Esophageal Varices

Overview and Facts about Esophageal Varices

Esophageal varices are abnormal, enlarged veins in the esophagus – which is the tube in the digestive health system that connects the throat and stomach. These varices occur when a clot, scar tissue, or other blockage gets in the way of normal blood flow to the liver.

When this happens, blood moves into smaller surrounding blood vessels to try to relieve the pressure, and since the smaller vessels are not intended to carry that much blood, they can leak or rupture.

Symptoms and Signs of Esophageal Varices

There are typically no signs and symptoms of esophageal varices unless the vessels bleed. Sigs of this include:

• Black, tarry or bloody stools
• Lightheadedness
• Loss of consciousness, which only happens in severe cases
• Vomiting and seeing significant amounts of blood in your vomit

Additionally, your doctor might suspect esophageal varices if you have signs of liver disease, including:

• Bleeding and bruising easily
• Fluid buildup in the abdomen
• Jaundice, which is a yellowing of the skin and whites of the eyes

Causes and Risk Factors of Esophageal Varices

Esophageal varices most often occur in people with serious liver diseases, such as cirrhosis of the liver, hepatitis infection, and alcohol liver disease.

Other causes of esophageal varices include:

• Thrombosis, which is a blood clot in the portal vein. The portal vein is the major vein feeding into the liver.
• Schistosomiasis, a parasitic infection. This can be picked up in parts of Africa, South America, the Caribbean, the Middle East and Southeast Asia, and can damage the liver, lungs, intestine and bladder.

The risk of bleeding in the varices is higher if your varices are naturally bigger or if you continue using alcohol heavily despite having a liver condition or high blood pressure.

Tests and Diagnosis of Esophageal Varices

If you have cirrhosis of the liver, your doctor should screen you for esophageal varices. The most common tests used to detect and diagnose esophageal varices include:

• Capsule endoscopy, which involves swallowing a vitamin-sized capsule with a tiny camera in it. That camera takes pictures of your esophagus and digestive tract.
• Endoscope exam, which is the preferred diagnostic test. It involves routing a lighted tube down your esophagus to the beginning of the small intestine to look for dilated veins and check for red streaks and spots.
• Imaging tests like CT scans and ultrasounds, which can help to determine the presence and extent of esophageal varices

Treatment and Care for Esophageal Varices

The most important thing to do when treating esophageal varices is to stop the bleeding. To do this, there are medications that can slow the blood flow into the portal vein and reduce pressure.

Your doctor may recommend using elastic bands to tie off bleeding veins, or he or she may think the TIPS procedure is best. In a TIPS procedure, the doctor places a shunt (a small tube) in the portal vein to lower the pressure and stop bleeding.