Esophageal varices: causes, symptoms and treatment methods

Diseases of the veins and large blood vessels are accompanied by significant changes in their physical condition, which negatively affects the quality of the blood circulation process. And esophageal varices, which can significantly reduce the quality of life of the patient due to the deterioration of the quality of digestion and blood flow in the body, require an attentive attitude and timely initiation of treatment. This pathology may be accompanied by the addition of secondary lesions of Organs digestive organs, or it may occur and proceed independently.

However, with any kind of appearance, dilated veins of the esophagus and subsequent varicose veins are accompanied by unpleasant symptoms that make it possible to identify the lesion in question at an early stage of development and initiate a therapeutic effect in a timely manner, preventing the development of complications. Medical statistics note that this pathology of the esophageal veins occurs predominantly in the male population (women are affected by varices of the esophagus twice as rarely as men), while the average age at which the first manifestations of the disease can be observed is 50 -55 years.

Causes of the disease

The causes that cause the appearance of esophageal varices can be different depending on the manifestation of the disease, the general state of the patient's body, in each case the set of causes may vary. However, in any case, varicose veins that occur in the veins of Organs digestive organs are the result of a change in the general condition of the veins. The reason for the manifestation of varicose veins of this location is excessively high blood pressure in the venous circulation, which is most often characteristic of liver cirrhosis.

And the result of such an expansion can be massive bleeding, the danger of which lies in the absence of symptoms, which can be considered a warning: bleeding in esophageal varices is often profuse, representing a real danger to the general condition of the patient. Therefore, the knowledge of the manifestation of this pathology of the esophageal veins and the disease prevention measures will allow to diagnose it earlier and start an adequate therapeutic effect.

In addition, the following patient conditions can be the causes of this pathological change in the veins of Organs digestive organs:

  • congestion observed in the portal vein;
  • portal thrombosis;
  • development of malignant goiter;
  • esophageal angioma.

In addition, the occurrence of the lesion in question may be caused by the symptoms and vascular pathologies that accompany Randu-Osler disease. All these diseases and conditions are accompanied by negative changes in the circulatory system and digestive organs, which initially affect the general state of the veins and large arteries of the esophagus and stomach tissues. Changes in the circulatory system of internal organs such as liver, spleen, gallbladder can cause the development of varicose changes in the esophagus.

patient symptoms

The main manifestation of a condition like varicose veins located in the esophagus is bleeding. This symptom can be observed in the absence of alert manifestations, in the context of the so-called "full health". A sign of impending bleeding can be considered a slight tickling in the throat, a characteristic taste of blood when swallowing (salty-sour). The blood that forms during bleeding during the development of varicose veins is usually pronounced bright scarlet, it can resemble coffee grounds. The result of this bleeding, which is often prolonged and profuse, is dizziness, a feeling of weakness, loss of consciousness.

dizziness with esophageal varices

As the causes of worsening varicose veins can be a variety of injuries to the internal organs and the circulatory system as a whole, the overall quality of functioning of these organs is largely determined by the likelihood of developing varicose veins and the symptoms that may accompany this injury.

A symptom of the considered pathological change in Organs digestive organs can be considered bleeding, which develops during the asymptomatic course of the initial manifestations of the disease. This bleeding can be either insignificant, which does not immediately attract the patient's attention, or profuse, which carries a high risk of death. Varicose veins, which are seen in the tissues of the esophagus and stomach, are most often characterized by the absence of significant changes that allow timely detection and treatment. However, this disease is one of the most formidable: with unexpected bleeding, characterized by an abundance of blood released, there is a high probability of death for the patient. According to medical statistics, of the five cases of manifestation and aggravation of varicose veins in Organs digestive organs, four are the death of the patient.

