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The term phlebitis refers to an inflammation of a vein, usually in the leg, frequently accompanied by blood clots that adhere to the wall of the vein. When the affected vein is close to the surface, the condition is called superficial phlebitis.
Risk Factors
Risk factors for any type of phlebitis include recent surgery or childbirth, varicose veins, inactivity, sitting for long periods (such as on a long airplane ride), and smoking. Prolonged placement of intravenous catheters can also cause phlebitis, possibly requiring antibiotic treatment. The use of progestins (synthetic progesterones, but not natural progesterone) will increase the likelihood of deep vein thrombophlebitis by 3 to 4 times.
Signs & Symptoms
Symptoms of superficial phlebitis include pain, swelling, redness, and warmth around the affected vein. The vein feels hard to the touch because of the clotted blood.
Deep vein thrombosis is more difficult to diagnose. It can occur without any symptoms until the clot reaches the lungs. However, in about half of cases, there are warning symptoms including swelling, pain and warmth in the entire calf, ankle, foot, or thigh (depending on where the involved vein is located). Although these symptoms can also be caused by more benign conditions, deep vein thrombosis is such a life-threatening disorder that physician consultation is necessary.
Treatment & Prevention
Conventional treatments for superficial phlebitis include analgesics for pain, warm compresses, and compression bandages or stockings to increase blood flow. In more severe cases, anticoagulants or minor surgery may be required. Superficial phlebitis inflammation generally is reduced within 7-10 days, but it may be 3-6 weeks for the problem to be entirely gone.
Deep vein thrombosis requires more aggressive treatment, including hospitalization, strong anticoagulants, and a variety of possible surgical procedures.
Note: Because deep vein phlebitis is a potentially life-threatening disorder, you should seek a doctor's advice before attempting any natural treatments.
Aortic glycosaminoglycans (GAGs) are substances found in the tissues of the body including blood vessels, and sometimes available supplementally. They are closely related to the anticoagulant drug heparin. Preliminary evidence suggests that aortic GAGs might be helpful in treating phlebitis, although not all studies agree. [Ann Ital Med Int. 1989;4: pp.378-85, Minerva Med. 1984;75: pp.1733-8]
Homeopathy (to be taken 4 times daily for up to 7 days): - If the condition follows an injury: Arnica 6c
- If bruising persists: Hamamelis 6c
- If the veins are worse in heat and when the limb is not elevated: Pulsatilla 6c.
General recommendations:- Include niacin in the diet. This B vitamin helps prevent clotting. Vitamin C helps strengthen the walls of veins and arteries.
- Eat a good nourishing diet of fruits, vegetables, raw nuts, seeds, legumes, and whole grains.
- Do not eat fried, salty, processed foods; dairy products; or hydrogenated vegetable oils. Do not eat meat.
- A high-protein diet increases blood-clotting factors.
- Use enough fiber in the diet, so you do not have to strain at the stool. Straining increases venous pressure on the legs.
- Maintain a low-fat diet and drink enough water.
- It is now known that food allergies can be involved. Search them out and eliminate them.
- Avoid dangling the feet. Pressure against the popliteal vessels may cause obstruction of blood flow. Do not cross your legs.
- Deep breathing or singing helps empty out the large veins, thus increasing venous circulation.
- Quit tobacco. If you smoke, and seem to keep having recurring phlebitis, you may have Buerger's disease (which see). Its symptoms are severe pain and blood clots, usually in the legs. Smoking constricts the blood vessels.
- Do not wear anything tight about the waist, or bands on the legs.
- Beware of "economy class syndrome." A remarkable number of people who fly in the cramped economy class seats of jets develop thromboplebitis. You are confined to your seat more on planes than in cars or boats. So request an aisle seat and get up every 30 minutes and walk up and down the aisles.
- Once you have had phlebitis, or clots of any type, you can have it again. Surgery or prolonged bed rests increase the likelihood that you will have another attack. Keep that in mind when you consider elective surgery.
- Fasting decreases blood coagulation, and can be beneficial when needed.
Prognosis; Complications; Seek medical attention if
This condition usually resolves on its own without further complications.
When phlebitis occurs in a deep vein, it is called deep vein thrombosis (DVT). DVT is a life-threatening condition because a clot could dislodge from the vein and lodge in the lungs.
If a swollen, painful vein does not disappear within 2 weeks, consult a physician.
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Signs, symptoms & indicators of Phlebitis / Thrombophlebitis:
Conditions that suggest Phlebitis / Thrombophlebitis:
Risk factors for Phlebitis / Thrombophlebitis:
Phlebitis / Thrombophlebitis suggests the following may be present:
Recommendations and treatments for Phlebitis / Thrombophlebitis: | | | | | Botanical |  Grape Seed Extract | A one-month of treatment reduced lower limb circumference and improved subjective symptoms better than horse chestnut seed extract in a study of 40 patients with diagnosed chronic venous insufficiency. [Phytother Res 2002;16(2): pp.1-5] |
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Diet |
 Therapeutic Fasting |
Digestion |
 Bromelain| | Due to its anti-inflammatory properties and ability to prevent blood platelet aggregation, bromelain has been suggested as a treatment for phlebitis. There are some positive reports in clinical trials of bromelain improving thrombophlebitis. [Planta Med 1990 56:249, Alt. Med. Rev. 1996 1:243, Angiology. 1969;20: pp.22-6] |
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Habits |
Aerobic Exercise| | It is important to get regular moderate exercise. Walking is the best, and swimming may also be helpful. Regular exercise increases the body's ability to dissolve clots.
