Diseases of the veins and large blood vessels are associated with significant changes in their physical condition, which negatively 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 attention to self and timely initiation of treatment. This pathology may be associated with the addition of secondary lesions of the digestive system, or it may arise and continue on its own.
However, for any appearance, varicose veins of the esophagus and subsequent varicose veins that appear are accompanied by unpleasant symptoms that make it possible to identify the lesion in question in the initial stage of development and the immediate onset of a therapeutic effect, preventing the development ofcomplications. . Medical statistics indicate that this pathology of the esophageal veins occurs mainly in the male population (women are affected by esophageal varices twice less often than men), while the average age when the first manifestations of the disease can be observed is 50 years. -55 years.
Causes of disease onset
The reasons that cause the appearance 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 reasons may change. However, in any case, varicose veins, which appear in the veins of the digestive organs, become a consequence of changes in the general condition of the veins. The reason for the appearance of varicose veins of such a localization is the extremely high blood pressure in the venous section of the bloodstream, which is most often characteristic of cirrhosis of the liver.
And the result of such an expansion of them can be massive bleeding, the risk of which lies in the absence of symptoms, which can be considered as a warning: varicose veins of the esophagus are often abundant, which is a real risk forgeneral condition. of the patient. Therefore, recognition of the manifestation of this pathology of the esophageal veins and measures to prevent the disease will enable its faster diagnosis and the beginning of an adequate therapeutic effect.
Also, the following patient conditions may be the causes of 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 can be caused by the symptoms and vascular pathologies that accompany Randu-Osler disease. All these diseases and conditions are associated with negative changes in the circulatory system and digestive organs, which initially affects the general condition of the large veins and 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.
Patient symptoms
The main manifestation of a condition such as varicose veins located in the esophagus is bleeding. This symptom can be observed in the absence of warning manifestations, against the background of the so-called "complete health". A sign of imminent bleeding can be considered a slight tickling of the throat, a characteristic taste of blood during swallowing (salty-sour). The blood that forms during bleeding during the development of varicose veins is usually pronounced bright red, it may resemble coffee grounds. The result of such bleeding, which is often prolonged and profuse, is dizziness, feeling of weakness, loss of consciousness.
Since the causes of varicose vein deterioration can be a number of lesions of the internal organs and the circulatory system as a whole, the overall quality of functioning of these organs is mainly determined by the possibility of developing varicose veins and the symptoms that. may accompany this lesion.
A symptom of a considerable 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 may also be insignificant, which does not immediately attract the patient's attention, or profuse, which have 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 change that allows timely detection and treatment. However, this disease is one of the most frightening: with sudden bleeding, which is characterized by an abundance of blood released, there is a high probability of death for the patient. According to medical statistics, out of five cases of occurrence and aggravation of varicose veins in the digestive organs, four are 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 which has its own characteristics of development, changes 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 is possible to determine the presence of the disease, its stage and stage of development.
There are the following degrees of dilation of gastric veins and varicose veins:
- the first degree, in which there is a slight change in the lumen of the body veins. Esophageal varices, characteristic of grade 1, may not be noticed by the patient, as there are rarely defined and pronounced symptoms. The veins of the esophagus have a lumen on average 5 mm, which does not differ much from their healthy state. However, even at this size, they become less elastic, as even small changes in their lumen lead to a decrease in the intensity of blood flow through them, and the overall quality of blood circulation in the affected organ is disturbed. . Grade 1 varicose veins of the esophagus can be detected 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 up to 10 mm, the speed of blood flow through the veins is gradually reduced, which negatively 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, an expansion of the lumen of the veins in the esophagus and stomach by more than 10 mm is observed, the vessels, due to their expansion, are located close to each other, even light ones. trauma can provoke bleeding. Often, it is in the third stage of disease development that 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 vein lesion of this organ to a certain degree and begin treatment, which has a positive effect on the patient's condition. The treatment of esophageal varices should be chosen by a physician, who, based on studies and analyzes of the general condition of the patient, chooses both the exposure scheme and the exposure variant, taking into account the characteristics of his organism.
Varicose veins of the stomach
The dilation of the veins, due to a negative change in their condition, can also be noticed in the stomach. In this case, as in the case of esophageal varices, a gradual decrease in the degree of elasticity of the venous walls is observed, the appearance of a considerable probability of bleeding. Modern diagnostic methods make it possible to timely detect the pathology in question and begin its treatment.