Types and degrees of esophageal varices

Today, specialists distinguish various degrees of development of esophageal varices, each of them has its own developmental characteristics, differs in the list of manifestations and requires a certain therapeutic effect, which allows you to avoid the aggravation of the pathology. Thanks to modern diagnostic methods, it becomes possible to determine the presence of the disease, its stage and degree of development.

abdominal pain due to esophageal varices

There are the following degrees of expansion of stomach veins and varicose veins:

  • the first degree, in which there is a slight change in the lumen of the veins of the body. Esophageal varices, characteristic of grade 1, may not be perceived by the patient, as they rarely present defined and pronounced symptoms. Esophagus veins have a lumen of 5 mm on average, which is not much different from their healthy state. However, even at this size they become less elastic, as even small changes in their lumen lead to some decrease in the intensity of blood movement through them, and the general quality of blood circulation in the affected organ is disturbed. 1st degree esophageal varices can be detected during a routine examination of this organ;
  • the second degree is characterized by an increase in the lumen of the veins in the diseased organ of up to 10 mm, the speed of blood flow in the veins gradually decreases, which negatively affects the condition of the veins: they continue to lose their elasticity, the walls become gradually thinner, which can cause bleeding due to the high probability of rupture;
  • in the third stage of aggravation of the pathology, there is an expansion of the lumen of the veins in the esophagus and stomach by more than 10 mm, the vessels, due to their expansion, are located close to each other, and even their slight trauma can provoke bleeding. Often, it is in the third stage of the development of the disease that heavy bleeding is observed, which causes the death of the patient, it is a real danger to the life of a sick person suffering from varicose veins in the tissues of Organs digestive organs .

The above classification of esophageal varices allows us to classify the existing lesion of the veins of this organ to a certain extent and start treatment, which has a positive effect on the patient's condition. The treatment of esophageal varices must be chosen by a doctor who, based on studies and analysis of the patient's general condition, chooses both the exposure schedule and the exposure variant, taking into account the characteristics of his organism.

Stomach varicose veins

The expansion of the veins, due to a negative change in their condition, can also be observed in the stomach. In this case, as in the case of esophageal varices, there is a gradual decrease in the degree of elasticity of the walls of the veins, with a significant probability of bleeding. Modern diagnostic methods make it possible to detect the pathology in question in time and start its treatment.

Methods for curing varicose veins, which are located in the tissues of the stomach, differ, but they all aim to eliminate the root cause of this condition. NTSH RAMS provides this data on options for causes and methods of treating varices of the esophagus and stomach:

  • curing the manifestation of varicose veins in the esophagus and stomach according to the method described in the book of the leading specialists in gastroenterology, the differentiation of the identified diseases of the digestive organ is carried out, and this method and a detailed description of the manifestations of such rare lesions as pathology of the operated esophagus, difficult-to-diagnose diseases of the digestive organs provide the greatest amount of information necessary for the elaboration of a treatment regimen for both therapists and narrow specialists-gastroenterologists;
  • Zdenek Marzhatka, one of the most prominent experts in the field of gastroenterology and diseases of the esophagus, accompanied by damage to the veins in their tissues, describes in detail in his writings various methods of diagnosis of the disease, types of endoscopy of the tissues of the stomach and esophagus.
pain in the abdomen with esophageal varices

Today, to prevent the aggravation of the existing pathology, increasingly modern diagnostic methods are used, aiming at a more detailed study of the state of the tissues of the affected digestive organs.

Disease diagnosis

Methods and options for diagnosing varicose veins that have arisen in Organs digestive organs (esophagus and stomach) include the following diagnostic manipulations and procedures:

  1. Fibroesophagoscopy, which allows to identify the cause of bleeding. In addition, this method makes it possible to determine the presence of mechanical causes for the occurrence of bleeding, the condition of the walls of the esophageal veins.
  2. X-ray of the walls of the esophagus, which is more informative when using contrast.

Both options for diagnosing the disease in question have the ability to detect the cause of bleeding, determine the condition of the walls of the veins and the likelihood of rupture of existing aneurysms. The use of both diagnostic options allows, with maximum precision, not only to detect the pathology of the veins and vessels of the esophagus and stomach, but also to obtain the greatest amount of information available about the pathology.

Possible complications

Since varicose veins that occur in the tissues of the esophagus and stomach are especially dangerous due to the likelihood of bleeding, the possible complications of this pathology must be taken into account. Significant damage to Organs digestive organs, worsening cirrhosis of the liver are the most dangerous consequences of this pathology of the veins.

treatment methods

The therapeutic effect to eliminate the risk of bleeding in case of damage to the veins of the esophagus and stomach should take into account the stage of the pathological process, the general health of the patient, the susceptibility of his body to the ongoing therapeutic effect. Modern medicine is constantly improving methods of influencing the veins of the esophagus, which allows you to quickly eliminate the most obvious manifestations of the pathology in question.

