Newspaper article St Louis Post-Dispatch (MO)

How to Handle Esophageal Veins

Newspaper article St Louis Post-Dispatch (MO)

How to Handle Esophageal Veins

Article excerpt

Dear Dr. Donohue: I have esophageal varices. Is this varicose veins? I need an interpretation of that. Also, what would the symptoms be? What are the treatment and cure?

A varix is an enlarged - varicosed - blood vessel. "Varices" is the plural form of "varix."

Here, the enlargement is of veins serving the lower part of the esophagus, the swallowing tube. That might seem a strange location for varicose veins, but they do form there because of abnormal blood flow from the liver to the heart. That can begin with liver cirrhosis, where the shrunken and scarred organ diverts blood flow in an abnormal direction, allowing it to enter and stretch out the esophagus vessels.

Because esophageal veins lie close to the surface, any break poses a threat of serious internal bleeding. So control becomes important, all the more so since early symptoms are scant. Often, it just bursts forth in a copious vomiting of blood.

Treatment of esophageal varices takes three forms:

You can do away with the veins using an oral scope device to inject them with a scar-forming material.

Sometimes, beta blocker drugs can reduce the pressure in the affected veins.

More rarely, surgery is done to redirect the local blood circulation so that the veins in question no longer bear the brunt of the abnormal pressure.

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Dear Dr. Donohue: There seems to be some doubt about treatment for my endometriosis. What's the best?

Treatment depends on the severity of the pain and the location of the endometrial implants. …

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