Esophageal Varices
Esophageal varices are enlarged veins at the lower end of the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. Varices most often occur because of problems with blood flow in the liver caused by chronic liver disease. Normally a blood vessel called the portal vein carries blood from the digestive organs to the liver. With liver disease, blood flow can be blocked due to scarring of the liver. This increases the blood pressure in the portal vein (a condition known as portal hypertension). Blood then backs up in nearby veins in the esophagus and stomach, causing varices. Varices can be a serious and even deadly problem. Treatment is needed to prevent them from bursting (rupturing) and bleeding. If bleeding occurs, it can be fatal.

With esophageal varices, blood vessels in the esophagus become abnormally enlarged. They may then burst (rupture) and bleed.

Symptoms of esophageal varices

Symptoms do not occur unless the varices are bleeding. This is considered a medical emergency. If you have any of the following symptoms, get medical attention right away:

• Vomiting blood
• Black, tarry, or bloody stools
• Feeling lightheaded, or fainting (loss of consciousness) 

Diagnosing esophageal varices

You will likely be checked for varices if you have liver disease or other health problems that can cause them. Your healthcare provider will ask about your symptoms and health history. You will also be examined. Tests are then done to confirm the problem. Tests can include:

• Upper endoscopy. This is done to see inside the upper digestive tract. During the test an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It is inserted through your mouth. It is then guided down through your esophagus, stomach, and the first part of your small intestines. This allows the provider to look for varices and find any bleeding.
• Imaging tests. These provide pictures of the liver or of blood flow in the liver. They allow the provider to check for enlarged veins around the liver and assess the risk of bleeding. Common imaging tests include ultrasound and CT scans.

Treating esophageal varices

The goal of treatment is to reduce the risk of bleeding or to control bleeding. Treatment can include one or more of the following:

• Medicines. These may be prescribed to lower the blood pressure inside the enlarged veins. This reduces the risk of bleeding. Beta-blockers are the most common medicine used.
• Endoscopic therapy. These are treatments for enlarged or bleeding veins that are done using an endoscope. Ligation is a treatment where small rubber bands are placed around the veins to close them off and to stop any bleeding. Sclerotherapy is a treatment where blood-clotting medicine is injected into the veins to cause scarring and to shrink them.
• Balloon tamponade. A tube with a balloon is guided down into your esophagus and stomach. The balloon is then filled with air. This puts pressure on enlarged or bleeding veins to control bleeding. This is a short-term (temporary) way to control bleeding until other treatments are available. 
• Surgery. Surgery may be done to place a tube-like device (stent) in the liver. The stent helps redirect blood flow in the liver to lower the blood pressure in the enlarged veins. Sometimes the enlarged veins may be connected to other nearby veins to redirect blood flow and lower the blood pressure in the enlarged veins. In severe cases, a liver transplant may be needed. For this surgery, a diseased liver is replaced with a healthy liver from another person. 

Follow-up

Regular visits with your provider are needed to check for bleeding of the varices. If bleeding occurs, it is likely to occur again. More treatments will then be needed in the future. Once endoscopic therapy (banding) is performed, regular follow-up endoscopic scans with banding are done to completely get rid of the varices. If you are given medicines to take by mouth, be sure to take them as directed. Work closely with your provider to manage your condition. Know when to seek emergency care.

Esophageal Varices
Esophageal varices are enlarged veins at the lower end of the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. Varices most often occur because of problems with blood flow in the liver caused by chronic liver disease. Normally a blood vessel called the portal vein carries blood from the digestive organs to the liver. With liver disease, blood flow can be blocked due to scarring of the liver. This increases the blood pressure in the portal vein (a condition known as portal hypertension). Blood then backs up in nearby veins in the esophagus and stomach, causing varices. Varices can be a serious and even deadly problem. Treatment is needed to prevent them from bursting (rupturing) and bleeding. If bleeding occurs, it can be fatal.

With esophageal varices, blood vessels in the esophagus become abnormally enlarged. They may then burst (rupture) and bleed.

Symptoms of esophageal varices

Symptoms do not occur unless the varices are bleeding. This is considered a medical emergency. If you have any of the following symptoms, get medical attention right away:

• Vomiting blood
• Black, tarry, or bloody stools
• Feeling lightheaded, or fainting (loss of consciousness) 

Diagnosing esophageal varices

You will likely be checked for varices if you have liver disease or other health problems that can cause them. Your healthcare provider will ask about your symptoms and health history. You will also be examined. Tests are then done to confirm the problem. Tests can include:

• Upper endoscopy. This is done to see inside the upper digestive tract. During the test an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It is inserted through your mouth. It is then guided down through your esophagus, stomach, and the first part of your small intestines. This allows the provider to look for varices and find any bleeding.
• Imaging tests. These provide pictures of the liver or of blood flow in the liver. They allow the provider to check for enlarged veins around the liver and assess the risk of bleeding. Common imaging tests include ultrasound and CT scans.

