Etiology of Upper and Lower Gastrointestinal Bleeding
Esophageal Varices and Their Contribution to Upper GI Bleeding
Esophageal varices, caused by portal hypertension, are a major contributor to upper GI bleeding. Early diagnosis and treatment are crucial for preventing complications.
6/7/2025• 3 min read• 62 views
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normalintermediateGeneral Medicine
Etiology of Upper and Lower Gastrointestinal Bleeding
Esophageal Varices and Their Contribution to Upper GI Bleeding
Esophageal varices are dilated submucosal veins that develop in the esophagus due to increased portal hypertension, often seen in patients with liver cirrhosis. These veins are prone to rupture, leading to severe upper gastrointestinal bleeding.
Causes of Esophageal Varices
- Chronic liver disease (cirrhosis)
- Portal hypertension
- Alcoholic liver disease
- Hepatitis-related liver damage
Clinical Presentation
Patients with esophageal varices often remain asymptomatic until rupture occurs, leading to life-threatening bleeding. Symptoms include:
- Hematemesis (vomiting blood)
- Melena (dark, tarry stools)
- Hypotension and shock
Diagnosis
Endoscopic evaluation is the gold standard for diagnosing esophageal varices. Additional imaging such as Doppler ultrasound may assess portal hypertension.
Treatment and Management
Management of esophageal varices includes:
- Endoscopic band ligation or sclerotherapy
- Pharmacologic therapy (beta-blockers to reduce portal pressure)
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Liver transplantation in severe cases
Tags
#Esophageal Varices#Upper GI Bleeding#Liver Cirrhosis#Portal Hypertension