Bleeding Varices Health Article

Definition

Bleeding varices are bleeding, dilated (swollen) veins in the esophagus (gullet), or the upper part of the stomach, caused by liver disease.

Description

Engorged veins are called varices (plural of varix). Varices may occur in the lining of the esophagus, the tube that connects the mouth to the stomach, or in the upper part of the stomach. Such varices are called esophageal varices. These varices are fragile and can bleed easily because veins are not designed to handle high internal pressures.

Causes and symptoms

Liver disease often causes an increase in the blood pressure in the main veins that carry blood from the stomach and intestines to the liver (portal veins). As the pressure in the portal veins increases, the veins of the stomach and esophagus swell, until they eventually become varices. Bleeding varices are a life-threatening complication of this increase in blood pressure (portal hypertension). The most common cause of bleeding varices is cirrhosis of the liver caused by chronic alcohol abuse or hepatitis. Bleeding varices occur in approximately one in every 10,000 people.

Symptoms of bleeding varices include

• vomiting blood, sometimes in massive amounts
• black, tarry stools
• decreased urine output
• excessive thirst
• nausea
• vomiting
• and blood in the vomit

If bleeding from the varices is severe, a patient may go into shock from the loss of blood, characterized by pallor, a rapid and weak pulse, rapid and shallow respiration, and lowered systemic blood pressure.

Diagnosis

Bleeding varices may be suspected in a patient who has any of the above-mentioned symptoms, and who has either been diagnosed with cirrhosis of the liver or who has a history of prolonged alcohol abuse. The definitive diagnosis is established via a specialized type of endoscopy, namely, esophagogastroduodenoscopy (EGD), a procedure that involves the visual examination of the lining of the esophagus, stomach, and upper duodenum with a flexible fiberoptic endoscope.