Esophageal Varices
Esophageal varices are enlarged and swollen veins in the lining of the lower esophagus, which can occur due to increased pressure in the veins that bring blood from the digestive tract to the liver
Symptoms
Esophageal varices may not cause any symptoms until they rupture and bleed. However, some people with esophageal varices may experience symptoms such as:
- Pain or discomfort in the upper abdomen
- Black, tarry, or bloody stools
- Vomiting blood or material that looks like coffee grounds
- Dizziness or lightheadedness
- Rapid or irregular heartbeat
- Low blood pressure
Causes
In some conditions, such as liver cirrhosis, portal vein thrombosis, or other liver diseases, the liver is unable to process blood efficiently, causing pressure to build up in the portal vein. This increased pressure can cause the veins in the esophagus to become swollen and engorged, forming varices.
Other factors that may increase the risk of developing esophageal varices include alcohol abuse, viral hepatitis (such as hepatitis B or C), and certain genetic disorders that affect the liver. Additionally, certain medications and blood thinners can also increase the risk of developing esophageal varices by irritating the lining of the esophagus and causing bleeding. In some rare cases, esophageal varices can be caused by conditions such as portal vein thrombosis or splenic vein thrombosis.
Diagnosis & Treatment
Diagnosis of esophageal varices typically involves an endoscopy, During the endoscopy, the doctor can visualize the varices and assess their size and severity. If varices are found, the doctor may also perform a biopsy to check for signs of liver disease.
Treatment of esophageal varices aims to reduce the risk of bleeding and prevent complications. Some treatment options include:
- Medications: Drugs called beta-blockers can be used to reduce the pressure in the veins and prevent bleeding. Other medications may be used to treat underlying conditions that contribute to the development of varices, such as antiviral medications for hepatitis B or C.
- Endoscopic therapy: Endoscopic treatments, such as band ligation or sclerotherapy, can be used to seal off the varices and reduce the risk of bleeding.
- Transjugular intrahepatic portosystemic shunt (TIPS): TIPS is a procedure that involves creating a shunt (or bypass) between the portal vein and the hepatic vein to reduce pressure in the veins and prevent bleeding.
- Surgery: In some cases, surgery may be necessary to remove the varices or perform a liver transplant if the liver is severely damaged.
What to expect after treatment
The specific expectations and outcomes will depend on the type of treatment received and the severity of the varices. If medications were prescribed, you may need to take them long-term to reduce the risk of bleeding and prevent the varices from returning If endoscopic therapy or TIPS was performed, you may experience some discomfort or difficulty swallowing for a short period after the procedure. a soft or liquid diet will be recommended for a few days after the procedure to allow your esophagus to heal. You may also be prescribed medications to relieve pain or reduce inflammation.
In some cases, a repeat endoscopy may be needed to monitor the varices and assess the effectiveness of the treatment. It is important to follow a healthy diet and lifestyle to prevent further damage to the liver and reduce the risk of complications. Avoiding alcohol and maintaining a healthy weight can also be beneficial.
