What are esophageal varices?
Esophageal varices are abnormally dilated veins at the end of the esophagus – although sometimes they are also found at the top – through which blood passes that would normally have to pass through the liver.
These veins are dilated due to the resistance that a diseased liver presents to the passage of blood.
The main problem of these varicose veins is the risk of rupture, which occurs when the pressure inside the veins exceeds the resistance of its wall, causing significant bleeding that, in some cases, can cause death.
Prognosis of esophageal varices
Esophageal varices is a serious problem, since bleeding, which is potentially fatal, cannot always be prevented.
In fact, patients who have suffered a hemorrhage are much more likely to suffer another bleeding episode. It should also be noted that up to one in three relapses are fatal.
Esophageal varices are associated with other types of disorders, such as renal, cardiovascular, immune or even respiratory disorders.
Symptoms of esophageal varices
Esophageal varices have no specific symptomatology, and in many cases there are no signs, except for bleeding. The symptoms of bleeding esophageal varices are as follows:
- Vomiting
- Vomiting accompanied by a large amount of blood.
- Feeling lightheaded
- Black stools
- In severe cases, loss of consciousness may occur.
In turn, the specialist may suspect esophageal varices if signs of liver disease are noted, such as a yellowing of the skin and the “whites” of the eyes, known as jaundice; a tendency to bleed, as well as bruising and accumulation of tissue in the abdomen.
Image of a blocked vein in the case of esophageal varices obtained through the endoscope.
Medical tests for esophageal varices
The main medical tests performed to detect the presence or diagnose esophageal varices are as follows:
- Endoscopic examination: through the endoscope, dilated veins, spots or red dots, which are signs of bleeding, are looked for.
- Diagnostic imaging tests: these are explorations through computed tomography (CT), ultrasound, Doppler ultrasound…
- Capsule endoscopy: in this test, the patient swallows a capsule equipped with a micro camera that will photograph the esophagus as it moves down the digestive tract.
What are the causes of esophageal varices?
Esophageal varices sometimes form when the blood flow to the liver is obstructed, often by scar tissue in the liver caused by liver disease. Thus, the blood flow increases its pressure within the vein that carries blood to the liver.
This pressure causes the blood to seek other places of passage through smaller veins, swelling these veins by the amount of additional blood, being able to give way and burst on certain occasions.
Some causes are:
- Acute hepatic scarring, cirrhosis: some liver diseases can cause cirrhosis, such as hepatitis infection, alcoholic cirrhosis, fatty liver…
- Blood clots, thrombosis: a blood clot can cause esophageal varices to form.
- Parasitosis: schistosomiasis is a parasitosis that can damage the liver, lungs, intestine and bladder.
Can esophageal varices be prevented?
At present there is no specific treatment to prevent the appearance of this disease in people with liver disease, although beta-blockers have proven to be effective in preventing bleeding in people with esophageal varices, although they do not prevent the formation of varices as such.
Some ways to maintain healthy liver and liver function are as follows:
- Avoiding alcohol consumption
- Maintaining a healthy, balanced diet
- Maintaining a normal, healthy weight
- Reducing the risk of getting sick from hepatitis.
- Using chemicals (household or at work) in moderation and with caution.
Treatment for esophageal varices
As mentioned above, the main goal of treatment for esophageal varices is based primarily on preventing bleeding, since bleeding is life-threatening. In the event that bleeding does occur, there are ways to try to stop it.
- Treatments to prevent bleeding
- Pressure-reducing medications
- Use of elastic bands to compress bleeding veins
- Treatment in cases of hemorrhage: immediate treatment in these cases is essential. Treatments used to stop the bleeding and try to reverse the effects of blood loss are as follows:
- Use of elastic bands to tie off bleeding veins.
- Medications that slow the flow of blood into the portal vein
- Diverting blood flow away from the portal vein
- Restoring blood volume, perhaps through transfusion
- Preventing infection from bleeding through antibiotics
- Liver transplant
Which specialist treats esophageal varices?
The specialist in charge of diagnosing and treating esophageal varices problems is the Digestive Tract specialist.