Causes and risk factors
Oesophageal varices are commonly seen in patients with liver disorders. It is caused due to obstruction of normal blood flow to the liver. The blood that flows to the liver gets hampered due to the scar tissue or clots in liver. This increases pressure on portal vein leading to portal hypertension. This causes blood to find alternate pathway into adjacent small blood vessels such as those in lower part of oesophagus. These vessels are incapable of carrying large volume of blood. Thus they distend, or may even rupture causing bleeding. Causes that lead to varices are liver cirrhosis, thrombosis, parasitic infection, budd chiari syndrome.
Clinical presentation
Many times patient is asymptomatic unless they bleed. Bleeding varices may present as vomiting of blood [hematemesis], black tarry or bloody stools, and shock in severe cases. the signs of liver disease may suspect varices such as yellow discoloration of your skin and sclera, a cluster of tiny blood vessels on the skin shaped like a spider [spider nevi], reddening of the skin on the palm of your hands [palmer erythema], enlarged spleen, ascites.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Endoscopy, capsule endoscopy, CT, MRI scan help in diagnosis of oesophageal varices.
Treatment
No treatment is required for asymptomatic patients. Treating the underlying cause is essential. Treatment primarily involves stoppage of bleeding. This can be achieved by oesophageal band ligation, medications to stop bleeding and reduce pressure on portal vein. Surgical treatment involves procedure called transjugular intrahepatic portosystemic shunt [TIPS].
Other Modes of treatment
The other modes of treatment can also be effective in treating Oesophageal varices.
Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Oesophageal varices.
