Buerger Disease

What is Buerger disease?

Buerger disease is one of many types of vasculitis. This is inflammation of small and medium-size blood vessels. Buerger disease causes a tightening, or a blockage, of the blood vessels in your feet and hands. When blood doesn’t flow well to your hands and feet, especially during activity, you may have pain and tissue damage. In the worst cases, sores (ulcers) appear on your fingers and toes due to poor circulation to the skin and tissue. The ulcers can become infected and cause gangrene. In a small number of people, Buerger disease reduces blood flow to the heart, belly, or brain.

Who is at risk for Buerger disease?

People at the greatest risk for Buerger disease are those who are heavy smokers. Men of Asian or Middle Eastern descent between ages 20 and 40 seem to be more at risk. It has also been identified in cigar smokers, marijuana users, and those who use smokeless tobacco such as chewing tobacco and snuff. It's a rare disorder, and less a risk in countries where the use of tobacco has declined.

What causes Buerger disease?

Healthcare providers are not sure what causes Buerger disease. It's a rare type of vasculitis.

What are the symptoms for Buerger disease?

Symptoms of Buerger disease include:

• Pain, soreness, or burning feeling in your lower legs or feet when walking

• Pain or soreness in your hands or forearms

• Blood clots

• Ulcers on your toes and fingers

• Change in the color of the skin on the fingers and toes to pale, redness, and sometimes bluish in color

How is Buerger disease diagnosed?

To make a diagnosis, your healthcare provider will consider:

• Your overall health and health history

• Your symptoms

• Lifestyle choices, such as whether you smoke

• A physical exam

• Blood tests

• Imaging tests to assess tissue damage

How is Buerger disease treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

There is no known cure for Buerger disease. Treatment may depend on how far your disease has progressed. It will focus on trying to improve blood flow to the affected area or to reduce pain. Choices include:

• Stopping all smoking and other forms of tobacco use, including electronic cigarettes.

• Having surgery to bring blood to the affected tissues

• Other types of surgery to cut the nerves to the tissue to reduce pain or treat damaged extremities

Some medicines help to relax the blood vessels and improve blood flow to the tissue.

What are possible complications of Buerger disease?

Possible complications from Buerger disease include:

• Changes in the way you walk or move due to pain

• Ulcers

• Tissue damage or tissue death (gangrene)

• Amputation

What can I do to prevent Buerger disease?

The goal is to prevent the disorder from getting worse by:

• Stopping smoking and not using any tobacco products

• Not spending long periods of time in cold temperatures

• Dressing warmly in cold temperatures

How can I manage Buerger disease?

Follow your healthcare provider’s advice for taking care of yourself. The best way to stop or slow Buerger disease is to stop using tobacco completely. Talk with your healthcare provider if you need help quitting tobacco.

When should I call my healthcare provider?

Call your healthcare provider right away if you have:

• Pain in your lower legs, feet, hands, or forearms that continues to get worse

• Sores on your hands or feet that don't heal

• Signs of infection in the affected areas

Key points about Buerger disease

• Buerger disease causes the blood vessels to narrow and severely limits the blood flow to the area, usually in the hands and feet.

• It's a rare disorder that can’t be prevented. It affects men more often than women.

• Quitting smoking and stopping the use of any form of tobacco or nicotine is important to reduce the risk of complications.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours and on weekends and holidays.