Diseases of the veins and large blood vessels are accompanied by significant changes in their physical condition, which adversely affects the quality of the circulatory process. And varicose veins of the esophagus, which can significantly reduce the quality of life of the patient due to the deterioration of the quality of digestion and blood flow in the body, require careful treatment and timely initiation of treatment. This pathology may be accompanied by the addition of secondary lesions of the digestive organs, or it may occur and proceed independently.
However, in any appearance, varicose veins of the esophagus and subsequent varicose veins are accompanied by unpleasant symptoms that allow to identify the lesion in question at an early stage of development and to begin timely therapeutic effect, preventing the development of complications. Medical statistics note that this pathology of the esophageal veins occurs mainly in men (women are affected by varicose veins of the esophagus twice less often than men), while the average age at which the first manifestations of the disease can be noted is 50-55 years.
Causes of the disease
The causes of varicose veins of the esophagus can be different depending on the manifestation of the disease, the general condition of the patient's body, in each case the set of causes may vary. However, in any case, varicose veins that appear in the veins of the digestive organs are the result of a change in the general condition of the veins. The reason for the manifestation of varicose veins with such localization is excessive high blood pressure in the venous circulation, which is most often characteristic of cirrhosis of the liver.
And the result of such dilation can be massive bleeding, the danger of which lies in the lack of symptoms, which can be seen as a warning: bleeding in varicose veins of the esophagus is often profuse, which is a real danger to the general condition of the patient. Therefore, knowledge of the manifestation of this pathology of the esophageal veins and measures to prevent the disease will allow to diagnose earlier and start an adequate therapeutic effect.
Also, the following conditions of the patient may be the reasons for this pathological change in the veins of the digestive organs:
- congestion observed in the portal vein;
- portal thrombosis;
- development of malignant goiter;
- esophageal angioma.
Also, the appearance of the lesion in question may be caused by the symptoms and vascular pathologies that accompany Randu-Osler disease. All these diseases and conditions are accompanied by negative changes in the circulatory system and digestive organs, which initially affects the general condition of the veins and major arteries of the esophagus and gastric tissues. Changes in the circulatory system of such internal organs as liver, spleen, gallbladder can provoke the development of varicose changes in the esophagus.
Patient's symptoms
The main manifestation of a condition such as varicose veins located in the esophagus is bleeding. This symptom can be noted in the absence of warning signs, against the background of so-called "complete health". A sign of impending bleeding can be considered a slight tickling in the throat, a characteristic taste of blood when swallowed (hydrochloric acid). The blood that is formed during bleeding during the development of varicose veins, usually pronounced bright scarlet, may resemble coffee grounds. The result of such bleeding, which is often prolonged and profuse, is dizziness, weakness, loss of consciousness.
Since the causes of varicose veins can be different lesions of the internal organs and the circulatory system in general, the overall quality of the functioning of these organs is largely determined by the likelihood of developing varicose veins and the symptoms that mayto accompany this lesion.
Symptom of the considered pathological change in the digestive organs can be considered bleeding, which develops during the asymptomatic course of the initial manifestations of the disease. Such bleeding can be both minor, which does not immediately attract the patient's attention, and heavy, which has a high risk of death. Varicose veins, which are observed in the tissues of the esophagus and stomach, are most often characterized by the absence of any significant changes that allow timely detection and treatment. However, this disease is one of the most terrible: in case of unexpected bleeding, which is characterized by an abundance of blood, there is a high probability of death for the patient. According to medical statistics, out of five cases of manifestation and worsening of varicose veins in the digestive organs, four are the death of the patient.
Types and degrees of varicose veins of the esophagus
Today, experts distinguish several stages of development of varicose veins of the esophagus, each of them has its own characteristics of development, differs in the list of manifestations and requires a certain therapeutic effect, which makes it possible to prevent further deterioration of the pathology. Thanks to modern diagnostic methods it becomes possible to determine the presence of the disease, its stage and degree of development.
