Let's learn about Buerger's Disease, a dangerous disease that causes black fingers and toes due to smoking.

Are you a smoker? Or do you use tobacco? Do you often experience pain and numbness in the tips of your fingers, toes, and toes? Do your fingers sometimes turn blue or pale? Don't ignore these things. This could be the beginning of a serious condition called 'Buerger's disease', which is unique to smokers. Today, we will talk about this in a simple way that you can understand.

What exactly is Buerger's Disease?

Simply put, Buerger's disease is a rare condition that affects the blood vessels (blood vessels) in your arms and legs. The small and medium-sized blood vessels that lead to your fingertips are the ones that are most affected.

There is another medical name for this, which is `(Thromboangiitis Obliterans)` . The name seems a bit complicated, doesn't it? Let's understand it simply.

• 'Thrombo' means a blood clot.
• 'Angiitis' refers to inflammation, or swelling, of the blood vessels.
• 'Obliterans' means something being blocked, becoming completely absent.

So, simply put, this is a disease in which blood vessels become swollen, blood clots form inside them, and blood flow is completely blocked .

Imagine a water pipe that is clogged with rust and dirt. That's what happens to our blood vessels in this disease. When blood flow through the blood vessels is disrupted, tissues as far away as the fingertips do not receive the oxygen and nutrients they need. This causes intense pain at first, and then the tissues begin to die.

This disease is more common in countries like Sri Lanka where tobacco use is high. However, the good news is that with the decrease in the number of smokers, the number of cases of this disease has also decreased significantly.

What are the symptoms of this disease? How do you recognize it?

The symptoms of Buerger's disease do not appear suddenly. They develop gradually over time. There are symptoms that appear early on, as well as symptoms that appear as the disease progresses.

Why does this disease occur? Who is at higher risk?

Scientists still don't know the exact cause of Buerger's disease, but the strongest and clearest link found so far is tobacco use .

Scientists believe that a chemical in tobacco damages the lining of blood vessels and causes inflammation. This causes the blood vessels to swell and become blocked by blood clots. Some scientists think it may be a genetic factor or an autoimmune disease.

There are several factors that increase the risk for this disease:

• Tobacco use: Smoking anything like cigarettes, beedis, cigars, and chewing tobacco is the main risk factor. Cannabis use may also be involved.
• Making your own cigarettes: People who use roll-your-own cigarettes are at higher risk.
• Gender: Men are more likely to develop this disease than women.
• Age: This disease most commonly occurs in young and middle-aged people between the ages of 20 and 45.

What are the possible complications of Buerger's disease?

If this disease is not properly controlled, that is, if tobacco use continues, serious complications can occur. However, these are rarely seen in most cases.

• Amputation: This is the most common complication. When gangrene occurs, the dead tissue must be surgically removed. Otherwise, the infection can spread throughout the body.
• Stroke
• Heart attack
• Transient ischemic attack
• Problems with the blood vessels in the intestines.
• Problems related to the nervous system.

How does a doctor diagnose this?

If you have these symptoms, you should definitely see a doctor. He or she will ask you questions, examine you, and try to determine if this is the disease.

The following are usually helpful in making a diagnosis:

1. Your medical history: You will be asked about things like whether you smoke, how long you have been smoking, and how many cigarettes you smoke per day.

2. Physical examination: Your pulse will be checked. In Buerger's disease, the distal pulses (e.g., in the legs and arms) may be weak.

3. Special tests for blood vessels:

• Ultrasound Scan: This can check for blood clots inside the blood vessels.
• Ankle-Brachial Index (ABI): This measures the blood pressure in your leg and arm and compares the two values. If the blood pressure in your leg is significantly lower than in your arm, it means that there is less blood flow to your leg.
• Angiogram: This is the best test to look for blockages in your blood vessels. In this, a special dye is injected into one of your blood vessels and an X-ray or CT/MRI scan is performed. This allows the doctor to clearly see where and how much the blockage is.

What is the best treatment for this?

This is the main and number one treatment for this disease. Even if you smoke one cigarette a day or wear a nicotine patch, the disease will not get better, it will only get worse.

Many patients experience a dramatic improvement in their symptoms when they stop smoking. Some even go into remission.

In addition to quitting smoking, your doctor may also recommend other treatments to help control your symptoms.

What should I pay attention to while living with this disease?

If you have Buerger's disease, you will need to make some small changes to your lifestyle.

• Avoid tobacco completely: This is the most important thing. Nicotine patches and marijuana are also good options. If you need help quitting smoking, talk to your doctor about it.
• Protect yourself from the cold: Cold can cause blood vessels to constrict further. So wear warm socks and gloves on cold days.
• Prevent injuries to your hands and feet: Even a small injury can take a long time to heal, so be careful when putting on shoes and working.
• Use the medicine exactly as prescribed by the doctor.
• Be careful when taking other medications: Some medications (e.g., some cold medicines) can constrict blood vessels. So ask your doctor before taking any medication.

When should I see a doctor?

If you have any of the symptoms mentioned in this article, especially if you are a smoker, see a doctor immediately. If your symptoms get worse or new symptoms appear, let your doctor know.

When should I go to the Emergency Department (ETU)?

If you experience symptoms of a stroke or heart attack (e.g. sudden chest pain, difficulty speaking, loss of sensation on one side of the body), go to a hospital's emergency department (ETU) immediately. Also, if a wound on your fingers is causing severe pain, swelling, or a foul odor, it could be a sign of a serious infection. In such cases, seek medical advice immediately.

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