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Varices (of the Esophagus)

What are esophageal varices?
What are the signs of esophageal varices?
What causes esophageal varices?
How does my doctor tell if I have esophageal varices?
How are esophageal varices treated?

What are esophageal varices?

Esophageal varices are swollen blood vessels in the tube that carries food from your mouth to your stomach (the esophagus), and in the upper part of the stomach. They are similar to the varicose veins that some people have in their legs. Varices cause no symptoms unless they rupture and bleed, which can be a medical emergency.

What are the signs of esophageal varices?

Esophageal varices cause no symptoms unless they rupture and bleed. Then can they cause:

  • Vomiting of blood
  • Bloody stools
  • Black and tarry stools
  • Feeling light-headed or dizzy
  • Low blood pressure
  • Paleness
  • Rapid heart rate

What causes esophageal varices?

The root cause of esophageal varices is liver disease, such as cirrhosis of the liver. The scarring that happens with cirrhosis can cause portal hypertension, which is an increase in pressure in the veins of the liver. Because of this increased pressure, blood can't flow through the liver properly.

The backup of blood from the liver can cause extra veins to form in the esophagus and stomach. These veins, or varices, are thinner and more fragile than normal blood vessels. They can rupture easily, and result in a large amount of blood loss. It can be difficult to stop bleeding from esophageal varices.

How does my doctor tell if I have esophageal varices?

Your doctor my suspect esophageal varices if you have:

  • Signs of chronic liver disease or cirrhosis
  • Low blood pressure
  • A rapid heart rate
  • Bloody or black stools during a rectal exam

To diagnose esophageal varices, your doctor will perform an upper gastrointestinal endoscopy, in which he or she uses an endoscope - a tiny video camera mounted on a thin, flexible tube with a light at the end - to look inside your esophagus and stomach. The doctor inserts the endoscope through your mouth. You will be given medication to make you relaxed and drowsy during the procedure, which only takes 15-20 minutes.

How are esophageal varices treated?

Ruptured and bleeding esophageal varices must be repaired immediately. In severe cases, a patient may be placed on a ventilator and given blood and fluids intravenously to prevent shock and death until the bleeding can be stopped.

To repair esophageal varices, and to prevent future bleeding, a doctor may use an endoscope to place elastic bands around the bleeding veins. The doctor inserts the endoscope through your mouth. You will be given medication to make you relaxed and drowsy during the procedure. Guided by the video images created by the endoscope, the doctor will use a tiny tool to place small rubber bands over the varices, which cuts off blood flow through those veins.

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