What are esophageal varices?
Esophageal varices are enlarged veins in the food pipe (esophagus). This condition develops in people with liver disease. The liver is the organ that serves several functions including the removal of toxins from the blood. Liver disease affects the blood flow to the liver due to the presence of a clot or scar in the portal vein or splenic vein. As a result, the pressure in the portal vein shoots up. The portal vein is the vein that delivers blood to the liver.
As the pressure shoots up in the portal vein, the blood is pushed into surrounding blood vessels, including vessels in the esophagus. These blood vessels have a thin wall and cannot hold the extra blood. Hence, the blood vessels of the esophagus expand and swell, which are known as varices. If the extra blood exerts more pressure on the walls of the esophageal vessels, the varices can break open and bleed. Bleeding is an emergency condition, as uncontrolled bleeding can lead to shock and death.
Some of the conditions that can cause esophageal varices include
- Cirrhosis (severe scarring) of liver
- Budd–Chiari syndrome (blockage of certain veins in the liver)
- Schistosomiasis (infection caused by a freshwater parasitic worm)
What are the symptoms of esophageal varices?
Esophageal varices don’t show any symptoms until they bleed. When the varices start to bleed, the symptoms include
- Vomiting large amounts of blood
- Loss of consciousness in severe cases
- Black, tarry or bloody stools
- Lightheadedness
These may be the signs of underlying liver disease
- Jaundice (yellowing of skin and eyes)
- Ascites (fluid buildup in your abdomen)
- Bruising or bleeding easily
What liver conditions can lead to esophageal varices?
Any severe liver disease can cause esophageal varices. Some of the most common liver conditions that can lead to esophageal varices include
- Cirrhosis
- Alcoholic liver disease
- Fatty liver disease
- Viral hepatitis
Who is at risk for esophageal varices that break open and bleed?
Not every person who has esophageal varices will have bleeding. Some of the factors that may increase the chance of bleeding include
- High portal blood pressure
- Large varices
- Severe liver disease
- Severe alcohol consumption
- Red marks on the varices (when viewed through a flexible tube with camera, i.e., the endoscope)
- Liver failure
How are esophageal varices treated?
The primary goal of the treatment is to prevent bleeding. If bleeding occurs, treatments are available to stop the bleeding.
Treatment to prevent bleeding
The treatment options include
- Medicines to reduce blood pressure, such as propranolol and nadolol
- Elastic bands to tie off bleeding veins
Treatment to stop bleeding
The treatment options include
- Using elastic bands to tie off bleeding veins
- Medicines, such as vasopressin and octreotide, to slow blood flow into the portal vein
- Diverting blood flow away from the portal vein with a procedure called transjugular intrahepatic portosystemic shunt (TIPS)
- Placing pressure on varices with the help of balloon tamponade to stop bleeding
- Restoring blood volume by giving a transfusion
- Preventing infection
- Liver transplant
You can prevent esophageal varices by
- Avoiding alcohol and drug abuse
- Eating a healthy diet
- Maintaining a healthy weight
- Reducing your risk of hepatitis by practicing safe sex, getting vaccinated (hepatitis A and B) and not sharing razors or needles
SLIDESHOW
Super Tips to Boost Digestive Health: Bloating, Constipation, and More See SlideshowHealth Solutions From Our Sponsors
Cleveland Clinic
Mayo Clinic
Top What Is the Main Cause of Esophageal Varices Related Articles
Bleeding Varices
Varices are dilated blood vessels usually in the esophagus or stomach. Symptoms of bleeding varices include vomiting blood, black stools, low blood pressure, shock, and rapid heart rate. Bleeding varices are a medical emergency. Treatment may involve liver transplant, devascularization, distal splenorenal shunt, banding, sclerotherapy, or transjugular intrahepatic protosystemic shunt.
Blood Disorders Quiz
Exactly what is sickle cell anemia? Learn about sickle cell and other diseases by testing your IQ with the Blood and Bleeding Disorders Quiz.
Blood in the Stool (Rectal Bleeding, Hematochezia)
Blood in the stool or rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Common causes include anal fissures, hemorrhoids, diverticulitis, colitis, Crohn's disease, colon and rectum polyps, and cancer. The color of the blood in the stool may provide information about the origin of the bleeding. The color of stool with blood in it may range from black, red, maroon, green yellow, gray, or white, and may be tarry, or sticky. Treatment of blood in the stool depends on the cause.
Blood in the Stool (Rectal Bleeding) in Adults
In most cases, bright red blood indicates bleeding in the lower intestine or rectum, whereas darker blood is a sign of bleeding in the small bowel or upper area of the gut. Very dark or black-red blood is often associated with bleeding in the stomach or other parts in the digestive system.Blood When I Wipe: 11 Causes of Rectal Bleeding
Oozing of blood from the anus or rectum during passing stools is called rectal bleeding. The blood may be from any part of the gut or even from stomach. The color of blood may vary depending on the site. Fresh red color is a sign of bleeding in the rectum or anus.
Cirrhosis (Liver)
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.Symptoms include yellowing of the skin (jaundice), itching, and fatigue.
The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
Jaundice (Hyperbilirubinemia) in Adults
Jaundice (hyperbilirubinemia) in adults may be caused by a variety of medical diseases or conditions. Some cases of jaundice can be managed at home with a doctor's supervision, while other causes of jaundice may be life-threatening. Symptoms of jaundice are yellow skin, yellowing of the whites of the eyes, pale colored stools, dark urine, itchy skin, vomiting, nausea, and rectal bleeding.
Treatment of jaundice is focused on the disease or condition that is causing jaundice.
Liver Disease Quiz
What is liver disease? Take the Liver Disease Quiz and test your knowledge about this organ and its function.
Primary Biliary Cirrhosis (PBC)
Primary Biliary Cirrhosis (PBS) is a liver disease in which bile building up in the organ damages bile ducts. Ultimately, this can cause liver failure. A number of drugs are available to treat this disease of unknown cause, but the only ultimate cure is a liver transplant.
Primary Biliary Cirrhosis (PBC) Treatment
Primary biliary cirrhosis (PBC) is thought to be an autoimmune disorder that involves the deterioration of the liver's small bile ducts. These ducts are crucial to transport bile to the small intestine, digesting fats and removing wastes. Symptoms of PBC are edema, itching, elevated cholesterol, malabsorption of fat, liver cancer, gallstones, urinary tract infections (UTIs), and hypothyroidism. Treatments include ursodeoxycholic acid (UDCA); colchicine (Colcrys); and immunosuppressive medications, such as corticosteroids; obeticholic acid (Ocaliva); and medications that treat PBC symptoms. For PBC that is associated with cirrhosis of the liver, liver transplantation may be indicated in extreme cases.
Schistosomiasis
Schistosomiasis (snail fever), a disease caused by parasites, causes a variety of symptoms and signs, such as cough, rash and bloody diarrhea. Praziquantel is used in the treatment of schistosomiasis.
Is There a Cure for Cirrhosis of the Liver?
Liver cirrhosis results from disease- or chemical-induced injury to the liver over a sustained period. The injury kills liver cells, and your body attempts to rebuild the damage. In the process, the existing cells are inflamed and scar tissue results, compromising the structure of the liver and hampering its function.
What is Easy Bruising a Sign Of?
Why do you or people you know bruise easily? Learn the signs of easy bruising, what causes it, how doctors diagnose it, and what you can do to treat it.