Vein and macrovascular disease is accompanied by significant changes in the physical condition, which negatively affects the quality of the circulatory process. Esophageal varicose veins, due to the deterioration of digestion and the quality of blood flow in the body, can significantly reduce the quality of life of patients and require a careful attitude and timely treatment. This pathology may be accompanied by an increase in secondary lesions of the digestive organs, or it may occur and progress independently.
However, with any type of appearance, esophageal dilated veins and subsequent varicose veins are accompanied by unpleasant symptoms, which make it possible to identify problematic lesions at the initial stages of development and initiate treatment effects in a timely manner, preventing complicationsdevelopment of. Medical statistics indicate that this esophageal venous disease mainly occurs in the male population (women are twice as likely to be affected by esophageal varicose veins), and the average age at which the first manifestation of the disease can be noticed is 50-55 years old.
Causes
The causes of esophageal varicose veins can vary, depending on the presentation of the disease, the general condition of the patient's body, and in each case, the cause may be different. In any case, however, varicose veins that develop in the veins of the digestive organs are the result of changes in the general condition of the veins. The cause of this localized varicose appearance is hypertensive blood pressure in the venous circulation, which is often characteristic of cirrhosis.
While the result of this dilation can be massive bleeding, the danger is that there are no symptoms, which can be seen as a warning: esophageal variceal bleeding tends to be prolific and poses a real danger to the overall condition. patient. Therefore, understanding the manifestations of this pathology of the esophageal veins and measures to prevent the disease will make it possible to diagnose it more quickly and initiate adequate therapeutic effects.
In addition, the following conditions in the patient may be responsible for this pathological change in the veins of the digestive organs:
- Hyperemia is observed in the portal vein;
- Portal vein thrombosis;
- the development of a malignant goiter;
- Esophageal hemangioma.
Furthermore, the occurrence of the lesions in question may be caused by the symptoms and vascular lesions that accompany Randu-Osler disease. All of these diseases and conditions are accompanied by negative changes in the circulatory system and digestive organs, initially affecting the general condition of the veins and large arteries of the esophagus and stomach tissue. Changes in the circulatory system of internal organs such as the liver, spleen, and gallbladder can cause the development of esophageal varices.
patient's symptoms
The main manifestation of diseases such as varicose veins located in the esophagus is bleeding. In the context of so-called "perfect health", this symptom can be noticed without warning manifestations. Signs of imminent bleeding can be thought of as a slight itching in the throat, which is the characteristic blood taste (salty acid) when swallowed. The blood that forms during bleeding during the development of varicose veins is often distinctly bright red and may resemble coffee grounds. This bleeding is usually prolonged and profuse, and the result is dizziness, weakness, and loss of consciousness.
Since varicose veins can be exacerbated by various lesions of the internal organs and the entire circulatory system, the overall function of these organs is largely determined by the likelihood and symptoms of varicose veins. may accompany this disease.
The symptoms of the pathological changes considered in the digestive organs can be considered as hemorrhages, which develop during the asymptomatic course of the initial manifestations of the disease. This bleeding can be either insignificant and not immediately noticeable to the patient, or massive with a high risk of death. The most common feature of varicose veins found in the tissue of the esophagus and stomach is the absence of any significant changes that can be detected and treated in time. However, the disease is one of the most terrifying: unintended bleeding, characterized by the release of large amounts of blood, with a high probability of death for the patient. According to medical statistics, among the 5 cases of varices in the digestive organs and aggravation, 4 patients died.
Type and degree of esophageal varices
Today, experts distinguish several degrees of development of esophageal varices, each of which has its own developmental characteristics, different manifestations, and requires a certain therapeutic effect, which makes it possible to prevent the further deterioration of the pathology. With the help of modern diagnostic methods, the presence, stage and extent of the disease can be determined.