Treating esophageal varices

The goal of treatment is to reduce the risk of bleeding or to control bleeding. Treatment can include one or more of the following:

• Medicines. These may be prescribed to lower the blood pressure inside the enlarged veins. This reduces the risk of bleeding. Beta-blockers are the most common medicine used.
• Endoscopic therapy. These are treatments for enlarged or bleeding veins that are done using an endoscope. Ligation is a treatment where small rubber bands are placed around the veins to close them off and to stop any bleeding. Sclerotherapy is a treatment where blood-clotting medicine is injected into the veins to cause scarring and to shrink them.
• Balloon tamponade. A tube with a balloon is guided down into your esophagus and stomach. The balloon is then filled with air. This puts pressure on enlarged or bleeding veins to control bleeding. This is a short-term (temporary) way to control bleeding until other treatments are available. 
• Surgery. Surgery may be done to place a tube-like device (stent) in the liver. The stent helps redirect blood flow in the liver to lower the blood pressure in the enlarged veins. Sometimes the enlarged veins may be connected to other nearby veins to redirect blood flow and lower the blood pressure in the enlarged veins. In severe cases, a liver transplant may be needed. For this surgery, a diseased liver is replaced with a healthy liver from another person. 

Follow-up

Regular visits with your provider are needed to check for bleeding of the varices. If bleeding occurs, it is likely to occur again. More treatments will then be needed in the future. Once endoscopic therapy (banding) is performed, regular follow-up endoscopic scans with banding are done to completely get rid of the varices. If you are given medicines to take by mouth, be sure to take them as directed. Work closely with your provider to manage your condition. Know when to seek emergency care.

Esophageal Varices
Esophageal varices are enlarged veins at the lower end of the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. Varices most often occur because of problems with blood flow in the liver caused by chronic liver disease. Normally a blood vessel called the portal vein carries blood from the digestive organs to the liver. With liver disease, blood flow can be blocked due to scarring of the liver. This increases the blood pressure in the portal vein (a condition known as portal hypertension). Blood then backs up in nearby veins in the esophagus and stomach, causing varices. Varices can be a serious and even deadly problem. Treatment is needed to prevent them from bursting (rupturing) and bleeding. If bleeding occurs, it can be fatal.

With esophageal varices, blood vessels in the esophagus become abnormally enlarged. They may then burst (rupture) and bleed.

Symptoms of esophageal varices

Symptoms do not occur unless the varices are bleeding. This is considered a medical emergency. If you have any of the following symptoms, get medical attention right away:

• Vomiting blood
• Black, tarry, or bloody stools
• Feeling lightheaded, or fainting (loss of consciousness) 

Diagnosing esophageal varices

You will likely be checked for varices if you have liver disease or other health problems that can cause them. Your healthcare provider will ask about your symptoms and health history. You will also be examined. Tests are then done to confirm the problem. Tests can include:

• Upper endoscopy. This is done to see inside the upper digestive tract. During the test an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It is inserted through your mouth. It is then guided down through your esophagus, stomach, and the first part of your small intestines. This allows the provider to look for varices and find any bleeding.
• Imaging tests. These provide pictures of the liver or of blood flow in the liver. They allow the provider to check for enlarged veins around the liver and assess the risk of bleeding. Common imaging tests include ultrasound and CT scans.

Treating esophageal varices

The goal of treatment is to reduce the risk of bleeding or to control bleeding. Treatment can include one or more of the following:

• Medicines. These may be prescribed to lower the blood pressure inside the enlarged veins. This reduces the risk of bleeding. Beta-blockers are the most common medicine used.
• Endoscopic therapy. These are treatments for enlarged or bleeding veins that are done using an endoscope. Ligation is a treatment where small rubber bands are placed around the veins to close them off and to stop any bleeding. Sclerotherapy is a treatment where blood-clotting medicine is injected into the veins to cause scarring and to shrink them.
• Balloon tamponade. A tube with a balloon is guided down into your esophagus and stomach. The balloon is then filled with air. This puts pressure on enlarged or bleeding veins to control bleeding. This is a short-term (temporary) way to control bleeding until other treatments are available. 
• Surgery. Surgery may be done to place a tube-like device (stent) in the liver. The stent helps redirect blood flow in the liver to lower the blood pressure in the enlarged veins. Sometimes the enlarged veins may be connected to other nearby veins to redirect blood flow and lower the blood pressure in the enlarged veins. In severe cases, a liver transplant may be needed. For this surgery, a diseased liver is replaced with a healthy liver from another person. 

Follow-up

Regular visits with your provider are needed to check for bleeding of the varices. If bleeding occurs, it is likely to occur again. More treatments will then be needed in the future. Once endoscopic therapy (banding) is performed, regular follow-up endoscopic scans with banding are done to completely get rid of the varices. If you are given medicines to take by mouth, be sure to take them as directed. Work closely with your provider to manage your condition. Know when to seek emergency care.