Diseases of the veins and large blood vessels are accompanied by significant physical changes, which negatively affect the quality of blood circulation. And esophageal varices, which can significantly reduce a patient's quality of life due to impaired digestion and blood flow in the body, requires a caring attitude and prompt treatment. . This pathology can be accompanied by the addition of secondary lesions of the digestive organs, or it can occur and proceed independently.
However, with any form of presentation, the esophageal veins become dilated and then develop varicose veins with unpleasant symptoms, making it possible to identify the lesion in question at an advanced stage. initial development and the start of effective treatment in a timely manner, preventing the development of complications. Medical statistics record that this esophageal varices mainly occurs in men (women are affected by esophageal varices twice as rare as men), while the average age when these varices occur. The first manifestation of the disease can be noted 50-55 years.
Cause of disease onset
The causes of the appearance of esophageal varices can be different depending on the manifestation of the disease, the general condition of the patient's body, in each case the set of possible causes is different. However, in all cases, varicose veins occur in the veins of the digestive organs as a result of a change in the general condition of the veins. The reason for the manifestations of such localized varicose veins is excessively high blood pressure in the venous circulation, which is a common feature of cirrhosis.
And the result of such an enlargement can be massive bleeding, the danger of which lies in the absence of symptoms, which can be taken as a warning: bleeding in esophageal varices is often profuse, represents a real danger to the general condition of the patient. Therefore, knowledge about the manifestation of this esophageal varices and prevention measures will help diagnose the disease earlier and bring about appropriate treatment.
In addition, the following patient conditions may be the cause of this pathological change in the veins of the digestive organs:
- Obstruction observed in the portal vein;
- portal vein thrombosis;
- the development of malignant goiter;
- esophageal vascular tumor.
In addition, the appearance of the lesion in question may be due to the symptoms and vascular pathology associated with Randu-Osler disease. All of these diseases and conditions are accompanied by negative changes in the circulatory system and digestive organs, which initially affect the general condition of the veins and great 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 varicose changes in the esophagus.
Patient's symptoms
The main manifestation of pathologies such as varicose veins located in the esophagus is bleeding. This symptom can be noted in the absence of warning manifestations, against the background of the so-called "holistic health". Signs of impending bleeding can be seen as a slight tickling sensation in the throat, a characteristic taste of blood when swallowed (sour). The blood that is formed during bleeding during the development of varicose veins is usually bright red, which can resemble coffee grounds. The result of such bleeding, which is often prolonged and profuse, is dizziness, feeling weak, and loss of consciousness.
Since the reason for the exacerbation of varicose veins can be multiple lesions of the internal organs and the circulatory system in general, the overall quality of the functioning of these organs is largely determined byboth the likelihood of developing varicose veins and symptoms. may be associated with this injury.
A symptom of a pathological change in the digestive system under consideration can be considered bleeding, which develops during the asymptomatic course of the initial manifestations of the disease. Such bleeding may be insignificant, does not immediately attract the patient's attention, and carries a high risk of death. Varicose veins, which are noted in the tissues of the esophagus and stomach, are often characterized by the absence of any significant changes that make it possible to promptly identify and initiate treatment. However, this disease is one of the most terrible: with sudden bleeding, characterized by a large amount of blood, the patient has a high chance of death. According to the medical statistics, out of 5 cases with manifestations and aggravation of varicose veins in the digestive organs, 4 cases were fatal.
Types and degrees of esophageal varices
Today, specialists distinguish several degrees of development of esophageal varices, each with its own characteristics of development, differing in the list of manifestations and requiring a certain therapeutic effect, can prevent the exacerbation of the disease. Thanks to modern diagnostic methods, it is possible to determine the presence of the disease, its stage and degree of development.
There are degrees of gastric varices and varicocele as follows:
- the first degree, where there is a slight change in the lumen of the veins of the body. Esophageal varices, characteristic of grade 1, may go unnoticed by patients, as it rarely has obvious and obvious 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, they become less elastic, as even small changes in their lumen lead to some reduction in the intensity of blood movement through them and the overall quality of the blood. Blood circulation in the affected organ is disturbed. Grade 1 esophageal varices can be detected during 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 flowing through the veins gradually decreases, which negatively affects the condition of the veins: they continue to lose their elasticity, their walls become thinner, which can cause bleeding due to their high rupture potential;
- in the third stage of exacerbation of the pathology, there is a lumen enlargement 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 slightlythey. Trauma can cause bleeding. Usually, in the third stage of the disease, it is noted that the patient's fatal bleeding, which is really dangerous to the patient's life, is caused by varicose veins in the tissues of the body. digestive organs. .
The above classification of esophageal varices allows us to classify the existing damage of the veins of this organ to a certain extent and initiate treatment, which has a positive effect on the condition. of the patient. Treatment of esophageal varices should be selected by a physician, who, on the basis of a study and analysis of the general condition of the patient, chooses both the exposure scheme and the method of exposure, taking into account the characteristics of the patient. their body.
