Esophageal Varices

1.What is Esophageal Varices?The esophagus tube runs in front of the spine and behind the windpipe and heart connecting the throat and the stomach. This tube is lined with a tissue called the mucosa. When the blood vessels around the esophagus become large or swollen it results in Esophageal Varices, EV. The larger these Varices are the more serious the condition becomes. When it is detected, the doctor grades it as per the size and is defined as the below types of Esophageal Varices.Grade 1: SmallGrade 2: EnlargedGrade 3: LargeEsophageal Varices SymptomsThere are no symptoms that are noticeable especially if the Varices are small. If it leads to variceal bleeding then a person will start to vomit blood in large quantities. Those who bleed in small quantities swallow the blood and their stools many become red. Varices caused due to cirrhosis will have liver disease symptoms. Some of the other signs seen when the Varices bleed include:

  • Feeling continuously tired
  • Feeling dizzy and faint
  • Abnormally pale skin
  • Vomiting red blood
  • Tarry stools or red blood in stools

Immediate care of a gastroenterologist is needed if a person starts to see the above symptoms coupled with blood vomit. 2.Who is at Risk?Esophageal Varices risk factors are a pre-existing liver disease especially Portal Hypertension. These people are likely to have Varices at some point but may not bleed. Chances of developing Esophageal Varices are high due to the following factors:

  • Chronic Hepatitis
  • Cirrhosis due to excessive alcohol use

The likelihood of Esophageal Varices leading to bleed increases due to:

  • Enlargement of the Varices
  • Portal hypertension which is an increase in the blood pressure in the portal vein
  • Infection due to certain bacterias
  • Red marks on the Varices
  • Constipation
  • Vomiting excessively due to other medical conditions
  • Severe and persistent cough
  • Family history of liver diseases
  • Liver failure or liver diseases can increase the risk of bleeding

Esophageal Varices Causes

  • The most common underlying cause of Esophageal Varices is cirrhosis which is scarring of the liver due to Hepatitis C. 30% of the people who have cirrhosis have Varices. Up to 5% of small Varices and 15% of the large Varices start to bleed in the first year of diagnosis.
  • Portal hypertension is another cause for Varices. In this condition, the blood circulation to the liver is blocked. This results in a buildup of pressure in the portal vein. When the blood flow to the liver is restricted, it gets accumulated in the esophagus and causes swelling of the veins and becomes Varices.
  • Budd-Chiari Syndrome and Schistosomiasis can also cause Varices.

3.How is Esophageal Varices diagnosed?After inquiring about the symptoms and the medical history of the patients, the doctor will do a physical examination for Esophageal Varices diagnosis and order the below tests to confirm if it is EV.

  • Blood tests: To check the counts of WBC, RBC, and Platelets. Kidney and liver function is also tested.
  • Endoscopy: It is ordered to get a closer look at the veins and take tissue samples.
  • Imaging tests: CT and MRI scans are ordered to evaluate the condition of the liver and the abdomen. The blood flow to the organs is also checked.

A person with cirrhosis should get tests done for EV regularly. 4.How is Esophageal Varices treated?The main focus of the Esophageal Varices treatment is to prevent the Varices from bleeding. Hence steps to control portal hypertension have to be done. It includes prescribing beta-blockers as medicine for Esophageal Varices to reduce pressure. It contains chemicals that make the heartbeat with less force. If the beta-blockers are not effective, then the surgical procedures have to be done:

  • Endoscopic sclerotherapy to inject medicines into swollen veins
  • Endoscopic Variceal banding where a rubber band is tied to the Varice to stop bleeding.
  • If bleeding recurrently a shunt may be placed.

If you are looking for the best treatment option for your EV problem, we at have experts who can provide the best procedures based on the grade. 5.How can Esophageal Varices be Prevented?The best Esophageal Varices cure is to treat the underlying cause. If liver disease is the underlying cause, the following Esophageal Varices prevention can be taken:

  • Staying away from alcohol
  • Consuming a diet that is low on salt, high on lean protein. Consume vegetables, fruits, and whole grains in your daily diet.
  • Reduce the risk of hepatitis. Avoid contact with an infected person
  • Maintain a healthy diet
  • Regular screening to check for EV.

Bleeding Esophageal Varices can lead to serious complications and hence if the patient feels it is ruptured go to the hospital immediately.


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