Esophageal varices are dilated veins that can cause bleeding and serious complications. Discover how they are treated in this informative article.
They occur due to difficulty in blood flow in the liver, resulting in increased pressure in the veins of the hepatic portal system, usually associated with liver diseases, such as cirrhosis and chronic hepatitis.
Understand better the symptoms of this condition, as well as the diagnosis and other preventive care until the treatment of the problem to control its progression.
What are esophageal varices?
Have you ever heard about this problem? This specific condition affects the veins located in the inner lining of the esophagus, the tube that connects the throat to the stomach.
They can occur due to certain factors related to gastrointestinal health, which can lead to dilation and distortion of the veins.
These varices can be diagnosed through specific tests performed by experienced health professionals.
Once diagnosed, they can be treated with appropriate medical interventions, aimed at reducing the risks associated with this condition.
In addition, it is essential to follow medical recommendations regarding prevention and necessary care after treatment.
It is important to remember that gastrointestinal health should be treated seriously, and any concern in this area should be discussed with a health professional. He will be able to provide appropriate guidance based on individual needs.
Causes and symptoms of esophageal varices
There are several causes that can lead to the development of varices in this region.
The most common cause is liver cirrhosis, a chronic condition that causes scarring in the liver and hinders the normal flow of blood through it.
Other causes include portal vein thrombosis, an obstruction of the hepatic veins, and chronic liver diseases, such as hepatitis B and C.
Symptoms can range from no visible sign to serious complications.
Often, varices are asymptomatic and are only discovered during routine exams or endoscopic procedures.
However, in more advanced cases, varices can rupture and cause severe bleeding, resulting in vomiting of blood, bloody or black stools, and a feeling of abdominal fullness.
Bleeding, in these cases, is a medical emergency and requires immediate attention. If severe bleeding occurs, urgent medical intervention may be necessary to stop the bleeding and prevent serious complications.
To reduce the risk of developing esophageal varices, it is important to treat underlying conditions, such as liver cirrhosis.
For this reason, understanding how to diagnose and care for or prevent is essential.
Diagnosis and necessary exams
Proper diagnosis and treatment are essential to prevent complications and manage this condition.
Thus, the diagnosis of this situation usually involves a combination of clinical exams, upper digestive endoscopy, and imaging exams.
The doctor will perform a detailed clinical history, considering the patient’s symptoms, such as vomiting blood, dark stools, abdominal pain, or unexplained weight loss.
Upper digestive endoscopy is the gold standard exam to identify varices.
During this procedure, a flexible tube with a camera at the end is inserted through the mouth into the esophagus, allowing the doctor to view the dilated veins and determine the severity of the condition.
In addition, endoscopy can be used to perform variceal ligation, a treatment procedure to reduce the risk of bleeding.
Other imaging exams, such as endoscopic ultrasonography or computed tomography, may be performed to assess the extent of varices, the presence of other complications, and assist in treatment planning.
Besides these already mentioned, laboratory tests, such as complete blood count and coagulation tests, may be requested to assess liver function and identify other possible underlying causes of esophageal varices.
Available treatments for esophageal varices
There are different treatment alternatives available for this problem, which aim at both controlling acute bleeding and preventing future bleeding.
The main treatment options include:
Sclerotherapy
In this procedure, a sclerosing agent is injected into the varices, causing their obliteration.
This leads to the formation of a clot and subsequent scarring of the vein, thus reducing the risk of bleeding.
Elastic ligation
This technique involves the use of elastic bands, which are placed around the varices, interrupting the blood flow and leading to their necrosis and fall.
Transjugular intrahepatic portosystemic shunt (TIPS)
This procedure is more invasive and involves creating a direct connection between the liver veins and the systemic venous system, diverting blood flow and reducing pressure on varices.
Medications like Propranolol
These beta-blocker medications can be prescribed to reduce blood pressure and heart rate, decreasing pressure on varices and reducing the possibility of bleeding.
In addition to these options, it is essential to adopt general prevention measures and regular medical follow-up to monitor the state of varices.
It is also important to remember that treatment should be individualized, considering the severity of the condition, the presence of additional complications, and the specific characteristics of each patient.
Therefore, it is essential to consult a specialist doctor to evaluate the case and determine the best treatment plan.
Prevention and care after treatment
After the treatment of esophageal varices, it is very important to adopt prevention measures and care to reduce the risk of future complications.
The patient should follow medical guidelines to ensure proper recovery.
Here are some important measures to consider:
1- Maintain a balanced diet
A healthy and balanced diet is essential to maintain liver health and prevent the development of new varices.
It is recommended to avoid foods high in saturated fats and cholesterol, and opt for a diet rich in fruits, vegetables, whole grains, and lean proteins.
2- Restrict alcohol
Alcohol consumption should be limited or, preferably, completely eliminated, as it can aggravate liver condition and thereby increase the risk of variceal bleeding.
3- Maintain weight control
Staying at a healthy weight is important to reduce pressure on the liver and esophageal veins.
If there is excess weight, it is recommended to adopt measures to achieve an appropriate weight, such as a combination of a healthy diet and regular physical exercise.
4- Use prescribed medication
The doctor may prescribe medications to reduce pressure in the veins, such as beta-blockers, which help to decrease the bleeding rate and the risk of recurrence of varices, as already mentioned.
To effectively treat the condition, it is necessary that these medications are used correctly.
5- Regular medical exams and follow-up
It is essential to maintain regular medical follow-up to monitor liver health and the condition of the situation.
Follow-up consultations, imaging exams, and periodic blood tests may be necessary.
In addition to these measures, it is important to be aware of warning signs, as already mentioned, vomiting with blood, dark or bloody stools, intense abdominal pain, and increased heart rate.
If any of these symptoms occur, it is necessary to seek medical attention immediately, as it may indicate bleeding.
Esophageal varices are a serious condition and require immediate medical attention.
The main goal of treatment is to prevent complications, such as bleeding and rupture of varices.
For this, it is essential to adopt preventive measures, such as a healthy diet, low in fats and alcohol.
Therefore, it is important to treat the underlying cause of varices, such as liver cirrhosis, and carry out medical follow-up to monitor the condition.
Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.