What are esophageal varices?
Esophageal varices are enlarged veins located at the lower end of the esophagus (swallowing tube). These veins develop as a result of a back-up pressure from the liver called portal hypertension. This is not related to common high blood pressure. The most common cause of portal hypertension is cirrhosis, which is severe scarring of the liver. This back-up pressure can cause changes to other blood vessels and structures including the lining of the stomach and the spleen.
What are the symptoms of esophageal varices?
Esophageal varices do not cause any symptoms unless they burst and bleed. The bleeding can be significant and serious. The person may vomit red blood or dark colored material. They may also pass red, maroon or dark black stools. If bleeding ever occurs, the person should call 911 or have someone drive them directly to the emergency room.
Who should be evaluated for esophageal varices?
Patients with cirrhosis or any cause of portal hypertension should have periodic endoscopies to monitor for varices. The frequency of these endoscopic examinations will depend on whether varices are present and if so, how large the varices are.
How are esophageal varices treated?
If esophageal varices are present, the patients are often treated with a medication called a non-selective beta-blocker. Two examples are propranolol (Inderal) and nadolol (Corgard). Common side effects of these medications are a drop in blood pressure with a change in position causing a weak feeling and general tiredness. When taking these medications, the pulse rate is used to determine if the correct dose has been prescribed. You’ll be instructed by your provider how to manage your pulse rate.
Bleeding varices are treated with endoscopy by placing rubber bands or injecting a clotting material into the vein. In some serious cases, radiologic or surgical shunts may be placed to relieve the pressure.