Today, an integrated approach is used in the treatment of the considered pathology of the esophageal and stomach veins, which consists of a traditional, surgical and medical exposure method. Each method has its own characteristics, can be used for certain indications and is prescribed by a doctor. The course of treatment must be monitored at all stages by the attending physician, who, if necessary, will make the necessary adjustments in a timely manner and avoid the likely risks of complications.

traditional method

Firstly, when using the traditional treatment option for esophageal varices, bleeding stops, which can be fatal. This will also allow for additional methods of therapeutic action, which will ensure faster regeneration of damaged tissues and create the necessary scar at the site of the esophageal vein injury.

To compensate for hypovolemia and prevent the occurrence of hemorrhagic shock, a significant dose (calculated by the doctor) of vitamin K is introduced into the patient's body, as well as infusions of frozen plasma (1-2 doses, intravenous transfusion is carried out).

Conservative method

With severe bleeding, which becomes a real danger to the patient's life, a rubber balloon can be used to stop the bleeding quickly. With the help of a probe, the bleeding vessel is pressed, which stops the movement of blood. For example, the probe of such a device - the Sengstaken-Blackmore probe is popular in eliminating bleeding during the development of varicose veins in Organs digestive organs, in particular in the esophagus. Corrugated varieties of such probes are also used, widely used in the treatment of bleeding esophageal varices and bleeding gastric ulcers.

probe for esophageal varices

With the introduction of the probe below the site of the vein rupture, the esophagus can be washed with hot water at a temperature of 40°C - this measure usually stops active bleeding and stabilizes the patient's condition. However, with repeated and high-intensity bleeding, in parallel with the use of tubes, intravenous and intramuscular administration of substances that also contribute to the stoppage of the blood is recommended. Calcium chloride 10-20 ml is administered intravenously. Do not use for the introduction of drugs whose action is aimed at increasing blood pressure.

Endoscope treatment

As this disease of the esophageal veins is most often diagnosed during the endoscopic examination, endoscopic hemostasis may be prescribed to eliminate the most characteristic manifestations of the lesion (elimination of bleeding). This method involves suturing the affected areas of the veins in the esophagus, and it is this variant of the therapeutic effect that is preferable compared to injection sclerotherapy because of the more pronounced positive dynamics of the treatment.

The performance of the endoscopic treatment is marked by a rapid stop of bleeding, prevention of probable recurrences of the disease. The drug, used in the implementation of endoscopic treatment of bleeding in varicose veins of the esophagus and stomach, is administered intravenously at 50 mcg, its action aims to increase visceral vascular resistance, which allows stabilizing the patient's condition, preventing excessively active blood loss. . This medication is preferable to other medications that can be given to stop venous bleeding from the esophagus because it has fewer side effects, even with prolonged use.

Using an endoscope involves using a special endoscopic examination of the esophagus, which is most often prescribed for bleeding, the cause of which is unclear. This technique is very popular due to the high efficiency of this diagnostic method and the good positive dynamics of the treatment (the ligation is performed), performed by means of an endoscope. Endoscopic examination of the veins of the esophagus and stomach proved to be well at any stage of the development of the pathological process; In addition, this method makes it possible to detect even the initial manifestations of diseases of the digestive system in relation to blood circulation in the veins and identify esophageal varices.

The use of balloon tamponade

The endoscopic method of exposure also involves the use of such a variant to stop bleeding from the esophageal veins, such as balloon tamponade. It consists of the impact at the site of damage to the vein of special buffering agents. However, with severe bleeding, balloon tamponade may not be very effective; Additional drugs must be used to stimulate regenerative processes in the tissues of the vein walls.

The classification that is proposed today for the division of esophageal varices allows to determine the most effective regimen of therapeutic effects. Taking into account the peculiarities of the stage of the current pathological process, the organism's perception of the drugs used and the control of the ongoing treatment provides the attending physician with the opportunity to make timely adjustments and achieve the best results in stopping bleeding and stabilizing the condition. of the patient.

Surgical intervention

Heavy bleeding, which poses a threat to the patient's life due to significant blood loss, may require surgery.

