Esophageal Varices

Esophageal varices are swollen veins in the mucosa (lining) of the lower part of the esophagus occurring because of portal hypertension due to cirrhosis of your liver. This is often accompanied by varices of the stomach.
( Several causes of Cirrhosis tend to be alcohol liver disease, hepatitis B, C, drug treatments, glycogen storage diseases, autoimmune diseases)
Structure of the top Gastrointestinal tract. (see diagram in Wiki http://en.wikipedia.org/wiki/Gastrointestinal_tract )
Food consumed in the mouth is actually chewed, then enters your Esophagus (muscular pipe covered along with a mucosal membrane ) and is moved alongside through peristalsis on the stomach exactly where digestive function takes place.
Layers of esophagus from inside to exterior -
*  Mucosa – innermost filling commonly of a solid cell layer
*   Submucosa- has blood vessels arteries and also veins, lymphatic vessels and nerves
*   Muscle mass – round and longitudinal muscle
*   Adventitia – outermost lining
Physiology
The superficial veins draining the esophagus drains into the portal vein structure which usually goes by over the liver organ. Whenever cirrhosis (scarr tissue ) happens in the liver it occludes or even squeezes the veins decreasing circulation so there is a back-up of blood causing the veins to utilize a collateral systemic of veins higher than the liver organ. These types of collateral veins then turn out to be dilated and also sent in to the mucosa and also lumen of your wind pipe and abdominal forming problematic veins that are thin and may be destroyed without difficulty causing blood loss in to the lumen of your esophagus.
Symptoms
Result from your complication associated with destroyed vessels and so are the following:
Vomiting large amounts blood – (25 to 30% of persons with varices have got hemorrhage)
Dark colored sticky stools from swallowed blood
Dizziness, some weakness, loss of consciousness,
60% of sufferers having liver disease develop varices therefore signs of persistent liver disease (jaundice, edema, stomach irritation, pruritus, sexual disorder, psychological confusion )
Differential diagnosis connected with blood loss from your Higher gastro intestinal tract
Duodenal Ulcers (35%)
Gastric ulcers (20%)
Mallory weis tears(10%)
Esophgeal Varices(5-11%)
gastric or esophageal carcinoma (6%) unusual reason for considerable upper GI blood loss
Diagnosis
The prognosis is done generally by history ( alcoholic beverages use and also chronic liver illness ) and also the throwing up of massive amount of blood.
Gold standard – Confirmed simply by endoscopy – This procedure can be either diagnostic and therapeutic.
Ref : http://www.esophagealvarices.org/