Esophageal Varices

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Esophageal varices is a medical condition causing the veins to dilate in the channel between the throat and the stomach. This condition most often develops in people with liver disorders.

When someone has esophageal varices, it is not always immediately realized. This is because esophageal varices do not cause certain symptoms unless the vessels have burst and are bleeding. When this happens, the condition of esophageal varices becomes dangerous and possibly life-threatening.

Esophageal varices appear when normal blood flow to the liver is blocked by clots or scar tissue in the liver. In order to get through the blocked area, blood flows through the smaller blood vessels, which are only able to drain a small volume of blood. Due to this condition, the small blood vessels leak or even burst, causing bleeding.

A person with esophageal varices is advised to undergo treatment as soon as possible. Doctors can help stop the bleeding and improve the condition of the blood vessels through numerous medical procedures and medications.

Causes of Esophageal Varices

Esophageal varices generally form when there is a blockage of blood flow to the liver and increased pressure in the veins. This pressure forces the blood to find another pathway through the smaller vessels to allow blood to flow to the liver.

However, these tiny vessels are not designed to carry large amounts of blood. As a result, the walls of the blood vessels will break and bleed.

The condition of blockage in the veins is common in patients with liver disease and cirrhosis.

In general, the common causes of esophageal varices are:

  • Cirrhosis or liver damage due to the formation of scar tissue. Cirrhosis is caused by various types of liver diseases, such as hepatitis, bile duct disorders, and various other liver diseases.
  • Thrombosis or blood clots. Blood clots in large blood vessels can cause esophageal varices.
  • Parasitic infection. Parasites can attack and damage the liver, lungs, intestines, bladder and other organs. This condition can also trigger esophageal varices.

When to See a Doctor for Esophageal Varices?

Patients diagnosed with esophageal varices can consult a gastroenterologist.

First, the doctor will ask about the patient’s symptoms and medical history. The doctor will immediately examine the symptoms of esophageal varices if the patient has cirrhosis.

The primary tests done to diagnose esophageal varices are:

  • Endoscopic test, the doctor will insert a thin tube with a light at the end, called an endoscope, down the throat through the mouth.
  • Imaging tests, performed via CT scan or ultrasound of the veins to show if there is blockage and if the blockage is causing esophageal varices. An ultrasound test helps measure the scar tissue that has formed.
  • Capsule endoscopy, the patient will be asked to swallow a capsule that has a small camera inside. The camera will take pictures of the inside of the esophagus as it passes through the digestive tract. This process is more expensive than the usual endoscopic test and is generally performed by people who have certain medical conditions, making endoscopic testing impossible. 

Symptoms of Esophageal Varices

Symptoms of esophageal varices do not appear in the early stages of the disease. Usually, patients only feel certain symptoms after the blood vessels have burst and experience bleeding.

When that happens, the patient will experience the following symptoms:

  • Vomit blood.
  • Mild headaches.
  • Low blood pressure.
  • Increase in heart rate intensity.
  • Bloody, black-colored, and dry stools 

Additionally, the doctor may also diagnose a patient with esophageal varices if they have signs of liver disease, such as:

  • Fluid build-up in the stomach.
  • Yellow color to the skin and eyes.
  • Bleeds easily and bruises on the body.

When you are bleeding, it indicates a severe case of esophageal varices. In very severe cases, if not treated immediately, the patient may experience shock that can lead to death.

After the bleeding has stopped, the patient has the potential to experience complications or new diseases that arise due to past diseases. These complications can include pneumonia, liver failure, kidney failure, and coma.

Treatment for Esophageal Varices

In some severe cases, the patient may undergo treatment with a breathing machine installed to prevent the lungs from filling up with blood. The doctor will also immediately give antibiotics to prevent blood infections.

When esophageal varices are detected early enough, the doctor will perform treatment to prevent the risk of bleeding. The treatment is carried out by:

  • Consuming medications to reduce pressure due to blockages in the main veins. These drugs are usually beta blockers, including propranolol and nadolol to reduce the chance of bleeding.
  • Using an elastic band to tie the blood vessels that bleed. If the varicose veins may potentially cause heavy bleeding, the doctor will recommend the next stage of treatment called endoscopic band ligation.
  • Endoscopic band ligation, performed using an endoscope to pull out the varicose veins and wrap it with an elastic rubber band. The tape will “choke” the blood vessels so they cannot bleed.

If esophageal varices are detected in a relatively severe stage or when the patient is already bleeding, treatments may include: 

  • Sclerotherapy, a method by injecting varicose veins using a blood clotting solution.
  • Liver transplant, performed on patients with esophageal varices who also have end-stage liver disease.
  • Esophageal transection, a surgical procedure done by cutting the esophagus and then clamping it back after binding the varicose veins.
  • Devascularization, a surgical technique to stop varicose bleeding. This procedure is performed when other attempts have failed to stop the bleeding.

Treatment Cost for Esophageal Varices 

The cost for esophageal varices treatment varies, depending on the severity and treatment method given.

For more information regarding the estimated costs of esophageal varices treatment, contact Smarter Health.

Prevention of Esophageal Varices

Prevention of esophageal varices is done by avoiding contracting liver disease, which is a common trigger for symptoms. People with liver disease can immediately treat their disease to avoid complications of esophageal varices.

In addition, beta-blocker medications can help prevent bleeding in varicose veins.

Generally, preventive measures include: 

  • Avoid consuming alcohol.
  • Eat healthy foods regularly.
  • Prevent yourself from hepatitis.
  • Maintain a proportional body weight.

Home Remedies for Patients Diagnosed with Esophageal Varices

Treatment of esophageal varices patients can be done at home after undergoing hospital treatment.

For patients who undergo treatment through surgical procedures, home remedies include resting and maintaining a healthy lifestyle during the recovery period.

In addition, it is also important to regularly consume beta-blocker medications as prescribed by your doctor. Perform routine checks to control your liver and prevent esophageal varices from recurring.

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