He is one of the best gastroenterology doctors I have ever visited. Took my uncle for stomach pain, the doctor did endoscopy & colonoscopy, diagnosed the problem as large intestine cancer, the doctor asked a...
The doctor is extremely professional and polite. He explains the problem patiently and does not prescribe unnecessary medication. He gives priority to the patient's well-being over everything. I Will definitely recommend him
I have referred/recommended a couple of my relatives and friends to this Dr (Dr. Srujan Kumar Dasyam). I say that the diagnosis and treatment are good and also Dr listens patiently in understanding the patient's...
Apoorva Reddy Panyala
Table Of Contents
- What are Esophageal Varices?
- What Causes Esophageal Varices?
- What are the Symptoms of Esophageal Varices?
- How are Esophageal Varices Diagnosed?
- What are the Complications of Esophageal Varices?
- What is the Treatment for Esophageal Varices?
What are Esophageal Varices?
Esophageal varices are swollen or enlarged veins present on the esophageal lining.
When normal blood flow to the liver is interrupted by a clot or scar tissue, esophageal varices occur. Blood moves into tiny blood arteries that aren’t meant to carry significant amounts of blood to get around the obstructions creating varices. Blood can leak or even explode from these vessels, producing life-threatening hemorrhages.
Esophageal varices can be fatal if left untreated.
What Causes Esophageal Varices?
Esophageal varices develop when blood supply to the liver is impeded. This is most commonly caused due to the scar tissue in the liver produced by liver disease. This is why blood starts to back up, putting pressure on the primary vein (portal vein) that delivers blood to the liver.
This elevated pressure (portal hypertension) pushes blood to seek alternate routes through smaller veins, such as those in the lower section of the esophagus, creating varices.
Causes of esophageal varices can be:
- Severe liver scarring: Liver diseases such as hepatitis infection, alcoholic liver disease and fatty liver disease.
- Blood clotting: Thrombosis in the portal vein or splenic vein can cause esophageal varices.
- Parasitic infection: Schistosomiasis is a parasite that can damage the liver, as well as the lungs, intestine, bladder and other organs leading to varices.
What are the Symptoms of Esophageal Varices?
Generally, esophageal varices do not produce symptoms unless they bleed. The following are signs and symptoms of bleeding esophageal varices:
- Blood in vomiting in significant quantities
- Stools that are black, tarry, or bloody
- In extreme situations, there can be a loss of consciousness.
How is Esophageal Varices Diagnosed?
Tests and procedures include:
- Endoscopy: A flexible, lighted tube is inserted through the mouth in the abdomen to look for swollen, distended veins.
- Imaging tests: Esophageal varices can be detected with abdominal CT scans and Doppler ultrasounds of the splenic and portal veins. Transient elastography, an ultrasound test that assesses liver scarring, can help your doctor decide if you have portal hypertension, leading to esophageal varices.
What are the Complications of Esophageal Varices?
The most serious complication of this condition is severe bleeding. If there is enough blood loss, it can lead to death if not treated in time.
What is the Treatment for Esophageal Varices?
The primary goal of esophageal varices treatment is to prevent bleeding. Esophageal varices that bleed might be fatal. If bleeding develops, there are treatments available to try and stop it.
Treatment to prevent bleeding:
Reduction of blood pressure in the portal vein may reduce the likelihood of esophageal hemorrhage-
- Medications that lower portal vein pressure: Beta-blockers, a kind of blood pressure medication, may help lower blood pressure in the portal vein, reducing the risk of bleeding.
- Tying up bleeding veins using elastic bands: Endoscopic band ligation can be used if the esophageal varices look to be at high risk of bleeding.
Treatment if there is bleeding:
Esophageal varices that are bleeding are life-threatening and must be treated right away. These treatments can stop bleeding:
- Medications to slow down blood in the portal vein: Drugs such as vasopressin can be used to slow down blood in the portal vein and thus, reduce bleeding.
- Diverting blood flow away from the portal vein: A procedure called transjugular intrahepatic portosystemic shunt (TIPS) can be done if medications fail to work. The shunt is a connection between the portal vein and the hepatic vein, which transports blood from the liver to the heart. The shunt relieves pressure in the portal vein and frequently prevents esophageal variceal bleeding.
- Restoring blood volume: Blood transfusion can be given to replace lost blood.
- Liver transplantation.