Esophageal Varices

Esophageal Varices: Causes, Symptoms, Diagnosis and Treatment

Esophageal varices is a condition that affects people who suffer from serious liver problems. It is a serious condition that requires immediate medical attention. The condition can trigger the swelling of veins on the esophagus lining. Ignoring the condition can lead to the breaking and opening of the veins. So, it can result in bleeding that can prove fatal to your health. People with the liver cirrhosis condition get affected by the issue. You need to gain more information about it to prevent the problem from destructing your life. With the right information, you can prevent the varices from bleeding or control the bleeding. So, you can prevent liver damage.

What Is Esophageal Varices?

Varices means enlarges, abnormal or swollen veins. So, it is condition resulting in the swollen veins on the tube connecting the stomach/esophagus and the throat. The condition develops when the normal blood flow to the liver get disturbed. It is condition occurring due to the scar tissue in the liver or a clot. Your body decides to go around the blockages to send a blow. Hence, it redirects the blood into smaller blood vessels. Unfortunately, the small blood vessels do not have the design to carry large blood volume. So, it results in blood leak or vein rupture. You can experience life-threatening bleeding.

You need to consult the doctor immediately to get the right treatment. With the help of drugs or medical procedures, you can stop the esophageal varices bleedings. Therefore, the assistance from a skilled medical professional can help you choose the right treatment ranging from non-invasive to invasive that can overcome the problem.

Symptoms Of Esophageal Varices

How do you know you have encountered the problem? People who suffer from the problem have underlying liver complications. If you note the symptoms provided below, then it means you have liver disease.

  • Yellow colored skin and eyes (due to jaundice)
  • Easy to get bruised or suffer bleeding
  • Building up of fluids in your ascites (abdomen)

When you encounter such issues, it is better to seek medical help. Your doctor can detect the liver issue precisely. Once your doctor confirms it, you need to maintain caution. People with liver problems are more prone to getting varices. So, talk to your doctor about your risk of getting the issue. You can also check with your doctor about the endoscopy procedure to detect the esophageal varices.

You may think about why it is necessary to perform an endoscopy to detect the issue. Unfortunately, varices do not cause any visible symptoms in your body. You see the signs only when the varices bleed. Therefore, the signs and symptoms associated with the bleeding varices include:

  • Frequent vomiting
  • Seeing the significant amount of blood in the vomit
  • Lightheadedness
  • Black or tarry colored stools
  • Presence of blood in stools
  • Loss of consciousness (only with severe cases)

If you see the above-mentioned signs, you need to contact your doctor immediately. Bleeding esophageal varices can cause severe complications. Therefore, you need to see medical help as soon as possible. It will avoid further complications.

Causes Of Esophageal Varices

The blocking of the blood flow to the liver is the root problem triggering the health issue. The main cause leading to is the scar tissue. In the majority of the cases, liver disease can leave scar tissues. So, the block can make your blood flow to back up. It can elevate the pressure levels with the portal vein (the large vein carrying blood to the liver). The pressure is referred to as portal hypertension. It can force the blood to seek other pathways. Hence, it results in smaller veins to carry the blood. Mostly the vein in the lower part of your esophagus carries the blood. So, it causes extra pressure on the thin-walled veins. The final result is the ballooning of the small veins. It can put the veins at risk of rupturing or bleeding. So, the major factors contributing to esophageal varices are:

Cirrhosis

Cirrhosis

A different number of liver diseases can create severe scarring on the organ. It can lead to cirrhosis and ultimately varices. The liver diseases triggering the problem include:

  • Fatty liver disease
  • Hepatitis infection
  • Primary biliary cirrhosis (a form of bile duct disorder)
  • The scarring results in the blocking of blood to the liver.

Thrombosis

The medical term thrombosis refers to the blood clot inside a vein. Thrombosis can lead to varices. The blood clot in the portal vein or splenic vein can result in esophageal varices. The portal vein conveys the blood from spleen, stomach, intestines, and pancreas to the liver. While the splenic vein feeds into the portal vein. Therefore, a block in either of the veins can result in varices.

Parasitic Infection

Some parasites can attack your liver can damage the organ. The serious parasites like Schistosomiasis. It has the capability to damage other organs like bladder, intestine, lungs along with the liver. You can find the parasites in regions like:

  • Africa
  • Caribbean
  • Southeast Asia
  • Middle East
  • South America

Risk Factors Leading To Esophageal Varices

People having liver diseases can develop esophageal varices. Even with the chronic varices, you may not bleed. But, some people can develop bleeding. So, the people who are at risk of developing the bleeding are:

High Portal Vein Pressure

If you have increased portal hypertension, then the bleeding risk increases. Therefore, the amount of pressure you develop in the portal veins determines your susceptibility for bleeding.

