Monday, July 22, 2024

What Causes Ulcers On Your Legs

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What To Avoid If You Have An Ulcer

What causes leg ulcers? When should I see a specialist?

If you have an ulcer, avoid NSAIDs or smoking, which can reduce the ability of the stomach lining to protect itself against stomach acid. Foods that increase stomach acid, such as dairy, coffee, and soda should be taken out of the diet. Highly acidic foods, such as tomatoes and citrus, will only make things worse. Finally, substances that irritate the stomach, such as alcohol or spicy foods, are probably not a good idea.

Clinical Use Of Honey

Several studies have proven that local honey is beneficial for wounds, cuts, minor burns, bed sores and even leg ulcers. But, this does not mean you can simply dab honey as much as you want on the affected area.

  • The amount of local honey required on the wound relates to the amount of fluid exuding from the wound diluting it.
  • It is recommended to apply honey to an absorbent dressing prior to application. When applied directly to a wound, the honey may run off before the application of a dressing to hold it in place.
  • Honey may not soak readily into absorbent dressings. To facilitate soaking, warm the honey to body temperature. You can also add 1 part water to 20 parts honey to make the honey more fluid.
  • To treat cavity wounds, a blister of honey can be held on a wound using an adhesive film dressing.
  • As infection may lie in the tissues underlying the wound area, honey dressings may be needed beyond the inflamed area surrounding a wound.

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Can Venous Leg Ulcers Be Prevented

There are several ways to help prevent developing a venous leg ulcer in people at risk.

These include:

  • elevating your leg when possible
  • stopping smoking if you smoke

These measures are particularly important if you previously had a leg ulcer.

This is because you’re at increased risk of having another one in the same leg within months or years.

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How Are Leg Ulcers Diagnosed

A vascular specialist a healthcare provider specializing in the circulatory system and knowledgeable about wound care can examine the ulcer. Your provider will examine your skin and the wound.

You may also get:

Medical History And Examination

Leg Ulcers

Your GP or practice nurse will ask whether you have any other symptoms associated with venous leg ulcers, such as:

  • swelling in your ankles
  • discoloured or hard skin

They’ll try to determine the cause of the ulcer by asking about underlying conditions or previous injuries, such as:

Read more about how venous leg ulcers are treated.

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How Is A Vascular Ulcer Diagnosed

A healthcare provider can quickly diagnose a vascular ulcer by examining it. They will look closely at the ulcer and may feel the area around it, checking for specific symptoms.

However, your provider will also want to diagnose whatever caused the ulcer. Parts of their examination of the wound will help them do this, but they will also order certain tests to help them fully understand the cause, mainly because vascular ulcers can have multiple causes and many of those causes can be connected.

Further Developments In Curing Venous Leg Ulcers:

Developments since have been equally valuable. There is still no easy way of treating deep valve failure. Conversely, we treat superficial valve failure with ablation. Introduced into the UK in 1999 by Mark Whiteley, the ablation of superficial venous reflux is highly successful even in the long term. We have now shown our 15 year success rates in a study published from The Whiteley Clinic.

This is excellent news for our patients at The Whiteley Clinic.

Provided the patient can walk, most are now curable.

Research has continued. Deep vein reflux is usually secondary to a deep vein obstruction at a higher level. Placing an expandable metal tube called a Stent through such obstructions, opens them up and holds them open. Therefore in many cases, even deep vein problems are now curable.

As such, no patient who can walk should ever accept long-term dressings and compression for a leg ulcer unless they have been fully investigated by an expert team.

If you want to know more about venous leg ulcers and how they can be cured permanently, see Leg Ulcer Treatment Revolution published in November 2018. This is available on and in good bookshops.

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What To Expect After Treatment With Cvm

At CVM, we’re ready to help diagnose and treat your leg ulcers at our select wound care locations:

Our expert team will carefully consider all potential chronic pelvic pain causes, with a special emphasis of diagnosing any potential vascular disorders.

We provide complete chronic pelvic treatment for pain. Aside from implementing innovative techniques to treat your pain, including treatments for vascular issues, we’re committed to listening to your concerns and treating your pain seriously. Many of our patients go on to have significant improvement or resolution of their symptoms.

Referral To A Specialist

Leg ulcers – Diagnosis and treatment of leg ulcers

In some cases, your GP or nurse may decide to refer you to a specialist in conditions affecting the blood vessels .

For example, you may be referred to a vascular specialist if your GP or nurse is unsure about your diagnosis, or if they suspect your ulcer may be caused by artery diseases, diabetes or rheumatoid arthritis.

After taking your medical history and examining you, the vascular specialist may need to arrange further investigations to plan your treatment.

