A pathological condition in which there is vasodilatation in the lower part of the tube of the esophagus or stomach adjacent to it, called varicose veins of the esophagus, symptoms of which will be discussed in this article.
The disease develops as a result of increased pressure in the portal vein, the reduction of the outflow of blood. This condition is called chronic hepatitis To cirrhosis of the liver. There is a change in structure of blood vessels. On their walls are formed of different protrusion, and the shell of the capillary thinning.
The vessels have a tortuous shape, the mucous membrane is hyperemic and has sores. This leads to massive bleeding who do not have prior symptoms.
Pathology has a code ICD 185, which is defined as varicose veins of the esophagus, 185 (9) without bleeding, 185 (0) bleeding.
What it is
Resistant hypertension (high blood pressure in the portal Vienna in 2-4 times more than normal leads to disease of the esophagus. Further increase in pressure (24 – 27 waters.St) leads to rupture of the vessel and development of bleeding.
Hypertension in the portal vein leads to a decrease in blood flow, the deformation of blood vessels-their elongation and thinning of the walls. On the walls of blood vessels are formed protrusions where the blood. At elevated pressure increases the load on the capillary wall and can burst.
At pathologies of the vascular system varicose veins are very small and localized across the surface of the tube of the esophagus. If the extension is called pathological processes that occur in the liver, the vessels are more dilated, and am amazed they are in the lower area of the esophagus.
Complications such as bleeding do not depend on the size of the varicose node, or from the state of the vascular wall and the jump in pressure in the portal vein.
It provoked:
- overeating;
- enhanced physical activity;
- the increase in 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 blood clotting. Here dangerous than varicose veins of the esophagus.
With the disease of varicose veins of the esophagus ICD 10 code the doctor needs to know.
Esophageal varices: 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 from the outside, multiple sclerosis);
- chronic insufficiency of the cardiovascular system.
At risk people who may receive varicose of the esophagus include:
- >persons older than 50 years (most were men);
- patients with chronic pathology of the cardiovascular system and digestive tract;
- patients with liver cirrhosis.
Most often varicose veins of the esophagus develops in liver cirrhosis, chronic hepatitis. The abuse of alcohol occurs changes in the structure of the parenchyma. There, scars are formed that disrupt normal blood flow, slow it down, resulting in stagnation of blood and formation of varicose vessels.
The stage of the disease
Isolated congenital form that occurs in newborns. But this pathology is rare and is accompanied by other serious violations. The development of the disorders causes by hereditary factors and pregnancy. The acquired form occurs in men over 50 years old and have bad habits.
According to the degree of vascular lesions there are four types of disease:
1 phase. This is the initial degree to which the varices in an amount not exceed 3 mm and are determined only by endoscopic examination. When conducting x-ray with contrast agent shows slow blood flow, but no bleeding. In this case the esophageal hole is shrinking "jumps".
Phase 2. In this stage the lumen of the vessel is not broken and varicose veins are not enlarged, but the veins become tortuous structure. The diagnosis is confirmed using contrast radiography, showing no clear contours of the vessels and rounded protrusions. No bleeding.
3 phase. There has been a steady expansion of some parts of the vessels, the lumen of the vein is narrowed. Clearly visible varices, altered mucous membrane (thinning). This phase is characterized by a high risk of bleeding.
On the x-ray image visible formation on the mucous membrane of the esophagus in the form of polyps, as well as the exact perforation of the mucosa. The condition is regarded as severe and requires immediate hospitalization.
Phase 4. There is a significant thinning of the mucous membrane of the vessels, education polyps. Varices of the esophagus in this stage have the form of clusters and substantially block the lumen of the esophagus. With the progression of the disease can shut it down. During this period, the patient suffers from redness of the mucous membrane, formation on it of erosive defects. This condition is regarded as critical, because it causes frequent and massive bleeding.
Varicose veins of the esophagus symptoms
The beginning of the disease does not manifest itself. Therefore, patients seek treatment when the disease is already "gained momentum". To independently identify the disease it is impossible, because the initial manifestations of the disease are similar to symptoms of disorders of the digestive system. So, if there is dilatation of the esophagus, the symptoms will be the following:
- the emergence of shortness of breath;
- the presence of heartburn (does not depend on the meal);
- soreness in the region of the xiphoid process;
- violations of swallowing.
