Varices

What are varices?

Varices are enlarged veins that can occur in people who have liver disease. Normally, blood flows freely through the portal system in the liver. 
If blood struggles to get through the liver, either due to a blockage like a clot, or due to scarring in the liver then new blood vessels called varices can form. 

Varices are abnormal connections made as blood tries to bypass the liver. If these varices form in the lining of the gut, such as in the oesophagus (food pipe) or stomach then there is a risk that they can bleed.

The most common cause of varices is liver cirrhosis (scarring), with 9 out of 10 people with cirrhosis developing varices within 10 years.
The best way to stop varices from forming is to prevent or treat the underlying condition.

If you have a liver condition, or have varices, our specialists at the London Liver Group will help you come up with a plan to reduce your risk of bleeding and live your life as you want.

Causes

Varices are caused by conditions that affect the blood flow through the liver. In people who have cirrhosis, between 40%-95% of them have varices.

The condition is more common in men than women.

In Western countries, cirrhosis due to alcohol or from viral hepatitis are the most common causes of varices.
Other causes can include:

•    A blood clot in the portal vein
•    Acute hepatitis
•    Squeezing of the vein, such as with a cancer

Symptoms

If you have varices, you may not know it, because often they do not cause any symptoms.

This is why it is important that if you have liver disease, you are under the care of a specialist who will ensure that your condition is well managed. 
If varices start to bleed it can lead to:

•    Vomiting blood (haematemesis)
•    Passing blood or altered blood (melaena) in your stool
•    Abdominal pain
•    Confusion

If someone has varices that are bleeding quickly, they may appear pale, drowsy and feel cold to the touch. Bleeding varices is a medical emergency, and needs to be treated in a hospital immediately.

Diagnosis

If your specialist thinks that your liver condition puts you at risk of developing varices, they may suggest an endoscopy. This involves passing a thin camera through the mouth and down to the oesophagus. 

If you have varices your specialist will be able to see them, and assess their size and location. They may opt to perform treatment at the same time.

Your specialist may suggest other investigations if the cause of your liver condition is not known. These may involve blood tests and scans such as CT or MRI.

Treatments

The best way to prevent varices is to treat your underlying liver condition.

If you have already developed varices, your specialist may decide to treat them during an endoscopy, either by injecting them to block them, or by passing a band over them which will remove them.

For some patients, your specialist may recommend medication that can reduce the risk of bleeding. At the London Liver Group we will work with you to form a plan to manage your liver condition and reduce your risk of having a complication from varices.