Treatments of Esophageal Varices

An esophageal varice is a dilated vein in the lower part of the esophagus or in the upper section of the stomach. Commonly caused by liver disease, these swollen blood vessels can burst open and cause extreme bleeding.
Esophageal varices do not always have symptoms before they rupture. For this reason, many medical professionals prefer to screen all patients who have liver diseases, such as cirrhosis of the liver. Cirrhosis is a medical condition in which the liver becomes scarred. With the scarring, comes a decreased capacity of blood flow through the liver. This extra blood is sidetracked to the esophageal area and this increased blood flow is what causes the vein dilation.
Some of the most common symptoms of an esophageal varice are black and tarry stools, visible blood in the stools, a feeling of faintness, paleness, vomiting, or perhaps dark streaks in the stools. For people who have cirrhosis it is recommended that you discuss having a screening to determine if there are signs of varices in the esophagus.
Screening methods include the use of nasogastric tubes to look for signs of active bleeding and the source of the bleeding. If bleeding is recognized at the time of screening, the health care provider will be able to treat the bleeding at that time.
Common treatments include the use of an endoscope to place a rubber band around the swollen and bleeding veins to stop the bleeding. The health care professional might instead opt to inject a clotting medication or a blood vessel restriction medication directly into the vein. A balloon tamponade procedure can be carried out to create pressure on the bleeding vein. This course of action requires a tube to be inserted through the nose and down to the stomach where it is then inflated with air.
If the bleeding is acute, the doctor might need to place the patient on a ventilator to prevent blood from entering the lungs and to protect the patient’s airway. As massive bleeding can cause shock and imminent death, it is vital to get the bleeding under control as quickly as possible.
If the doctor does not see active bleeding during the screening, but observes the varices, treatment can be carried out to prevent bleeding. Medications known as beta blockers reduce the chance of future bleeding from the varices. Rubber banding the veins is another option and can be carried out with only the use of an endoscope.
Surgical means of treatment include a procedure called TIPS in which new associations are created between blood vessels in the liver. When the liver is capable of transporting the blood on its own instead of sending it through the esophagus veins, there is a greatly diminished risk of varices and bleeding.
Treatment of the underlying cause of the esophageal varices is imperative to overcoming the varices itself. When a patient is suffering from severe liver disease, it is recommended that they receive a liver transplant. Without treatment, the prognosis is very poor.
Ref;http://www.esophagealvarices.org/