood clots to form in your blood vessels. This restricts normal blood flow and prevents blood from fully circulating through your tissues. This results in tissue death because the tissues are starved of nutrients and oxygen.
Buerger’s disease usually starts with pain in the areas affected, followed by weakness. The symptoms include:
- pain in your hands and feet, or your legs and arms, which may come and go
- open sores on your toes or fingers
- inflamed veins
- pale toes or fingers when in cold temperatures
Buerger’s disease is a “clinical diagnosis,” meaning there’s no specific test to determine if you have the disease. However, there are a number of other conditions which mimic Buerger’s disease that can be ruled out by your doctor performing certain tests.
After going over your symptoms, your doctor may order blood tests to rule out lupus, diabetes, or blood clotting disorders. If these are negative, your doctor may move on to order some imaging in the form of a vascular ultrasound or an angiogram.
An angiogram is a special type of X-ray that involves a physician injecting contrast dye into your arteries at the same time as the X-ray is performed. It requires a needle placed into the large arteries of your legs or arms, and sometimes requires the use of catheters.
Another test your doctor may perform is called an Allen test. This test checks blood flow to your hands. A positive test result may help your doctor diagnose Buerger's, but it could also indicate a number of other conditions.
There isn’t a cure for Buerger’s disease. However, the single-most important factor in improving symptoms and preventing its progression is quitting smoking.
Additionally, in some cases, pain can be controlled by avoiding cold weather.
In rare cases, the pain may be so severe that a surgical procedure called a sympathectomy may be performed to eliminate the pain.
On the other hand, some people report symptom improvement by drinking plenty of fluids and staying active, which increases your circulation.
There’s no vaccine or behavior modification that can prevent a person from developing Buerger’s disease. However, quitting smoking can prevent progression of the disease.
If you stop using tobacco products, the symptoms associated with Buerger’s disease may simply disappear without any need for treatment.
If your condition is severe, complications like gangrene or circulation problems in other parts of your body may be unavoidable. Severe gangrene may require limb amputation. Visiting your doctor when you first begin to feel unwell will help you to avoid any complications that may arise.