Gastric Varices

Overview and Facts about Gastric Varices

Gastric varices are enlarged and dilated blood vessels in the stomach. While they produce no symptoms when swollen, if they burst they can cause fatal internal bleeding.

Gastric varices typically form when blood flow to the liver is blocked, either by scar tissue or a clot. Since blood cannot pass through these main vessels, it diverts to smaller vessels that are not equipped to handle the bigger load, causing them to swell. If left untreated, these vessels can eventually burst under the pressure.

Symptoms and Signs of Gastric Varices

Because gastric varices produce no digestive health symptoms until they burst, you may not know you have this problem until it becomes an emergency. Symptoms that your gastric varices have burst include:

• Fast heart rate and low blood pressure
• Feeling lightheaded and weak
• Having black, bloody or tarry stools
• Losing consciousness
• Vomiting blood

Causes and Risk Factors of Gastric Varices

The main cause of gastric varices is cirrhosis, also known as liver disease. Half of patients with this disease develop gastric varices because of scarring and damage to the liver, preventing blood from flowing normally.

This process is known as portal hypertension. Other causes of portal hypertension include:

• A blood clot in the portal vein
• Parasitic infections that damage the liver

Tests and Diagnosis of Gastric Varices

Testing for gastric varices involves using imaging tests or an endoscopy to observe the situation inside your body. If you have cirrhosis, your doctor should screen you for this condition when you are diagnosed by performing one or more of the following:

• Capsule endoscopy, which involves swallowing a pill containing a camera that takes pictures of your digestive tract
• Endoscope exam, which involves inserting a tube down your throat with a camera on the end

Treatment and Care for Gastric Varices

If your gastric varices have not burst, there are a few actions doctors can take to lower the chances of this happening. These include:

• Cyanoacrylate injection, which is when your doctor injects a glue-like substance into the swollen veins using an endoscope
• Medications to lower your blood pressure

For gastric varices that have burst, immediate endoscopy will be required, as well as blood transfusions and other intravenous medications to reduce pressure in the varices. Your doctor also might:

• Perform sclerotherapy or glue injection, which involves injecting the area with a blood-clotting solution.
• Place a stent in the middle of the liver to reconnect the hepatic vein with the portal vein, a procedure which is known as a transjugular intrahepatic portosystemic shunt (TIPS).
• Reduce pressure on the varices by connecting the splenic vein to the kidney vein, a process known as distal splenorenal shunt (DSRS).