Esophageal Varices

What are Esophageal Varices?

Esophageal varices are swollen veins in the esophagus (the tube connecting your mouth to your stomach). They can form when the liver is damaged, usually due to cirrhosis, which causes scarring of the liver. This scarring can block blood flow, creating pressure in the veins, leading to the development of these swollen veins, called varices. Varices can get bigger if the liver damage worsens, or shrink if the liver improves.

Why Are They Dangerous?

Varices can be very dangerous because they may start bleeding, which can be life-threatening. About 25-40% of people with varices will experience severe bleeding. The symptoms of bleeding include:

• Vomiting blood or coffee ground vomitus
• Passing black or very dark stools
• Feeling faint or lightheaded
• In severe cases, loss of consciousness

If you notice any of these signs, get emergency help immediately.

How Are Esophageal Varices Detected?

Because bleeding from varices can be very serious, doctors recommend that all people with cirrhosis get tested to check for varices. The most common test is upper endoscopy, where a thin, flexible tube with a camera is passed through the mouth to look at the esophagus and stomach. If no varices are found, this test is usually done every 2-3 years. If varices are found, the test might be repeated every 1-2 years to monitor them.

How Can I Prevent Bleeding?

Here are some important steps to help prevent bleeding:

• Avoid alcohol: Alcohol can worsen liver damage and increase bleeding risk.
• Avoid heavy lifting: Lifting heavy objects can increase pressure in the veins and trigger bleeding.
• Avoid certain medications: Medications like aspirin and ibuprofen can cause bleeding and should be avoided.
• Lose weight: If you're overweight, losing weight can help improve liver health.
• Take prescribed medications to reduce liver pressure: Medications like propranolol/ carvedilol help lower pressure in the veins and reduce the risk of bleeding. They need to be taken daily, and your doctor will monitor your blood pressure and heart rate.
• If there is an episode of prior bleeding then regular endoscopy and endotherapy sessions may be advised by your treating doctor.

Other Treatments for Varices

If your varices are at risk of bleeding, your doctor may use variceal band ligation, which involves placing small rubber bands around the varices during an endoscopy to stop the bleeding. You may also need medications to reduce stomach acid.

Important Takeaways

If you have cirrhosis, it's important to regularly follow up with your doctor to monitor for varices and to take steps to prevent complications, including bleeding.

Disclaimer: Some portions of this content may be derived from publicly available sources on the internet.