Varicose veins of the esophagus: causes, symptoms and methods of treatment

Diseases of the veins and large blood vessels are accompanied by significant changes in their physical condition, which negatively affects the quality of the blood circulation process. And varicose veins of the esophagus, which can significantly reduce the quality of life of the patient due to the deterioration of the quality of digestion and blood flow in the body, requires an attentive attitude and timely initiation of treatment. This pathology may be accompanied by the addition of secondary lesions of the digestive organs, or it may occur and proceed independently.

However, with any type of appearance, the dilated veins of the esophagus and subsequently arising varicose veins are accompanied by unpleasant symptoms that make it possible to identify the lesion in question at the initial stage of development and start a therapeutic effect in a timely manner, preventing the development of complications. Medical statistics notes that this pathology of the veins of the esophagus occurs predominantly in the male population (women are affected by varicose veins of the esophagus twice as rarely as men), while the average age when the first manifestations of the disease can be noted is 50-55 years.

Causes of the disease

The causes that cause the appearance of varicose veins of the esophagus may be different depending on the manifestation of the disease, the general condition of the patient's body, in each case the set of causes may vary. However, in any case, varicose veins that occur in the veins of the digestive organs are the result of a change in the general condition of the veins. The reason for the manifestation of varicose veins of such localization is an excessively high blood pressure in the venous circulation, which is most often characteristic of cirrhosis of the liver.

And the result of such an expansion can be massive bleeding, the danger of which lies in the absence of symptoms, which can be regarded as a warning: bleeding with varicose veins of the esophagus is often profuse, representing a real danger to the general condition of the patient. Therefore, knowledge of the manifestation of this pathology of the veins of the esophagus and measures to prevent the disease will make it possible to diagnose it sooner and begin an adequate therapeutic effect.

Also, the following conditions of the patient may be the causes of this pathological change in the veins of the digestive organs:

• congestion observed in the portal vein;
• portal thrombosis;
• development of malignant goiter;
• esophageal angioma.

Also, the occurrence of the lesion in question can be caused by the symptoms and vascular pathologies that accompany Randu-Osler disease. All of these diseases and conditions are accompanied by negative changes in the circulatory system and digestive organs, which initially affects the general condition of the veins and large arteries of the esophagus and stomach tissues. Changes in the circulatory system of such internal organs as the liver, spleen, gallbladder can provoke the development of varicose changes in the esophagus.

Patient's symptoms

The main manifestation of a condition such as varicose veins located in the esophagus is bleeding. This symptom can be noted in the absence of warning manifestations, against the background of the so-called "full health". A sign of impending bleeding can be considered a slight tickling in the throat, a characteristic taste of blood when swallowing (saltish-sour). The blood that forms during bleeding during the development of varicose veins is usually pronounced bright scarlet, and may resemble coffee grounds. The result of such bleeding, which is often prolonged and profuse, is dizziness, a feeling of weakness, loss of consciousness.

Since the causes of aggravation of varicose veins can be a variety of lesions of the internal organs and the circulatory system as a whole, the overall quality of the functioning of these organs is largely determined by both the likelihood of developing varicose veins and the symptoms that may accompany this lesion.

A symptom of the considered pathological change in the digestive organs can be considered bleeding, which develops during the asymptomatic course of the initial manifestations of the disease. Such bleeding can be both insignificant, which does not immediately attract the attention of the patient, or abundant, which have a high risk of death. Varicose veins, which are noted in the tissues of the esophagus and stomach, are most often characterized by the absence of any significant changes that allow timely detection and treatment. However, this disease is one of the most formidable: with unexpected bleeding, which is characterized by an abundance of blood released, there is a high probability of death for the patient. According to medical statistics, out of five cases of manifestation and aggravation of varicose veins in the digestive organs, four are the death of the patient.

Types and degrees of varicose veins of the esophagus

Today, experts distinguish several degrees of development of esophageal varicose veins, each of them has its own characteristics of development, differs in the list of manifestations and requires a certain therapeutic effect, which makes it possible to prevent further aggravation of the pathology. Thanks to modern diagnostic methods, it becomes possible to determine the presence of the disease, its stage and degree of development.

