Overview of Esophageal Varices

Overview of Esophageal Varices-An esophageal varice is a swollen vein in the lower section of the esophagus. The esophagus is the tube that runs from the back of the throat to the stomach. Esophageal varices can also transpire in the top section of the stomach.
Many times esophageal varices are caused by cirrhosis, which is scarring of the liver. If the liver becomes scarred, blood is prevented from passing through the liver and therefore will flow through the esophagus veins. The added blood flow through the esophagus from a scarred liver can result in those esophageal veins ballooning out. The veins can potentially rupture and result in relentless bleeding.
Common symptoms that arise from esophageal varices are black and tarry stools, bloody stools, pale skin, vomiting (perhaps with blood), and a feeling of light-headedness. If the esophageal varices are not bleeding very much there may be only dark streaks in the stool.
Chronic liver diseases such as cirrhosis of the liver are the leading cause of esophageal varices. Because of this, doctors commonly prefer to screen all patients suffering from liver disease for esophageal varices as there are not always clear symptoms.
Screening for esophageal varices includes running a nasogastric tube through the nose and down into the stomach to check for bleeding or signs of bleeding. Esophagogastroduodenoscopy (EGD) is another screening tool, which essentially checks for varices with or without bleeding. EGD tests are routinely ordered for patients who have recently been diagnosed with liver diseases such as cirrhosis.
Because esophageal varices can rupture and bleed profusely, this is the most important aspect of treatment. Profuse bleeding can cause shock and ultimately death if not controlled quickly. If the event of excessive bleeding, medical professionals might place the patient on a ventilator so that the blood does not go into the lungs.
Doctors use an endoscope when they need to inject the varices with a medicine to cause clotting or to rubber band the veins that are bleeding. An endoscope is simply a small tube with a light on the end. Medications can also be delivered that constrict blood vessels as well.
Once the bleeding is under control or in the event bleeding has not yet occurred, health care professionals can treat the esophageal varices in a variety of ways. The most popular treatment is medication. Beta-blockers can be used to prevent future bleeding. Nadolol and propranolol are two drugs that are commonly prescribed for this use.
A medical procedure called TIPS might be carried out in which new links are made between the liver’s blood vessels. This procedure is done with the hope that extra blood flow will not be diverted to the esophageal area. Surgeries to place blood vessel shunts into the veins or to remove completely the esophagus are rarely attempted, as they are quite risky.
Without treatment of some sort, the esophageal varice is likely to return. In extreme cases, liver damage might be so great that a liver transplant might need to be carried out to prevent further harm to the esophagus