Large Varices

The development of large varices can put you at danger of bleeding.

Consuming Alcohol

Continuing alcohol even after the detection of liver disease can endanger your health. So, the risk of variceal bleeding increases with the consumption of alcohol. If you have developed the liver disease due to excess alcohol consumption, then it makes you more prone to the problem.

Liver Failure

The development of chronic cirrhosis can increase your chances of bleeding. Liver failure can trigger varices bleeding.

Red Marks

Endoscopy can reveal the status of the varices. The appearance of red marks on the varices indicates high bleeding risk. The endoscope passed down your throat can shed light on the actual status of the varices. If the images of varices show red spots or long red streaks, then the risk of bleeding increases.

Complications Due To Esophageal Varices

You may wonder why you need immediate treatment for varices. The answer is the complication you can develop due to varices. You can experience bleeding. It is the most serious complication of esophageal varices can result in a fatal complication. If you have experienced one episode of bleeding, then you have a greater risk of experiencing the same problem. So, the excess loss of blood can lead to shock. It is a serious condition leading to death.

Diagnosis Of Esophageal Varices

It is impossible to diagnose the issue with just the symptoms. And, you may never experience any signs before the varices start to bleeds. Therefore, if you suspect an issue, seek medical help. Your doctor can use sophisticated diagnostic methods to confirm the problem. Therefore, the main methods to detect the presence of esophageal varices are:

Endoscopy

Endoscopy

It is the most preferred method to diagnose the issue. Your doctor can suggest the endoscopy if you have cirrhosis. Patients suffering from cirrhosis are at risk of suffering the problem. Therefore, doctors perform the screening tests after diagnosing cirrhosis. Depending on the severity of your condition, the frequency of screening tests varies. The main types of tests you can undergo to diagnose the problem conclusively are:

Endoscope Exam

The gastrointestinal endoscopy is the most common method opted by the doctors to detect the esophageal varices. The upper endoscopy can provide a comprehensive picture of the esophagus and its problems. For the test, your doctor inserts an endoscope through your mouth. The endoscope is a thin, flexible tube with a camera at one end. The endoscope travels through the esophagus, stomach and the duodenum (the beginning part of the small intestine).

Using the images, the doctor can look for dilated veins, red spots or red streaks. The doctor measures the veins. It provides insight into the risk of bleeding. So, the test can give an idea about the treatment option. At times, your doctor can perform treatment during the exam itself.

Capsule Endoscopy

It is the non-invasive diagnostic technique providing a clear picture of the varices. As the name suggests, you swallow a capsule. The vitamin-sized capsule has a tiny camera. It takes pictures as it travels through the digestive tract. So, your doctor can get clear pictures of the esophagus. The test provides a good option for people who do not wish to have a regular endoscopy examination. But, the test is available at a higher price. Since it uses the most sophisticated technology, it is not widely accessible.

Imaging Tests

Apart from the different endoscopic techniques, imaging tests can detect the problem. The abdominal CT scan can provide comprehensive images that can help in the detection of varices. Doppler ultrasound is the other imaging technique that suggests the esophageal varices presence in your body. So, your doctor can suggest the tests to get a clear idea about the problem.

Treatment Options For Esophageal Varices

Preventing bleeding is the main aim while treating varices. As bleeding varices can cause severe life-threatening complications, your doctor adopts steps to prevent it. The treatment options also try to stop the bleeding. So, it can eliminate any fatal complications. The main treatment methods are:

Treatment To Avoid Bleeding

The treatment to prevent bleeding aims to reduce the blood pressure in the portal vein. So, lowering the pressure on the portal veins can prevent bleeding. The different treatment options try to reduce bleeding risks.

Medications

The blood pressure blood drug known as beta blocker lowers the risk of bleeding. It reduces the pressure in the portal vein. So, it decreases your chance to bleed. The common medication that can serve the purpose is:

  • Nadolo (Corgard)
  • Propranolol (Innopran, Indreal)

Band Ligation

Band Ligation

It is the method adopted to reduce the bleeding of high-risk esophageal varices. The band ligation uses elastic bands to restrict the chances of bleeding. The procedure done with the help of an endoscope can prevent the varices from rupturing. The doctor snares the varices and strangles the veins with elastic bands. But, the procedure has some side effects like esophagus scarring.

Bleeding Varices Treatment

The bleeding varices pose a high risk as it can put your life in danger. Therefore, immediate treatment can prevent complication. The following treatments can stop the bleeding as well as reverse blood loss effects:

Use Elastic Bands

The elastic bands can stop the bleeding from the veins. The doctor can perform the band ligation and prevent bleeding.