Methods for treating varicose veins, located in the stomach tissues, vary, but all aim to eliminate the root cause of this condition. The National Chemistry Center of the Russian Academy of Medical Sciences provides such data on the causes and methods of treatment of varicose veins of 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, the differentiation of the identified disease of the digestive organ is performed, and this technique and a detailed description of such manifestations. Rare lesions such as operated esophageal pathology, difficult-to-diagnose diseases of the digestive organs provide the greatest amount of information needed to design 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 esophageal diseases, associated with venous damage to his tissues, describes in his writings in detail various methods for diagnosing the disease, types of tissue endoscopy ofstomach and esophagus.
Today, to prevent further deterioration of existing pathology, more and more modern diagnostic methods are used, aiming at a more detailed study of the tissue condition of the affected digestive organs.
Diagnosis of the disease
Methods and options for diagnosing varicose veins that have appeared 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 for the appearance of bleeding, the condition of the walls of the esophageal veins.
- X-ray of the esophageal walls, which is more informative when contrast is used.
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 possibility 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 information available about the pathology.
Possible complications
Since varicose veins occurring 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, worsening of cirrhosis of the liver are the most dangerous consequences of this pathology of the veins.
Treatment methods
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 ongoing therapeutic effect. Modern medicine is constantly improving the methods of impact on the veins of the esophagus, which makes possible the rapid elimination of the most obvious manifestations of the pathology in question.
Today, an integrated approach is used in the treatment of the considered pathology of the esophageal and gastric veins, which consists of a traditional, surgical and medical method 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 attending physician, who, if necessary, will make the necessary adjustments in a timely manner and prevent potential risks of complications.
traditional method
First of all, when you use the traditional treatment option for varicose veins of the esophagus, the bleeding stops, which can be fatal. This will also enable additional methods of therapeutic action, which will ensure faster regeneration of damaged tissue 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, a considerable dose (calculated by the doctor) of vitamin K is introduced into the patient's body, as well as frozen plasma infusions (1-2 doses, intravenous transfusion is performed). .
Conservative method
With 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 pressed, which stops the movement of blood. For example, the probe of such a device - the Sengstaken-Blackmore probe is known to eliminate bleeding during the development of varicose veins in the digestive organs, in particular, in the esophagus. Wavy varieties of such probes are also used, which are widely used in the treatment of varicose veins of the esophagus with bleeding and gastric ulcers with bleeding.
By inserting the probe under the site of the vein rupture, 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, with repeated bleeding and their high intensity, in parallel with the use of probes, it is recommended to carry out intravenous and intramuscular administration of substances that also contribute to the inhibition of blood. Calcium chloride 10-20 ml is administered intravenously. Do not use for the introduction of drugs, the action of which is intended to increase blood pressure.
Endoscopic treatment
Since this disease of the esophageal veins is most often diagnosed during endoscopic examination, endoscopic hemostasis can be prescribed to eliminate the most characteristic manifestations of the lesion (elimination of bleeding). This method involves suturing the affected areas of the veins to the esophagus and it is this variant of the therapeutic effect that is preferred over injection sclerotherapy due to the more pronounced positive dynamics of treatment.
Performing endoscopic treatment is characterized by rapid cessation of bleeding, prevention of possible recurrences 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 aims to increase 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 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, 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 treatment (bonding is performed) using an endoscope. Endoscopic examination of the esophageal and gastric veins was well shown at every stage of the development of the pathological process; Also, this method makes it possible to detect the initial manifestations of diseases of the digestive system in connection with the blood circulation in the veins and the identification of esophageal varices.
Use of balloon tamponade
The endoscopic method of exposure also involves the use of such a variant of stopping bleeding from the esophageal veins, such as balloon tamponade. It consists in the impact on the venous injury site of special closing agents. However, with severe bleeding, balloon tamponade may not be very effective; additional drugs should be used to stimulate regenerative processes in venous wall tissues.
The classification proposed today for the separation of varicose veins of the esophagus and allows you to determine the most effective scheme of therapeutic effects. Taking into account the peculiarities of the stage of the current pathological process, the body's perception of the drugs used and the control of continuous treatment gives the attending physician the opportunity to make timely adjustments and achieve the best results in stopping bleeding and stabilizingpatient's condition.