Gastric veins and varices have the following degrees of dilatation:
- In the first degree, there is a slight change in the lumen of the veins in the body. Esophageal varices are a grade 1 feature that patients may not notice because it has few clear and distinct symptoms. The veins of the esophagus have an average lumen of 5 mm, which is not much different from their healthy state. However, even at this size, their elasticity is reduced, as even small changes in their lumen can result in somewhat less intensity of blood movement through them and disturbances in the overall quality of blood circulation in the affected organs. 1st degree esophageal varices can be detected on routine examination of this organ;
- Second degree is characterized by an increase in the venous lumen of the diseased organ by up to 10 mm and a gradual decrease in the velocity of blood flow through the veins, which negatively affects the condition of the veins: they continue to lose their elasticity and the walls gradually become thinner, due to the high probability of rupturehigh, which may cause bleeding;
- In the third stage of pathological exacerbation, the lumen of the veins in the esophagus and stomach dilate by more than 10 mm, the blood vessels come close to each other due to the dilation, and even minor trauma to them can cause bleeding. Often, in the third stage of the development of the disease, massive bleeding occurs, leading to the death of the patient, which constitutes a real danger to the life of the patient suffering from varicose veins in the tissues of the digestive organs.
The above classification of esophageal varices allows us to classify and initiate treatment to a certain extent the existing lesions in the veins of this organ, which has a positive impact on the patient's condition. The treatment of esophageal varices should be chosen by the doctor, who should choose the exposure plan and exposure method based on the research and analysis of the patient's general condition, taking into account his body characteristics.
gastric varices
Due to negative changes in its condition, dilation of the veins can also be observed in the stomach. In this case, as in the case of esophageal varices, the degree of elasticity of the vein wall is gradually reduced, and there is a high chance of bleeding. Modern diagnostic methods make it possible to detect relevant pathologies in a timely manner and initiate treatment.
Treatments for varicose veins located in stomach tissue vary, but all of them aim to eliminate the underlying cause of the condition. The National Chemical Center of the Russian Academy of Medical Sciences provides data on the causes and treatment of esophageal and gastric varices:
- Based on the methods described in the book of leading specialists in gastroenterology for the treatment of manifestations of esophageal and gastric varices, the identification of established diseases of the digestive organs and a detailed description of the manifestations of this technique in rare lesions as pathology of the surgical esophagus, digestive organsof difficult-to-diagnose diseases provides therapists and stenosis specialists - gastroenterologists with the greatest amount of information necessary to formulate treatment effect plans;
- Zdenek Marzhatka is one of the most prominent specialists in the field of gastroenterology and diseases of the esophagus, accompanied by venous damage in the tissue, in his book various methods of diagnosing the disease are described in detail, types of tissue endoscopy of the stomach andesophagus.
Today, in order to prevent further deterioration of existing pathologies, more and more modern diagnostic methods are used, aiming to study the tissue state of the affected digestive organs in greater detail.
Disease diagnosis
Methods and options for diagnosing varicose veins in the digestive organs (esophagus and stomach) include the following procedures and diagnostic procedures:
- Fiberoptic esophagoscopy, which allows you to determine the cause of the bleeding. In addition, this method allows you to determine the presence of a mechanical cause of bleeding, the condition of the esophageal vein wall.
- An X-ray of the wall of the esophagus, which is more informative when a contrast agent is used.
Both options for diagnosing the associated disease are able to detect the cause of the bleeding, determine the condition of the vein wall, and the likelihood of rupture of an existing aneurysm. Using these two diagnostic options not only allows for the detection of pathology in the veins and vessels of the esophagus and stomach with the greatest accuracy, but also for the greatest amount of information available about the pathology.
possible complications
Since varicose veins that occur 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 is the most dangerous consequence of this venous pathology.
treatment method
The therapeutic effect of eliminating the risk of bleeding in the case of damage to the esophagus and gastric veins should take into account the stage of the pathological process, the general health of the patient, the sensitivity of his body to the effect of the ongoing treatment. Modern medicine continues to improve methods of affecting the veins of the esophagus, which makes it possible to quickly eliminate the most obvious manifestations of the associated pathology.