Surgical intervention may be prescribed for major blood loss, in which the intravenous administration of plasma, blood, and blood replacement fluids does not bring a pronounced positive result. There are several types of surgery for significant blood loss. Each of them is prescribed according to their indications determined by the doctor.

Today, the following types of surgical intervention are recognized as the most effective:

  • imposition of a special dressing made of medical rubber. Such a ligation of damaged veins allows you to quickly stop blood circulation, stop blood loss, which can cause a significant deterioration in the patient's condition;
  • an operation like bypass surgery leads to a decrease in blood pressure in the veins and, as a result, stops bleeding. During the shunt, the liver tissue is affected, a special stent is inserted in the middle of this organ, which creates a kind of bridge between the liver tissues and the tissues of the esophagus, which reduces blood pressure. The hepatic and portal veins, having such a "bridge", receive reduced pressure, which leads to a stop of bleeding;
  • Splenorenal shunt is a type of bypass surgery that helps prevent possible bleeding when varicose veins are detected in the tissues of the esophagus and stomach.
surgical instruments for esophageal varices

The listed options for surgical intervention allow you to eliminate the increase in blood pressure in the esophageal veins damaged by varicose veins. All of them are carried out under the control of x-rays and provide the greatest positive effect of manipulations to stop bleeding.

Medical treatment of varicose veins

There is also a variant of medicinal effects on the body to treat the initial stage of esophageal varices. The choice of drug type is determined by the doctor after examining the patient's body, determining the stage of the current pathological process. When carrying out this type of therapy, such indicators as the susceptibility of the patient's body to the drug used, the likelihood of developing allergic reactions should be taken into account.

The most commonly used in the treatment of this disease are the following drugs with a pronounced effect on the veins:

The medications listed have a number of possible side effects that should be considered when prescribing.

Treatment with folk remedies

The reliability of medicines and methods of traditional medicine has been tested for centuries, but their effectiveness is not high enough to independently deal with the manifestations of esophageal varices. Traditional medicine can be used as a maintenance medicine, to increase the rate of healing processes in the tissues of the veins. For example, with a high probability of bleeding, it is recommended to take decoctions and infusions of herbs that have a hemostatic effect. It can be nettle, thyme, highlander bird collections.

Treatment with folk remedies is also possible at home, which is especially important for maintenance therapy of the disease, in the remission stage. Since esophageal varices are a serious injury, which represents a serious danger to the health and life of the patient, it is necessary to take into account the degree of impact of the selected traditional medicine. Home treatment is carried out under the constant supervision of a doctor.

you need a diet

When diagnosing varicose veins in Organs digestive organs, the question of choosing a diet should be considered one of the most important, since it is on the foods that enter the patient's body that both his well-being and indicators of the ongoing therapeutic effect largely depend. . The recommended diet for varicose veins of the esophagus involves observing several workable rules, which involve excluding certain foods and including in the daily menu certain products that heal the body as a whole and the esophagus in particular.

diet for esophageal varices

The diet for esophageal varices should exclude the following foods and substances from the patient's diet:

  • spices;
  • a lot of table salt;
  • excessive amounts of oils, mainly of animal origin;
  • fried, canned, smoked foods, which irritate the tissues of the esophagus and can cause bleeding.

Nutrition for varicose veins of the esophageal tissues, as well as cirrhosis of the liver, should include more cooked and boiled foods, fermented dairy products will perfectly support the necessary microflora in the intestines, without creating an excessive load on the digestive system as a whole. Nutrition fractionated in small portions, control of the number of calories to avoid excessive effects on the digestive system will prevent the aggravation of existing pathology and maintain the health of the esophagus.

Disease prevention methods

As a preventive measure for varicose veins, it is imperative to exclude bad habits including smoking, drinking alcoholic beverages, fast food from junk food.

Regular examinations by a gastroenterologist will help to identify venous disease even at an early stage of the development of the pathology and start its treatment.

Healthy lifestyle

Maintaining a healthy lifestyle should be mandatory for anyone looking to maintain a healthy digestive system.

Prevention of diseases of the veins, the use of vitamin preparations to maintain a high level of immunity, and medical examinations are important components of success.

Physical exercise

To maintain the tone of the veins, to maintain the proper functioning of the digestive system, you should regularly perform the necessary minimum of physical exercise.

Walking, light jogging, exercise therapy exercises can be considered good preventive measures in the development of varicose veins.