Diseases of the veins and large blood vessels are accompanied by significant changes in their physical condition, which negatively affects the quality of blood circulation. And esophageal varicose veins, which can significantly affect the patient's quality of life due to the deterioration in the quality of digestion and blood flow in the body, require careful adjustment and timely start of treatment. This pathology can be accompanied by secondary lesions of the digestive organs, or they can appear and progress independently.
However, the dilated veins of the esophagus and the varicose veins that appear subsequently are accompanied with each occurrence of unpleasant symptoms, which make it possible to identify the lesion in question at the initial stage of development and timely achieve a therapeutic effect. prevents the development of complications. Medical statistics note that this pathology of the veins of the esophagus occurs predominantly in the male population (women are twice less likely to be affected by varicose veins of the esophagus than men), while the average age at which the first manifestations of the disease can be detected is50-55 years.
Causes of the onset of the disease
The causes that cause the appearance of varicose veins of the esophagus may be different depending on the manifestation of the disease, the general condition of the patient's body, in each case the causes may vary. But 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 of such a localization is too high blood pressure in the venous circulation, which is most often characteristic of cirrhosis of the liver.
And the consequence of such an expansion can be massive bleeding, the danger of which lies in the absence of symptoms, which should be taken as a warning: esophageal varicose veins often bleed profusely and pose a real threat to the general condition patient. Therefore, knowledge of the manifestation of this pathology of the veins of the esophagus and measures to prevent the disease will allow earlier diagnosis and the beginning of an adequate therapeutic effect.
Also, the following conditions of the patient can be the causes of this pathological change in the veins of the digestive organs:
- Congestion observed in portal vein;
- portal vein thrombosis;
- development of a malignant goiter;
- esophageal angioma.
The appearance of the lesion in question can also 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 first of all affect the general condition of the veins and large arteries of the esophagus and stomach tissues. Changes in the circulatory system of such internal organs as the liver, spleen, gallbladder can provoke the development of varicose changes in the esophagus.
The main manifestation of such a disease as varicose veins in the esophagus is bleeding. This symptom can be noted without any warning signs against the background of the so-called "full health". A slight tickling in the throat and a characteristic taste of blood when swallowing (salty-sour) can be interpreted as a sign of impending bleeding. The blood produced during bleeding during the development of varicose veins is usually bright scarlet in color and may resemble coffee grounds. The consequence of such bleeding, which is often long-lasting and strong, is dizziness, a feeling of weakness, unconsciousness.
Since the causes of the aggravation of varicose veins can be a variety of lesions of the internal organs and the entire circulatory system, the overall quality of the functioning of these organs is largely determined both by the likelihood of the development of varicose veins and by the symptoms that can accompany this lesion.
A symptom of the considered pathological change in the digestive organs can be considered bleeding, which develops in the asymptomatic course of the first manifestations of the disease. Such bleeding can be both insignificant, which does not immediately attract the patient's attention, and profuse, which carries a high risk of death. Varicose veins found in the tissues of the esophagus and stomach are most often characterized by the absence of significant changes that allow timely detection and treatment. However, this disease is one of the most dangerous: with unexpected bleeding, characterized by a large amount of blood shed, there is a high probability of death for the patient. According to medical statistics, four out of five cases of manifestation and aggravation of varicose veins in the digestive organs are the death of the patient.