Stomach varicose veins
Dilation of the veins, due to a negative change in their condition, can also be observed in the stomach. In this case, as is the case with esophageal varices, the degree of elasticity of the venous wall gradually decreases, a significant possibility of bleeding occurs. Modern diagnostic methods help to detect the pathology in time and start treatment.
The methods of treating varicose veins localized in the tissues of the stomach, although different, are aimed at eliminating the root cause of this condition. The National Chemical Center of the Russian Academy of Medical Sciences provides such data on the causes and treatment of varicose veins of both the esophagus and the stomach:
- Treatment of manifestations of esophageal and gastric varices according to the method described in the books of leading specialists in gastroenterology, conduct the differential diagnosis of definite diseases of the digestive system, perform this technique anddescribe in detail the symptoms of that disease. Rare lesions such as esophagitis and difficult-to-diagnose diseases of the gastrointestinal tract provide the greatest amount of information needed for effective treatment planning for both specialists and physicians. gastroenterology specialist;
- Zdenek Marzhatka, one of the most prominent specialists in the field of digestion and diseases of the esophagus, accompanied by damage to the veins in its tissues, describes in detail in his articles the methods ofDiagnosis of diseases, endoscopic types of tissues of the stomach and esophagus.
Today, in order to prevent aggravation of the existing pathology, more and more modern diagnostic methods are used, aimed at a more detailed study of the state of the tissues of the affected digestive organs. .
Diagnostic
Methods and options for diagnosing varicose veins that have arisen in the gastrointestinal tract (esophagus and stomach) include the following diagnostic manipulations and procedures:
- Fiber optic esophagoscopy, which allows you to determine the cause of the bleeding. In addition, 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 contrast is used.
Both of the diagnostic options mentioned are capable of detecting the cause of bleeding, determining the condition of the vein wall, and the possibility of rupture of existing aneurysms. The use of both diagnostic options makes it possible not only to detect the pathology of the veins and vessels of the esophagus and stomach with maximum accuracy, but also to obtain the greatest amount of information about the pathology.
Possible complications
Since varicose veins occurring in the tissues of the esophagus and stomach are especially dangerous because of the possibility of bleeding, it is necessary to be aware of the possible complications of this pathology. Significant damage to the digestive system, exacerbation of cirrhosis are the most dangerous consequences of this venous pathology.
Treatments
The effectiveness of treatment 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 susceptibility of the organism towith ongoing treatment. Modern medicine is constantly improving the methods of affecting the esophageal veins, helping to quickly eliminate the most obvious manifestations of the disease being acquired.
Today, an integrative approach is used in the treatment of considered pathologies of the esophageal and gastric veins, including traditional, surgical and medical approaches. Each method has its own characteristics, can be used for certain indications and prescribed by a doctor. The course of treatment should be monitored at all stages by the attending physician, who, if necessary, will make the necessary adjustments promptly and prevent the risk of possible complications.
traditional method
First of all, when using the traditional treatment of esophageal varices, the hemostasis will stop the bleeding, which can be fatal. This will also allow for additional treatments, ensuring faster regeneration of damaged tissue and creating the necessary scarring at the site of damage to the esophageal vein.
To compensate for hypovolemia and prevent hemorrhagic shock, a substantial dose of vitamin K (calculated by the physician) is administered to the patient, as well as an infusion of frozen plasma (1-2 doses), intravenous infusion is performed).
Conservative method
In case of serious bleeding, really dangerous to the patient's life, a rubber ball can be used to stop the bleeding quickly. With the help of a probe, the bleeding vessel is compressed, stopping the movement of blood. For example, the probe of such a device - the Sengstaken-Blackmore probe is popular in the elimination of bleeding during the development of varicose veins in the digestive organs, in particular, the esophagus. Waveforms of such transducers are also used, widely used in the treatment of bleeding esophageal varices and bleeding gastric ulcers.
With the transducer inserted below the ruptured vein, the esophagus can be flushed with hot water at 40°C - this usually actively stops bleeding and stabilizes the patient's condition. However, with repeated and high-intensity bleeding, in parallel with the use of the transducer, intravenous and intramuscular injection of substances that also contribute to stopping the bleeding should be performed. Calcium chloride 10-20 ml is administered intravenously. Do not use to introduce drugs that have an effect on increasing blood pressure.
Endoscopic treatment
Since this disease of the esophageal vein is most often diagnosed during endoscopic examination, endoscopic hemostasis may be indicated to eliminate the most characteristic manifestations of the lesion (remove bleeding). This method involves suturing the affected areas of the veins in the esophagus, and it is a variant of the treatment effect that is preferred over injection therapy due to the apparent positive dynamics. more pronounced of the treatment method.
Conduct endoscopic therapy by rapidly stopping bleeding, preventing possible recurrences of the disease. The drug is used in the endoscopic treatment of bleeding in esophageal and gastric varices, administered intravenously at a dose of 50 mcg, its effect is to increase visceral wall strength, allowingstabilize the patient's condition, prevent excessive blood loss. . This drug is preferred over other drugs that can be used to stop esophageal varices because it has fewer side effects, even with long-term use.
