Esophageal Varicose Veins: Symptoms, Causes, Diagnosis, and Prevention


Swelling of the veins (veins) known as varicose veins generally occurs in the leg area. However, this condition can also attack the veins in other parts of the body, such as the esophagus. This condition is known as esophageal varices.

What are Esophageal Varices?

Esophageal varices are a condition where the veins in the esophagus become swollen. The esophagus is the tube that connects the stomach to the esophagus.

Esophageal varices occur when blood flow that should be going to the liver is blocked by a clot or scar tissue in the liver. As a result, blood uses an ‘alternative route’ through small blood vessels that are not supposed to be flowing with large volumes of blood.

As a result, there is blockage of blood vessels that lead to swelling of the veins.

This condition is prone to be experienced by someone who has liver disease. If not treated immediately, this disease can be life threatening for the sufferer.

Symptoms of Esophageal Varices

At first, this condition does not show any special features or symptoms. Symptoms in general can only be seen after the portal blood vessels burst until bleeding occurs.

In general, symptoms of esophageal varices include:

  • Vomiting accompanied by blood (hematemesis) in considerable amounts.
  • Stool is black and accompanied by blood (melena).
  • Loss of consciousness.
  • Head feels dizzy.
  • Stomach ache.

In addition, the characteristics of esophageal varices are also similar to the symptoms caused by chronic liver disease, namely:

  • The eyes and skin experience a yellowish discoloration.
  • Bruises on the skin.
  • There is a buildup of fluid in the abdomen ( ascites ).

If you experience one or more of the symptoms above, visit a doctor immediately so that medical treatment can be done immediately, considering that esophageal varices are a dangerous disease that can cause death.

Causes of Esophageal Varices

The presence of scar tissue in the liver (cirrhosis) is the most common cause of esophageal varices. Cirrhosis will cause blood flow to turn back to the portal blood vessels, which are blood vessels that carry blood from the intestines and stomach to the liver.

The reversal of blood flow back into the portal vein results in an increase in blood pressure in these veins. So are a number of other blood vessels in the vicinity.

Ultimately, the blood uses an ‘alternative route’ through small blood vessels, one of which is at the bottom of the esophagus. This is what makes the blood vessels swell quickly and have the potential to burst.

Furthermore, the causes of this condition, include:

1. Cirrhosis

Cirrhosis occurs when there is an injury to the liver. This condition is also associated with a number of liver diseases such as hepatitis, bile duct disorders, and so on. So do not be surprised, people with liver disease generally also experience esophageal varices.

2. Parasitic Infection

Parasitic infectious diseases such as Schistosomiasis , which are common in South America, the Middle East, Southeast Asia, and Africa, are one of the causes of esophageal varices.

Parasites can cause damage to the liver and a number of other important organs. This condition can lead to cirrhosis which is the cause of esophageal varices.

3. Thrombosis

Thrombosis or blood clots are the cause of esophageal varices. This condition occurs if the blood clot occurs in the portal vein or other blood vessel that has a pathway to the portal vein (splenic blood vessel).

Risk Factor

Generally people with liver disease can experience esophageal varices. However, most patients do not experience bleeding.

The risk of bleeding may increase in the following conditions:

  • High pressure in the portal vein.
  • Have chronic hepatitis B.
  • Large varicose veins.
  • There are red marks on varicose veins.
  • Severe cirrhosis or liver failure.
  • Alcohol addiction.
  • At risk for blood clots.

Diagnosis of Esophageal Varices

To determine whether you have esophageal varices or not, it is necessary to carry out a series of disease diagnosis procedures by a specialist. A number of inspections were carried out, including:

1. History

First of all, the doctor will ask a number of questions regarding the complaints experienced by the patient. Generally, these questions include:

  • How long has this condition lasted?
  • What does the body feel?
  • Have you ever had a history of the same disease before?
  • Have you ever consumed alcohol?
  • What has been done to overcome this condition?
  • Have a drug allergy?

2. Physical Examination

The doctor will examine the patient’s physical condition by referring to the symptoms of esophageal varices in general, such as swelling in the esophageal area, yellowish eyes and skin, and other symptoms.

3. Supporting Examination

Furthermore, a number of supporting diagnostic procedures will be carried out before the doctor actually sentences the patient to suffer from esophageal varices. The diagnostic procedure in question, namely:

  • Blood test, aims to check blood levels, as well as kidney and liver function.
  • Imaging , aims to check the condition of the veins, liver, and a number of other organs of the body. Imaging methods that may be used such as CT-Scan, MRI, or ultrasound.
  • Endoscopy , a test to identify the presence of dilated veins, red spots on varicose veins. The doctor will insert a small tube with a camera into the mouth all the way to the esophagus and small intestine.
  • Capsule Endoscopy , just like a regular endoscope, the difference is that the capsule medium doctor used is a capsule with a wireless camera. This test is performed if the patient is unable to undergo the endoscopic method with a tube.

Esophageal Varicose Veins Treatment

How to treat esophageal varices basically aims to prevent more damage to the liver, prevent bleeding in varicose veins, and control the bleeding that occurs.

1. Prevents Liver Damage

Patients with liver disorders are advised to avoid toxins that cause liver stress. This is done to prevent further damage to the liver.

2. Prevent Bleeding in Varicose Veins

Administration of beta-blocking drugs such as propranolol. This drug works to lower blood pressure in the portal vein.

If the patient is at high risk of bleeding, ligation may be performed. This technique uses a special rubber that serves to stop bleeding.

3. Control Bleeding

Treatment of bleeding varicose veins is to control the bleeding. Here are some actions that can be taken:

  • Blood transfusions to replace blood that has been wasted.
  • Injection of a blood clotting fluid ( sclerotherapy ) to close the bleeding.
  • Diverting blood flow in the portal vein by the transjugular intrahepatic portosystemic shunt (TIPS) method.
  • Liver transplantation, especially in patients with advanced liver disease.
  • Take antibiotics to prevent infection.

Complications That Can Occur

Esophageal varices can cause serious complications such as bleeding. After a patient has had a bleeding episode, the risk of another bleeding episode may increase.

This condition is quite dangerous because it can cause a person to lose enough blood. As a result, you can go into shock that can lead to death.

Prevention of Esophageal Varices

Because it is related to diseases of the liver, the way to prevent it is to maintain the health of this organ. Here are some actions that can be taken:

  • Avoid alcohol consumption.
  • Limit the use of chemicals, such as household cleaning products.
  • Apply a healthy diet by consuming low-fat foods. You can increase the consumption of fruits and vegetables, whole grains, and other foods that are high in lean protein.
  • Maintain ideal body weight. Because the accumulation of fat in the body can put a lot of pressure on the liver.
  • Exercise regularly.

Now you know what esophageal varicose veins are, from symptoms, causes, to prevention. If you experience symptoms of this condition, do not delay to check with your doctor for further treatment.

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