Varicose veins of the esophagus
Varicose veins of the esophagus in its lower part, the department occurs due to a blockage of the phenomena in the system of the hepatic portal vein, which appear when the thrombosis and liver cirrhosis. The cause of this disease, in the top department is the evil one, the crop. The hepatic vein is compressed, which causes the blood stream by themselves. Phlebectasia esophagus also appears as a complication of disease of the heart and of the spleen.
The factors that cause this disease:
- the stenosis of the portal vein, characteristic of the young generation, as a result of a thrombosis, multiple sclerosis;
- liver disease, occur in old age – cirrhosis, amyloidosis, echinococcosis;
- disease chiari;
- the angioma of the esophagus;
- malignant goitre;
- from the vascular pathology.
Varicose veins of the esophagus occurs most often in the following groups of patients:
- in the men;
- in people older than 50 years;
- in patients with a history of disease of the pancreas, the stomach, the heart of the chronic, cirrhosis.
The occurrence of bleeding does not affect both the level of pressure, how sudden in their fluctuations. The risk of rupture of the high and of those patients who suffer from heart diseases which impact negatively on the structure of the walls of the vessels.
Classification of the disease of varicose veins of the esophagus are repeatedly changed, however, now uses the 1997 version of the veins of the esophagus, separate disease grades:
- The first-degree. Vienna, reach a diameter of 5 mm, markedly elongated, are located in the lower level of the authority.
- At the second level. Vienna perplexis, reach a diameter of 10 mm, are found in the middle part of the authority.
- By the third grade. The vessels extended over up to 10 mm, wall tense, thin, are close to, twisting by the management, have red spots in the external surface.
If varicose veins of the esophagus all of the same has caused internal bleeding, according to the statistics after the survive only 50% of patients. More than half of the survivors after the bleeding of the sick are facing in a period of 1 to 3 years, with relapse of the disease and are forced to start a new treatment.
Varicose veins grade 1
The clinical picture is weakly expressed. The patient there are practically no complaints. For the follow-up survey: varicose veins are not a crystal up to 3 mm, ectasia of the veins are not, or are only unique, it clear that will not be filled. Is diagnosed only through endoscopy. The first measure is important as quickly as possible to begin treatment.
Varicose veins grade 2
Well observed irregularity of the vessels, there are also some nodules, of a size greater than 3 millimeters. To the east of the mucosa of the esophagus remains in the integrity, without any type of violations to its integrity.
In the study we can diagnose the expansion in the bulging of the vessels. The treatment must be carried out in a timely manner, just so you can get rid of the unpleasant symptoms of the disease in the initial phase. The bleeding is not characteristic in this stage.
Varicose veins grade 3Most frequently used the diagnosis. The patient is severely expressed by the symptoms. As a general rule, in this case, prescribed the operation. Vienna, too bulky, the nodes clearly act constantly improved, they occupy 2/3 of the esophagus, the mucosa of the esophagus is very thin. Arise gastroesophageal reflux.
Varicose veins 4 grade
This grade is taken out of the disease, when in the esophagus to detect numerous nodules of the veins, not descending, with a fine surface. In the mucosa of the layer are detected, numerous erosion. Patients record, in addition to the signs of esophagitis, salty taste in the mouth. The fourth level more often leads to spontaneously arising out of the bleeding.
The symptoms of varicose veins of the esophagus
The first years of varicose veins of the esophagus may occur without obvious symptoms. Sometimes are noted rare episodes of acid reflux, the weakness of gravity in the chest, belching. Some patients complain of difficulty swallowing.
Symptoms progressive of the disease usually appear a few days before the start of the bleeding. Signs consist of a greater severity in the chest and the deterioration of the general health of the patient. Other patients, symptoms may be subtle in the expression of the ascites.
In addition, the symptoms of the disease of the veins of the esophagus can manifest in the form of the head of the medusa". This phenomenon is a sort of figure, that it very well is seen on the front of the wall of the abdominal cavity different pathological resulting signaling of the vessels or the veins.
After the vein is broken, there is a strong bleeding, accompanied by the typical symptoms:
- strong reduction of the blood pressure;
- to detect the impurities in vomiting;
- to detect the impurities in the mass fecal;
- expressed in terms of the tachycardia.
When the small bleeding of a person may feel some weakness, discomfort, as well as the symptoms of anemia. Diagnosed varicose veins of the esophagus by laboratory tests, ultrasound of the organs of the abdominal cavity, if necessary, perform x-rays of research and esophagoscopy.
The diagnosis is pulled out to the root of the complaint, the external inspection, the primary identification of the disease. The instrumental of the research are:
- data of laboratory analysis of blood;
- x-ray with contrast substance;
- esophagoscopy should be performed with care, the risk of bleeding.
For the diagnosis of the possible causes must be taken into account and excluded, only then will final and accurately determine the cause of the bleeding and the change of the veins of the esophagus.
The treatment of varicose veins of the esophagus
If you experience symptoms of varicose veins of the esophagus treatment is done only in an intensive care unit or intensive care unit. The main classification of the non-surgical procedures focuses on the prevention and elimination of bleeding by reducing the pressure in the vessels:
- The treatment with medicines as the intake of vitamins, knitting medications, and antacids (drugs that reduce the acidity in the stomach). This method aims at the prevention of peptic of esophagitis, the inflammation may go on the walls of the vessels, causing a haemorrhage.
- Transfusions of blood, red cells, packed, the plasma;
- The introduction of the solutions colloidal;
- Receiving stream revitalizing and contribute to the vasoconstriction of the drug.
In the case of the methods of the list is not enough for a solid stop the bleeding, and the risk of repeated vascular damage in the future, they resort to surgery.
Patients should be lifelong strict diet, despite being:
- frequent meals in small portions.
- the exception of hot and cold dishes.
- displayed a low-fat broths and soups, cereal, diluted in milk or water, compotes, fruit in rub form, stews of vegetables.
- they are contraindicated in acute, sour, salty, fatty and fried foods, meat products, it is necessary to boil, to cook in the form of puree.
Is absolutely contraindicated in alcohol, soft drinks, beer.
The prevention of the
To prevent the transformation of healthy veins of the esophagus disease, varicose veins in the first place, it is necessary to monitor the state of the liver and in a timely manner and to cure all their diseases. To do this, experts advise to regularly access them, the counseling and follow all recommendations.
The prognosis for the life
Unfortunately, varicose veins of the esophagus terminal. However, in the case of the diagnosis, appropriate timely maintenance treatment will substantially improve the quality of life of the patient and help prevent the terrible state of the hemorrhage.
Mortality when it has already appeared the bleeding of the varicose veins of the esophagus is more than 50 % and depends on the severity of the underlying disease and the state of the organism in general. The survivors, after the bleeding of the sick in 75% of cases, in the next 1-2 years, there is a relapse.
In general, the long-term prognosis of the survival of patients with this disease remains low, which, primarily, serves the fault main of severe liver disease.