Varicose veins of the esophagus
Varicose veins of the esophagus in its lower part occurs because of stagnation in the portal vein of the liver, which appear in thrombosis and cirrhosis of the liver. The cause of the disease in the upper part is a malignant goiter. The veins of the liver are compressed, making the flow of blood through them difficult. Phlebectasia of esophagus also appears as a complication in diseases of the heart and spleen.
The factors that cause this disease:
- stenosis of the portal vein, which is characteristic for the young generation that occur due to thrombosis, sclerosis;
- liver disease that occurs in old age – cirrhosis, amyloidosis, echinococcosis;
- disease Chiari;
- angioma of the esophagus;
- malignant goitre;
- of vascular pathology.
Varicose veins of the esophagus occurs most often in the following categories of patients:
- in people older than 50 years;
- in patients with a history of diseases of the pancreas, stomach, heart, chronic cirrhosis.
On the occurrence of bleeding is not only affected by the level of pressure, how sharp fluctuation. The risk of rupture is high, and those patients who suffer from vascular diseases that affect the structure of the vessel walls.
Classification of diseases of varicose veins of the esophagus has been changed several times, however, now use the version of 1997 for the veins of the esophagus, which separates the disease by degrees:
- First degree. The vein diameter reaches 5 mm, significantly extended, situated in the lower level of the body.
- Second degree. Vienna perplexis in diameter reaches 10 mm, located in the middle part of the body.
- Third degree. Vessels dilated more than 10 mm, the walls tense, thin, nearby, writhing in the direction of have the red spots on the outer surface.
If varicose veins of the esophagus still caused internal bleeding, according to the statistics — after it survives only 50% of patients. More than half of the survivors of the bleeding patients face within 1-3 years, with relapse of the disease and have to re-start treatment.
Varicose veins 1 degree
The clinical picture is poorly expressed. The patient has almost no complaints. In the survey see: varicose veins are not strong to 3 mm veins ectasia no, or only a single lumen is not filled. Is diagnosed only through endoscopy. At the first degree it is crucial to start the treatment.
Varicose veins 2 degrees
Well traced the roughness of the vessels, as there are nodules larger than 3 mm. In this case the mucous membrane of the esophagus remain in integrity, without any violations of its integrity.
The study can be diagnosed in large protrusion of vessels. Treatment must be carried out in a timely manner, the only way will be able to get rid of unpleasant symptoms of the disease at an early stage. Bleeding is not typical at this stage.
Varicose veins are 3 degreeThe most common diagnosis. The patient strongly pronounced symptoms. As a rule, in this case schedule surgery. Veins are very swollen, nodes distinctly to be constantly extended, occupy 2/3 of the esophagus, the mucosa of the esophagus is thin. Occur gastroesophageal reflux.
Varicose veins 4 degrees
This degree of the disease exhibited when the esophagus revealed numerous nodules and veins, not a drop and with fine surface. On the mucous layer found numerous erosion. Patients are registering, in addition to signs of esophagitis, salty taste in your mouth. Fourth degree often leads to spontaneous bleeding.
Symptoms of varicose veins of the esophagus
The first few years of varicose veins of the esophagus can occur without obvious symptoms. Sometimes there is a rare bouts of heartburn, mild heaviness in the chest, belching. Some patients complain of difficulty swallowing food.
The symptoms of progressive disease usually appear several days before the onset of bleeding. Signs are strong of heaviness in the chest and the deterioration of General health of the patient. In other patients the symptoms may be expressed in the manifestation of ascites.
In addition, the symptoms of the disease veins of the esophagus can manifest as the appearance of a "jellyfish head". This phenomenon is a pattern that is quite well seen on the anterior wall of the abdominal cavity of various pathological the formed convex vessels or veins.
Once the veins burst, causing severe bleeding, accompanied by the typical symptoms:
- greatly reduced blood pressure;
- spotting impurities in vomiting;
- spotting impurities in the stool;
- the expressed tachycardia.
With a slight bleeding, the person may feel some weakness, malaise, and symptoms of anemia. Diagnosed varicose veins of the esophagus by means of laboratory tests, ultrasound examination of abdominal cavity organs, if necessary, carry out radiological examinations and esophagoscopy.
The diagnosis put on the basis of complaints, external examination, identification of primary disease. To the instrumental research include:
- laboratory data blood;
- x-ray with contrast substance;
- esophagoscopy which must be done carefully because of the risk of possible bleeding.
At diagnosis all possible causes should be considered and eliminated, only then can completely and accurately determine the root cause of bleeding and changes in the veins of the esophagus.
Treatment of varicose veins of the esophagus
If you experience symptoms of varicose veins of the esophagus treatment is carried out only in the intensive care unit or intensive care. The basic classification of non-surgical procedures aimed at the prevention and elimination of bleeding by reducing pressure in the vessels:
- Medication in the form of vitamins, binders of medications and antacids (drugs that reduce acidity in the stomach). This method is aimed at the prevention of peptic esophagitis, where inflammation can go on the walls of blood vessels, causing bleeding.
- Transfusion of blood, erythrocyte mass, plasma;
- The introduction of colloidal solutions;
- Reception regenerating blood and promotes vasoconstriction drugs.
If the listed methods are not sufficient for a thorough hemostasis and the risk of re-injury blood vessels in the near future, resorting to surgery.
Patients need a lifetime to follow a strict diet, despite health:
- frequent small meals.
- exception of hot and cold dishes.
- shown low-fat broths and soups, porridges on a diluted milk or water, fruit drinks, fruit wipe, steamed vegetables.
- contraindicated spicy, sour, salty, fatty and fried meat products; all you need to cook, prepare the mashed.
Absolutely contraindicated alcohol, carbonated drinks, beer.
To prevent the transformation of healthy veins of the esophagus in pathological varicose, first need to monitor liver and promptly treat her disease. Experts suggest regularly contact him for advice and to follow all recommendations.
The prognosis for life
Unfortunately, varicose veins of the esophagus incurable. However, in the case of timely diagnosis, adequate supportive care will significantly improve quality of life and help prevent a terrible state – bleeding.
The mortality rate in patients with recent bleeding from varicose veins of the esophagus is more than 50 % and depends on the severity of the underlying disease and condition of the organism as a whole. The survivors after hemorrhage patients in 75% of cases within the next 1-2 years there is a relapse.
In General, the prognosis for long-term survival of patients with this disease remains low, which mainly is the fault of the main severe liver disease.