A pathological condition in which dilation of the vessels in the lower part of the tube of the esophagus or of the stomach, adhering to it, called varicose veins of the esophagus, the symptoms of which are discussed in detail in this article.
The disease due to the increased pressure in the portal vein, the reduction of the flow of blood. Such a state is called chronic hepatitis, cirrhosis of the liver. It is a change in the structure of the blood vessels. Their walls are formed of various rough, and the sheath capillary tapers.
The vessels are of the sinuous forms, the mucosa is hyperemic and lesions. This leads to massive haemorrhage, not having the pre-symptoms.
The pathology has a code ICD 185, which is defined as the varicose veins of the esophagus, 185 (9) without bleeding, 185 (0) of bleeding.
What is this
Stable high blood pressure (hypertension) in the portal vein 2-4 times more than the standard leads to disease of the esophagus. Further increase of the pressure (24 – 27 of the eau.de the article) led to a vessel rupture and the development of hemorrhage.
Hypertension in the portal vein leads to a decrease of the blood flow, the deformation of blood vessels, their elongation and thinning of the wall. On the walls of the blood vessels grow rough, where will the blood. When the pressure increases it increases the pressure on the wall of the capillary and it can break.
In heart disease varicose veins has a tiny size and is localized on the surface of the tube of the esophagus. If the extension is called by processes that take place in the liver, the vessels, more extensive, and were surprised-they in the neighbourhood of the lower esophagus.
Complications such as bleeding do not depend on the size of the varicose veins of the host or of the state of the vascular wall, and jump out of pressure in the portal vein.
Of his cause:
- bulimia;
- enhanced physical activity;
- the increase in intra-abdominal pressure.
Sometimes, the bleeding is manifested during sleep. There are factors that aggravate the condition: failure cardia, as well as the reduction of coagulation. Here are the most dangerous varicose veins dilated veins of the esophagus.
In the case of esophageal varices icd-10 code must know the doctor.
Varicose veins of the esophagus: causes
The causes of its development are of the pathological processes leading to portal hypertension vienna. It is:
- parenchymal disease of the liver caused by cirrhosis, tumors, amyloidosis;
- stenosis of the vein (thrombosis, collapse outside, multiple sclerosis);
- chronic insufficiency of the cardio-vascular system.
To a risk group, persons who may appear in varicose veins of the esophagus, including:
- >people who are older than 50 years (most often men);
- patients with a chronic pathology of the SMT and the GASTRO-intestinal tract;
- the cirrhotics.
Most often varicose veins of the esophagus develops when the cirrhosis and chronic hepatitis. Alcohol abuse produces changes in the structure of the parenchyma. There are formed scars, which disrupt the normal blood flow, slow down, resulting in a stagnation of blood and formation of varicose blood vessels.
The stage of the disease
Emit innate to the form, which is observed in newborns. But this pathology is rare and is accompanied by other serious violations. The development of the violation causes the hereditary factor and during pregnancy. Acquisition of the form observed in the men, stepped 50 years old and having bad habits.
Depending on the degree of the lesion of the vessels there are four types of disease:
Phase 1. This is the initial measurement, during which the varicose veins do not exceed 3 mm and are only defined during the endoscopic study. When conducting x-rays with contrast to see slowed traffic, but no bleeding. When this esophagus hole reduced "irregular".
Phase 2. At this stage of the lumen of the blood vessel is not broken and varicose veins is not increased, but the veins acquire winding structure. The diagnosis is confirmed using contrast radiography, we distinguish the contours of the vessels and rounded rough. Bleeding.
3 phase. We observe resistant to the extension of some parts of the vessels, the clearance of the vein reduces. Clearly the varicose veins, the alteration of the mucous membrane (thinning). This phase is the characteristic of a high risk of onset of bleeding.
On the chest x-ray to a visible image of education on the mucosa of the esophagus in the form of polyps, as well as carved out the perforation of the mucosa. The state is considered as heavy and requires immediate hospitalization.
4 phase. We observe a strong thinning of the lining of the vessels, of the education on it polyps. Varicose veins of the esophagus, and at this stage have the appearance of bunches and far outweigh skylight of the esophagus. During the progression of the disease can be completely closed. In this period, the patient may produce a reddening of the mucosa of the education on its erosion defects. Such a state is regarded as critical, since the causes of frequent and massive bleeding.
Varicose veins of the esophagus: symptoms
The beginning of the disease nothing does not manifest itself. Therefore, the sick to seek treatment, when the disease is already "grown". You recognize the disease of the impossible, because the first manifestations of the disease are similar to symptoms of disorders of the digestive system. Therefore, if a varicose veins of the esophagus, the symptoms are the following:
- the onset of dyspnea;
- the presence of heartburn (does not depend on the intake of food);
- the pain in the area of the xiphoid apophyse;
- violation of swallowing.