There are the following degrees of expansion of the veins of the stomach and varicose veins:

• the first degree, at which there is a slight change in the lumen of the veins of the body. Varicose veins of the esophagus, characteristic of grade 1, may not be noticed by the patient, since it rarely has definite and pronounced symptoms. The veins of the esophagus have a lumen of 5 mm on average, which is not much different from their healthy state. However, even at this size, they become less elastic, since even slight changes in their lumen lead to some decrease in the intensity of blood movement through them, and the overall quality of blood circulation in the affected organ is disturbed. Varicose veins of the esophagus of the 1st degree can be detected during a routine examination of this organ;
• the second degree is characterized by an increase in the lumen of the veins in the diseased organ up to 10 mm, the speed of blood flow through the veins gradually decreases, which negatively affects the condition of the veins: they continue to lose their elasticity, the walls gradually become thinner, which can cause bleeding due to the high probability of their rupture;
• at the third stage of aggravation of the pathology, there is an expansion of the lumen of the veins in the esophagus and stomach by more than 10 mm, the vessels, due to their expansion, are located close to each other, and even their slight trauma can provoke bleeding. Often, it is at the third stage of the development of the disease that heavy bleeding is noted, which causes the death of the patient, is a real danger to the life of a sick person suffering from varicose veins in the tissues of the digestive organs.

The above classification of varicose veins of the esophagus allows us to classify the existing lesion of the veins of this organ to a certain degree and begin treatment, which has a positive effect on the patient's condition. Treatment of esophageal varicose veins should be chosen by a doctor who, on the basis of the studies and analysis of the general condition of the patient, chooses both the scheme of exposure and the variant of exposure, taking into account the characteristics of his organism.

Varicose veins of the stomach

Expansion of the veins, due to a negative change in their condition, can also be observed in the stomach. In this case, just as in the case of esophageal varicose veins, there is a gradual decrease in the degree of elasticity of the walls of the veins, the occurrence of a significant likelihood of bleeding. Modern diagnostic methods make it possible to detect the pathology in question in time and begin its treatment.

Methods for curing varicose veins, which are localized in the tissues of the stomach, differ, but they are all aimed at eliminating the root cause of this condition. NTSH RAMS provides such data on options for causes and methods of treatment of varicose veins of both the esophagus and the stomach:

• curing the manifestation of varicose veins in the esophagus and stomach according to the method described in the book of leading specialists in gastroenterology, differentiation of the identified diseases of the digestive organ is carried out, and this method and a detailed description of the manifestations of such rare lesions as the pathology of the operated esophagus, difficult to diagnose diseases of the digestive organs gives the greatest amount of necessaryinformation for drawing up a treatment scheme for both therapists and narrow specialists-gastroenterologists;
• Zdenek Marzhatka, one of the most prominent specialists in the field of gastroenterology and diseases of the esophagus, accompanied by damage to the veins in its tissues, describes in detail in his writings various methods of diagnosing the disease, types of endoscopy of the tissues of the stomach and esophagus.

Today, to prevent further aggravation of the existing pathology, more and more modern diagnostic methods are used, aimed at a more detailed study of the state of the tissues of the affected digestive organs.

Diagnosis of the disease

Methods and options for diagnosing varicose veins that have arisen in the digestive organs (esophagus and stomach) include the following manipulations and diagnostic procedures:

1. Fibroesophagoscopy, which allows you to identify the cause of bleeding. Also, this method allows you to determine the presence of mechanical causes for the occurrence of bleeding, the condition of the walls of the veins of the esophagus.
2. X-ray of the walls of the esophagus, which is more informative when using contrast.

Both options for diagnosing the disease in question have the ability to detect the cause of bleeding, determine the condition of the walls of the veins, and the likelihood of rupture of existing aneurysms. The use of both diagnostic options makes it possible, with maximum accuracy, not only to detect the pathology of the veins and vessels of the esophagus and stomach, but also to obtain the greatest amount of available information on the pathology.

Possible Complications

Since varicose veins that occur in the tissues of the esophagus and stomach are especially dangerous because of the likelihood of bleeding, the possible complications of this pathology should be taken into account. Significant damage to the digestive organs, aggravation of cirrhosis of the liver are the most dangerous consequences of this pathology of the veins.

Treatment methods

Therapeutic effect to eliminate the risk of bleeding in case of damage to the veins of the esophagus and stomach should take into account the stage of the pathological process, the general health of the patient, the susceptibility of his body to the ongoing therapeutic effect. Modern medicine is constantly improving the methods of influencing the veins of the esophagus, which makes it possible to quickly eliminate the most obvious manifestations of the pathology in question.