There are the following degrees of varicose veins of the stomach and varicose veins:
- first degree, in which there is a slight change in the lumen of the veins of the body. Varicose veins of the esophagus, characteristic of grade 1, may not be noticed by the patient, as they rarely have definite and pronounced symptoms. The veins of the esophagus have an average of 5 mm lumen, which does not differ much from their health. However, even at this size, they become less elastic, as even slight changes in their lumen lead to some reduction in the intensity of blood flow through them and impair the overall quality of blood circulation in the affected organ. Grade 1 varicose veins of the esophagus can be found during a routine examination of this organ;
- the second degree is characterized by an increase in the lumen of the veins in the diseased organ to 10 mm, the rate of blood flow through the veins gradually decreases, which adversely affects the condition of the veins: they continue to lose their elasticity, the walls gradually become thinner, which can cause bleeding due to the high probability of their rupture;
- in the third stage of exacerbation of the pathology there is a dilation of the lumen of the veins in the esophagus and stomach by more than 10 mm, the vessels, due to their dilation, are located close to each other and even mild trauma can provoke bleeding. Often in the third stage of the disease severe bleeding is observed, which causes the death of the patient, is a real danger to the life of a sick person suffering from varicose veins in the tissues of the digestive organs. .
The above classification of varicose veins of the esophagus allows us to classify the existing lesion of the veins of this organ to some extent and to begin treatment, which has a positive effect on the patient's condition. The treatment of varicose veins of the esophagus should be chosen by a physician who, based on research and analysis of the general condition of the patient, chooses both the scheme of exposure and the variant of exposure, taking into account the characteristics of his body.
Varicose veins of the stomach
Varicose veins can also be seen in the stomach due to a negative change in their condition. In this case, just as in varicose veins of the esophagus, there is a gradual decrease in the degree of elasticity of the walls of the veins, the appearance of a significant likelihood of bleeding. Modern diagnostic methods allow to detect the pathology in question in time and to start its treatment.
Methods of treating varicose veins, which are localized in the tissues of the stomach, differ, but they are all aimed at eliminating the root cause of this condition. The National Center of Chemistry of the Russian Academy of Medical Sciences provides the following data on the causes and methods of treatment of varicose veins of both the esophagus and stomach:
- treatment of manifestations of varicose veins in the esophagus and stomach by the method described in the book of leading specialists in gastroenterology, differentiation of the identified disease of the digestive tract, using this technique and a detailed description of the manifestations of such rare lesions as esophageal pathology, difficult to diagnose diseases of the digestive system provides the greatest amount of information needed to prepare a scheme of therapeutic effects for both therapists and narrow gastroenterologists;
- Zdenek Marzhatka, one of the most prominent specialists in the field of gastroenterology and diseases of the esophagus, accompanied by damage to the veins in his tissues, describes in detail in his works various methods for diagnosing the disease, types of endoscopy of stomach and esophageal tissues.
Today, in order to prevent further deterioration of the existing pathology, more and more modern diagnostic methods are used, aimed at a more detailed study of the condition of the tissues of the affected digestive organs.
Diagnosis of the disease
Methods and possibilities for diagnosing varicose veins in the digestive organs (esophagus and stomach) include the following manipulations and diagnostic procedures:
- Fibroesophagoscopy, which allows you to identify the cause of bleeding. Also, this method allows you to determine the presence of mechanical causes of bleeding, the condition of the walls of the esophageal veins.
- X-ray of the walls of the esophagus, which is more informative when using contrast.
Both options for diagnosing the disease in question have the ability to detect the cause of the bleeding, determine the condition of the vein walls and the likelihood of rupture of existing aneurysms. The use of both diagnostic options makes it possible with maximum accuracy not only to detect the pathology of the veins and vessels of the esophagus and stomach, but also to obtain the largest amount of available information about the pathology.
Possible complications
As varicose veins, which appear in the tissues of the esophagus and stomach, are particularly dangerous due to the possibility of bleeding, the possible complications of this pathology should be considered. Significant damage to the digestive organs, exacerbation of cirrhosis of the liver are the most dangerous consequences of this pathology of the veins.
Methods of treatment
The therapeutic effect to eliminate the risk of bleeding in case of damage to the veins of the esophagus and stomach should take into account the stage of the pathological process, the general health of the patient, the sensitivity of his body to the current therapeutic effect. Modern medicine is constantly improving the methods of impact on the veins of the esophagus, which makes it possible to quickly eliminate the most obvious manifestations of the pathology in question.