If the varicose veins of the esophagus and stomach, the sign — vascular figure on the skin of the abdominal wall in the form of "medusa's head". His form pathologically modified vienna. This symptom appears later in the period of development of the disease. Later, when the bleeding in a patient presents with:
- hematemesis;
- blood in the stool;
- tachycardia;
- hypotonia (severe drop in blood pressure);
- it was a shock.
The diagnosis and treatment
Determined by the patient's varicose veins of the stomach and the esophagus by methods such as:
- The ULTRASOUND study of the esophagus, organs of the abdominal cavity;
- total analysis of blood;
- the x-ray with the application of contrast.
Establish a diagnosis, to take account of the fact that the bleeding can lead to ulcer is a defeat of the esophagus, the decomposition of the tumor. This is longitudinal of the gap of the mucous membrane of the upper part of the stomach or the distal region of the esophagus caused by frequent vomiting.
Upon the confirmation of the diagnosis of varicose veins of the esophagus the treatment is prescribed, depending on the degree of vascular lesions of the tube of the esophagus. If the disease is detected when the bleeding, then the treatment is devoted to his judgment:
- the transfusion of blood;
- vasoconstrictor drugs;
- hemostatic drugs;
- electrocoagulation vascular disease;
- the pressure on the affected area special containers of the probe.
After that, organizes therapeutic interventions designed to prevent recidivism (repetition) of a heart attack. If you look at the varicose veins of the esophagus in cirrhosis of the liver, the underlying disease. It is dedicated to the recovery of the function of the liver tissue. In addition, the patient is recommended to give up bad habits, avoid strong physical constraints.
- Prescribe antacids (medicines which reduce stomach acidity), in order to prevent an excessive stimulation of the lining of the esophagus.
- Binding of drugsto relieve the inflammation.
- Activating vitamins therapy.
When the diagnosis of varicose veins of the esophagus medication may be supplemented by surgical intervention to prevent relapses, it is possible to organize.
Jockstrap top of the extension are installed small disks of rubber. The introduction of the solution as a hemostatic agent in vienna. The procedure should not be less than four times per year. Permanently deletes all of the damaged veins that are not recoverable.
In cases of liver cirrhosis in a patient of not making a classic of the operation. In this case, passing endoscopic the doping of the vessels of the esophagus. The procedure is the ligation of vessel in nylon or mesh by spring rings.
Particular of the bypass surgery, which bind portal and hepatic vein. This gives the possibility to normalize the pressure in the vessels.
Dietary food
When the diagnosis of esophageal varices treatment includes many measures, including the observance of certain dietary rules.
The regime of varicose veins of the esophagus involves the consumption of products able to enhance the elasticity of blood vessels, strengthen them, and prevent the formation of blood clots.
Featured products of the food must contain vitamin c as well as fiber:
- pulses;
- the lettuce leaves;
- corn oil and olive oil;
- citrus fruits;
- seafood;
- nuts;
- the vegetables and fruits.
The meat is better to replace the seafood or liver. It is not advisable to consume foods that are salty, spicy and salted, after which the patient drinks a lot of water. This leads to a swelling of the tissues. The recommended amount of fluid per day is 2 litres. Also you can't drink whole milk, because it contributes to reduce the elasticity of blood vessels.
Do not drink l':
- alcohol;
- the black tea and coffee;
- confectionery;
- canned goods and meats;
- sugar.
In the preparation and consumption of dishes, there are nuances. Cook need on the torque and / or the method of cooking and bake in the oven. Take food need small portions not to be transmitted, the meal must not be too hot or cold.
Prevention activities
For the prevention of the disease should be a quick access to a doctor. The treatment of pathologies of the liver, if they have a history. It is necessary to adhere to a good nutrition, getting rid of bad habits, to monitor the weight. Also, no need to expose excessive of the organism to physical effort.
This not only concerns the kind of activities, but the gym performing exercises of force. The physical exercises must not be excluded, but respond to a need of recharging, developed by the doctor of the CFL specially designed for the patients of varicose veins of the esophagus. The services of these exercises is to improve blood circulation, reduce the risk of formation of blood clots, the reduction of deposits of cholesterol.
Also in the prevention of this disease such as varicose veins of the esophagus, plays a role in good location. Therefore, these patients, it is recommended to consume infusions of herbs, having an effect choleretic and improving digestion. For the prevention of reflux (casting) the contents of the stomach into the esophagus and irritation of the mucosa, need to sleep, raising the head of bed on 10 see
The implementation of these recommendations will prevent the development of severe disease or relapse. And it must be remembered that contact the doctor needs at the onset of the first symptoms, so as not to allow of serious complications such as bleeding. Desirable to deal with the venous disease varicose veins of the esophagus.