What is the definition of Esophageal Varices?
Esophageal varices is a condition in which enlarged (varicose) veins develop in the lower esophagus (swallowing tube that connects mouth to stomach). Esophageal varices frequently occur in individuals with serious liver diseases, such as cirrhosis (liver scaring and fibrosis), who have developed portal hypertension (high blood pressure in portal vein). Esophageal varices can also be caused by parasitic liver diseases, such as schistosomiasis (flatworms). Esophageal varices can rupture and cause dangerous bleeding (hemorrhage).
What are the symptoms for Esophageal Varices?
Esophageal varices often do not have any symptoms until they bleed. Symptoms of bleeding esophageal varices include vomiting large quantities of blood, black, tarry or bloody stools, dizziness, and loss of consciousness. Since individuals with esophageal varices also usually have liver disease, such as cirrhosis, additional symptoms may include yellowing of the mucous membranes, skin, and whites of the eyes (jaundice), bruising easily, and fluid in the abdomen (ascites).
What are the current treatments for Esophageal Varices?
Treatment for bleeding esophageal varices include endoscopic band ligations (use of rubber bands to restrict blood flow to varices); medications to slow bleeding, such as octreotide (Sandostatin) and vasopressin (Vasostrict); sclerotherapy (drugs injected into the varices to constrict blood flow); balloon tamponade, or self-expanding metal stents (SEMS), which are used to apply pressure to the varices; transjugular intrahepatic portosystemic shunt (TIPS), in which a shunt is created between the portal and hepatic veins to stop the bleeding; transfusions; and antibiotics. Patients with bleeding esophageal varices and severe liver disease may be considered for liver transplantation. Medications such as beta blockers may be administered to prevent re-bleeding.