Types and degrees of varicose veins of the esophagus
Today, experts distinguish several degrees of development of esophageal varicose veins, each of which has its own developmental characteristics, differs in the list of manifestations and requires a certain therapeutic effect, which will allow to prevent further exacerbation 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 expansion of the gastric veins and varicose veins:
- the first degree, at which the lumen of the body veins changes slightly. Varicose veins of the esophagus, characteristic of grade 1, may not be noticed by the patient, since they rarely have clear and pronounced symptoms. The veins of the esophagus have an average lumen of 5 mm, which does not differ much from their healthy state. But even with this size, they become less elastic, since even minor changes in their lumen lead to some reduction in the intensity of blood flow through them, and the overall quality of blood flow to the affected organ is disturbed. Grade 1 esophageal varicose veins can be detected by routine examination of this organ;
- the second degree is characterized by an increase in the lumen of the veins in the diseased organ up to 10 mm, the speed of blood flow through the veins gradually decreases, which negatively affects the condition of the veins: they continue to lose their elasticity, the walls becomegradually thinning, which can lead to bleeding due to the high probability of their rupture;
- at the third stage of exacerbation of the pathology, there is an expansion of the lumen of the veins in the esophagus and stomach by more than 10 mm, the vessels are close to each other due to their expansion, and even minor trauma can provoke bleeding. Often at the third stage of the development of the disease, profuse bleeding is noted, which leads to the death of the patient and poses a real threat 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 to a certain extent the existing lesion of the veins of this organ and start treatment, which has a positive effect on the patient's condition. Treatment of varicose veins of the esophagus should be chosen by a doctor who, based on the studies and analysis of the general condition of the patient, will choose both the exposure scheme and the exposure variant, taking into account the characteristics of his organism.
varicose veins of the stomach
Expansion of the veins due to a negative change in their condition can also be observed in the stomach. In this case, as with varicose veins of the esophagus, the degree of elasticity of the vein walls gradually decreases, which leads to a significant probability of bleeding. Modern diagnostic methods make it possible to identify the pathology in question in time and start treatment.
The methods of healing varicose veins localized in the tissues of the stomach differ, but all are aimed at eliminating the root cause of this condition. The National Center for Chemistry of the Russian Academy of Medical Sciences provides such 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 according to the method described in the book of leading experts in gastroenterology, differentiation of the identified disease of the digestive organ and this technique, as well as a detailed description of the manifestations of such rare lesions as pathologies of the operated esophagus, diseases difficult to diagnoseof the digestive organs give the greatest amount of information necessary to create a scheme of therapeutic effects for both therapists and narrow specialists-gastroenterologists;
- Zdenek Marzhatka, one of the most famous specialists in the field of gastroenterology and diseases of the esophagus, accompanied by damage to the veins in its tissues, describes in detail in his writings various methods of diagnosing the disease, types of endoscopy of the tissues of the stomach and esophagus.
Today, in order to prevent further aggravation of the existing pathology, more and more modern diagnostic methods are used, aimed at a more detailed study of the tissue condition of the affected digestive organs.
diagnosis of the disease
Methods and ways of diagnosing varicose veins that have arisen 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 the occurrence of bleeding and the condition of the walls of the veins of the esophagus.
- X-ray of the walls of the esophagus, which is more descriptive when using contrast.
Both ways of diagnosing the disease in question have the ability to identify the cause of bleeding, determine the condition of the vein walls and the likelihood of rupture of existing aneurysms. The use of both diagnostic options allows not only to detect the pathology of the veins and vessels of the esophagus and stomach with maximum accuracy, but also to obtain the largest possible amount of available information about the pathology.
Since varicose veins that appear in the tissues of the esophagus and stomach are especially dangerous due to the likelihood of bleeding, it is worth considering the possible complications of this pathology. Significant damage to the digestive organs, exacerbation of cirrhosis of the liver are the most dangerous consequences of this pathology of the veins.
The therapeutic effect on eliminating the risk of bleeding with damage to the veins of the esophagus and stomach should take into account the stage of the pathological process, the general state of health of the patient and the susceptibility of his body to the prolonged therapeutic effect. Modern medicine is constantly improving the methods of affecting the veins of the esophagus, which allows to quickly eliminate the most obvious manifestations of the pathology in question.
