Esophageal Variceal Injection

(Sclerotherapy for Esophageal Varices; Endoscopic Sclerotherapy)

Definition

Esophageal variceal injections puts medicine into or near abnormal blood vessels in the esophagus. This is done to stop or prevent bleeding.

Reasons for Procedure

The injections are used to treat esophageal varices. These are abnormal blood vessels in the esophagus. They have thin walls and the blood pressure within them is very high. A burst blood vessel can be deadly.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Infection
  • Excess bleeding
  • Painful or difficult swallowing
  • Damage to the esophagus
  • Lung injury

Alcohol use disorder may raise the risk of problems.

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure
  • Whether you need a ride to and from the procedure

Anesthesia

The doctor may give:

  • An anesthetic spray to numb the throat
  • IV medicines to help you relax
  • General anesthesia—you will be asleep

Description of the Procedure

You will lie on your left side. A mouthpiece will be placed to help keep the mouth open. A scope with a small light and camera will be placed in the mouth and passed into the esophagus. Images will display on a monitor. Air will be passed through the scope to help view the esophagus better. A flexible needle will be passed through the scope. It will be used to inject medicine in or near a problem blood vessel. More than one injection may be needed. The needle and scope will be removed.

Upper GI Endoscopy
Endoscope in stomach

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How Long Will It Take?

About 30 to 60 minutes

Will It Hurt?

A sore throat is common in the first few days. It may be painful to swallow.

Post-procedure Care

At the Care Center

The staff will give you medicine to ease pain. You will also be monitored for signs of problems, such as blood loss.

At Home

Recovery takes about a week. You will have a smaller risk of bleeding from the blood vessels.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Pain that is not eased by medicine
  • Bleeding from the mouth
  • Nausea and vomiting
  • Bloody vomit
  • Problems swallowing
  • Coughing, shortness of breath, or chest pain
  • Bloody or dark black stools
  • Severe belly pain

If you think you have an emergency, call for medical help right away.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org

American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Health Canada
https://www.canada.ca

REFERENCES:

Esophageal varices. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/esophageal-varices. Updated November 12, 2014. Accessed May 5, 2020.

Kapoor A, Dharel N, et al. Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding. Gastrointest Endosc Clin N Am. 2015 Jul;25(3):491-507.

Last reviewed February 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD  Last Updated: 5/5/2020