Esophageal varices are veins that are found in the esophagus that have become abnormally dilated and enlarged.
Most often seen in patients with serious liver disease, esophageal varices will develop when the normal flow of blood to the liver becomes blocked. This can happen as a result of scar tissue or a clot in the liver.
In order to move around the blockage, the blood will flow into blood vessels that are smaller and not designed to carry such large amounts of blood. As a result, the vessels end up leaking blood or rupturing, resulting in a life-threatening condition.
Esophageal varices typically don’t cause any symptoms unless they’ve begun to bleed.
Once they start bleeding, you may experience bloody, tarry, or black stools, as well as lightheadedness, vomiting with presence of blood, and loss of consciousness when the situation becomes severe.
Symptoms of liver damage could also indicate the presence of esophageal varices. These signs include easily bruising or bleeding, a buildup of fluid within the abdomen, and jaundice.
Esophageal varices have a number of causes mostly related to damage and disease in a patient’s liver. When a patient’s liver becomes damaged, scar tissue forms that may impede the blood flow to the organ. When this blood flow is blocked in the portal vein, the blood tries to find a different path into the liver. One path is through the veins of the bottom portion of the esophagus. These veins will then become large and filled with excess blood.
The main liver diseases that lead to esophageal varices include alcoholic cirrhosis, biliary cirrhosis, various forms of hepatitis and fatty liver disease. Cirrhosis due to excessive alcohol consumption is the main cause.
Esophageal varices may also occur if a blood clot forms in the portal vein that supplies the liver. This creates the same backup of blood seen in cases of extensive liver damage.
A parasitic infection called schistosomiasis is responsible for esophageal varices as well. These parasites that come from snails can invade the body from contaminated freshwater supplies. This particular parasite can infect a number of different organs in the body.
When esophageal varices have been diagnosed, treatments will be designed to prevent any bleeding from starting.
To prevent bleeding, medications known as beta blockers can reduce blood pressure within the portal vein. Your doctor may also recommend band ligation, which is a procedure during which an elastic band is used to tie off a vein if it’s at a high risk of bleeding.
If bleeding is already present, it’s life threatening, so treatments will be focused on halting the bleeding. Band ligation, medicine that slows blood flow from other organs to the portal vein, and a procedure called transjugular intrahepatic portosystemic shunt (TIPS) may be prescribed. Also, a blood transfusion can replace lost blood.
In order to prevent esophageal varices from forming, it is important to prevent extensive damage to the liver from occurring. The main way that this is accomplished is by cutting back on the amount of alcohol one consumes. If one is going to drink alcohol, it needs to be consumed in moderation. Excessive alcohol consumption is the primary way in which the liver is damaged.
If a patient has a blood clotting disorder, it is important to follow all protocols to keep the blood thin. This will help to prevent any clots from forming in the portal vein.
Schistosomiasis is not a problem in North America. However, if a person is traveling to certain parts of the world such as sub-Saharan Africa and much of Asia, precautions against this parasite need to be taken. Avoid swimming in or walking in freshwater sources in places where this parasite is known to exist. Also, always drink bottled water from a safe source when traveling in places where schistosomiasis is found.