What is Buergers Disease?

In most cases, simple changes in your diet and lifestyle can help relieve symptoms and manage constipation. Less often, you may need medical treatment. Above all, recognize that a successful treatment program can take time and effort.

Diet and lifestyle changes

The following simple changes can go a long way toward reducing constipation:

A high-fiber diet. A diet with at least 20 to 35 grams of fiber each day helps your body form soft, bulky stool. High-fiber foods include beans, whole grains, and fresh fruits and vegetables. Limit foods that have little to no fiber, such as cheese, meat and processed foods.

Regular exercise. Physical activity can help stimulate intestinal activity.

Adequate fluid intake. Drinking plenty of water and other fluids will help soften your stool.

Take the time for bowel movements. Set aside sufficient time to allow undisturbed visits to the toilet. And don't ignore the
urge to have a bowel movement.


Laxatives

These over-the-counter medications should be considered only when diet and lifestyle changes aren't effective. Some can become habit-forming.

There are several different types of laxatives:

Fiber supplements, or bulk laxatives, are generally considered the safest of laxatives. Examples include FiberCon, Metamucil, Konsyl, Serutan and Citrucel. These agents must be taken with plenty of water.

Stimulants cause rhythmic contractions in the intestines. Examples include Correctol, Dulcolax and Senokot.

Lubricants enable stool to move through your colon more easily. Examples include mineral oil and Fleet.

Stool softeners moisten the stool and help prevent dehydration. Examples include Colace and Surfak.

Osmotics help fluids to move through the colon. Examples include Cephulac, Sorbitol and Miralax.

Saline laxatives act like a sponge to draw water into the colon for easier passage of stool. Examples include milk of magnesia and Haleys M-O.


Other medications

If lifestyle changes and over-the-counter medications don't improve your symptoms, your doctor may recommend prescription medications, such as:

Chloride channel activators. The agent lubiprostone (Amitiza) is available by prescription and increases fluid content of
stool.

5-HT-4 agonists. These agents stimulate release of compounds in your body that increase fluid secretion in the intestines and decrease colonic transit time. Prucalopride is one such 5-HT-4 agonist. These drugs are not available in the U.S., and there have been some concerns about the safety of their use.


Procedures

If your constipation does not respond to changes in lifestyle or medical treatment, your doctor may recommend in-office or, rarely,
surgical procedures.

Manual procedures. To help clear your colon of retained, impacted stool if laxatives are not effective, your doctor may first
gently insert a gloved finger and manually break up the impacted stool (disimpaction). Next, you will be given a laxative enema to soften the stool and provide lubrication for a bowel movement.

Surgical procedures. If you have chronic, severe constipation and other treatments haven't helped, surgical removal of part of your colon may be recommended. In this procedure, the problem segment or segments of the anal sphincter or rectum are removed.


Treating underlying causes

If an underlying disorder is causing your constipation, treatment will be aimed at the specific cause. If pelvic floor dysfunction is
the cause of your constipation, your doctor may suggest biofeedback as a treatment. This retraining technique may help you learn to better coordinate the muscles you use to have a bowel movement.

If you're pregnant and have constipation, try eating lots of high-fiber foods, such as fruits, vegetables and whole grains. Drink
plenty of fluids and get as much exercise as you can. Discuss with your doctor any plan, including exercise, to treat your constipation. Swimming and walking may be good choices.

Symptoms

Buergers disease symptoms include:

Pain that may come and go in your legs and feet or your arms and hands. This pain typically occurs when you use your hands or feet and eases when you stop activity (claudication).

Inflammation along a vein just below the skin's surface (due to a blood clot in the vein).

Fingers and toes that turn pale when exposed to cold (Raynaud's phenomenon).

Painful open sores on your fingers and toes.

Causes

It is not clear what triggers Buergers disease. It is possible that some people may have a genetic predisposition to the disease. The condition is characterized by swelling in the arteries and veins of the arms and legs. The cells that cause the inflammation and swelling — and eventually blood clots — form in the vessels leading to your hands and feet and block the blood flow to those parts of your body.

Reduced blood flow means that the skin tissue in your hands and feet doesn't get adequate oxygen and nutrients. This leads to the signs and symptoms of Buerger's disease, beginning with pain and weakness in your fingers and toes and spreading to other parts of your arms and legs.

Western Medicine Treatment

Smoking cessation

Although no treatment can cure Buergers disease, the most effective way to halt the disease's progress is to quit using all tobacco products. Even a few cigarettes a day can worsen the disease.

Your doctor can counsel you and recommend medications to help you stop smoking and stop the swelling in your blood vessels. You'll need to avoid nicotine replacement products because they supply nicotine, which activates Buergers disease; there are non-nicotine products that you can use. If the disease is still active, your doctor may check your urine for the presence of nicotine to see if you're still smoking.

Another option is a residential smoking-cessation program. In these programs, you stay at a treatment facility, sometimes a hospital, for a set number of days or weeks. During that time you participate in daily counseling sessions and other activities to help you deal with the cravings for cigarettes and to help you learn to live tobacco-free.

Other treatments

Other treatment approaches exist but are less effective. Options include:

Medications to dilate blood vessels, improve blood flow or dissolve blood clots

Intermittent compression of the arms and legs to increase blood flow to your extremities

Spinal cord stimulation

Surgery to cut the nerves to the affected area (surgical sympathectomy) to control pain and increase blood flow, although
this procedure is controversial

Medications to stimulate growth of new blood vessels (therapeutic angiogenesis), an approach that is considered experimental by many.

Amputation, if infection or gangrene occurs

Adopted From Mayo Clinic