Esophageal Varices

Enlarged veins in the food pipe (esophagus) are called esophageal varices. These swollen veins are often a result of problems with blood flow to the liver. The portal vein is a blood vessel that carries blood from the digestive organs (like the intestines) to the liver. When something blocks this blood flow, like a blood clot or scar tissue in the liver, blood has to find a different path. This extra pressure causes the veins in the esophagus to enlarge.

Imagine your food pipe as a narrow road. If that road gets blocked, traffic (blood) has to find alternative routes, which can be smaller and weaker roads. These smaller roads aren't built to handle the heavy traffic, so they can leak or burst, leading to dangerous bleeding. This usually happens in people with serious liver conditions.

Fortunately, there are treatments to prevent or stop this bleeding. Doctors have different ways to help with this. These might include certain medications or medical procedures.

Esophageal varices are swollen veins in the esophagus (the tube that connects your throat to your stomach). Usually, these varices don't cause problems. However, if they bleed, you can experience several symptoms.

Bleeding esophageal varices can cause you to vomit blood, often in large amounts. You might also have black, tarry stools (poop) or bloody stools. Low blood pressure from the bleeding can make you feel lightheaded or dizzy. In severe cases, you might lose consciousness.

These symptoms can be a sign of liver problems. If you have liver disease, especially cirrhosis (scarring of the liver), you're at higher risk for esophageal varices. Other signs of liver disease include:

• Jaundice: Your skin and eyes turn yellow.
• Easy bruising or bleeding: You bruise or bleed more easily than usual.
• Ascites: Fluid buildup in your abdomen.

If you're experiencing any of these symptoms, make an appointment with your doctor. If you already have liver disease, be sure to discuss your risk of esophageal varices with your doctor. Ask about ways to lower this risk, and if you should get a procedure to check for varices.

If you have been diagnosed with esophageal varices, your doctor will likely advise you to watch for signs of bleeding. Bleeding varices are a serious medical emergency. If you experience bloody vomit or black, bloody stools, call 911 or your local emergency services immediately.

If you're concerned about your health, schedule a visit with your doctor. If you have a liver condition, talk to your doctor about your chances of developing esophageal varices—these are swollen veins in your esophagus (the tube connecting your throat to your stomach). Ask your doctor what steps you can take to lower your risk of getting them. Also, ask if a test to check for esophageal varices is recommended.

If your doctor diagnoses you with esophageal varices, they'll likely advise you to watch for warning signs. Bleeding from esophageal varices is a serious medical problem that needs immediate attention. Call 911 or your local emergency number right away if you notice dark, tarry stools (black stools), or vomit that's bloody.

Esophageal varices are swollen veins in the esophagus (the tube connecting your mouth to your stomach). They often develop when blood flow to your liver is blocked. This blockage usually happens because of scar tissue in the liver, a condition called cirrhosis.

Imagine your liver as a filtering station for blood. When cirrhosis blocks normal blood flow through the liver, the blood has to find alternative routes. The main vein carrying blood to the liver (the portal vein) gets backed up with blood, increasing pressure within it. This high pressure, called portal hypertension, forces blood to look for smaller, thinner veins to travel through. The esophagus has tiny veins that are not strong enough to handle this extra blood flow. These veins stretch and balloon, and sometimes burst, causing bleeding.

Several things can lead to cirrhosis and subsequently esophageal varices:

• Severe liver scarring (cirrhosis): Many liver diseases can cause cirrhosis. These include:

  • Hepatitis: Inflammation of the liver, often caused by viruses.
  • Alcoholic liver disease: Liver damage from excessive alcohol consumption.
  • Fatty liver disease: Fat buildup in the liver.
  • Primary biliary cholangitis: A condition where the bile ducts in the liver are damaged.

• Blood clots (thrombosis): A blood clot in the portal vein or a vein leading to it (like the splenic vein) can also disrupt blood flow, potentially causing esophageal varices.

• Parasitic infections: In some parts of the world, a parasite called schistosoma can infect the liver. This infection can damage the liver, leading to cirrhosis and esophageal varices. This is particularly common in parts of Africa, South America, the Caribbean, the Middle East, and East Asia.

If you have any symptoms that suggest esophageal varices, it's important to see a doctor right away. Early diagnosis and treatment can help prevent serious complications.