Today, an integrated approach is used to treat considered pathology of the esophageal and gastric veins, including traditional, surgical, and medical exposure methods. Each method has its own characteristics and is available for certain indications and prescribed by a doctor. The attending physician should monitor the whole process of treatment and make necessary adjustments in a timely manner when necessary to prevent possible complications.
traditional method
First, when traditional esophageal varices treatment regimens are used, the bleeding stops, which can be fatal. This will also allow for additional therapeutic action methods that will ensure faster regeneration of damaged tissue and create the necessary scarring at the site of esophageal vein injury.
To compensate for hypovolemia and prevent hemorrhagic shock, a large (calculated by the doctor) dose of vitamin K is introduced into the patient, along with frozen plasma infusions (1-2 doses, given as an IV).
conservative law
Severe bleeding poses a real threat to the patient's life and can be stopped quickly with a rubber balloon. With the help of the probe, the bleeding vessel is compressed, thereby preventing blood flow. For example, the probe of this device - the Sengstaken-Blackmore probe is popular in eliminating bleeding during the development of varicose veins in the digestive organs, especially the esophagus. These probes are also available in corrugated varieties and are widely used in the treatment of bleeding esophageal varices and bleeding gastric ulcers.
The esophagus can be washed with hot water at 40°C by introducing the probe below the site of the venous rupture - a measure that usually stops active bleeding and stabilizes the patient's condition. However, due to repeated and high-intensity bleeding, intravenous and intramuscular administration of substances that also aid in hemostasis is recommended while the probe is being used. Intravenous calcium chloride 10-20 ml. Do not use to introduce drugs designed to increase blood pressure.
Endoscopic treatment
Since most esophageal venous disease is diagnosed during endoscopy, endoscopic hemostasis may be prescribed to eliminate the most typical manifestation of the lesion (elimination of bleeding). This approach involves suturing the affected area of the vein in the esophagus, a variant of this therapeutic effect that is preferable to injection sclerotherapy because the ongoing treatment has a more pronounced positive dynamic.
Endoscopic treatment can quickly stop bleeding and prevent possible recurrence of the disease. The drug is used to perform endoscopic treatment of esophageal and gastric variceal bleeding. It is administered intravenously at 50 mcg and is designed to increase splanchnic vascular resistance, thereby stabilizing the patient's condition and preventing excessive blood loss. This drug is more popular than other drugs that can be used to stop bleeding in the veins of the esophagus because it has fewer side effects even with prolonged use.
The use of endoscopy involves a special endoscopy of the esophagus, which is most often used for bleeding, the cause of which is not known. This technique is very popular due to the high efficiency of this diagnostic method and the good dynamic of aggressive treatment with endoscopy (performing ligation). Endoscopy of the esophageal and gastric veins performs well at any stage of the development of the pathological process; in addition, this method can even detect the initial manifestations of digestive disorders related to venous blood circulation and identify esophageal varices.
Use of balloon tamponade
Endoscopic exposure methods also involve the use of this variant of hemostasis from the esophageal vein, such as a balloon tamponade. It includes the effect of special occlusive agents on the damaged site of the vein. However, for severe bleeding, balloon tamponade may not be very effective; additional drugs should be used to stimulate the regeneration process of the vein wall tissue.
The classification of esophageal varicose veins presented today allows you to determine the most effective treatment outcomes. Taking into account the peculiarities of the current stage of the pathological process, the body's perception of the drugs used and the control of the ongoing treatment, the attending physician is provided with the opportunity to adjust in time to achieve the best effect of hemostasis and stabilization. patient's condition.
operation treatment
Major bleeding that is life-threatening to the patient due to massive blood loss may require surgery.
