Esophageal Varices

Esophageal varices are swollen, fragile blood vessels that are located in the esophagus (the tube that runs from your throat to your stomach).  The problem with esophageal varices is that if they burst open and hemorrhage, it quickly becomes a medical emergency associated with a high mortality rate because the medical treatment does not occur quick enough.  After it happens once, it is likely to happen again, so if you or a loved one has this condition…make sure it is carefully monitored.

Risk factors associated with development of esophageal varices include:

•    Portal hypertension (increased blood pressure in the veins that carry blood from the intestines to the liver).  This is the primary risk factor for development of esophageal varices and it is caused by impaired circulation of blood through the liver.  The body adjusts to this by forming collateral circulation (re-routing blood around the area of impairment via other veins to bypass the area that isn’t working).

•    Collateral circulation vessels develop at specific places in the body and create varices in the upper stomach and esophagus because the vessels enlarge and become full of twists and turns due to increased pressure.  Simply, they become varicose veins of the esophagus and these enlarged vessels are fragile and prone to bleeding.

•    Alcoholic cirrhosis

•    Viral hepatitis

•    Older adult individuals will frequently have a suppressed immune system, decreased liver function, and cardiac conditions that will make them more prone to bleeding more easily.

The scary part is that individuals may experience no signs and symptoms until the esophageal varices begin to bleed, then they will notice dark, tarry stools (melena) which would indicate blood in the stool, and if they were to vomit they would notice blood in it also.  If you or your loved one notice changes in your stool, do not hesitate to contact your provider for further tests and interventions.

There are certain activities that precipitate episodes of bleeding including the Valsalva maneuver, lifting heavy objects, coughing, sneezing and consumption of alcohol.  The Valsalva maneuver occurs when individuals bear down as if when they are having a bowel movement.  The older adult population is more at risk for this to precipitate their bleeding due to more frequent episodes of constipation and harder stools.  Basically, anything that increases the pressure in your arteries and veins makes bleeding more likely to occur.

If esophageal varices were to be actively bleeding the individual involved will experience both a low blood pressure and a fast heart rate, and should seek medical attention immediately or hopefully you will already be receiving inpatient medical treatment by this time.  Treatment for esophageal varices may involve preventative measures at first and you may be recommended to stop your consumption of alcohol so that your varices do not worsen and/or more do not develop.  Also, you may be prescribed an oral medication to help reduce pressure in your veins and arteries to prevent bleeding.  In addition, there are several invasive procedures that can be carried out in a controlled setting outside your home in order to stop the bleeding and hopefully prevent it from reoccurring in the future. 

Total Home Health has a program that is right for you.  We will work toward your safety and promotion of your health to prevent health complications so that you may continue to lead a positive and fulfilling life.  We will educate you regarding ways to best avoid complications and episodes of bleeding of your esophageal varices, while encouraging you to make any lifestyle changes accordingly.  We will strive to just be like family and our professional staff will encourage you to always express your thoughts and approach us whenever you feel the need.  The care we provide is focused solely on you and your wishes so don’t ever be shy!  Enroll today with Total Home Health and let’s give your health care journey a new beginning.