| Risk Factors
The esophagus connects the mouth to the stomach. Esophageal varices are abnormally swollen veins within the lining of the esophagus. If undiagnosed or untreated, esophageal varices can rupture and lead to life-threatening bleeding.
Copyright © Nucleus Medical Media, Inc.
Increased pressure in the veins that deliver blood to the liver is known as
portal hypertension. The increased pressure causes blood to back up into other smaller vessels, including those of the esophagus. This leads to the formation of esophageal varices.
The medical conditions that lead to the development of portal hypertension and esophageal varices include:
Factors that increase your chance of developing esophageal varices include:
Esophageal varices are usually only diagnosed when bleeding occurs. Though bleeding from esophageal varices may not be severe and may stop on its own, first-time bleeding events may result in death in some cases.
Signs of bleeding from esophageal varices include:
- Vomiting or coughing up blood
- Red, tarry, or very dark stools
- Low blood pressure
- Rapid heartbeat
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
Several treatments can help lower the risk of vessel rupture or stop bleeding if it starts. Treatment options include the following:
Medications may be given to lower blood pressure in the veins to decrease the risk of bleeding or help slow bleeding.
This procedure involves the passage of a balloon through the nose to help compress the bleeding varices.
TIPS involves threading a catheter from a neck vein to the liver. A stent, a small tube designed to keep veins open, is bound to the catheter and inserted into the liver. It will increase blood flow through the portal vein and relieve blood pressure in the esophageal varices.
This procedure can control bleeding in most cases.
DSRS is a surgical procedure that connects the main vein in the spleen to the left kidney vein. The procedure is done to lower blood pressure in the swollen vessels and to limit bleeding.
This procedure is reserved for those who fail to respond to medications or endoscopic treatment and are not considered good candidates for a shunting procedure.
To help reduce your chance of esophageal varices:
- Get treatment for complications related to alcohol use disorder.
- Tell your doctor if you are at risk for chronic liver disease, blood clots, or are on medications that may damage the liver.
If you already have chronic liver disease, your doctor may prescribe medications to prevent swollen vessels from developing.
Berry PA, Wendon JA. The management of severe alcoholic liver disease and variceal bleeding in the intensive care unit.
Curr Opin Crit Care. 2006;12(2):171-177.
Bhasin DK, Siyad I. Variceal bleeding and portal hypertension: new lights on old horizon.
D’Amico G. The role of vasoactive drugs in the treatment of oesophageal varices.
Expert Opin Pharmacother. 2004;5(2):349-360.
Garcia-Tsao G, Sanyal AJ. Prevention and management of gastroesophageal varicies and variceal hemorrhage in cirrhosis.
Am J Gastroenterol. 2007;102(9):2086-2102.
Gastroesophageal varices. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T113964/Gastroesophageal-varices. Updated November 12, 2014. Accessed September 29, 2016.
Kamath PS. Esophageal variceal bleeding: primary prophylaxis.
Clin Gastroenterol Hepatol. 2005;3(1):90-93.
Lubel JS, Angus PW. Modern management of portal hypertension.
Intern Med J. 2005;35(1):45-49.
Villanueva C, Piqueras M, Aracil C, et al. A randomized controlled trial comparing ligation and sclerotherapy as emergency endoscopic treatment added to somatostatin in acute variceal bleeding.
Last reviewed June 2016 by Daus Mahnke, MD
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Information Services. All rights reserved.