Surgical intervention can be used for massive blood loss, where intravenous plasma, blood, and blood substitute fluids do not lead to significantly positive results. There are several types of surgery to treat massive blood loss. Each of them is prescribed for an indication determined by a doctor.
Today, the following types of surgical interventions are considered the most effective:
- Use a special bandage made of medical rubber. This ligation of damaged veins allows you to quickly stop circulation and stop blood loss, which can lead to significant deterioration of the patient's condition;
- Procedures such as bypass surgery cause the blood pressure in the veins to drop, which stops the bleeding. During the shunt, liver tissue is affected, and a special stent is inserted into the middle of this organ, creating a bridge between liver tissue and esophagus tissue, which reduces blood pressure. The hepatic and portal veins with this "bridge" are decompressed, causing the bleeding to stop;
- Spleen-kidney shunt is a bypass surgery that helps prevent possible bleeding when varicose veins are detected in the esophagus and stomach tissue.
The listed surgical intervention options allow you to eliminate elevated blood pressure in the esophageal veins that have been damaged by varicose veins. All of this is done under the control of X-rays and is manipulated to stop the bleeding to provide maximum positive effect.
Medical treatment of varicose veins
To treat the initial stages of esophageal varices, there is also a variant of the action of the drug on the body. 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. Such treatment should take into account indicators such as the patient's body's sensitivity to the drug being used, as well as the possibility of an allergic reaction.
The most commonly used drugs to treat this condition are the following drugs that have significant effects on veins:
The listed drugs have many possible side effects that should be considered when prescribing them.
Healing with folk remedies
The reliability of drugs and traditional medical methods has been tested for centuries, but their effectiveness is not sufficient to independently address the manifestations of esophageal varices. Traditional medicines can be used as maintenance medicines to increase the speed of recovery of venous tissue. For example, there is a high probability of bleeding, and herbal decoctions and infusions with hemostatic effects are recommended. It can be a collection of nettles, thyme, highland birds.
In the remission phase, folk remedies can also be used at home, which is especially important for the maintenance treatment of the disease. Since esophageal varices is a serious disease that poses a serious threat to the health and life of patients, it is necessary to consider the degree of impact of choosing traditional medicines. Treatment at home is carried out under the constant supervision of a doctor.
do you need to diet
When diagnosing varicose veins of the digestive organs, the question of dietary choices should be considered as one of the most important, since the food that enters the patient's body is largely dependent on the patient's health status and indicators of ongoing treatment effects. Recommended forA diet for esophageal varicose veins involves following several actionable rules, including excluding certain foods and including certain products in your daily menu that heal your entire body, especially your esophagus.
A diet for esophageal varicose veins should exclude the following foods and substances from the patient's diet:
- seasoning;
- a lot of salt;
- excess oil, especially of animal origin;
- Fried, canned, and smoked foods can irritate the tissues of the esophagus and cause bleeding.
Nutrition for esophageal tissue varicose veins and cirrhosis should include more boiled, stewed foods, and fermented dairy products will perfectly support the necessary microflora in the gut without overtaxing the digestive system. all. Nutrition in small portions, and calorie counts to prevent undue effects on the digestive system will prevent the deterioration of existing pathologies and keep the esophagus healthy.
disease prevention methods
As a preventive measure for varicose veins, bad habits, including smoking, drinking, junk food, fast food, etc. , must be excluded.
Regular examinations by a gastroenterologist will help identify venous disease and begin treatment, even at the initial stages of pathological development.
healthy lifestyle
Maintaining a healthy lifestyle should be mandatory for those seeking to maintain a healthy digestive system.
Prevention of venous disease, the use of vitamin preparations to maintain high levels of immunity, and a doctor's examination are important components of success.
Physical exercise
In order to maintain the tone of the veins and maintain the good function of the digestive system, you should regularly engage in the minimum necessary physical activity.
Walking, jogging, kinesiotherapy exercise can be considered as good preventive measures for the development of varicose veins.