If you have varicose veins of the esophagus and stomach, its main characteristic vascular pattern on the skin of the anterior abdominal wall in the form of "Medusa head". 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 is:
- bloody vomiting;
- blood in the stool;
- tachycardia;
- hypotension (sharp decrease in blood pressure);
- shock.
Diagnosis and treatment
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 using contrast.
Making a diagnosis, take into account that the bleeding may cause ulcerative lesions of the esophagus, decaying of the tumor. A longitudinal rupture of the mucous membrane of the upper part of the stomach or distal region of the esophagus caused by frequent vomiting.
Upon confirmation of the diagnosis of varicose veins of the esophagus treatment according to degree of vascular lesions of the tube of the esophagus. If the disease is detected in the occurrence of bleeding, treatment is directed at stopping:
- blood transfusion;
- vasoconstrictors;
- styptic medicines;
- electrocoagulation of the affected vessel;
- pressure on the affected blood vessels by the probe.
After this is conducted therapeutic measures aimed at the prevention of recurrence (iteration) attack. If you are experiencing varicose veins of the esophagus liver cirrhosis, is the treatment of the underlying disease. It is aimed at restoring the function of liver tissue. Also, the patient should give up bad habits, avoid strong physical exercise.
- Prescribe antacids (medicines that reduce the acidity of gastric juice), to prevent excessive irritation of the esophagus.
- Astringent preparationsthat reduce inflammation.
- A vitamin therapy.
When the diagnosis of varicose veins of the esophagus drug therapies may be supplemented by surgical intervention for relapse prevention may hold.
Bandage over varicose set small disks of rubber. Introduction hemostatic solution into the affected vein. Carry out the procedure at least four times a year. Completely removed all the damaged veins that are not recoverable.
Cirrhosis of the liver the patient can not complete the operation. In this case, conduct an endoscopic investigation of esophagus vessels. The procedure is the ligation of the vessel with a nylon loop or elastic rings.
The particular bypass, which connect the portal and hepatic veins. This gives an opportunity to normalize the pressure in the blood vessels.
Diet
When the diagnosis of varicose veins of the esophagus treatment involves many activities, including compliance with certain rules of supply.
Diet for varicose veins of the esophagus involves the use of products capable of enhancing the elasticity of blood vessels, strengthen them and also prevent the formation of blood clots.
The recommended food should contain vitamin b, C and fiber:
- bean;
- lettuce;
- corn and olive oil;
- citrus;
- seafood;
- nuts;
- the vegetables and fruits.
Meat is replaced with seafood or beef liver. It is not advisable to eat salty, spicy and tangy dishes, after which the patient drinks plenty of water. This leads to swelling of the tissues. The recommended amount of fluid per day is 2 liters. Also can't drink whole milk, reducing the elasticity of blood vessels.
You can not use:
- alcohol;
- black tea and coffee;
- confectionery;
- canned and smoked meats;
- sugar.
In the preparation and consumption of dishes has its own nuances. To cook food you need a way of cooking, and bake. You need to eat small portions, so as not to transfer, this dish should not be too hot or cold.
Preventive measures
To prevent diseases it is necessary to consult a doctor. Treatment of pathologies of the liver, if they are in the history. You must follow proper nutrition, get rid of bad habits and monitor the weight. Also no need to subject the body to excessive physical loads.
This applies not only to activities but also training in the gym with the implementation of power exercises. Exercise should not be excluded, but need to perform exercises designed by physiotherapists specifically for patients on varicose veins of the esophagus. A range of exercises aimed at improving blood circulation, reducing the risk of blood clots, lower cholesterol deposits.
Also in the prevention of such disease as varicose veins of the esophagus plays a big role, well-coordinated work of the GASTROINTESTINAL tract. Therefore, in such patients it is recommended to drink infusions of medicinal herbswith choleretic action and enhance digestion. To prevent reflux (regurgitation) of stomach contents into the esophagus thus irritation needed the sleep, raising the head of the bed by 10 cm.
The implementation of these recommendations will help to avoid development of the disease or its recurrence. And we must remember that to go to the doctor when the first symptoms to prevent serious complications such as excessive bleeding. It is undesirable to deal with the disease venous dilatation of the esophagus.