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What Is The Best Home Remedy For An Ulcer

An ulcer needs time to heal, so the best home remedies help guard the stomach against unnecessary irritation and work to lower stomach acid. Here are some examples:

  • Avoid foods that increase stomach acid such as dairy, coffee, and soft drinks
  • Avoid foods that irritate or damage the stomach such as alcohol, spicy foods, and fatty foods
  • Eat small meals throughout the day
  • Smoking also increases stomach acid, so stop smoking
  • Avoid NSAIDs for pain if youre at risk of getting an ulcer. They reduce prostaglandins that protect the stomach lining from stomach acids. Use acetaminophen instead
  • Stress and nervousness may increase stomach acid, so manage stress with relaxation exercises, stretching, yoga, and other stress management techniques

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You Cannot Always Prevent Mouth Ulcers

Most single mouth ulcers are caused by things you can try to avoid, such as:

  • biting the inside of your cheek
  • badly fitting dentures, braces, rough fillings or a sharp tooth
  • cuts or burns while eating or drinking for example, hard food or hot drinks
  • a food intolerance or allergy
  • damaging your gums with a toothbrush or irritating toothpaste
  • feeling tired, stressed or anxious

Sometimes theyre triggered by things you cannot always control, such as:

  • hormonal changes such as during pregnancy
  • your genes some families get mouth ulcers more often
  • a long-term condition such as inflammatory bowel disease , coeliac disease or Behçets disease
  • a vitamin B12 or iron deficiency
  • medicines including some NSAIDs, beta blockers or nicorandil
  • stopping smoking people may develop mouth ulcers when they first stop smoking

Page last reviewed: 19 January 2021 Next review due: 19 January 2024

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What Tests Diagnose A Peptic Ulcer

To confirm a person has an ulcer a diagnostic imaging test will usually be ordered. The two most widely used tests are:

  • Upper GI series : This is a type of X-ray. The patient is given a chalky liquid to drink that increases the contrast on the X-ray, making certain features easier to see. Because this liquid contains barium, this test is sometimes called a barium swallow.
  • Endoscopy : An endoscope is a thin, flexible tube with a tiny camera at the end. The patient is given a mild sedative, and then the tube is passed through the mouth into the stomach. The doctor can see the lining of the stomach to diagnose a peptic ulcer. Tiny samples of the tissue will be taken , which are examined under a microscope.

If a diagnostic imaging test reveals an ulcer, the patient will most likely have a test to see if H pylori bacteria are present.

  • It is important to be certain about this, because treatment of the H pylori is likely to heal the ulcer.
  • Ulcers caused by H pylori are treated differently than ulcers caused by medications.

Three types of tests are available to detect H pylori.

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What Are The Symptoms Of A Venous Leg Ulcer

What is the Best Way to Heal a Leg Ulcer?

The most common symptom of a venous leg ulcer is a wound that doesnt heal and is irregularly shaped with dry, hard skin around the outside. Other symptoms include:

  • swelling, especially around the ankle of your affected leg
  • clear discharge.

Venous leg ulcers are at risk of becoming infected because theyre slow to heal. Signs of an infected leg ulcer include:

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    What Are My Treatment Options

    Treatment will depend on many factors, including the reason for the condition and your health status and history. Other factors your doctor will consider are:

    • Your specific symptoms.
    • How severe your condition is.
    • How well you can tolerate medications or procedures.

    The most common treatment for venous insufficiency is prescription-wear compression stockings, she says. These special elastic stockings apply pressure at the ankle and lower leg. They help improve blood flow and can reduce leg swelling.

    You also can improve blood flow by keeping your legs elevated whenever possible, which means keeping them uncrossed when you are seated and by exercising regularly.

    If you need medication, the most commonly prescribed include:

    • Diuretics. These medications draw extra fluid from your body through your kidneys.
    • Anticoagulants. These medications thin the blood.
    • Pentoxifylline . This medication helps improve blood flow.

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    How To Define Ulcerative Colitis Pain

    To help your doctor figure out whats causing your abdominal pain and other symptoms, you need to be able to accurately describe the sensation. Before seeing your doctor, take stock of what youre feeling. It may be useful to keep a colitis symptom journal to write down what you are experiencing. Be ready to describe:

    • How long youve had your pain
    • Where you feel your pain
    • How it feels, both in sensation and intensity
    • The frequency and duration of your pain
    • What seems to trigger your abdominal pain
    • What seems to help ease the pain
    • What time each pain occurred, including how long after eating, and how long it lasted

    The more specific you can be about your pain, the better, Dr. Kane says.

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    How Does A Vascular Ulcer Affect My Body

    Do varicose veins cause leg ulcers? Can leg ulcers be treated?

    Vascular ulcers can have several negative impacts on your life. These include:

    • Increased risk of infection. Your skin is a protective barrier that keeps germs out, and a vascular ulcer is a way that germs can bypass that barrier.
    • . If an infection isn’t treated, it can spread and lead to an extremely deadly condition called sepsis. This is when your body reacts so strongly to a major infection that your immune system begins to damage different parts of your body itself.
    • Gangrene. Infections or the lack of blood flow that caused the ulcer in the first place can cause cells in nearby tissue to die. This can cause gangrene, which will spread and ultimately be fatal if not treated.
    • Pain and limited movement. Vascular ulcers can be very painful. Depending on their location, they can keep you from working, resting or doing things you usually enjoy. Because physical activity improves circulation, a painful vascular ulcer can keep you from moving, making the ulcer even worse.

