Deep Vein Thrombosis

Description

Deep Vein Thrombosis (DVT) is a condition caused by a blockage of one of the deep veins by a thrombus, or 'plug' of red cells and protein.

Deep Vein Thrombosis is caused by an increased tendency for platelets (red blood cell fragments usually responsible for slowing or stopping bleeding) to clump together. This can be due to sluggish blood flow, turbulence in the blood, damage to the blood vessel walls or changes in the clotting characteristics of the blood itself. Factors known to increase the risk of DVT include:1

  • Immobility, especially in a seated position.
  • Recent surgery, trauma or malignancy,particularly to the lower limbs.
  • Smoking.
  • Oral contraceptive pill.
  • Dehydration and insufficient fluid intake.
  • Age over 40.


Signs & Symptoms

DVT may show no symptoms (up to 50% of patients) or may present as pain, swelling, discolouration (bluish) and the appearance of bulging veins in the affected area, usually the legs or extremities. In extreme cases, there may be severe Discolouration, oedema (swelling due to fluid retention) and eventually gangrene (tissue breakdown)2.

Management

DVT is a serious medical condition and requires immediate diagnosis and treatment by a medical practitioner. DVT is a potentially life threatening condition, as the 'plug' which blocks the vein may dislodge and become stuck in veins in the heart or lungs (coronary or pulmonary embolism). DVT may also cause considerable damage to tissues around the blockage. Always consult your Doctor.

Following the diet hints and following a regular exercise programme may reduce the risk of developing DVT. Remember to consult your Doctor before starting an exercise Programme. Ask your Pharmacist about support stockings to improve venous flow.

Economy Class Syndrome

Long flights in cramped conditions can increase the risk of DVT. Advice for travellers includes:3

  • Move around frequently, either by walking or flexing legs and ankles.
  • Wear loose fitting clothing and supportive stockings. Your Pharmacist can advise you on a range of compression stockings.
  • Drink plenty of water and avoid alcohol and caffeine, which can increase fluid loss from the body.
  • Your Doctor may recommend low dose aspirin for several days before flying.

Aspirin should not be given to children under 16 years of age unless specified by a Doctor. Aspirin should be avoided in children aged 12 to 15 if they are feverish.4


Lifestyle

Diet Hints

Your diet should be high in:

  • A VARIETY OF NUTRITIOUS FOODS including wholegrains and cereals, fresh fruit and vegetables, lean meats and low fat dairy products.

  • HIGH FIBRE FOODS. Eat plenty of wholemeal and whole-grain bread and cereal foods, legumes (baked beans, 3 bean mix, kidney beans), oats and oatbran, and vegetables.

These foods supply both insoluble fibre (to regulate bowel function) and soluble fibre (to help reduce blood cholesterol levels).

  • FISH OIL. Good dietary sources are salmon, tuna, sardines, mackerel and mullet. Fish oils help to reduce the stickiness of blood, to relax the walls of the arteries and to reduce blood triglyceride levels.

  • VITAMIN E. This vitamin acts as an antioxidant to prevent the degradation of poly-unsaturated and mono-unsaturated fats. These fats, when eaten in small amounts to replace saturated fats, are beneficial in lowering blood cholesterol levels.  

Good dietary sources of vitamin E are wheatgerm, sunflower seeds, sesame seeds, wholemeal flour and breads, cottonseed oil (especially if cold-pressed) and avocados.

Your diet should be low in:

  • TOTAL FAT CONTENT, especially SATURATED FATS. Saturated fats are harder, more solid at room temperature e.g., fat on meat, lard, dripping, butter, cream, full cream dairy foods, hard cheese, processed meats, cooking margarine, solid white cooking fats, coconut oil, palm oil, chocolate, commercial cakes, pastries, biscuits and deep-fried snack foods.

  • REFINED FLOUR AND SUGARS. These provide energy (kilojoules or calories) with little or no fibre or nutritional value. Avoid soft drinks, flavoured mineral waters, lollies, refined cakes, biscuits, pastries and sweetened cereals.