Wherever you may be, do not sit for more than an hour at a time without getting up and walking around. Better yet, every hour exercise the legs for 2 minutes, as if you are riding a bike (lifting the legs) while breathing deeply. Do not squat (sit back on your heels), except momentarily. If you have to travel a distance while seated (airplane, car, etc.), stop and walk around every so often. Do not let the circulation become sluggish. |
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Physical Medicine |
Incline Board| | Superficial phlebitis can be treated by elevating the leg frequently. It is not necessary to rest in bed but, every so often, rest with the leg 6-10 inches above the heart. This speeds the healing process. You can also lie on a slant board, if available, with your feet higher than your head for 15 minutes per day, especially if you stand on your feet a lot.
If you have to lie in bed for a long time, move your legs every so often to increase circulation. Elevate the foot of your bed by several inches to reduce venous pressure in your legs, which also reduces edema and pain. Do not use pillows under the legs, for doing so may reduce circulation. |
Hydrotherapy| | Hot packs may be helpful for superficial thrombophlebitis but probably will not benefit deep vein thrombosis. Taking alternating hot and cold sitz baths or using alternating hot and cold compresses may help improve circulation in the affected area. |
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Vitamins |
Vitamin E| | Milroy's disease is a rare, incurable disease due to poor development of the lymphatic system, with a consequent chronic pooling of lymph in the legs often with recurring attacks of thrombophlebitis. Every case Dr. Shute, MD treated with vitamin E resulted in a positive response, with some cases being fully cured. The dose of vitamin E used for thrombophlebitis is 600-1,600 IU daily. |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Allergy (Allergies)
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Anticoagulant
A substance that prevents or delays blood clots (coagulation). Examples: Heparin (endogenous), Dicumarol and
Warfarin (drugs), Melilotus (coumarin-containing).
Anti-inflammatory (Antiinflammatory)
Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous; they tend to grow slowly and don't spread (metastasize) like cancer tumors do.
Bruise (Bruised, Bruising)
Injury producing a hematoma or diffuse extravasation of blood without breaking the skin.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Edema
Abnormal accumulation of fluids within tissues resulting in swelling.
Fibrinolysis
A normal ongoing process within the body that dissolves fibrin and results in the removal of small blood clots.
Homeopathy (Homeopathic)
A system of medicine based on the belief that the cure of disease can be effected by minute doses of substances that, if given to a healthy person in large doses, would produce the same symptoms as are present in the disease being treated. Homeopathy employs natural substances in small doses to stimulate the body's reactive process to remove toxic waste and bring the body back into balance.
IU (mIU, uIU)
International Unit: An arbitrarily defined but agreed upon unit that depends on what is being measured.
mIU: 0.001 or one thousandth of an IU.
uIU: 0.000001 or one millionth of an IU.
Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Lymph
A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.
Lymphatic System
A network of vessels which collect fluid from the tissues of the body and return it to the blood. Lymphatic fluid (also called lymph) is rich in white blood cells that fight infection and an important part of the body's immune system.
Niacin (B3, B-3, Niacinamide, Vitamin B3)
A coenzyme B-complex vitamin that assists in the breakdown of carbohydrates, fats and proteins. Essential for the health of the skin, nerves, tongue and digestive system. It is found in every cell of the body and is necessary for energy production. Niacin is also needed for DNA formation.
Phlebitis
Inflammation of a vein. Symptoms of superficial phlebitis include pain, swelling, redness, and warmth around the affected vein. The vein feels hard to the touch because of the clotted blood.
Platelet Aggregation
Platelets are the small, rather uniform fragments of large bone marrow cells that aid the blood in coagulation, hemostasis, inflammation, and thrombus formation. Mild subclotting and sticking is a common early condition that can lead to thrombosis, atherosclerosis, and strokes, and can be helped by an aspirin a day, better fat digestion, and Ceanothus.
Progesterone
This is the hormone secreted after ovulation by the corpus luteum. It is a steroid (similar to a cholesterol), enters receptive cells to stimulate their growth, and acts as an anabolic agent. Estrogen should be viewed as the primary coat underneath all the cycles during a woman's reproductive years, with progesterone, its antagonist, surging for ten or twelve days in ovulatory months. Most of the actions of progesterone cannot occur without estrogen having previously induced the growth of progesterone-receptive binding sites.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Thrombophlebitis
Venous inflammation with formation of clots. It can occur without any symptoms until the clot reaches the lungs. However, in about half of cases, there are warning symptoms including swelling, pain and warmth in the entire calf, ankle, foot, or thigh (depending on where the involved vein is located).
Thrombosis
Formation of blood clots causing vascular obstruction.
Varicose Veins
Twisted, widened veins with incompetent valves.
Venous
Pertaining to the veins.
Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Vitamin E
An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.
Last updated: May 10, 2009
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