Bleeding esophageal varices

Bleeding esophageal varices

Bleeding esophageal varices

Esophageal varices are dilated blood vessels surrounding the esophagus and part of the stomach. This is a manifestation of a diseased liver, as scar tissue from the liver blocks or obscures blood flow. Major veins become unable to carry blood due to the obstruction or tissue clots and so the blood pressure rises, forcing blood to find alternate routes through smaller vessels, such as those in the lower part of the esophagus and upper part of the stomach.

When the pressure rises in these small veins, they dilate and may rupture causing massive bleeding. Actually, bleeding is the main manifestation of esophageal varices, along with black, tarry and bloody stools, vomiting, paleness or faintness feeling.

Nowadays, most physicians prefer to screen their liver-diseased patients in an attempt to determine whether they show any signs of bleeding esophageal varices. This involves searching for bleeding signs using a tubing technique. If the esophageal varices are discovered in time, they can be treated so that bleeding does not occur, thus avoiding any life-threatening complications.

When the esophageal varices are diagnosed, the treatment procedure can begin. This varies based on the gravity of the bleeding esophageal varices and the bleeding risk they pose. The use of rubber bands is one of the most common treatment methods, and is done by using an endoscope. Another method is based on injecting blood-clotting drugs directly into the dilated veins.

If during the screening the esophageal varices are stable and the bleeding risk is low, another type of treatment is carried out one to prevent bleeding. This involves the administration of beta blockers, drugs that help lowering the blood pressure in the affected veins. The use of rubber bands to tie the veins is a successful method that can be used in this stage too, but only with the use of an endoscope.

For severe bleeding esophageal varices cases, the use of surgical treatment is mandatory. One method is called TIPS and means placing a small tube between the portal and the hepatic veins, this way offering the blood an alternate route. Although this method is very efficient in stopping bleeding esophageal varices, it also can lead to serious complications due to the fact that blood toxins are now passed directly into the bloodstream.

The most successful method to stop esophageal varices from bleeding is the liver transplant but it is only used on patients with severe liver disease or repeated bleeding esophageal varices episodes, as the number of patients needing a liver transplant greatly outnumbers the number of available organs

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