Today, in the treatment of the considered pathology of the veins of the esophagus and stomach, an integrated approach consisting of a traditional, surgical and medical method of exposure is used. Each method has its own characteristics, can be used for specific indications and is prescribed by a doctor. The course of treatment at all stages should be monitored by the attending physician, who, if necessary, will make the necessary adjustments in a timely manner and prevent the likely risks of complications.
First, traditional treatment for esophageal varicose veins stops bleeding, which can be fatal. This also makes it possible to carry out additional therapeutic methods of action, which will ensure faster regeneration of damaged tissues and create the necessary scar at the site of damage to the esophageal vein.
To compensate for hypovolemia and prevent the occurrence of hemorrhagic shock, the patient is injected with a significant (the doctor calculated) dose of vitamin K, as well as an infusion of frozen plasma (1-2 doses, intravenous transfusion).
In the case of heavy bleeding that is life-threatening for the patient, a rubber inflation probe can be used, which allows for rapid hemostasis. With the help of a probe, the bleeding vessel is squeezed, stopping the movement of blood. For example, the probe of such a device, the Sengstaken-Blackmore probe, is popular in eliminating bleeding during the development of varicose veins in the digestive organs, especially the esophagus. Crimped variants of such probes, which are widely used in the treatment of bleeding esophageal varices and bleeding peptic ulcers, are also used.
If the probe is inserted below the site of the rupture of the vein, the esophagus can be flushed with water at 40 °C - this measure often stops active bleeding and stabilizes the patient's condition. However, with repeated bleeding and with its high intensity, in parallel with the use of probes, intravenous and intramuscular administration of substances that also help to stop bleeding is recommended. 10-20 ml of calcium chloride is injected intravenously. Do not use drugs for administration, the action of which is aimed at increasing blood pressure.
treatment with an endoscope
Since this disease of the veins of the esophagus is most often diagnosed during endoscopic examination, endoscopic hemostasis can be prescribed to eliminate the most characteristic manifestations of the lesion (elimination of bleeding). With this method, the affected areas of the veins in the esophagus are sutured, and this variant of the therapeutic effect is preferable to injection sclerotherapy treatment due to the more pronounced positive dynamics.
Carrying out endoscopic treatment is characterized by a rapid cessation of bleeding and the prevention of possible relapses of the disease. The drug used when conducting 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, thereby stabilizing the patient's condition and preventing excessively active blood loss . This drug is preferred over other drugs that can be given to stop venous bleeding from the esophagus because it has fewer side effects, even with long-term use.
The use of an endoscope involves the use of a special endoscopic examination of the esophagus, which is most often prescribed for bleeding whose cause is unclear. This technique is very popular due to the high efficiency of this diagnostic method and good positive dynamics of treatment (ligation is performed), which is carried out using an endoscope. Endoscopic examination of the veins of the esophagus and stomach showed up well at any stage of the development of the pathological process; Also, this method allows to detect already the first manifestations of diseases of the digestive system related to blood circulation in the veins and to identify esophageal varicose veins.
The use of balloon tamponade
The endoscopic method of exposure also involves the use of such a variant for stopping bleeding from the veins of the esophagus, such as: B. a balloon tamponade. It consists in the action of special plugging agents on the site of damage to the vein. However, with severe bleeding, balloon tamponade may not be very effective, additional drugs should be used to stimulate regenerative processes in the tissue of the vein walls.
The classification proposed 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, body perception of the drugs used and control of the ongoing treatment, the attending physician provides the opportunity to make timely adjustments and achieve the best results in stopping bleeding and stabilizing the patient's condition.
Severe bleeding that endangers the patient's life due to significant blood loss may require surgery.
Surgery may be prescribed for large blood losses where intravenous administration of plasma, blood, and blood-substituting fluids does not produce a markedly positive result. There are different types of surgeries for significant blood loss. Each of them is prescribed according to the indications established by the doctor.
Today, the following types of surgical intervention are considered the most effective:
- imposition of a special bandage made of medical rubber. Such a ligation of damaged veins allows you to quickly stop blood flow and stop blood loss, which can lead to a significant deterioration in the patient's condition.
