Esophageal varices are enlarged blood vessels in the esophagus, which are at risk of rupture, causing ulceration and bleeding. The bleeding can lead to health problems in and of itself, and esophageal varices can also be associated with infection, including pneumonia. More worryingly, varices in the esophagus are linked with issues with the hepatic portal vein which are usually caused by conditions such as cirrhosis, and problems with the portal vein can have very serious medical implications, including an increased risk for cardiovascular problems.
The typical cause of esophageal varices is high pressure in the portal vein. People can have high pressure in the portal vein without necessarily having hypertension due to issues such as scarring and blockage of the portal vein which drive up pressure. This vein is a major part of the system which drains blood from areas such as the gastrointestinal tract, and when it becomes occluded, it can lead to serious problems. Occlusion is often linked with cirrhosis, in which the liver becomes scarred by repeated damage.
People with esophageal varices may vomit blood, feel thirsty and lightheaded, and experience symptoms associated with the underlying liver disease which causes the varices. These symptoms can include abdominal pain and tenderness, jaundice, and edema. Varices can also form in other areas of the body, including the intestines. People may not necessarily experience pain, because the nervous system's interpretation of pain inside the chest cavity and abdomen can be very imprecise.
Esophageal varices can be identified by scoping the esophagus, in which case the enlarged vessels will be clearly visible. Bright red spots may also be seen, and sometimes active bleeding points the way to specific varices. Immediate treatment involves control of the bleeding, following by procedures such as banding or introducing medications to encourage the vessels to shrink. Once a patient has experienced a bleed from an esophageal varix, chances are high that bleeding will occur again.
While addressing esophageal varices is very important, it is also critical to address the underlying cause. Complications of cirrhosis can be uncomfortable and ultimately fatal. Examinations can be conducted to determine what is causing the cirrhosis, and what steps might be taken to address it. If the portal vein pressure is extremely high, some immediate measures can be taken to relieve the pressure on this vein to prevent complications and stabilize the patient until more long term treatment options can be explored.