5 Esophageal Varices, Causes, Symptoms and How to Overcome

Esophageal varices, causes, symptoms and how to overcome. What is Esophageal Varices? Esophageal varices are a disease characterized by widening of the venous blood vessels in the lower esophagus. Esophageal varices occur when there is obstruction of blood flow to the liver. Often blood flow is slowed by scarring in the liver caused by liver disease. Because vascular resistance in the liver sinusoid is low, an increase in portal venous pressure of less than 10 mmHg will proximal vein to the block and increase capillary pressure in the organs drained by the obstructed venous vessels, one of which is the esophagus.

5 Esophageal Varices, Causes, Symptoms and How to Overcome
Esophageal Varices
There is no balance between blood flow pressure and blood vessel ability resulting in enlargement of varices veins. In such circumstances, sometimes veins can rupture and bleed. Patients with esophageal varices who have bleeding have a 70% chance of re-bleeding, and about one third of fatal bleeding episodes are fatal. The highest risk of death is during the first few days after a bleeding episode and decreases slowly during the first 6 weeks.

Esophageal Varices, Causes, Symptoms and How to Overcome

Acute varices vein mortality rates that get surgical intervention are quite high. Related disorders in the kidney, lung, cardiovascular, and immune systems in patients with esophageal varices contribute to 20-65% in causing death. Schistosomiasis is an important cause of portal hypertension in Egypt and other countries. Whereas hepatitis C is the main cause of liver cirrhosis throughout the world. In women, esophageal varices usually occur in patients who have alcoholic liver disease, viral hepatitis, venoocclusive disease, and primary biliary cirrhosis. Whereas men usually suffer from alcoholic liver disease and viral hepatitis.

In European or American countries, alcoholic cirrhosis and viruses are the main cause of portal hypertension and esophageal varices. Venous portal thrombosis and secondary biliary cirrhosis are the most common causes of esophageal varices in children. Esophageal varices usually have no symptoms, unless they are torn and bleed. Some of the symptoms that occur due to esophageal bleeding are vomiting blood, black or bloody stools, urination to a little, very thirsty, dizziness and shock in severe cases.

Esophageal varices are usually a complication of cirrhosis. Cirrhosis is a disease characterized by the formation of scar tissue in the liver. The causes include hepatitis B and C. Another disease that can cause cirrhosis is blockage of the bile duct. Other conditions that can also cause esophageal varices include severe congestive heart failure, thrombosis of blood clots in the portal vein or splenic veins, sarcoidosis or schistomiasis.

In esophageal varices that have been bleeding, bleeding often comes back without treatment. Esophageal varices bleeding is a serious complication of liver disease and has poor results. Possible complications include encephalopathy sometimes called hepatic encephalopathy, endoscopic therapy, hypovolemic shock, pneumonia infection, bloodstream infection, peritonitis. A number of medical procedures can stop bleeding from esophageal varices. This treatment can also help prevent bleeding in patients with esophageal varices.

The esophagus is a hollow cylindrical organ with a length of about 18-26 cm. The esophagus connects between the pharynx and the stomach. The proximal esophageal border is the upper esophageal sphincter, which runs distally to the posterior mediastinum such as a muscular tube hollows to the lower esophageal sphincter. The esophagus is a functional part that is anatomically related to the meeting between the pharyngeal constrictor musculature and the cricopharynx. Esophagus is a tonic, thick-walled contraction center, with circular circular muscles that are 2-4 cm long, up to the diaphragmatic hiatus.

The esophageal wall consists of 4 layers: mucosa, submucosa, muscularis propria and adventisia. The esophagus does not have a serous layer so it is a unique digestive tract. The normal mucosa consists of a flat-lined epithelium, between muscularis propria and mucosa there is a lymphatic flow originating from muscularis propria. Muscularis propria consists of striped muscle and smooth muscle which is the proximal part of the striped muscle, the middle of the striped and innocent muscles and the distal part of the smooth muscle. The inner muscle layer is circularly arranged and the outer layer is longitudinal.

Esophageal vascularization follows a segmental pattern. In the upper esophagus is supplied by inferior and subclavian arteries, the middle part is supplied by the segmental aorta and bronchial artery, while the subdiafragmatic portion is supplied by inferior cystic and frenetic gastric arteries. Venous blood flow also follows a segmental pattern. The esophageal veins of the neck drain blood to the azygos veins and hemiazygos veins, which then go to the superior vena cava, and under the diaphragm the esophageal veins flow to the left gastric vein.

Signs and Symptoms of Esophageal Varices

Esophageal varices in the early stages do not cause signs and symptoms. But if the blood vessel has ruptured and bleeding occurs, esophageal varices sufferers will experience symptoms such as:

Vomiting blood

Black stools and blood


Loss of consciousness

The stomach hurts

Symptoms of chronic liver disease such as skin and eyes become yellow, easy to bleed or bruises and accumulation of fluid in the abdomen (ascites).

If there is a sign of varices veins, such as vomiting blood or bloody defecation, accompanied by low blood pressure, rapid heartbeat, pale skin, or shock, further treatment is needed. 
Because the condition has the potential to die.

Causes of Esophageal Varices

Esophageal varices can be caused by portal hypertension, which is high blood pressure in the portal vein. There are a number of factors that can trigger portal hypertension, including the formation of scar tissue in the liver and cirrhosis. Cirrhosis can be caused by fatty deposits in the liver, bile duct disorders or hepatitis.

Another factor that can cause portal hypertension is a blood clot in the portal vein, or a schistosomiasis parasitic infection that can damage the organs of the lungs, liver, bladder and intestines.

In some cases, it is not known what causes portal hypertension. This condition is often referred to as idiopathic portal hypertension.

How to Overcome Esophageal Varices

Overcoming esophageal varices is to reduce blood pressure in the portal vein, to prevent bleeding from esophageal varices. One of the recommended treatment methods is with a beta blocker drrug, which functions to reduce pressure on the portal vein. Another method that can be done is the binding of varices veins using special rubber to prevent bleeding from esophageal varices. If bleeding has occurred, the patient must immediately receive medical treatment, as soon as possible.

Thus a review of esophageal varices, causes, symptoms and how to overcome. In this paper, the aim is to make the reader more familiar with esophageal varices, and thank you for reading.

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