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    The New Understanding Of Leg Ulcers

    In the late 1980s, a new test called Duplex Ultrasound was invented.

    Duplex ultrasound allowed us to see the veins, and also see the blood flowing within them. Researchers using duplex ultrasound quickly found that the previous understanding of venous leg ulcers and varicose veins was completely wrong.

    Research published in the 1990s showed that most venous leg ulcers were caused by superficial vein reflux. Previously, it had been thought that when the valves failed in the superficial veins, the superficial venous reflux that resulted only casued varicose veins. The valves failing allow blood to fall the wrong way down the veins a process called reflux. This reflux was thought to stretch the wall of the veins, causing varicosities.

    However, this new research found that the majority of venous leg ulcers were caused by superficial vein reflux. Deep vein reflux alone was found in only a minority of cases.

    Even more interesting, many of the patients with superficial vein reflux did not even show varicose veins on the surface. This gives the term hidden varicose veins.

    The results of this research are startling. It means that:

    • Most venous leg ulcers are curable by varicose vein surgery
    • No one can tell the cause of a leg ulcer without a venous duplex ultrasound scan
    • Varicose veins are not cosmetic as they can go on to cause venous leg ulcers

    Leg Ulcer Treatment Revolution by Prof Mark S Whiteley

    Leg Ulcers: Symptoms Causes And Treatments

    When youâve heard the word âulcerâ in the past, you might immediately think of something like âstomach problemsâ or âstress-related,â but lower extremity ulcers often have a completely different cause.

    The most common cause of leg ulcers is vascular disease, so if you find yourself developing ulcers on your lower half and they arenât improving, they might be an indication of a cardiac problem.

    Knowing what a leg ulcer looks like, what causes it, and how theyâre treated wonât just improve your quality of life while dealing with one, it can make a difference in treating the heart disease it might indicate.

    Types of Leg Ulcers

    • Vascular ulcers: Most often affects the elderly and women, and often occurs due to damage inside the valves in the leg veins. Major risk factors for ulcers on the leg include advanced age, obesity, deep vein thrombosis, previous leg injury, varicose veins, and phlebitis
    • Neuropathic ulcers: Most often affect people with diabetes, caused by uncontrolled blood sugar levels
    • Arterial ulcers: Affect people with poor circulation due to peripheral artery disease

    Symptoms of Ulcers on Leg

    Leg ulcers are often diagnosed by a vascular surgeon based on the location, borders, and appearance on the body. Of course, leg and other lower extremity ulcers will be located on the lower half of the body, and often manifest as open, often painful sores that either never seem to heal or recur often.

    Causes of Leg Ulcers

    Treatment of a Leg Ulcer

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    What Questions Should I Ask My Healthcare Provider

    You may want to ask your healthcare provider:

    • What caused the leg ulcer?
    • What is the best treatment for me?
    • What changes can I make to heal the wound and prevent future ulcers?
    • Should I look out for signs of complications?

    A note from Cleveland Clinic

    Leg ulcers can be painful, unsightly and difficult to treat. Chronic leg ulcers need specialized wound care to prevent infection and aid healing. Your healthcare provider may recommend other treatments like medicines or procedures to improve blood flow to the leg. Even after they heal, leg ulcers can break open again. Your provider can offer suggestions on how to prevent a wound recurrence.

    Last reviewed by a Cleveland Clinic medical professional on 06/23/2022.


    Looking After Yourself During Treatment

    Venous Ulcers

    To help your ulcer heal more quickly, follow the advice below:

    • Try to keep active by walking regularly. Sitting and standing still without elevating your legs can make venous leg ulcers and swelling worse
    • Whenever you’re sitting or lying down, keep your affected leg elevated with your toes level with your eyes
    • Regularly exercise your legs by moving your feet up and down, and rotating them at the ankles. This can help encourage better circulation
    • If you’re overweight, try to reduce your weight with a healthy diet and regular exercise

    Read more about preventing venous leg ulcers.

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    Getting Diagnosed With A Leg Ulcer

    If you have a wound or sore that isnt healing, make an appointment at your GP practice as it could turn into or be the beginnings of a leg ulcer. You might be given an appointment to see the nurse rather than the doctor as nurses are often responsible for caring for patients with leg problems.

    Alternatively, there might be a Leg Club or specialist leg clinic in your area. You can attend these without having to be referred by your GP.

    Remember to remove any nail polish from your toenails before your appointment.

    When you see the nurse or doctor, they should:

    • Ask about your symptoms and how long you have had problems
    • Examine your lower legs
    • Do a simple test called a Doppler ultrasound. This test compares blood flow in your ankle with that in your arm to find out if there are blood flow problems in your lower leg. You may have to come back to have your Doppler test on another day or at another clinic.

    You may also be offered some other tests to check for other health problems that can affect your legs such as diabetes and anaemia.

    If your GP practice thinks you have problems with your veins or arteries, they may refer you for more tests at your local hospital or specialist clinic.

    You may hear different words to describe your wound such as ulcer, leg ulcer, sore, laceration, chronic wound and maybe others. Ask your nurse to explain their choice of word and what this may mean for you.

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