Any liver disease can increase a person’s risk of developing esophageal varices, but cirrhosis is the most common cause. A person with liver disease but no cirrhosis has a lower risk of varices.
Cirrhosis and portal hypertension are the most common causes of esophageal varices. These are both possible complications of liver disease.
When diagnosing liver disease, a doctor will have considered:
- the person’s symptoms
- their medical history
- results of blood tests, a physical examination, and sometimes a liver biopsy
A person who has cirrhosis should have regular screening for esophageal varices.
To check for these varices, a doctor uses an endoscope, and they may also require a CT scan.
Esophageal varices can be small or large. Small varices measure less than 5 millimeters in diameter, and they may require different treatments from larger varices.
Small varices do not always cause symptoms. A doctor will recommend ways to prevent further liver damage, which may involve medication and lifestyle changes.
Treatment for large varices may involve minor surgery to prevent bleeding.
Varices can also form in other areas of the body: Gastric varices occur in the stomach and duodenal varices form in the first part of the small intestine. A person can also develop rectal varices.
The main goal of treatment for esophageal varices is to prevent ruptures and bleeding. Initially, this often involves steps to control portal hypertension.
The doctor may prescribe beta-blockers to reduce blood pressure. These drugs work by blocking the effects of a hormone called epinephrine, making the heart beat slower and with less force.
A person with esophageal varices may also require one of the following surgical procedures.
Endoscopic sclerotherapy involves using an endoscope to perform minor medical tasks, such as injecting a medication into the swollen veins to make them shrink.
Endoscopic variceal banding involves using the same tool to place a rubber band around a varice to prevent the vessel from bleeding.
Additional treatments may be necessary for varices that bleed recurrently.
A doctor may recommend a transjugular intrahepatic portosystemic shunt, or TIPS, procedure. This involves using an X-ray to guide the placement of a small tube to connect the portal vein with the hepatic vein. This creates a new channel for blood, reducing pressure in the portal vein.
Another treatment option is a distal splenorenal shunt procedure. This connects the main vein of the spleen to the vein of the left kidney.
It is not always possible to prevent esophageal varices. Still, anyone with cirrhosis should receive treatment to reduce the risk of complications such as varices.
Also, medication and lifestyle changes can help reduce further liver damage and, thus, the risk of developing varices.
If a person has varices, beta-blockers can help prevent them from bleeding. Banding can also help keep varices closed. Avoiding any ruptures is key to preventing complications.
Esophageal varices are large or swollen blood vessels around the esophagus. If they rupture and the blood leaks, it can cause serious complications.
Esophageal varices usually result from cirrhosis and portal hypertension.
If the varices are small, a person may be able to prevent further damage by making lifestyle changes and taking medication.
If they are large, the person may need to undergo one or more minor surgical procedures.
This article is from Medical News Today - https://www.medicalnewstoday.com/articles/esophageal-varices#summary