A disease in which there is vasodilatation in the lower part of the tube of the esophagus stomach or adjacent to it, called varicose veins of the esophagus, the symptoms of which will be discussed in this article.
The disease develops because of the increased pressure in the portal vein, the reduction of blood flow. This condition is called chronic hepatitis b, cirrhosis of the liver. There has been a change in the structure of the blood vessels. In its walls are formed of different coming out, and the shell of the capillary thinning.
The vessels have a tortuous shape, the mucous membrane is hyperemic and has ulceration. This leads to a bleeding mass, without need of prior symptoms.
Pathology has a code ICD 185, which is defined as the varicose veins of the esophagus, 185 (9) without bleeding, 185 (0) bleeding.
What is
Resistant hypertension (high blood pressure) in the portal of Vienna in 2-4 times more than normal leads to disease of the esophagus. Further increase of the pressure (24 – 27 of water.St) leads to the rupture of the vessel and the development of bleeding.
Hypertension in the portal vein leads to a decrease in the blood flow, the deformation of blood vessels, their elongation and thinning of the walls. In the walls of blood vessels are formed emergencies where the blood. The high pressure increases the load on the capillary wall and can burst.
Diseases of the vascular system of the veins are very small and localized across the surface of the tube of the esophagus. If the extension is called pathological processes in the liver, the vessels are more dilated, and I'm surprised that they are in the lower area of the esophagus.
Complications, such as bleeding does not depend on the size of the varicose node, or from the state of the vascular wall and the jump of pressure in the portal vein.
Provoked:
- overeating;
- improved physical activity;
- the increase of the 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 the coagulation of the blood. Here dangerous than varicose veins of the esophagus.
With the disease of varicose veins of the esophagus ICD code 10 the doctor should know.
Esophagus varicose veins: causes
The reasons for its development are the pathological processes that lead to hypertension in the portal vein. This:
- parenchymal disease of the liver caused by cirrhosis, tumors, amyloidosis;
- stenosis of the portal vein (thrombosis, compression of the exterior, multiple sclerosis);
- chronic insufficiency of the cardiovascular system.
At the risk of the people who can get varicose veins of the esophagus include:
- >people over 50 years of age (most were men);
- patients with pathology chronic of the cardiovascular system and the digestive system;
- patients with liver cirrhosis.
Most often varicose veins of the esophagus develops in liver cirrhosis and chronic hepatitis. Alcohol abuse produces changes in the structure of the parenchyma. There is formed the scars that disturb the normal development of blood flow, slow it down, resulting in a stagnation of blood and formation of varicose veins and blood vessels.
The stage of the disease
Isolated congenital form that occurs in newborns. But this rare pathology and is accompanied by other serious violations. The development of disorders causes by hereditary factors and pregnancy. The acquired form occurs in men over 50 years of age and have bad habits.
According to the degree of vascular lesions there are four types of disease:
1 phase. This is the initial degree in which the varicose veins in an amount that does not exceed 3 mm and is determined only by the examination endoscopic. At the time of making the x-ray with contrast agent shows slow flow of blood, but no bleeding. While esophageal opening is reduced to "irregular".
Phase 2. In this stage, the lumen of the vessel is not broken and the veins are not enlarged, but the veins being tortuous structure. The diagnosis is confirmed with x-ray contrast, which does not show clear contours of the blood vessels and bumps rounded. No bleeding.
3 phase. There has been a steady expansion of some parts of the vessels, the vein lumen is reduced. Clearly visible varicose veins, alteration of the mucous membrane (thinning). This phase is characterized by a high risk of bleeding.
The x-ray image shows the formation in the mucosa of the esophagus in the form of polyps, as well as chiseled piercing the mucosa. The condition is regarded as serious and requires immediate hospitalization.
Phase 4. There is a strong thinning of the membrane lining of the vessels, the formation of polyps. Varicose veins of the esophagus at this stage have the form of clusters and substantially block the light, of the esophagus. With the progression of the disease, can shut down. During this period, the patient suffers from redness of the membrane lining, training on it's own defects. This condition is regarded as critical, since it causes frequent bleeding and massive.
