Esophageal varices are swollen veins in the esophagus that can bleed and are often caused by liver problems like cirrhosis.

• Cirrhosis: Scarring of the liver due to chronic liver diseases, such as hepatitis or long-term alcohol use, is the most common cause.
• Portal hypertension: High blood pressure in the portal vein forces blood into smaller veins, including those in the esophagus, causing them to swell.
• Blood clots: Clots in the veins that carry blood from the digestive organs to the liver can cause pressure to build, leading to varices.
• Parasitic infections: In some parts of the world, parasitic infections can block blood flow, increasing the risk of varices.

• People with liver cirrhosis: Those with liver damage caused by chronic diseases like hepatitis or alcohol abuse are at high risk.
• Individuals with portal hypertension: Any condition causing high blood pressure in the portal vein increases the risk.
• People with blood clots in the portal or splenic veins: Blood clots in these veins can obstruct blood flow, leading to increased pressure and varices.
• Those with parasitic infections: In regions where parasitic infections are common, these infections can block blood vessels, raising the risk of esophageal varices.

• Vomiting blood: This is often bright red but may also look like coffee grounds if the blood has been in the stomach for some time.
• Black, tarry stools: This can indicate bleeding in the upper digestive tract.
• Lightheadedness or dizziness: Blood loss may cause a drop in blood pressure, leading to fainting or feeling lightheaded.
• Difficulty swallowing: In some cases, the varices themselves may cause discomfort or trouble swallowing.
• Paleness and weakness: As a result of blood loss, people may feel very weak and appear pale.

• Severe vomiting of blood: Large amounts of blood in vomit are a sign of a ruptured varix, which needs urgent treatment.
• Rapid heartbeat and drop in blood pressure: These may signal significant blood loss.
• Fainting or confusion: Severe blood loss can lead to shock, a life-threatening condition that requires immediate care.

• Endoscopy: A doctor inserts a thin, flexible tube with a camera down the throat to examine the esophagus and check for swollen veins. This is the most common and reliable way to detect varices.
• Imaging tests: Ultrasounds, CT scans, or MRIs can help assess the liver and blood flow through the portal vein to check for conditions like cirrhosis or portal hypertension.
• Blood tests: These tests can help determine liver function, blood clotting ability, and overall health, which are important factors in diagnosing esophageal varices.

• Medications: Medications play an important role in managing esophageal varices. Beta blockers are often prescribed to lower blood pressure in the portal vein, which reduces the risk of varices rupturing. During an active bleed, vasoconstrictors are used to narrow the blood vessels, slowing blood flow to the varices and helping to control the bleeding.
• Endoscopic treatments: Endoscopic treatments are commonly used to manage esophageal varices and prevent bleeding. Endoscopic band ligation involves placing small rubber bands around the varices to block blood flow, reducing the risk of rupture. In sclerotherapy, a doctor injects a solution directly into the varices, causing them to shrink and minimize the likelihood of bleeding.
• Surgical or Procedural Treatments: In more advanced cases of esophageal varices, surgical or procedural treatments may be necessary. The Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure involves placing a stent to create a new pathway for blood flow, which reduces pressure in the portal vein and decreases the risk of varices rupturing. For patients with severe liver damage, a liver transplant may be the only long-term solution to control portal hypertension and prevent the recurrence of varices.

• Vomiting blood: This could be a sign of internal bleeding and needs urgent attention.
• Black, tarry stools: These indicate bleeding in the upper digestive tract.
• Feeling faint, weak, or lightheaded: This can be due to significant blood loss.
• Rapid heartbeat or a drop in blood pressure: These signs may suggest internal bleeding and require emergency medical care.

• Manage liver health: Treat underlying liver conditions such as cirrhosis, hepatitis, or fatty liver disease to lower the chances of developing varices.
• Limit alcohol consumption: Alcohol abuse is a major contributor to liver damage, so avoiding or reducing alcohol intake can help prevent liver-related complications like varices.
• Maintain a healthy weight: Obesity can contribute to liver disease, so maintaining a healthy diet and regular exercise routine is important for overall liver health.
• Avoid harmful chemicals: Long-term exposure to chemicals like pesticides or industrial toxins can damage the liver, increasing the risk of varices.
• Routine medical care: Regular check-ups, especially if you have liver disease, can help detect varices early and reduce the risk of complications.

• Beta blockers: These medications may be prescribed to prevent varices from forming or enlarging by reducing blood pressure in the portal vein.
• Routine endoscopy: For patients with liver disease, regular endoscopic examinations can help monitor and treat varices before they rupture.
• Treat portal hypertension: Addressing high blood pressure in the portal vein through medications or procedures like TIPS can significantly lower the risk of varices forming or bleeding.