Surgical intervention
Heavy bleeding, which poses a threat to the patient's life due to significant blood loss, may require surgery.
Surgical intervention can be prescribed for large blood losses, in which intravenous administration of plasma, blood and blood replacement fluids does not bring a pronounced positive result. There are several types of surgery for significant blood loss. Each of them is prescribed according to the indications prescribed by the doctor.
Today, the following types of surgical interventions are recognized as most effective:
- placing a special bandage made of medical rubber. Such connection of damaged veins allows you to quickly stop blood circulation, stop blood loss, which can cause a significant deterioration of the patient's condition;
- an operation such as bypass surgery leads to a decrease in blood pressure in the veins and, as a result, stops bleeding. During shunting the liver tissue is affected, a special stent is inserted between this organ, which creates a kind of bridge between the liver tissue and the esophageal tissue, which lowers blood pressure. The hepatic and portal veins, having such a "bridge", receive reduced pressure, which leads to the cessation of bleeding;
- Splenor 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 options listed for surgery allow you to eliminate the increased blood pressure in the esophageal veins damaged by varicose veins. All of them are performed under the control of x-rays and give the greatest positive effect from manipulations to stop bleeding.
Medical treatment of varicose veins
There is also a variant of medicinal effects on the body to treat the initial stage of varicose veins of the esophagus. The choice of the type of treatment is determined by the doctor after examining the patient's body, determining the stage of the current pathological process. When performing this type of therapy, indicators such as the sensitivity of the patient's body to the drug used, the likelihood of developing allergic reactions should be taken into account.
The most widely used in the treatment of this disease are the following drugs with a pronounced effect on the veins:
The drugs listed have a number of possible side effects that should be considered when prescribing them.
Treatment with folk remedies
The reliability of traditional medicine drugs and methods has been tested for centuries, but its effectiveness is not high enough to independently cope with the manifestations of varicose veins of the esophagus. Traditional medicine can be used as a maintenance medicine, to increase the rate of recovery processes in the venous tissues. For example, with a high probability of bleeding, it is recommended to take decoctions and infusions of herbs that have a hemostatic effect. They can be collections of nettles, thyme, mountain birds.
Treatment with folk remedies is also possible at home, which is especially important for disease maintenance therapy, in the remission phase. Since varicose veins of the esophagus are a serious lesion, which poses a serious risk to the health and life of the patient, it is necessary to consider the degree of impact of traditional medicine of choice. Home treatment is performed under the constant supervision of a doctor.
You need a diet
When diagnosing varicose veins in the digestive organs, the issue of choosing a diet should be considered one of the most important, as from the food that enters the patient's body depends mainly on his well-being and indicators of continuous therapeutic effect. . The diet that is recommended for esophageal varices includes the observance of certain workable rules, which include 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:
- spices;
- a large amount of table salt;
- excessive amounts of oils, especially of animal origin;
- fried, canned, smoked foods, which will irritate the esophageal tissues and may cause bleeding.
Nutrition for varicose veins of esophageal tissue, as well as for cirrhosis of the liver, should include more boiled, boiled food, fermented milk products will perfectly support the necessary microflora in the intestine, without creating aexcessive load on the digestive system. all. Partial diet in small portions, controlling the number of calories to prevent excessive effects on the digestive system will prevent the deterioration of existing pathology and maintain the health of the esophagus.
Disease prevention methods
As a preventative measure for varicose veins, it is necessary to exclude bad habits, including smoking, drinking alcoholic beverages, fast food of unwanted food.
Regular examinations by a gastroenterologist will help identify venous disease even in the initial stage of pathology development and start its treatment.
Healthy lifestyle
Maintaining a healthy lifestyle should be mandatory for those seeking to maintain a healthy digestive system.
Prevention of venous diseases, use of vitamin preparations to maintain a high level of immunity and examinations by the doctor are important components of success.
Physical exercises
To maintain the tone of the veins, to maintain the proper functioning of the digestive system, you should regularly perform the necessary minimum of physical exercises.
Walking, jogging, exercise therapy exercises can be considered as good preventive measures in the development of varicose veins.