- Surgery, such as bypass surgery, causes the blood pressure in the veins to drop, thereby stopping bleeding. When maneuvering the liver tissue is affected, a special stent is inserted into the middle of this organ, which forms a kind of bridge between the liver tissue and the tissue of the esophagus, which lowers blood pressure. The liver and portal veins, which have such a "bridge", receive a negative pressure that leads to a blood arrest;
- The splenorenal shunt is a type of bypass surgery that helps prevent possible bleeding if varicose veins are detected in the tissues of the esophagus and stomach.
The listed options for surgical intervention will allow you to get rid of the increased blood pressure in the veins of the esophagus damaged by varicose veins. All of them are done under X-ray control and offer the greatest positive effect of manipulations to stop bleeding.
Medical treatment of varicose veins
There is also a variant of the medicinal action on the body to treat the early stages of esophageal varicose veins. The choice of the type of drug is determined by the doctor after examining the patient's body, determining the stage of the current pathological process. When conducting this type of therapy, indicators such as the susceptibility of the patient's body to the drug used and the likelihood of developing allergic reactions should be taken into account.
The most common drugs used to treat this disease are the following drugs with a pronounced effect on the veins:
The medications listed have a number of possible side effects that should be considered when prescribing.
Treatment with folk remedies
The reliability of drugs and methods of traditional medicine has been tested for centuries, but their effectiveness is not high enough to independently cope with the manifestations of esophageal varicose veins. Traditional medicine can be used as a maintenance drug to increase the speed of recovery processes in the tissues of the veins. For example, with a high probability of bleeding, it is recommended to take decoctions and infusions of herbs that have a hemostatic effect. It can be collections of nettle, thyme, highland bird.
Treatment with folk remedies is also possible at home, which is especially important for maintenance therapy of the disease in the stage of remission. Since esophageal varicose veins are a serious lesion that poses a serious threat to the patient's health and life, it is necessary to take into account the degree of impact of the selected traditional medicine. Treatment at home is carried out under constant medical supervision.
Need a diet
When diagnosing varicose veins in the digestive organs, the question of dietary choice should be considered one of the most important, since both his well-being and the indicators of the prolonged therapeutic effect largely depend on the food that enters the patient's body . The diet recommended for varicose veins of the esophagus involves the observance of several feasible rules that involve the exclusion of certain foods and the inclusion in the daily menu of certain products that heal the body as a whole and the esophagus in particular.
The diet for varicose veins of the esophagus should exclude the following foods and substances from the patient's diet:
- a large amount of table salt;
- excessive amounts of oils, especially of animal origin;
- fried, canned, smoked foods, which can irritate the tissues of the esophagus and cause bleeding.
The diet in varicose veins of the esophageal tissue, as well as in cirrhosis of the liver, should include more boiled, stewed foods, fermented milk products perfectly support the necessary microflora in the intestines, without excessively burdening the digestive system at all. Fractional nutrition in small portions, controlling the number of calories to prevent excessive effects on the digestive system, prevents the exacerbation of the existing pathology and maintains the health of the esophagus.
Methods of preventing diseases
As a preventive measure against varicose veins, it is imperative to eliminate bad habits, including smoking, drinking alcoholic beverages, junk food fast food.
Regular examinations by a gastroenterologist will help to identify diseases of the veins even at the initial stages of the development of the pathology and to start treatment.
Maintaining a healthy lifestyle should be mandatory for those who want to maintain a healthy digestive system.
The prevention of venous diseases, the use of vitamin supplements to maintain a high level of immunity and medical examinations are important building blocks for success.
In order to maintain the tone of the veins and the proper functioning of the digestive system, you should regularly perform the minimum necessary physical exercise.
Walking, light jogging, physical therapy exercises can be considered good preventive measures in the development of varicose veins.