Esophageal varices

Esophageal varices: Description, Causes and Risk Factors: Longitudinal venous varices at the lower end of the esophagus as a result of portal hypertension; they are superficial and liable to ulceration and massive bleeding. Esophageal varicesEsophageal varices are abnormal, enlarged veins in the lower part of the esophagus (the tube that connects the throat and stomach). Esophageal varices occur most often in people with serious liver diseases. Esophageal varices happen when the esophagus undergoes a dilation of the submucosal vein. Esophageal varices develop when normal blood flow to your liver is slowed. The blood then backs up into nearby smaller blood vessels, such as those in your esophagus, causing the vessels to swell. Sometimes, esophageal varices can rupture, causing life-threatening bleeding. Hypertension or high blood pressure is often cited as one of the most common causes of this disorder. Most of the time individuals with this illness tend to experience heavy bleeding. Liver diseases and other causes of esophageal varices: Esophageal varices are most often a complication of cirrhosis — irreversible scarring of the liver. Other diseases and conditions also can cause esophageal varices. Causes can include: Severe liver scarring (cirrhosis). A number of liver diseases can result in cirrhosis, such as hepatitis infection, alcoholic liver disease and a bile duct disorder called primary biliary cirrhosis.
  • Blood clot (thrombosis). A blood clot in the portal vein or in a vein that feeds into the portal vein called the splenic vein can cause esophageal varices.
  • A parasitic infection. Schistosomiasis is a parasitic infection found in parts of Africa, South America, the Caribbean, the Middle East and Southeast Asia. The parasite can damage the liver, as well as the lungs, intestine and bladder.
  • A syndrome that causes blood to back up in your liver. Budd-Chiari syndrome is a rare condition that causes blood clots that can block the veins that carry blood out of your liver.
Risk Factors: High portal vein pressure.
  • Large varices.
  • Red marks on the varices.
  • Severe cirrhosis or liver failure.
  • Continued alcohol use.
Symptoms: Symptoms may include: Heartburn.
  • Difficulty swallowing.
  • Vomiting blood.
  • Vomiting material that looks like coffee grounds.
  • Black stool.
  • Rectal bleeding.
  • Red or maroon stool.
  • Anorexia.
Diagnosis: If you have cirrhosis or another serious liver disease, your doctor may screen you for esophageal varices. How often you'll undergo screening tests depends on your condition. Tests used to diagnose esophageal varices include: Using a scope to examine your esophagus:During an endoscopy (visual examination of the interior of a hollow body organ by use of an endoscope) exam, your doctor inserts a thin, flexible, lighted tube (endoscope) through your mouth and into your esophagus. If any dilated veins are found, they're graded according to their size and checked for red streaks, which usually indicate a significant risk of bleeding. Imaging tests:Both computerized tomography (CT) scans and magnetic resonance imaging (MRI) may be used to diagnose esophageal varices. These tests also allow your doctor to examine your liver and circulation in the portal vein. Treatment: To begin the treatment of esophageal varices, doctors may opt to pinpoint the cause of the disorder. Oftentimes focusing on the patient's blood pressure may reduce any risk of bleeding in the future. The patient might be ordered to undergo medication that slows the flow of the blood through the veins by taking drugs such as nadolol or propranolol. In other cases, a scope can be used to gain access to the bleeding part of the esophagus. If the varices are said to have a high chance of severe bleeding, a doctor can use an endoscope by inserting it inside the body and tying off the affected veins using an elastic band. During this process, the endoscope snares the varices and strangles the veins in order to prevent further bleeding. This ligation method, on the other hand, often carries with it a few complications such as the permanent scarring of the internal parts of the esophagus. A medical process called the endoscopic injection therapy involves the vaccinating of a solution right inside the wounds of the vein. The result is the shrinking of the esophageal varices. The only downside to this treatment is that the esophagus is placed under the risk of perforation and further scarring, giving the patient a difficult time swallowing hard food, a disorder known as dysphagia. Another common treatment method is the transjugular intrahepatic portosystemic shunt or TIPS, which is a small tube placed in the middle of the portal and the hepatic vein, which is responsible for the transportation of the blood from the liver into the heart. The shunt provides an extra path for the flow of the blood, thereby controlling the bleeding of the esophagus. Although liver malfunction and mental confusion can occur during the operation of the patient, TIPS is still widely used if on the occasion other possible methods have failed in the past. It is a temporary treatment process wherein the patient's physical efforts are highly needed. Of course, the patient can opt to cure esophageal varices by replacing his or her liver with a healthier one. It is an option for those who have harsher cases or those who are undergoing nonstop bleeding almost every day. NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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