Have you ever suddenly vomited blood? Or has your stool suddenly turned pitch black and sticky? These are scary and nerve-wracking things to hear, right? But these are the main symptoms of the very dangerous condition we are talking about today called 'Bleeding Varices'. This is not something to be taken lightly, as it can even be life-threatening. So let's find out more about this today.
Simply put, what are 'varices'?
Varicose veins are swollen and enlarged blood vessels in our esophagus or stomach. Imagine some people's legs with blue, twisted veins, right? This is something like that. But this happens inside our bodies, in the digestive tract.
These swollen veins, or varicose veins, usually don't show any symptoms until they burst and start bleeding. Many people don't even know they have them. But the problem starts when these veins rupture, burst, and start bleeding. That's when it becomes a very serious medical emergency.
What are the dangerous symptoms of bleeding varicose veins?
When someone has Bleeding Varices, it should be recognized immediately. Because every second counts. Pay close attention to the symptoms below.
| Symptom | What does this mean? |
|---|---|
| Vomiting blood | A swollen vein is the clearest sign that it has burst. |
| Black, tarry, sticky stools | Blood that has passed through the upper part of the digestive tract is digested and excreted in this way. |
| Extreme dizziness and feeling faint | A drop in blood pressure due to a large amount of blood being lost from the body. |
| Increased heart rate | The heart starts working faster to compensate for the loss of blood in the body. |
| Shock | This is a very serious condition. Excessive bleeding causes the body's organs to not receive enough blood. |
If you have these symptoms, don't stay home for a second. Go to a hospital's Emergency Department (ETU) immediately. If bleeding is not controlled quickly, a person can even die.
Even if the bleeding stops, serious complications such as pneumonia, sepsis, and liver and kidney failure can occur.
Why do these varicose veins form and bleed? What is the root cause?
The main reason for this is a condition called 'Portal Hypertension' . Now look, the main blood vessel that carries blood from our digestive system to the liver is called the 'Portal Vein'. 'Portal Hypertension' is when the blood pressure inside this vein increases excessively due to some reason.
Okay, so why is this pressure increasing?
The most common cause of this is cirrhosis of the liver, which means that the liver becomes scarred and hard like a rock. We medically call this 'Cirrhosis' .
- For those who drink alcohol excessively.
- People with long-term viral infections like Hepatitis B and C.
- Cirrhosis can occur in some people with fatty liver disease.
Imagine what happens when there is a traffic jam on a major road? The vehicles try to go along the side roads, the small gravel roads, right? That's what happens here too. When it's hard for the blood (vehicles) to get through the liver (the main road), that blood tries to go through the small, delicate veins (the side roads) in the esophagus and stomach.
These small veins can't handle this much blood and this much pressure. The result is that the veins swell up like balloons, their walls become thin, and eventually burst and bleed from even the slightest provocation.
What are the treatments for this dangerous condition?
First of all, when admitted to the hospital, the first goal of doctors is to stop the bleeding and stabilize the patient's life. This may involve connecting the patient to a breathing machine to prevent blood from entering the lungs, and giving antibiotics to prevent blood poisoning.
Once the bleeding is controlled, there are various ways to prevent rebleeding and treat varicose veins.
| Treatment method | Simply explained |
|---|---|
| Banding | A gastroenterologist uses an endoscope to enter the esophagus and place small rubber bands around the swollen veins. This stops the blood flow and causes the veins to die. |
| Sclerotherapy | Instead of placing rubber bands, a special solution that clots the swollen veins is injected through the endoscope. |
| TIPS (Transjugular Intrahepatic Portosystemic Shunt) | This is a radiology procedure. A catheter is inserted through a vein in the neck and a 'stent' (a small tube) is inserted into the center of the liver. This connects the high-pressure portal vein with a normal vein, reducing the pressure. |
| DSRS (Distal Splenorenal Shunt) | This is a surgical procedure that involves connecting the vein of the spleen to the vein of the left kidney to reduce pressure on the varicose veins and control bleeding. |
| Liver Transplant | If the liver is completely failing and the disease is in the final stages (end-stage liver disease), this is the best solution. |
Can this situation be prevented?
Of course it is possible. The best way to prevent this is to treat the underlying cause, which is liver disease. If liver disease is diagnosed and treated early, the development of these varicose veins can be largely prevented.
- Avoid alcohol completely. This is the main cause of cirrhosis.
- Get proper treatment for Hepatitis B and C.
- Control fatty liver through a healthy diet and exercise.
Also, some medications, such as beta-blockers for heart disease, can help reduce the risk of bleeding by reducing pressure in the portal vein. It is important to discuss all of this with your doctor and follow their instructions carefully.
Take-Home Message
- Varices are swollen veins in the esophagus or stomach. They usually don't show symptoms until they burst and bleed.
- Vomiting blood and passing black, tarry stools are the most serious symptoms. If you see these, go to a hospital's Emergency Department (ETU) immediately.
- The main reason for this is a condition called Portal Hypertension, which is caused by liver disease (especially cirrhosis).
- Avoiding excessive alcohol consumption and properly treating liver disease can reduce the risk of this condition.
- If you have liver disease, always consult with your doctor and follow the prescribed treatment and tests exactly.
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