A pathological condition in which there is expansion of blood vessels in the lower esophagus or tube region of the stomach adjacent to it, called varicose veins of the esophagus, symptoms of which will be discussed in this article.
Disease develops owing to the increased pressure in the portal the vein, reducing blood flow. This condition is called chronic hepatitis b, cirrhosis of the liver. There is a change in structure of blood vessels. On their walls are formed of different protrusion, and the shell of the capillary thinning.
The vessels have a tortuous shape, the mucous membrane is hyperemic and has ulceration. This leads to massive bleeding who do not have prior symptoms.
Pathology has a code ICD 185, which is defined as varicose veins of the esophagus, 185 (9) without bleeding, 185 (0) bleeding.
What it is
Resistant hypertension (high blood pressure) in the portal Vienna in 2-4 times more than normal leads to disease of the esophagus. Further increase in pressure (24 – 27 waters.St.) leads to rupture of the vessel and development of bleeding.
Hypertension in the portal vein leads to a decrease in blood flow, the deformation of blood vessels, extended and refined walls. On the walls of blood vessels are formed protrusions where the blood. At elevated pressure increases the load on the capillary wall and can burst.
At pathologies of the vascular system varicose veins are very small and localized across the surface of the tube of the esophagus. When the extension is invoked pathological processes that occur in the liver, the vessels are more dilated, and are surprised they are in the lower area of the esophagus.
Complications such as bleeding do not depend on the size of the varicose node, or from the state of the vascular wall and the jump in pressure in the portal vein.
It provoked:
- overeating;
- enhanced physical activity;
- the increase in intra-abdominal pressure.
Sometimes the bleeding is manifested during sleep. There are factors that exacerbate the condition: failure of the cardia, and a reduction in blood clotting. Here dangerous than varicose veins of the esophagus.
With the disease of varicose veins of the esophagus ICD 10 code the doctor needs to know.
Esophageal varices: causes
The reasons for its development are the pathological processes that lead to portal hypertension in Vienna. This:
- parenchymal disease of the liver caused by cirrhosis, tumors, amyloidosis;
- stenosis of the portal vein (thrombosis, compression from sclerosis);
- chronic insufficiency of the cardiovascular system.
At risk people who may receive varicose of the esophagus include:
- >persons older than 50 years (most were men);
- patients who have chronic diseases of the cardiovascular system and digestive tract;
- patients with liver cirrhosis.
Most often varicose veins of the esophagus develops in liver cirrhosis and chronic hepatitis. The abuse of alcohol occurs changes in the structure of the parenchyma. There are formed scarring that disrupt normal blood flow, slow it down, resulting in stagnation of blood and formation of varicose vessels.
The stage of the disease
Isolated congenital form that occurs in newborns. But this pathology is rare and is accompanied by other serious violations. The development of the disorders causes by hereditary factors and pregnancy. The acquired form occurs in men who have crossed 50 years of age and who have bad habits.
According to the degree of vascular lesions there are four types of disease:
1 phase. This is the initial degree to which the varices in an amount not exceed 3 mm and are determined only by endoscopic examination. When conducting x-ray with contrast agent shows slow blood flow, but no bleeding. While esophageal opening is reduced "irregular".
Phase 2. In this stage the lumen of the vessel is not broken and varicose veins are not enlarged, but the veins become tortuous structure. The diagnosis is confirmed using contrast radiography, which shows no clear contours of the vessels and rounded protrusions. No bleeding.
3 phase. There has been a steady expansion of some parts of the vessels, the vein lumen is narrowed. Clearly visible varices, altered mucous membrane (thinning). This phase is characterized by a high risk of bleeding.
On the x-ray picture shows the formation on the lining of the esophagus in the form of polyps, as well as chiseled perforation of the mucosa. The condition is regarded as severe and requires immediate hospitalization.
Phase 4. There is a strong thinning of the mucous membrane of the vessels, education polyps. Varices of the esophagus in this stage have the form of grapes and substantially block the lumen of the esophagus. With the progression of the disease can shut it down. During this period, the patient suffers from redness of the mucous membrane, formation on it of erosive defects. This condition is regarded as critical, because it causes frequent and massive bleeding.
Varicose veins of the esophagus symptoms
Onset of the disease does not manifest itself. Therefore, patients seek treatment when the disease is already "gained momentum". To independently identify the disease cannot, because the initial manifestations of the disease are similar to symptoms of disorders of the digestive system. Thus, if there is dilatation of the esophagus, the symptoms will be the following:
- the emergence of shortness of breath;
- the presence of heartburn (does not depend on the meal);
- soreness in the region of the xiphoid process;
- impaired swallowing.
