Saturday, May 5

Raynaud's phenomenon - Treatments and prevention of disease

In the treatment of Raynaud's phenomenon, the first step is to immediately remove the causative factors. For cure of Raynaud's disease, all possible steps to remove vasoconstriction and to promote vasodilation must be taken.
The aim of the treatment is to reduce the severity and frequency of Raynaud's incidences and to prevent tissue damage, gangrene, necrosis and loss of digits.

  There are two types of Raynaud's disorders. The primary Raynaud's is idiopathic, arising spontaneously from an unknown and obscure cause. Prevention of known triggering factors itself is cure for Raynaud's disease. However the secondary type, also known as Raynaud's syndrome, arises due to umpteen underlying causes and diseases. Complete treatment of the underlying cause only can resolve the symptoms completely. Till such time, some temporary measures can be taken to alleviate the condition. Sometime the treatment measures go out of control and become serious, leading to necrosis and ulcers, even requiring amputation.

Self-help in Raynaud's disease treatment 

  Mental stress and cold are the main triggers for the primary type.
Stress management for treatment
  If the attack is due to mental stress or anxiety, positive thinking must be developed to control the situation. Relaxation exercises, yoga, deep breathing or meditation can bring about the relaxed feeling and relieve vascular constriction.
Keeping warm
  The affected person should move immediately to a warmer place. Wearing warm clothing and hat helps in the treatment. Hands and feet may be kept in a warm water bath and gently wiggled to restore circulation. If warm water is not immediately available, keeping the affected fingers in mouth, armpit or crotch will help. Rubbing the hands can improve circulation to the extremities. Swinging the arms for several minutes also can restore circulation.

Raynaud's treatment with medication

  "Consult a qualified health professional before taking any medicine for Raynaud's disease".
If the triggering factor is mental stress, Fluoxetine, an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class, may be prescribed, which is quite effective in controlling anxiety. There are other effective antidepressants available.
Calcium channel blockers:
Calcium channel blockers like diltiazem or nifedipine have been found to be effective in dilating the constricted blood vessels and useful in Raynaud's disease treatment.
Angiotensin II receptor antagonist:
Also known as angiotensin receptor blockers (ARBs), AT1-receptor antagonists or sartans, have been found to reduce the severity and frequency of Raynaud's disease attacks.
Alpha blockers:
α1-adrenergic blockers have been found to be effective in treatment.
Phosphodiesterase-5 inhibitors:
Sildenafil is found to improve the blood circulation to the affected digits.
Topical nitroglycerin is also relieves the vascular constriction.

Surgical treatment for Raynaud's disease

  In rare cases when there is a fear of loss of digits, sympathectomy, is performed to save the fingers. The nerves stimulating the constriction of blood vessels are surgically severed. Microsurgery may be performed to bypass the affected arteries. To block the sympathetic nerves chemicals may be injected. There are some positive results with laser treatment for Raynaud's disease. If there is severe necrosis and gangrene, amputation of the digit has to be considered.

Alternative medicine for Raynaud's treatment

  In a few experiments it is found that applying extract of Ginkgo biloba leaves reduces the frequency of Raynaud's attack. Fish oil supplements containing long-chain omega-3 fatty acids are effective in control of Raynaud's disease. However greater quantities (6.5 grams) are to be used.
 Biofeedback is a process of mental control of physiological processes used in many disease treatments, initially using certain equipments. Eventually, this can be accomplished without the use of extra equipment. Temperature biofeedback is used by biofeedback therapists for treatment of Raynaud's disease. This helps in treatment to bringing the temperature of fingers under voluntary control.

Prevention of Raynaud's disease and emergency measures

  • Focusing on having a relaxed state of mind and relaxation exercises reduce anxiety and stress.
  • It is important to keep the whole body warm by wearing warm clothing to prevent episodes of Raynaud's disease.
  • Avoiding cold places and winter sports helps in treatment.
  • Cool drinks and cold food must be avoided.
  • Consuming hot beverages and hot food puts off attacks.
  • Avoiding chilly weather and not getting drenched in rain is necessary.
  • For Raynaud's disease treatment Keeping home warm and turning down air conditioner is necessary.
  • Wear gloves and socks and keep your hands and feet warm.
  • Guard your hands and feet from trauma and injuries.
  • Avoid tight-fitting clothes, wrist bands, jewelry and shoes as they may restrict blood circulation and hamper Raynaud's disease treatment.
  • Wear a hat to prevent loss of body heat through scalp.
  • Exercising regularly improves blood circulation and reduces the frequency of Raynaud's disease episodes.  
  • Wearing gloves while removing food from refrigerator protects the fingers from getting cold.
  • Avoid walking barefoot.
  • Avoid using vibrating tools to reduce the chances for getting fresh episodes of Raynaud's.
  • Quit smoking as nicotine and other chemicals in the tobacco smoke cause vasoconstriction.
  • Avoid coffee and other beverages containing caffeine, as it is a vasoconstrictor.
  • Immediate treatment of Raynaud's disease ulcers should be undertaken to avoid serious infections.
  • Avoid contraceptive pills and if required to use, take only those containing progesterone alone.
  • Unless prescribed by a physician knowing your Raynaud's status, avoid medicating yourself.
  • If the Raynaud's disease induced by any particular medicine, consult a physician for an alternative. 
  • Certain medicines used for treatment of cold, hypertension and weight loss can worsen the Raynaud's disease.
Though several self-help measures and treatments may bring relief to the Raynaud's disease affected person, the underlying triggering factors must be completely addressed to prevent recurrence. Unfortunately patients afflicted by autoimmunity induced Raynaud's disease do not respond satisfactorily to treatments.
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