User:Mr. Ibrahem/Esophageal varices

Esophageal varices are dilated veins under the mucosa in the lower third of the esophagus. The first symptom is generally GI bleeding, with vomiting blood, red blood per rectum, or black blood per rectum. Associated symptom may include itchiness, weight lose, and yellowish skin.

The most common cause is cirrhosis, which frequently occur due to alcoholism or viral hepatitis. Other causes include portal vein thrombosis, right-sided heart failure, schistosomiasis, alpha-1 antitrypsin deficiency, and primary biliary cirrhosis. The underlying mechanism involves portal hypertension. Diagnosis is typically by an upper endoscopy.

Treatment of bleeding may include endoscopic band ligation. Other measures may include intravenous fluids, fresh frozen plasma, antibiotics, and octreotide. Esophageal balloon tamponade may be used in cases were other measures are not effective. Longer term management may involved beta blockers or transjugular intrahepatic portosystemic shunt (TIPS). About 5 to 15% of people have bleeding per year. Of those with an episode of bleeding, about 15% die over the next 6 weeks and more than half die within the year.

About 30% of people at the diagnosis of cirrhosis have varices. Males are more commonly affected than females. It is the second most common cause of an upper GI bleed after stomach ulcers. Esophageal varices were described as early as 1859 by Sappey.