If you have varicose veins of the esophagus and stomach, its main sign — vascular pattern on the skin of the anterior abdominal wall in the form of "Medusa head". It consists of pathologically changed veins. This symptom appears in the later period of the disease. Later, with the appearance of bleeding in a patient being present:
- bloody vomiting;
- blood in the stool;
- tachycardia;
- hypotension (sharp decrease in blood pressure);
- shock.
Diagnosis and treatment
Is determined by the patient's varicose veins of the stomach and esophagus such techniques as:
- Ultrasound of the esophagus, abdominal cavity;
- General analysis of blood;
- x-ray using contrast.
Making a diagnosis, take into account that the bleeding may cause ulcerative lesions of the esophagus, decaying of the tumor. A longitudinal tear in the mucosa of the upper part of the stomach or distal region of the esophagus caused by frequent vomiting.
Upon confirmation of the diagnosis of varicose veins of the esophagus treatment, according to the degree of vascular lesions of the esophagus tube. If the disease is discovered when you see the bleeding, then treatment is aimed at stopping:
- a blood transfusion;
- vasoconstrictors;
- hemostatic medicine;
- electrocoagulation of the affected vessel;
- pressure on the affected blood vessels by the probe.
After this is conducted therapeutic measures aimed at the prevention of recurrence (iteration) attack. If you are experiencing varicose veins of the esophagus liver cirrhosis, is the treatment of the underlying disease. It is aimed at restoring the function of liver tissue. Also, the patient should give up bad habits, avoid strong physical exercise.
- Prescribe antacids (medicines that reduce the acidity of gastric juice), to prevent unnecessary irritation of the esophagus.
- Astringent preparationsthat reduce inflammation.
- A vitamin therapy.
When the diagnosis of varicose veins of the esophagus drug therapies may be supplemented by surgical intervention for relapse prevention may hold.
Bandage over varicose set small disks of rubber. Introduction hemostatic solution into the affected vein. Carry out the procedure at least four times a year. Completely removed all the damaged veins that are not amenable to restoration.
Cirrhosis of the liver the patient can not complete the operation. In this case, conduct an endoscopic investigation of esophagus vessels. The procedure is the ligation of the vessel with a nylon loop or elastic rings.
The particular bypass, which connect the portal and hepatic veins. This gives an opportunity to normalize the pressure in the blood vessels.
Diet
When the diagnosis of varicose veins of the esophagus treatment includes many measures, including compliance with certain rules of supply.
Diet for varicose veins of the esophagus refers to the use of products capable of enhancing the elasticity of blood vessels, strengthen them and also prevent the formation of blood clots.
The recommended food should contain vitamin b, C and fiber:
- bean;
- lettuce;
- corn and olive oil;
- citrus;
- seafood;
- nuts;
- the vegetables and fruits.
Meat is replaced with seafood or beef liver. It is not advisable to eat salty, spicy and tangy dishes, after which the patient drinks plenty of water. This leads to swelling of tissues. The recommended amount of fluid per day is 2 liters. Also can't drink whole milk, reducing the elasticity of blood vessels.
You cannot apply:
- alcohol;
- black tea and coffee;
- confectionery;
- canned and smoked meats;
- sugar.
In the preparation and consumption of dishes has its own nuances. To cook food you need a way of cooking, and bake. You need to eat small portions, so as not to transfer, this dish should not be too hot or cold.
Preventive measures
To prevent diseases you need to consult a doctor. Provides treatment of pathologies of the liver, if they are in the history. You must follow proper nutrition, get rid of bad habits and monitor the weight. Also no need to subject the body to excessive physical loads.
This applies not only to activities but also training in the gym with the implementation of power exercises. Exercise does not have to be turned off, but you need to perform exercises designed by physiotherapists specifically for patients with varicose veins of the esophagus. A range of exercises aimed at improving blood circulation, reducing the risk of blood clots, lowering of cholesterol deposits.
Also in the prevention of such diseases as varicose veins of the esophagus plays a big role, well-coordinated work of the digestive tract. Therefore, in such patients it is recommended to use infusions of herbsthat have choleretic effect and improve digestion. To prevent reflux (regurgitation) of stomach contents into the esophagus, thus irritation of the need to sleep, raising the head of your bed 10 cm.
The implementation of these recommendations will help to avoid development of the disease or its recurrence. And we must remember that to go to the doctor necessary at the first symptoms to prevent serious complications such as excessive bleeding. It is undesirable to deal with the disease venous dilatation of the esophagus.