Raynaudís disease is a
condition that affects the blood supply to the fingers, toes and
occasionally the ears and nose. During a Raynaudís attack, or episode,
the blood vessels constrict (narrow) and the blood supply to these areas
is reduced. This results in several skin color changes which are often
accompanied by a throbbing or burning sensation, cold, and numbness. The
exact cause of Raynaudís disease remains unknown. However, current
research is coming closer to determining a probable cause.
What Are The Symptoms Of
During a typical
Raynaudís attack the affected area may first become white (pallor) as
the blood supply is reduced, then blue (cyanosis) as the oxygen supply
to the area is depleted, followed by bright red (rubor) as the blood
returns to the area (reactive hyperemia). Raynaudís disease, by
definition, involves three color changes. However, they do not always
occur in the same order for all people all of the time nor do all three
changes always occur in a given attack.
What Causes A Raynaudís
Raynaudís episodes can be
triggered by cold, either by touching cold objects or by being in a cold
environment. Emotions such as stress and anxiety may also play a role.
The severity of attacks will vary from episode to episode, as well as
from patient to patient. Attacks typically last a few minutes.
Who Gets Raynaudís
Raynaudís disease occurs
more frequently in women than in men. Although it can occur at any age
it usually begins between the ages of 15 and 40. It is estimated that 4
- 5% of the United States population is affected. Recently, a
cluster has been documented in patients who have been exposed to
toxigenic molds. More studies are being conducted, but now
researchers have discovered a definite link between the two.
How Is Raynaudís
Raynaudís is divided into
Primary Raynaudís or
Raynaudís disease, occurs when an individual has only the above
mentioned color changes along with the typical symptoms of pain or
numbness. There is no other medical problem which may be causing the
or Raynaudís phenomenon, occurs when the Raynaudís episodes are
secondary to another medical condition. In other words, the individual
with Raynaudís has another medical condition which is causing the
attacks. Or, Raynaudís is only one of the symptoms associated with the
other disease. Although this form is less common than primary
Raynaudís, it is a more complex and serious disorder. Some examples of
other underlying diseases associated with Raynaudís are: connective
tissue diseases, scleroderma,
rheumatoid arthritis, lupus, vibration
white finger, occlusive arterial disease, thoracic outlet syndrome,
carpel tunnel syndrome.
How Is Raynaudís
Primary Raynaudís disease
is diagnosed following the Allen Brown criteria:
At least two of the three color changes
occurring during attacks which are provoked by cold and or
Episodes have been
occurring periodically for at least two years.
Attacks occurring in both hands.
There is no other
identifiable cause for the Raynaudís episodes.
testing which a physician might do to help with the diagnosis:
What Is The Treatment For
There is no known cure
for this condition, therefore, effective treatments are essential. Most
cases of primary Raynaudís can be controlled with proper medical care.
What you can do:
Many people are able
to find relief by simply adjusting their lifestyle. For example:
- Protect yourself
from the cold.
- Avoid excessive
- Do not use
What a doctor might do:
For more severe
cases that require medication, your doctor might prescribe drugs which
keep your blood vessels from narrowing and help them dilate (expand),
such as nifedipine, diltiazem, or nitroglycerin. Some of these
medications may have side effects which you should discuss with your
physician before taking.
If linked to fungal
exposure, an IgG Panel should be conducted to determine fungal
antibodies, then, if testing is positive to high positive, a course of
anti-fungals and cholestyramine should also be prescribed in addition to
above treatment to arrest further fungal growth.
Biofeedback has been
demonstrated to be safe and effective for some individuals. This is a
technique designed to help a person gain control over involuntary body
functions, such as skin temperature, heart rate, or blood pressure.
Biofeedback training is necessary and several methods are available.
In rare instances,
a sympathectomy may be performed. This operation cuts the nerves that
may also be affecting the blood vessels to the fingers. This procedure
is usually not necessary and may only work for a short period of time.
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