  • DIETARY CHOLESTEROL. Avoid brains, liver, kidney, pate, fish roe and egg yolks (no more than 3 per week). Most cholesterol in the blood comes from the liver, not from foods in the diet. Low-fat foods and low fat cooking techniques are preferable to 'low cholesterol' or 'cholesterol-free foods'. 


Vitamins/Minerals/Herbs
  • Protein digesting enzymes such as bromelain and papain (from pineapples and pawpaw fruit) may be of benefit it preventing thrombosis5.

  • Garlic and ginger have been used tradtitionally to thin the blood. The recommended dose of garlic is the equivalent of a clove a day.6 7

  • The herbs ginkgo biloba and Cat's Claw may help reduce the stickiness of the blood.8 9

  • Flavonoids, such as those found in grape seed extract, tea, grape skins, red wine and berry fruits may help reduce the risk of blood clots.10 11 12

  • Essential fatty acids (found in certain fish and cold pressed vegetable oils) can reduce blood stickiness by modifying levels of chemicals called prostaglandins.
Pharmacist's Advice

Ask your Pharmacist for advice.

  1. Follow the Diet Hints.
  2. Some experts recommend that anyone with a higher risk of Thrombosis should have one low dose aspirin tablet a day, to help keep the blood thin. For more information talk to your Pharmacist.
  3. Ask your Pharmacist for advice about compression stockings which may help to reduce the risk of developing thrombosis.13
  4. Stop smoking. Smoking is a major risk factor for the development of Thrombosis14. Ask your Pharmacist for advice on quitting.
  5. If dietary intake is inadequate, nutritional supplements may be beneficial.

Aspirin should not be given to children under 16 years of age unless specified by a Doctor. Aspirin should be avoided in children aged 12 to 15 if they are feverish.15

Notes

References

  1. Bellingham C. Giving advice on traveller's thrombosis. The Pharmaceutical Journal 2001 Jan 27; 266 (7132):116-117.
  2. Davidson's Principles and Practise of Medicine. Churchill Livingstone. 16th Edition. 1991.
  3. Bellingham C. Giving advice on traveller's thrombosis. The Pharmaceutical Journal 2001 Jan 27; 266 (7132):116-117.
  4. News Summary. Older children should also avoid aspirin. The Pharmaceutical Journal 2002 Apr 27; Vol.268, No.7195:557-561. 
  5. Felton, G. E. Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients. Medical Hypotheses. 6:1123-1133, 1980.
  6. Ali, M., et al. Consumption of a garlic clove a day could be beneficial in preventing thrombosis. Prostaglandins Leukot Essent Fatty Acids. 53(3):211-212, 1995.
  7. Srivastava, K. C. Effects of aqueous extracts of onion, garlic and ginger on platelet aggregation and metabolism of arachidonic acid in the blood vascular system: in vitro study. Prostaglandins, Leukotrienes and Medicine. 13:227-235, 1984.
  8. Braquet P, et al. Ethnopharmacology and the development of natural PAF antagonists as therapeutic agents. J Ethnopharmacol. 1991 Apr;32(1-3):135-9.
  9. Chen, J., et al. Inhibitory effect of rhynchophylline on platelet aggregation and thrombosis. Acta Pharmacologica Sinica. 13:126-30, 1992.
  10. Sagesaka-Mitane, Y., et al. Platelet aggregation inhibitors in hot water extract of green tea. Chem Pharm Bull (Tokyo). 38:790-793; 1990.
  11. Reported at the: 46th Annual Scientific Session of the American College of Cardiology, 1997.
  12. Chang, W. C., et al. Inhibition of platelet aggregation and arachidonate metabolism in platelets by procyanidins. Prostaland Leukotr Essential Fatty Acids. 38:181-188, 1989.
  13. Brandjes, et al. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. The Lancet. 349 (9054). Mar 15, 1997.
  14. McCarty MF. Fish oil may be an antidote for the cardiovascular risk of smoking. Nutrition 21, San Diego, CA 92109, USA. Med-Hypotheses. 1996 Apr; 46(4). pp 337-47.
  15. News Summary. Older children should also avoid aspirin. The Pharmaceutical Journal 2002 Apr 27; Vol.268, No.7195:557-561.