Many people know varicose veins as the formations in the legs, but experts warn that varicose veins may also occur in the esophagus due to reasons mostly originating from the liver.
Noting that esophageal varices will not be seen in people with healthy liver, Yeditepe University Kozyatağı Hospital Gastroenterology Specialist Prof. Dr. Meltem Ergün said, “Varicose veins may occur due to the thickening and enlargement of the veins due to long-term diseases of the liver caused by various reasons, especially cirrhosis. Apart from cirrhosis, those with long-term chronic hepatitis B and hepatitis C disease are also at risk. The person cannot feel whether there is varicose veins in the esophagus. “Varicose veins do not give any symptoms without bleeding, but they can be detected endoscopically”.
Pointing out that very severe bleeding in esophageal varices presenting with oral bloody vomiting can be life-threatening, Prof. Dr. Ergün said, “Our aim as a physician is to detect and take precautions without bleeding. However, even if the patient applies to the physician with the complaint of bleeding, it is necessary to start endoscopic treatment as soon as possible so that the patient does not reach a life-threatening dimension.
In patients with cirrhosis, against the risk of bleeding, varicose veins should be followed endoscopically at regular intervals. Drug treatment is started to prevent growth in patients with varicose veins. Although drug therapy can be applied in patients who have not experienced any bleeding; The approach changes in patients with bleeding. In this case, treatments such as endoscopic taping of varicose veins or closing them with occlusive treatment come into question ”.
Stating that the endoscopic method is the gold standard to diagnose esophageal varices, Prof. Dr. Ergün said, “Since the problem is limited to the esophagus, it is not related to different digestive system problems. If the cirrhotic patient is vomiting blood, it is very likely that the underlying problem is esophageal varices. Like the diagnosis of the problem, its treatment is done by endoscopic method, ”he said.
Stating that esophageal varices do not cause cancer, but severe bleeding can be life-threatening, Prof. Dr. Ergün ended his words as follows:
“In general, patients with cirrhosis should avoid salt, as accompanying ascites (ie, fluid accumulation in the abdomen) may be seen. If they have hepatitis, they are recommended to use their medication regularly. It is also appropriate for patients with varicose veins to use beta blocker drugs that reduce the pressure inside the varicose veins. If there are other complications such as varicose bleeding or ascites due to cirrhosis, the patient is actually a candidate for liver transplantation. It is beneficial to be registered at a center where the transfer is made and to have its name in the transfer list. Once the donor is found, the definitive treatment for these patients is liver transplantation. “