Esophageal Varices

What Is It?

Esophageal varices are extra, swollen veins that develop in the lining of the lower esophagus near the stomach. They are caused by liver disease and are similar to the varicose veins that some people have in their legs. These swollen veins can rupture and cause dangerous bleeding.

Esophageal varices almost always occur in people who have cirrhosis of the liver. Cirrhosis causes scarring of the liver, which slows the flow of blood through the liver. This causes blood to back up in the portal vein, the main vein that delivers blood from the stomach and intestines to the liver. This condition is called portal hypertension. The backup of blood forces extra blood vessels to form around the stomach and esophagus. These extra vessels are called esophageal varices. They usually have enlarged, irregularly shaped bulbous regions (varicosities) that are interrupted by narrower regions. Because the blood pressure inside the varices is higher than inside normal blood vessels, and the walls of the vessels are thin, they rupture easily and can bleed profusely.

Symptoms

Portal hypertension often does not cause any symptoms, and sometimes is discovered only when the varices bleed. When significant bleeding occurs, patients will vomit blood, often in large amounts. People with massive bleeding frequently feel dizzy, and may lose consciousness. Some people bleed in smaller amounts over a longer period of time, and they swallow the blood rather than vomit. Their stools may contain red or tarry-black blood. People with either type of bleeding from the esophagus usually also have symptoms of cirrhosis of the liver.