Psst … hemorrhoids fall under the varicose veins umbrella.
Typically, most people think of varicose veins as the twisting, bulging veins on the legs, and for good reason: They are the most common location for visible varicose veins. Thanks to gravity, veins in the legs have to work extra hard to bring blood back to the heart, so problems with the vein walls or valves can quickly lead to reflux of blood in the veins.
That said, the legs aren’t the only location you’ll find enlarged veins, even if you can’t always see them. Here are other problems associated with varicose veins, according to Kira Minkis, MD, PhD, dermatologist at Weill Cornell Medicine:
Hemorrhoids: These are a swollen vein inside or on the anus or rectum, and they cause itching, pain, and/or bleeding. They’re typically caused by straining and are common among people who experience chronic constipation or diarrhea.
Varicoceles: These are enlarged veins in the scrotum, or the sac of skin that holds the testicles. They tend to form during puberty but may grow over time. They’re often harmless, but can sometimes lower sperm production and affect fertility.
Gastroesophageal varices: These are enlarged veins in the stomach or esophagus, and they’re common in people who have cirrhosis of the liver. That’s because scarring caused by cirrhosis obstructs blood flow and causes higher pressure in the portal vein—a vein that moves blood from the intestines to the liver. These can be dangerous due to the high risk of rupture and gastric bleeding, which can be fatal.
Some varicose veins beyond the legs don’t need treatment, such as varicoceles. Many men live with varicoceles and it has no effect on their lives. Hemorrhoids can be painful or a nuisance, but they can be treated with lifestyle changes and/or medications, such as topical creams to reduce pain and swelling.
Gastroesophageal varices are the biggest medical concern, due to the life-threatening risk of gastric bleeding. The goal of treatment is to reduce the risk of bleeding, which includes lifestyle changes (losing weight and avoiding alcohol), medications like beta blockers, and a procedure known as variceal band ligation.
If you think you have some type of varicose veins—on your legs or elsewhere—talk to your doctor. You may be eligible for certain treatment options that could improve your quality of life, and in some cases, even save your life. Learn more about the benefits of seeking varicose veins treatment early here.
Dr. Minkis is a dermatologist at Weill Cornell Medicine, an assistant professor of dermatology at Weill Cornell Medical College, Cornell University, and an assistant attending dermatologist at NewYork-Presbyterian Hospital.
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Varicose veins are enlarged veins,
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visible on the surface of the skin,
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or just under the surface of the skin.
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They look like enlarged, engorged, blood vessels,
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and you could also have them in other sites.
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The more advanced they become,
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the more symptomatic and the more difficult it is to treat,
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so you're not necessarily just treating the varicose veins
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at that point, but you might also have to deal
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with the complications that they have caused as well.
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Varicose veins occur most commonly in the lower legs,
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but other areas where you could get an enlargement of veins
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similar to varicose veins include varicoceles in the scrotum,
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hemorrhoids, which form around the anus
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from increased pressure there.
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Hemorrhoids can bleed and can become painful
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and a nuisance, and veins that are engorged
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around the esophagus could also be dangerous
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because they could potentially lead to an upper gastric bleed,
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which can lead to a life-threatening condition
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where you could lose a lot of blood very rapidly.
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And varicose veins are also present
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around some visceral organs or internal organs.
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We have some excellent treatment options available
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for patients which varicose veins,
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and I would just recommend that if somebody notices
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that they're starting to develop them to seek the care
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of your physician, your dermatologist, or a vein specialist,
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because there are many treatment options
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that we have that could help to prevent and to treat
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varicose veins and any complications related to varicose veins.
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Garcia-Pagan JC, Barrufet M, Cardenas A, Escorsell A. Management of gastric varices. Clin. Gastroenterol. Hepatol. 2014;12:919-28.
Hemorrhoids. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on February 26, 2020 at https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids.)
Home and office treatment of symptomatic hemorrhoids. Waltham, MA: UpToDate, 2020. (Accessed on February 26, 2020 at https://www.uptodate.com/contents/home-and-office-treatment-of-symptomatic-hemorrhoids.)
Patient education: esophageal varices (beyond the basics). Waltham, MA: UpToDate, 2020. (Accessed on February 26, 2020 at https://www.uptodate.com/contents/esophageal-varices-beyond-the-basics.)
What are varicoceles? Linthicum, MD: Urology Care Foundation. (Accessed on February 26, 2020 at https://www.urologyhealth.org/urologic-conditions/varicoceles.)