Medication

The medication provided will slow the blood flow from the other internal organs to the portal veins. In most cases, your doctor uses a drug called octreotide. Using it in combination with endoscopic therapy can slow the blood flow. So, you need to use it regularly for the next five days after you encounter the bleeding episode.

Divert Blood Flow

Divert Blood Flow

Another method to relieve pressure from the portal vein is to divert the blood flow. The doctor recommends a procedure known as TIPS (Transjugular Intrahepatic Portosystemic Shunt). The procedure places a small tube known as a shunt. So, the shunt placed between the hepatic vein and portal vein can reduce the pressure. The hepatic vein is responsible for carrying the blood from the liver to the heart. So, it can stop the bleeding from the esophageal varices.

The high risks associated with the procedure can make you shy away from it. It can causes issues like metal confusion and liver failure. The issues develop due to the passing of toxins accumulated in the body through the shunt into the blood. In normal cases, your liver filters the toxins. So, the TIPS is the last resort procedure. Your doctor opts for it when all the treatments have failed. It is also useful for people who are waiting for a liver transplant.

Restoring Blood Volume

The blood loss due to the varices rupturing can make you feel ill. So, your need blood transfusion to replace the lost blood volume. It also acts as the clotting factor. So, it can stop the bleeding from causing complications.

Antibiotics

The bleeding can put you at risk of getting affected by infections. Therefore, the doctor prescribes antibiotics. It aids in preventing and overcoming the infections.

Liver Replacement

The liver problem or liver failure can trigger esophageal varices. Therefore, a liver transplant is an option who encounter frequent varices bleeding episodes. The liver transplantation can successfully curb the problem. But, the issue is the unavailability of the organs. The number of people awaiting transplant surgery is high compared to the available organs.

Prevent Rebleeding

Bleeding can recur in people suffering the esophageal varices. Therefore, the doctor often prescribes medication to prevent recurrent bleeding. The most common methods to prevent it are using the beta blockers as well as the band ligation.

Preventing Esophageal Varices

You have no medical treatment that can prevent the development of varices. All people who suffer from cirrhosis. But, effective treatments can prevent varices bleeding. Medications like beta blocker drugs can prevent internal bleeding and avoid complication. You can never prevent the occurrence of the varices. So, you need to talk to your doctor. People who have developed liver disease need to adopt strategies to avoid complication. The best step is to improve the liver heart. Therefore, the following steps can avoid complication from developing further:

Include Healthy Diet

A good diet can provide all the necessary nutrients to keep your liver hale and healthy. So, opt for a plant-based diet. The diet that consists of vegetables and fruits can keep you fit. The whole grains, as well as the lean source of protein, can enhance your health. Reduce the consumption of processed and fatty foods. It can put unnecessary pressure on your liver. So, limit the intake of fried and fatty foods.

Limit Alcohol Consumption

Alcohol can damage your liver. So, it can result in your body replacing the healthy tissues with scar tissue. Over time, it can make your liver vulnerable to other problems. Hence, your doctor advises you to quit drinking alcohol. It reduces the pressure off the liver. A stressed-out liver can become more vulnerable to diseases due to alcohol consumption.

Healthy Weight

You need to maintain a height weight to avoid lifestyle diseases. The excess amount of fat can lead to the malfunctioning of the liver. People suffering from obesity are at risk of liver disease like cirrhosis. Therefore, obese people need to lose weight. Maintaining the body mass index can ward off many illnesses from their life.

Limit Use Of Chemicals

People with liver disease need to use chemicals carefully and sparingly. The liver removes the accumulating toxins from the body. So, you need to follow all the directions while using housing chemicals. It ensures you limit the toxins entering your body. The action can provide a break to your liver. So, you need to handle with care the items like inspect sprays and cleaning supplies. If you work around chemicals, then make sure you follow the guidelines. Following the safety precaution can keep your liver safe.

Keep Yourself Safe From Hepatitis

The hepatitis B, as well as hepatitis C, can endanger your liver health. The sharing of needles, as well as unprotected sex, can increase your risk. Therefore, disposing needles and practicing safe sex can prevent health issues. You need to either abstain from sex or use a condom while participating in an intimate act. It is always better to get vaccinated for hepatitis A and hepatitis B.

Conclusion

Esophageal varices with proper treatment cannot disrupt your life. But, make sure to monitor your body for the signs. If you have liver disease, then it is better to check off the varices. Getting treatment will reduce the risk of complication.

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