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Esophageal Varices

Dilated thin-walled veins in the lower esophagus due to portal hypertension; they carry a risk of bleeding.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Esophageal Varices?

Esophageal varices arise when collateral veins from the portal venous system to the systemic circulation become dilated in the lower esophagus due to portal hypertension. Approximately 50% of cirrhotic patients develop varices; the risk of bleeding increases as the varices enlarge.

Variceal bleeding is one of the leading causes of mortality in cirrhosis; the 6-week mortality after a first bleed may exceed 20%. It presents as acute upper GI bleeding with hematemesis (vomiting blood) or melena (black stool).

Endoscopy is both mandatory and effective for diagnosis and primary treatment. Prophylactic therapy (non-selective beta-blocker or endoscopic band ligation) significantly reduces the risk of bleeding.

Symptoms

Hematemesis (vomiting blood) - usually asymptomatic until bleeding occurs
Melena (tarry-colored stool)
After major bleeding: rapid heartbeat, dizziness, and altered mental status
Underlying cirrhosis-related jaundice, abdominal swelling, spider angiomas

Risk Factors

Liver cirrhosis
Portal vein thrombosis
Schistosomiasis (in endemic regions)
Large and red-streaked varices (high-risk endoscopic appearance)
Impaired liver function (Child-Pugh C)
Previous variceal bleeding history

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When vomiting blood or dark black stool begins (EMERGENCY - go to hospital immediately!)
  • When cirrhosis is diagnosed (for screening endoscopy)
  • When new bleeding signs appear despite beta-blocker therapy
  • If dizziness, sweating, and palpitations suggest GI bleeding

Treatment Methods

01
Acute bleeding: IV terlipressin or octreotide plus emergency endoscopic band ligation
02
When endoscopic control cannot be achieved, Sengstaken-Blakemore balloon as a bridge
03
Primary prophylaxis: non-selective beta-blockers (carvedilol, propranolol) or endoscopic band ligation
04
Secondary prophylaxis (after first bleed): combination of beta-blocker plus band ligation
05
TIPS: in cases failing medical and endoscopic treatment
06
Liver transplantation evaluation in suitable candidates

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.