Today, an integrated approach is used in the treatment of the considered pathology of the veins of the esophagus and stomach, which consists of a traditional, surgical and medical method of exposure. Each method has its own characteristics, can be used for certain indications and is prescribed by a doctor. The course of the treatment should be monitored at all stages by the attending physician, who, if necessary, will make the necessary adjustments in a timely manner and prevent the likely risks of complications.

traditional method

First of all, when using the traditional treatment option for varicose veins of the esophagus, bleeding is stopped, which can cause death. This will also allow for additional methods of therapeutic action, which will ensure faster regeneration of damaged tissues and create the necessary scar at the site of damage to the vein of the esophagus.

In order to compensate for hypovolemia and prevent the occurrence of hemorrhagic shock, a significant (calculated by the doctor) dose of vitamin K is introduced into the patient's body, as well as frozen plasma infusions (1-2 doses, intravenous transfusion is performed).

conservative method

With severe bleeding, which becomes a real danger to the life of the patient, a rubber balloon can be used to quickly stop bleeding. With the help of a probe, the bleeding vessel is pressed, which stops the movement of blood. For example, the probe of such a device - the Sengstaken-Blackmore probe is popular in eliminating bleeding during the development of varicose veins in the digestive organs, in particular, the esophagus. Corrugated varieties of such probes are also used, which are widely used in the treatment of esophageal varicose veins with bleeding and bleeding stomach ulcers.

With the introduction of the probe below the site of the rupture of the vein, the esophagus can be washed with hot water at a temperature of 40 ° C - this measure often allows you to stop active bleeding and stabilize the patient's condition. However, with repeated bleeding and with their high intensity, in parallel with the use of probes, it is recommended to carry out intravenous and intramuscular administration of substances that also contribute to stopping the blood. Calcium chloride 10-20 ml is administered intravenously. Do not use for the introduction of drugs whose action is aimed at increasing blood pressure.

Treatment with an endoscope

Since this disease of the veins of the esophagus is most often diagnosed during endoscopic examination, endoscopic hemostasis can be prescribed to eliminate the most characteristic manifestations of the lesion (elimination of bleeding). This method involves stitching the affected areas of the veins in the esophagus, and it is this variant of the therapeutic effect that is preferable in comparison with injection sclerotherapy due to the more pronounced positive dynamics of the treatment.

Carrying out endoscopic treatment is marked by a quick stop of bleeding, prevention of probable relapses of the disease. The drug, used in the implementation of endoscopic treatment of bleeding in varicose veins of the esophagus and stomach, is administered intravenously at 50 mcg, its action is aimed at increasing visceral vascular resistance, which allows stabilizing the patient's condition, preventing excessively active blood loss. This drug is preferred over other drugs that may be given to stop venous bleeding from the esophagus because it has fewer side effects, even with long-term use.

The use of an endoscope involves the use of a special endoscopic examination of the esophagus, which is most often prescribed for bleeding, the cause of which is unclear. This technique is very popular due to the high efficiency of this diagnostic method and the good positive dynamics of treatment (ligation is performed) carried out using an endoscope. Endoscopic examination of the veins of the esophagus and stomach has shown itself well at all stages of the development of the pathological process; Also, this method allows you to identify even the initial manifestations of diseases of the digestive system in relation to blood circulation in the veins and to identify varicose veins of the esophagus.

Application of balloon tamponade

The endoscopic technique of exposure also involves the use of such a variant of stopping bleeding from the veins of the esophagus, such as balloon tamponade. It consists in the impact on the site of damage to the vein of special plugging agents. However, with severe bleeding, balloon tamponade may not be very effective; additional drugs should be used to stimulate regenerative processes in the tissues of the vein walls.

The classification that is proposed today for dividing varicose veins of the esophagus, and allows you to determine the most effective treatment regimen. Taking into account the peculiarities of the stage of the current pathological process, the body's perception of the medications used and the control of the treatment being carried out, it is possible for the attending physician to make adjustments in a timely manner and achieve the best results in stopping bleeding and stabilizing the patient's condition.

Surgical intervention

Heavy bleeding, which poses a threat to the life of the patient due to significant blood loss, may require surgery.

