Esophageal varices are abnormally swollen veins in the lining of the tube (esophagus) that goes from the mouth to the stomach.
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Portal hypertension is when pressure builds in the veins that bring blood to the liver. The pressure causes blood to backup into other smaller blood vessels, such as those found in the esophagus. This leads to varices.
This may happen due to:
Things that raise the risk of this problem are:
A person may not have problems until bleeding starts. Bleeding may not be serious. It may also stop on its own. Signs of bleeding are:
- Vomiting or coughing up blood that may look like coffee grounds
- Red, tarry, or very dark stools
- Rapid heartbeat
You will be asked about your symptoms and health history. A physical may be done.
The esophagus may need to be viewed. This can be done with:
The goal is to prevent or stop varices from bleeding. Choices are:
Medicines may be given to lower blood pressure or cholesterol. This will help lower the risk of bleeding or slow any bleeding that is happening
Procedures may be done, such as:
- Endoscopic band ligation to tie a band around the varices to prevent or stop bleeding
- Balloon tamponade to pass a balloon through the nose to compress bleeding varices
- Transjugular intrahepatic portosystemic shunting to connect the portal vein to the hepatic vein using a stent to control bleeding
- Distal splenorenal shunt to limit bleeding by connecting the main vein in the spleen to the vein in the left kidney
A liver transplant is the only way to completely cure esophageal varices.
There are no known guidelines to lower the risk of this problem.
American Society for Gastrointestinal Endoscopy
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Association of Gastroenterology
Canadian Liver Foundation
de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015 Sep;63(3):743-752.
Esophageal varices. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/esophageal-varices. Accessed October 21, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD Last Updated: 10/21/2020