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Variceal bleeding refers to the occurrence of bleeding from enlarged and fragile blood vessels called varices. Varices are most commonly found in the esophagus and stomach, but they can also occur in other parts of the gastrointestinal (GI) tract, such as the rectum. Varices develop when there is increased pressure in the portal vein, the large vein that carries blood from the digestive organs to the liver. This increased pressure can result from liver cirrhosis or other conditions that cause portal hypertension.
The most common cause of variceal bleeding is cirrhosis of the liver. In cirrhosis, the liver undergoes extensive scarring and becomes nodular, disrupting normal blood flow within the liver and leading to increased portal vein pressure. However, other conditions that cause portal hypertension, such as portal vein thrombosis, Budd-Chiari syndrome, and schistosomiasis, can also lead to varices and variceal bleeding.
Aortic dissections usually occur due to weaknesses in the inner layer of the aortic wall. Factors that can contribute to the development of aortic dissections include:
Symptoms of variceal bleeding can vary depending on the severity of the bleed but may include:
1. Vomiting of bright red blood or “coffee ground” material (partially digested blood).
2. Passage of black, tarry stools (melena) due to the presence of digested blood in the stool.
3. Low blood pressure and rapid heart rate due to blood loss.
4. Weakness, lightheadedness, or fainting.
Variceal bleeding can be life-threatening and requires urgent medical attention.
Diagnosis of variceal bleeding is typically based on clinical presentation and confirmed by endoscopy, where a flexible tube with a camera (endoscope) is inserted into the esophagus and stomach to visualize and identify the varices.
Treatment for variceal bleeding aims to stop the bleeding, prevent rebleeding, and manage the underlying cause of portal hypertension. Treatment options may include:
Preventing variceal bleeding involves managing the underlying cause of portal hypertension, such as treating liver cirrhosis and other liver diseases. Additionally, lifestyle modifications such as avoiding alcohol, following a low-sodium diet, and taking medications as prescribed can help reduce the risk of complications.
If you suspect variceal bleeding or experience symptoms of severe GI bleeding, seek immediate medical attention. Early diagnosis and appropriate intervention can significantly improve outcomes and reduce the risk of complications.