Many people with serious liver problems get swollen veins in their esophagus (esophageal varices). But most of the time, these veins don't bleed. However, bleeding is more likely if certain factors are present:

• High blood pressure in the portal vein: The portal vein carries blood to the liver. When this vein's pressure gets too high, it puts extra pressure on the esophageal varices, making them more prone to bursting and bleeding. Think of it like a water pipe under too much pressure. The higher the pressure, the greater the risk.

• Large varices: Varices that are bigger are more likely to bleed because they're weaker and more easily damaged. Imagine a balloon; the larger it is, the thinner its walls become, and the more likely it is to burst.

• Visible signs of bleeding risk: Sometimes, the varices have red streaks or spots. Doctors can see these using a thin, flexible tube called an endoscope that they pass down your throat. These red marks are a warning sign that the varices are at high risk of bleeding.

• Severe liver disease: If your liver disease is very advanced or causing liver failure, the risk of bleeding from the varices increases significantly. A failing liver can't regulate blood pressure as well, leading to higher portal vein pressure.

• Continued alcohol use: If you continue to drink alcohol, especially if your liver disease is related to alcohol, your risk of bleeding from esophageal varices is much greater than if you quit drinking. Stopping alcohol use can help improve liver health and reduce the risk of bleeding.

• Prior bleeding episodes: If you've had bleeding from esophageal varices before, you have a higher chance of bleeding again in the future. Your body may have already been damaged by the previous bleeding, making it more vulnerable.

Esophageal varices are swollen veins in the esophagus. A serious problem arises when these veins bleed. A bleeding episode significantly raises the chances of future bleeding. If you lose a lot of blood from this bleeding, you can develop a life-threatening condition called shock, which could be fatal.

Currently, there's no cure to stop esophageal varices from forming in people with cirrhosis. While certain medications, called beta blockers, can help prevent bleeding from existing esophageal varices in many people, they don't stop the varices from developing in the first place.

If you have liver disease, talk to your doctor about ways to reduce your risk of complications. Here are some important steps you can take to keep your liver healthy:

• Avoid alcohol: Your liver is responsible for processing alcohol. Drinking alcohol can put extra stress on a liver that's already struggling. If you have liver disease, it's often recommended to stop drinking altogether.

• Eat a nutritious diet: Focus on fruits, vegetables, whole grains, and lean proteins. Limit fatty and fried foods. A healthy diet provides your body with the nutrients it needs to function properly, including supporting liver health.

• Maintain a healthy weight: Extra body fat can damage your liver. Obesity is a significant risk factor for complications related to cirrhosis. If you're overweight or obese, losing weight can help improve your liver health.

• Handle chemicals carefully: Follow all instructions on cleaning products, pesticides, and other chemicals. If you work with chemicals, follow safety procedures. Your liver filters toxins from your body. By limiting your exposure to chemicals, you lessen the burden on your liver.

• Protect yourself from hepatitis: Sharing needles or having unprotected sex can increase your risk of hepatitis B and C. Use condoms during sex, and avoid sharing needles. Get tested for hepatitis A, B, and C. If you test positive, you can discuss treatment options with your doctor. Ask your doctor about getting vaccinated against hepatitis A and B. These infections can worsen liver disease.

A doctor uses a thin, flexible tube with a light and camera (called an endoscope) to look inside your throat, esophagus, stomach, and the beginning of your small intestine (the duodenum). This is called an upper endoscopy.

If you have cirrhosis (scarring of the liver), your doctor will likely check for esophageal varices (enlarged veins in the esophagus). How often these checks happen depends on your specific health situation.

There are a few ways to check for esophageal varices:

• Imaging tests: X-rays like CT scans of your abdomen and ultrasound tests of the veins (like the splenic and portal veins) can sometimes show signs of enlarged veins. A special ultrasound called transient elastography can measure the amount of scarring in your liver. This helps figure out if you have portal hypertension (high blood pressure in the veins leading to the liver). Portal hypertension can cause esophageal varices.

• Endoscopy: A doctor will perform an upper gastrointestinal endoscopy. This is a common way to look for esophageal varices. It's like the upper endoscopy, but it's specifically focused on the presence of enlarged veins. The doctor uses the endoscope to look at the esophagus, stomach, and the beginning of the small intestine. They look for swollen veins (varices). If varices are found, the doctor measures them and checks for signs of bleeding (red streaks or spots). Sometimes, treatment can be done during the same procedure.

Essentially, these methods help doctors see if you have enlarged veins in your esophagus that could be dangerous. The doctor will use the best approach for your situation, considering your specific health condition.