The use of an endoscope involves the use of a special endoscope of the esophagus, 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 dynamics of the treatment (performing ligation), which is performed using an endoscope. Endoscopy examination of the veins of the esophagus and stomach reveals itself well at any stage of the development of the pathological process; In addition, this method can detect even the initial manifestations of diseases of the digestive system related to venous blood circulation and identify esophageal varices.
The use of tamponade bubbles
The endoscopic contact method also involves the use of such a variant to stop bleeding from the veins of the esophagus, such as balloon tamponade. It consists of applying special plugs to the site of damage to the vein. However, in cases of severe bleeding, balloon compression may not be very effective; it is advisable to add other drugs to stimulate regeneration in the tissues of the venous wall.
The classification proposed today to divide the varicose veins of the esophagus, and 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 awareness of the drugs used and the control of the ongoing treatment provide the attending physician the opportunity to treattimely correction and achieve the best results in hemostasis and stabilization of the patient's condition.
Surgical intervention
Heavy bleeding, life-threatening for the patient due to a lot of blood loss, so surgery may be required.
Surgical intervention may be indicated for cases of major blood loss in which intravenous administration of plasma, blood, and blood replacement fluids has not yielded a markedly positive result. There are several types of surgery for significant blood loss. Each of them is prescribed according to its indications determined by the doctor.
Today, the following types of surgical interventions are recognized as the most effective:
- Apply a special bandage made of medical rubber. Such ligation of damaged veins allows you to quickly stop blood circulation, stop blood loss, which can significantly worsen the patient's condition;
- a surgery such as bypass surgery leads to a decrease in blood pressure in the veins and, as a result, hemostasis. During drainage, liver tissue is affected, a special stent is inserted between this organ, creating a kind of bridge between the liver tissue and the tissue of the esophagus, helping to lower blood pressure. The hepatic and portal veins, which have such a "bridge", receive reduced pressure, which leads to cessation of bleeding;
- Splenorenal shunting is a type of bypass surgery that helps prevent bleeding that can occur when varicose veins are found in the tissues of the esophagus and stomach.
The listed options for surgical intervention allow you to eliminate increased blood pressure in the veins of the esophagus damaged by varicose veins. All are performed under X-ray control and provide the greatest positive effect from hemostatic manipulations.
Medical treatment of varicose veins
There is also a variation of the drug effect on the body to treat the early stages of esophageal varices. The choice 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, it is necessary to take into account such indicators as the degree of sensitivity of the patient's body to the drug used, the possibility of allergic reactions.
The most often used in the treatment of this disease are the following drugs that have a pronounced effect on the veins:
The drugs 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 its effectiveness is not high enough to independently cope with the manifestations of esophageal varices. Traditional medicine can be used as a maintenance drug, to speed up the recovery process in the tissues of the veins. For example, with a high probability of bleeding, it is recommended to use decoctions and infusions of herbs with a hemostatic effect. It can be collections of nettles, thyme, upland birds.
Treatment with folk remedies can also be done at home, which is especially important as maintenance treatment of the disease in the stage of remission. Because esophageal varices is a serious injury, endangering the health and life of the patient, it is necessary to take into account the degree of influence of the selected traditional medicine. Home treatment is carried out under the constant supervision of a doctor.
Do you need a diet?
When diagnosing varicose veins in the gastrointestinal tract, the issue of dietary choices should be considered as one of the most important, because the food entering the patient's body depends largely on the health of the patient. of patients and indicators of treatment effectiveness. . The recommended diet for esophageal varices includes the observance of several possible rules, including the exclusion of certain foods and the inclusion of certain healing products in the daily menu. body in general and esophagus in particular.
Diet for patients with esophageal varices should exclude the following foods and substances from the patient's diet:
- Spice;
- a large amount of table salt;
- too much oil, especially of animal origin;
- Fried, canned, and smoked foods irritate the tissues of the esophagus and can cause bleeding.
Nutrition for patients with varicose veins of the esophagus as well as for patients with cirrhosis should add a lot of boiled, stewed food, and fermented dairy products to perfectly support the necessary microflora in the intestinal tract. , does not create an undue burden on the digestive system. full. A diet in small portions, controlling the number of calories to avoid undue influence on the digestive system will prevent the exacerbation of existing diseases and maintain the health of the esophagus.
Methods of disease prevention
To prevent varicose veins, it is necessary to eliminate bad habits, including smoking, drinking alcoholic beverages, fast food and junk food.
Routine examination by a gastroenterologist will help to identify venous disease even at the initial stage of pathological development and initiating treatment.
Healthy lifestyle
Maintaining a healthy lifestyle is a must for those who want to maintain a healthy digestive system.
Prevention of venous diseases, use of vitamin preparations to maintain a high level of immunity, and doctor visits are important factors for success.
Do exercise
To maintain the tone of the veins, to maintain the proper functioning of the digestive system, you should regularly perform the minimum necessary physical exercises.
Walking, gentle jogging, performing therapeutic exercises can be considered good preventive measures during the development of varicose veins.