Today, the treatment of the considered pathology of the veins of the esophagus and stomach uses an integrated approach, which consists of traditional, surgical and medical methods of exposure. Each method has its own characteristics, can be used for certain indications and is prescribed by a doctor. The progress of treatment should be monitored at all stages by the treating physician, who, if necessary, will make the necessary adjustments in a timely manner and prevent the possible risks of complications.
traditional method
First of all, when the traditional option of treating varicose veins of the esophagus is used, the bleeding stops, which can be fatal. This will allow additional methods of therapeutic action, which will provide faster regeneration of damaged tissues and will create the necessary scar at the site of injury of the esophageal vein.
To compensate for hypovolaemia and to prevent haemorrhagic shock, a significant (calculated by the physician) dose of vitamin K is administered to the patient's body, as well as frozen plasma infusions (1-2 doses, intravenous transfusion).
Conservative method
In case of severe bleeding, which becomes a real danger to the patient's life, a rubber balloon can be used to quickly stop the bleeding. With the help of a probe, the bleeding vessel is compressed, which stops the movement of blood. For example, the Sengstaken-Blackmore probe is popular for eliminating bleeding during the development of varicose veins in the digestive tract, especially the esophagus. Corrugated varieties of such probes are also used, which are widely used in the treatment of varicose veins of the esophagus with bleeding and bleeding stomach ulcers.
With the introduction of the probe under the site of rupture of the vein, the esophagus can be washed with hot water at a temperature of 40 ° C - this measure often stops active bleeding and stabilizes the patient's condition. However, in case of repeated bleeding and their high intensity, in addition to the use of probes, intravenous and intramuscular administration of substances that also contribute to blood clots is recommended. Calcium chloride 10-20 ml is administered intravenously. Do not use for the introduction of drugs whose action is aimed at raising blood pressure.
Endoscope treatment
As this disease of the esophageal veins is most often diagnosed during endoscopic examination, endoscopic hemostasis may be prescribed to eliminate the most characteristic manifestations of the lesion (elimination of bleeding). This method involves suturing the affected areas of the veins in the esophagus and this variant of the therapeutic effect is preferable to injection sclerotherapy due to the more pronounced positive dynamics of treatment.
Conducting endoscopic treatment is characterized by rapid cessation of bleeding, prevention of possible recurrence of the disease. The drug used in the endoscopic treatment of bleeding in varicose veins of the esophagus and stomach is administered intravenously at 50 mcg, its action is aimed at increasing visceral vascular resistance, which allows stabilizing the patient's condition, preventing excessive active loss ofblood. . This drug is preferred over other drugs that can be given to stop venous bleeding from the esophagus, as it has fewer side effects, even with prolonged use.
The use of an endoscope involves the use of a special endoscopic examination of the esophagus, which is most often prescribed for bleeding, the cause of which is unclear. This technique is very popular due to the high efficiency of this diagnostic method and the good positive dynamics of the treatment (ligation is performed) performed with the help of an endoscope. Endoscopic examination of the veins of the esophagus and stomach has shown itself well at every stage of the development of the pathological process; Also, this method makes it possible to detect even the initial manifestations of diseases of the digestive system in connection with blood circulation in the veins and to identify varicose veins of the esophagus.
The use of balloon tamponade
The endoscopic method of exposure includes the use of such an option to stop bleeding from the veins of the esophagus, such as balloon tamponade. It consists in the impact on the site of vein damage of special occluding agents. However, in severe bleeding, balloon tamponade may not be very effective; additional drugs should be used to stimulate the regenerative processes in the tissues of the venous walls.
The classification offered today for the division of varicose veins of the esophagus allows you to determine the most effective scheme of therapeutic effects. Taking into account the specifics of the stage of the current pathological process, the body's absorption of drugs and control of current treatment give the doctor the opportunity to make timely adjustments and achieve the best results in stopping bleeding and stabilizing the patient's condition.
Surgical intervention
Heavy bleeding, which threatens the patient's life due to significant blood loss, may require surgery.