Varicose veins of the esophagus symptoms
Onset of the disease does not manifest itself. Therefore, patients seek treatment when the disease is already "gaining momentum". Independently to identify the disease is impossible, as the first manifestations of the disease are similar to symptoms of disorders of the digestive system. Therefore, if there is dilation of the esophagus, the symptoms will be the following:
- the appearance of dyspnoea;
- the presence of heartburn (does not depend on the flour);
- pain in the region of the xiphoid process;
- impairment of swallowing.
If you have varicose veins of the esophagus and of the stomach, its main characteristic pattern of vascular on the skin of the abdominal wall above in the form of "head of Medusa". 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 (decrease blood pressure);
- shock.
Diagnosis and treatment
It is determined by the patient's varicose veins of the stomach and esophagus by methods such as:
- Ultrasound of the esophagus, abdominal cavity;
- General analysis of blood;
- x-ray with contrast.
Make a diagnosis, take into account that the bleeding may cause ulcerative lesions of the esophagus, the decomposition of the tumor. Longitudinal tear in the mucosa of the upper part of the stomach or the distal region of the esophagus caused by frequent vomiting.
After the confirmation of the diagnosis of varicose veins of the esophagus treatment, respectively, the degree of vascular lesions of the tube of the esophagus. If the disease is discovered when you see the bleeding, then the treatment is directed to stop:
- a blood transfusion;
- vasoconstrictors;
- styptic medicines;
- electrocoagulation of the affected vessel;
- the pressure on the affected blood vessels by the probe.
After that it carries out therapeutic measures aimed at the prevention of the recurrence (iteration) attack. If you are experiencing varicose veins of the esophagus liver cirrhosis, is the treatment of the underlying condition. It is aimed at the restoration of the function of the liver tissue. Also, the patient must give up bad habits, avoid strong physical exercise.
- Prescribe antacids (medication to reduce the acidity of the juice gastric), to avoid unnecessary irritation of the esophagus.
- Astringent preparationsthat reduce inflammation.
- A vitamin therapy.
When the diagnosis of varicose veins of the esophagus drug therapies can be supplemented by surgical intervention for the prevention of relapse can be the owners.
Bandage for varicose veins set of small disks of rubber. Introduction hemostatic solution into the affected vein. Perform the procedure at least four times a year. Completely removed all of the damaged veins that are not recoverable.
Cirrhosis of the liver the patient can not complete the operation. In this case, to conduct an endoscopic investigation of the esophagus blood vessels. The procedure consists of ligation of the vessel with a nylon loop or elastic rings.
The special shunt, connecting the portal and hepatic veins. This gives an opportunity to normalize the pressure in the blood vessels.
The diet
When the diagnosis of varicose veins of the esophagus treatment includes many measures, including the compliance with certain rules of supply.
Diet for varicose veins of the esophagus involves the use of products capable of improving the elasticity of blood vessels, strengthen them, and also prevents the formation of blood clots.
The recommended food should contain vitamin b, C and fiber:
- bean;
- lettuce;
- the corn and olive oil;
- citrus fruits;
- seafood;
- nuts;
- the vegetables and fruits.
The meat is substituted with seafood or meat liver. It is not advisable to eat salty, spicy and tangy dishes, after which the patient drinks a lot of water. This leads to an inflammation of the tissues. It is recommended that the amount of fluid per day is 2 liters. Also you can not drink whole milk, the reduction of the elasticity of the blood vessels.
You can't use:
- alcohol;
- black tea and coffee;
- confectionery;
- pickled and smoked;
- sugar.
In the preparation and consumption of dishes has its own nuances. To cook food you need a way of cooking and baking. You need to eat small portions, so as not to transfer, this plate must not be too hot or cold.
Measures of prevention
To prevent disease you should immediately contact your doctor. Treatment of the pathology of the liver, if they are in the story. You must follow proper nutrition, get rid of bad habits and weight control. Also no need to subject the body to excessive loads physical.
This applies not only to activities, but also training in the gym with the implementation of power exercises. The exercise should not be excluded, but need to perform exercises designed by physiotherapists specifically for patients with varicose veins of the esophagus. A series of exercises intended to improve circulation of the blood, 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 system. Therefore, in these patients it is recommended to drink infusions of medicinal herbsthat have choleretic effect, improves digestion and l'. In order to avoid reflux (regurgitation) of the stomach contents into the esophagus thus, the irritation, you need to sleep, elevate the head of your bed 10 cm.
The implementation of these recommendations will help to prevent the 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 dilation of the esophagus.