What are esophageal varices and their Prognosis?

Esophageal varices are abnormally dilated veins in the final part of the esophagus —although sometimes they are also found in the upper part— through which blood passes that in normal conditions would have to pass through the liver.

These veins are dilated due to the resistance that a diseased liver presents to the passage of blood.

The main problem with these varicose veins is the risk of their rupture, something that happens when the pressure inside the veins exceeds the resistance of their wall, causing significant bleeding that, in some cases, can cause death.

Prognosis of esophageal varices

Esophageal varices are a severe problem since bleeding, which is potentially fatal, cannot always be prevented.

Patients who have suffered a hemorrhage are much more likely to have another bleeding episode. In turn, it should be noted that up to one in three relapses are fatal.

Esophageal varices are associated with disorders such as renal, cardiovascular, immune, or even respiratory.

Symptoms of esophageal varices

Esophageal varices do not have specific symptoms, and on many occasions, they do not present signs, except for bleeding. Symptoms of bleeding esophageal varices are as follows:

  • vomiting
  • Vomiting accompanied by a large amount of blood
  • The feeling of being groggy
  • black stools
  • In severe cases, loss of consciousness may occur

In turn, the specialist may suspect the existence of esophageal varices if signs of liver disease are noted, such as a yellowish coloration of the skin and the “white” of the eyes, known as jaundice . ; a tendency to bleeding, as well as the formation of bruises and the accumulation of tissue in the abdomen.

Medical tests for esophageal varices

The main medical tests that are carried out to detect the presence or diagnose esophageal varices are the following:

  • Examination with an endoscope: through the endoscope, dilated veins, red spots, or dots are looked for, signs of bleeding.
  • Imaging diagnostic tests: they are examinations through computed tomography  (CAT),  ultrasoundDoppler ultrasound
  • Capsule endoscopy: In this test, the patient swallows a capsule equipped with a micro camera to photograph the esophagus as it travels down the digestive tract.

What are the causes of esophageal varices?

Esophageal varices sometimes form when blood flow to the liver is obstructed, often by scar tissue in the liver caused by liver disease. In this way, the blood flow increases its pressure within the vein that carries blood to the liver.

This pressure causes the blood to seek other places of passage through smaller veins, these veins swelling due to the amount of additional blood and may give way and burst on certain occasions.

Some causes are:

  • Acute liver scarring, cirrhosis: Some liver diseases can cause cirrhosis, such as hepatitis infection, alcoholic cirrhosis, fatty liver 
  • Blood clots, thrombosis: A blood clot can cause esophageal varices to form.
  • Parasitosis: schistosomiasis is a parasitosis that can damage the liver, lungs, intestine, and bladder.

Can esophageal varices be prevented?

To date, there is no specific treatment to prevent the onset of this disease in people with liver disease. However, beta-blockers have proven to be effective in preventing bleeding in people with esophageal varices, although they do not control the formation of varices as such.

Some ways to keep your liver and liver function healthy include:

  • Avoid drinking alcohol
  • Maintain a balanced and healthy diet
  • Maintain an average, healthy weight
  • Reduce the risk of getting sick from hepatitis
  • Use chemicals (household or at work) with moderation and caution

Treatment for esophageal varices

As mentioned above, the main objective of treatment for esophageal varices is to prevent bleeding since this is life-threatening. However, if bleeding does occur, there are ways to stop it.

  • Treatments to prevent bleeding
    • Medications that reduce pressure
    • Use of elastic bands to compress bleeding veins
  • Treatment in cases of bleeding: immediate treatment in these cases seems essential. Medicines used to stop bleeding and try to reverse the effects of blood loss include the following:
  • Use of elastic bands to tie off bleeding veins
  • Medications that slow blood flow to the portal vein
  • divert blood flow away from the portal vein
  • Restore blood volume, perhaps through transfusion
  • Prevent bleeding infection through antibiotics
  • Liver transplant

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