Surgery may be prescribed for major blood loss in which intravenous administration of plasma, blood and blood-substituting fluids does not produce a clear positive result. There are several types of surgery for significant blood loss. Each of them is prescribed according to the indications determined by the doctor.
Today, the following types of surgery are recognized as the most effective:
- imposing a special bandage made of medical rubber. Such ligation of damaged veins allows you to quickly stop blood circulation, stop blood loss, which can lead to significant deterioration of the patient's condition;
- surgery such as bypass lowers blood pressure in the veins and, as a result, stops the bleeding. During shunting, the liver tissue is affected, a special stent is inserted in the middle of this organ, which creates a kind of bridge between the liver tissue and the tissues of the esophagus, which lowers blood pressure. The hepatic and portal veins having such a "bridge" receive reduced pressure, which leads to cessation of bleeding;
- Splenorenal shunting is a type of bypass surgery that helps prevent possible bleeding when varicose veins are found in the tissues of the esophagus and stomach.
The listed surgical options allow you to remove high blood pressure in the veins of the esophagus damaged by varicose veins. All of them are performed under the control of X-rays and provide the greatest positive effect of the manipulations to stop the bleeding.
Drug treatment of varicose veins
There is also a variant of drug action on the body for the treatment of the initial stage of varicose veins of the esophagus. The choice of the type of drug is determined by the doctor after examination of the patient's body, determining the stage of the current pathological process. When conducting this type of therapy should take into account indicators such as the sensitivity of the patient's body to the drug used, the likelihood of developing allergic reactions.
The most commonly used in the treatment of this disease are the following drugs with a pronounced effect on the veins:
The listed drugs have a number of possible side effects that should be taken into account when prescribing them.
Treatment with folk remedies
The reliability of medicines and methods of traditional medicine has been tested for centuries, but its effectiveness is not high enough to cope on its own with the manifestations of varicose veins of the esophagus. Traditional medicine can be used as a supportive drug to increase the speed of recovery processes in the tissues of the veins. For example, in case of high probability of bleeding, it is recommended to take decoctions and infusions of herbs that have a hemostatic effect. These can be collections of stinging nettle, thyme, alpine birds.
Folk remedies are also possible at home, which is especially important for maintenance therapy of the disease in remission. As varicose veins of the esophagus are a serious lesion that poses a serious threat to the health and life of the patient, it is necessary to take into account the degree of impact of the chosen traditional medicine. Treatment at home is carried out under the constant supervision of a doctor.
Do I need a diet
When diagnosing varicose veins in the digestive system, the question of choosing a diet should be considered one of the most important, because it is from the food that enters the patient's body, both his well-being and indicators of therapeutic effect are very large. degree dependent. The diet recommended for varicose veins of the esophagus includes compliance with several enforceable rules, including the exclusion of certain foods and the inclusion in the daily menu of certain foods that treat the body as a whole and the esophagus in particular.
A diet for varicose veins of the esophagus should exclude the following foods and substances from the patient's diet:
- spices;
- a large amount of salt;
- excessive amounts of oils, especially of animal origin;
- fried, canned, smoked foods that will irritate the tissues of the esophagus and can provoke bleeding.
Nutrition for varicose veins of the esophagus, as well as cirrhosis of the liver, should include more cooked, stewed food, fermented dairy products will perfectly maintain the necessary microflora in the intestine without creating an excessive load on the digestive system as a whole. Fractional feeding in small portions, controlling the amount of calories to prevent excessive effects on the digestive system will prevent the deterioration of existing pathology and preserve the health of the esophagus.
Methods of disease prevention
As a preventative measure for varicose veins, it is imperative to rule out bad habits, including smoking, drinking alcohol, unhealthy fast food.
Regular examinations by a gastroenterologist will help identify venous disease even in the early stages of the pathology and begin treatment.
Healthy life style
Maintaining a healthy lifestyle should be a must for those who strive to maintain a healthy digestive system.
Prevention of venous diseases, the use of vitamin preparations to maintain a high level of immunity and medical examinations are important components of success.
Exercise
To maintain the tone of the veins, to maintain the proper functioning of the digestive system, you need to regularly perform the necessary minimum of exercise.
Walking, light jogging, physical therapy exercises can be considered good preventive measures in the development of varicose veins.