Surgical intervention can be prescribed for large blood losses, in which intravenous administration of plasma, blood and blood-substituting fluids does not bring a pronounced positive result. There are several types of surgery for significant blood loss. Each of them is prescribed according to its indications determined by the doctor.

Today, the following types of surgical intervention are recognized as the most effective:

• imposition of a special bandage made of medical rubber. Such ligation of damaged veins allows you to quickly stop blood circulation, stop blood loss, which can cause a significant deterioration in the patient's condition;
• an operation such as bypass surgery leads to a decrease in blood pressure in the veins and, as a result, stops bleeding. When shunting is performed, the liver tissue is affected, a special stent is inserted into the middle of this organ, which creates a kind of bridge between the liver tissues and the tissues of the esophagus, which lowers blood pressure. The hepatic and portal veins, having such a "bridge", receive reduced pressure, which leads to a stop of bleeding;
• Splenorenal shunting is a type of bypass surgery that helps prevent possible bleeding when varicose veins are detected in the tissues of the esophagus and stomach.

The listed options for surgical intervention allow you to eliminate the increased blood pressure in the veins of the esophagus damaged by varicose veins. All of them are carried out under the control of x-rays and provide the greatest positive effect from manipulations to stop bleeding.

Medical treatment of varicose veins

There is also a variant of medicinal effects on the body in order to treat the initial stage of esophageal varicose veins. The choice of the type of medication is determined by the doctor after examining the patient's body, determining the stage of the current pathological process. When conducting this type of therapy, such indicators as the susceptibility of the patient's body to the drug used, the likelihood of developing allergic reactions should be taken into account.

The most commonly used in the treatment of this disease are the following medications with a pronounced effect on the veins:

The listed drugs have a number of possible side effects that should be considered when prescribing them.

Treatment with folk remedies

The reliability of drugs and methods of traditional medicine has been tested for centuries, but its effectiveness is not high enough to independently cope with the manifestations of varicose veins of the esophagus. Traditional medicine can be used as a maintenance drug, to increase the rate of recovery processes in the tissues of the veins. For example, with a high probability of bleeding, it is recommended to take decoctions and infusions of herbs that have a hemostatic effect. It can be collections of stinging nettle, thyme, highlander bird.

Treatment with folk remedies is also possible at home, which is especially important for maintenance therapy of the disease, at the stage of remission. Since varicose veins of the esophagus is a serious lesion, which poses a serious danger to the health and life of the patient, it is necessary to take into account the degree of impact of the selected traditional medicine. Treatment at home is carried out under the constant supervision of a doctor.

Do you need a diet

When diagnosing varicose veins in the digestive organs, the issue of choosing a diet should be considered one of the most important, since it is on the food entering the patient's body that both his well-being and the indicators of the ongoing therapeutic effect largely depend. The diet that is recommended for varicose veins of the esophagus involves the observance of several feasible rules, which involve the exclusion of certain foods and the inclusion in the daily menu of certain products that heal the body as a whole and the esophagus in particular.

The diet for varicose veins of the esophagus should exclude the following foods and substances from the patient's diet:

• seasonings;
• a large amount of table salt;
• excessive amounts of oils, especially of animal origin;
• fried, canned, smoked foods, which will irritate the tissues of the esophagus and can cause bleeding.

Nutrition for varicose veins of the esophageal tissues, as well as for cirrhosis of the liver, should include more boiled, stewed food, fermented milk products will perfectly support the necessary microflora in the intestines, without creating an excessive burden on the digestive system as a whole. Fractional nutrition in small portions, control of the number of calories to prevent excessive effects on the digestive system will prevent the aggravation of the existing pathology and maintain the health of the esophagus.

Disease prevention methods

As a preventive measure for varicose veins, it is imperative to exclude bad habits, including smoking, drinking alcoholic beverages, junk food fast food.

Regular examinations by a gastroenterologist will help identify vein disease even at the initial stage of pathology development and begin its treatment.

Healthy lifestyle

Maintaining a healthy lifestyle should be mandatory for those who seek to maintain a healthy digestive system.

Prevention of vein diseases, the use of vitamin preparations to maintain a high level of immunity, and examinations by a doctor are important components of success.

Physical exercise

To maintain the tone of the veins, to maintain the good functioning of the digestive system, you should regularly perform the necessary minimum of physical exercise.

Walking, light jogging, exercise therapy exercises can be considered good preventive measures in the development of varicose veins.