Esophageal varices

Esophageal varices are abnormally enlarged veins in the esophagus (the tube connecting the throat and stomach). They most often develop in people with advanced liver disease, especially cirrhosis. Why esophageal varices form When liver scarring blocks normal blood flow, pressure builds in the portal vein (portal hypertension). Blood is forced into smaller veins—such as those in the lower esophagus—that aren’t built to handle high pressure. These veins enlarge, can leak, and may rupture, causing life-threatening bleeding. Symptoms Varices usually don’t cause symptoms unless they bleed. Signs of bleeding include: Vomiting blood Black, tarry or bloody stools Lightheadedness or fainting from blood loss Loss of consciousness in severe cases People with liver disease may also have: Jaundice (yellow skin/eyes) Easy bruising or bleeding Ascites (fluid buildup in the abdomen) Emergency: Bloody vomit or black/bloody stools require immediate medical care (call 911). Causes Cirrhosis from hepatitis, alcohol-related liver disease, fatty liver disease, or primary biliary cholangitis Blood clots in the portal or splenic vein Schistosomiasis (parasitic infection in certain regions) Risk factors for bleeding High portal vein pressure Large varices Red streaks or spots seen on endoscopy Severe cirrhosis or liver failure Continued alcohol use Previous variceal bleeding Complications Massive bleeding, shock, and death High risk of recurrent bleeding after a first episode Prevention & management Varices themselves can’t always be prevented, but bleeding risk can be reduced: Nonselective beta blockers (e.g., propranolol, nadolol) to lower portal pressure Endoscopic screening for people with cirrhosis; band ligation for high-risk varices Avoid alcohol Healthy diet and weight management Protect the liver: safe sex, avoid needle sharing, get vaccinated for hepatitis A and B Use chemicals and medicines carefully If you have liver disease, ask your healthcare professional about screening and preventive treatment for esophageal varices.