Thumbnail image of: Digestive System: Illustration

Esophageal Varices

What are esophageal varices?

Esophageal varices are swollen veins in the walls of your esophagus. The esophagus is the tube that carries food from your throat to your stomach. Increased pressure in the swollen veins can cause the veins to break open and bleed. Because of the risk of severe bleeding, esophageal varices are a serious, possibly life-threatening problem.

What is the cause?

The most common cause of esophageal varices is scarring of the liver. The liver helps your body digest and use food, helps clean your blood, and helps keep your body healthy. The scarring is called cirrhosis. The scarring prevents the normal flow of blood from the intestines back through the liver. The blood bypasses the liver, increasing the blood flow and pressure in the veins of the esophagus. Scarring of your liver can be caused by:

  • Alcoholic liver disease
  • Hepatitis B or C infections
  • Hemochromatosis, a condition caused by too much iron in your body

Rarely, esophageal varices are caused by other medical problems.

What are the symptoms?

The varices may not cause any symptoms, or they may cause some bleeding. At first you may have just small amounts of bleeding, which is passed on through the digestive system. You may see dark or black tarry digested blood in your bowel movements. As bleeding increases, you may have dark red or black diarrhea. You may start vomiting bright red blood.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • Blood tests
  • Endoscopy, which uses a slim, flexible, lighted tube passed through your mouth to look at your esophagus and upper digestive tract
  • Barium swallow, which is an X-ray taken of the upper part of your digestive tract after you swallow barium. Barium is a liquid that helps the walls of your esophagus show up well on the X-ray.
  • CT scan, which uses X-rays and a computer to show detailed pictures of the esophagus and liver
  • MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the esophagus and liver

How are they treated?

Varices may be treated with medicine to help prevent bleeding by lowering pressure in the swollen veins.

Emergency treatment for bleeding varices may include:

  • Injection of medicine into the veins to cause them to scar and close
  • Placement of tight bands around the bulging veins to close them off
  • Balloon tamponade, which uses a tube with a balloon at the end to put pressure on areas that are bleeding

If bleeding cannot be controlled, you may need surgery to improve blood flow through your liver.

How can I take care of myself?

  • Follow the full course of treatment prescribed by your healthcare provider. Take your medicines exactly as prescribed.
  • Do not use alcohol, cigarettes, and chewing tobacco because they slow the healing of varices. If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking. If you have alcoholic cirrhosis, it’s very important to get help to stop drinking.
  • Ask your provider if you can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen. Your provider may want you to use acetaminophen for pain relief instead.
  • Getting infectious hepatitis will make your liver scarring worse. Ask your provider if you need shots to prevent hepatitis A or B. There is no vaccine against hepatitis C.
  • It’s important not to irritate the varicose veins and cause them to bleed. This means you should avoid coughing and vomiting as much as much as you can. If you need help preventing these problems, ask your provider.
  • Ask your healthcare provider:
    • How and when you will hear your test results
    • How long it will take to recover
    • What activities you should avoid and when you can return to your normal activities
    • How to take care of yourself at home
    • What symptoms or problems you should watch for and what to do if you have them
  • Make sure you know when you should come back for a checkup.

How can I help prevent esophageal varices?

The only way to prevent esophageal varices is to try to prevent the underlying causes, such as liver disease.

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-01-31
Last reviewed: 2013-12-04
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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