Esophageal Varices

Esophageal varices are swollen veins in the lining of the lower esophagus (the tube that connects the mouth to the stomach). These swollen veins resemble varicose veins that some people have in their legs. Because these veins are so close to the surface of the esophagus, they can rupture and bleed.

Symptoms

Esophageal varices don’t usually have any signs or symptoms unless they bleed. Signs of bleeding include:

  • Vomiting blood
  • Black, tarry or bloody stool
  • Feeling lightheaded or passing out (usually when there is a lot of bleeding).
  • Liver disease:
    • Yellow coloration of skin and eyes
    • Spider-like cluster of tiny blood vessels
    • Enlarged liver or spleen
    • Feeling tired or lethargic all the time
    • Swollen spleen
    • Fluid build-up in abdomen.

The most serious complication of esophageal varices is bleeding. Once there is one bleeding episode there is the risk of another bleeding episode. In some cases, blood loss can be so great that it causes shock. If bleeding occurs, the patient should immediately go to the emergency room or call 911. A doctor who specializes in digestive disorders (gastroenterologist) can determine the cause of the bleeding.

Test and diagnosis

  • Upper endoscopy – a thin flexible tube that has a camera and light on it goes thru the mouth and into the esophagus. The doctor can check for veins that are swollen and measure their size. Treatment can be done during this exam.
  • Liver ultrasound and Doppler

Treatment

  • Medications:
    • Beta blocker that reduces the blood pressure in the portal vein.
    • Over the counter drugs like Omeprazole, Lansoprazole or Pantoprazole.
  • Variceal band ligation – small rubber bands are used to stop the bleeding.

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