Pathological, a condition in which it appears the expansion of blood vessels in the lower department of the tube the esophagus or stomach adjacent to it, is called varicose veins of the esophagus, the symptoms will be discussed in great detail in this article.
Disease develops due to an increase in portal pressure in vienna, the reduction of the flow of blood. This state is called chronic course of hepatitis b, cirrhosis of the liver. Occurs a change of the structure of the blood vessels. Its walls are formed of different protrusions, and the shell itself hair thins.
The vessels have a meandering shape, the mucous membrane of the hyperemic, and has ulceration. This results in a massive bleeding, do not have a pre-symptomatology.
Pathology has the code for CID 185, which is defined as varices of the esophagus, 185 (9) no bleeding, 185 (0) with bleeding.
What is
Resistant hypertension (increase of pressure) in the portal of vienna, in the 2 to 4 times the normal leads to diseases of the esophagus. Further increasing the pressure (from 24 to 27 of the water.art) leads to a rupture of the vessel, and the development of a bleeding.
Hypertension in port vienna, leads to the reduction of the flow of blood, the deformation of the blood vessels, your stretching and peeling of the wall. On the walls of the vessels are formed protrusions where the blood goes. When the pressure increases the pressure on the wall of the capillary and it can be broken.
When pathologies of the cardiac system of varicose veins has small dimensions and is located on the entire surface of the tube of the esophagus. If the extension is called the pathological processes that occur in the liver, vessels more extensive and are surprised with them in the lower area of the esophagus.
Complications such as bleeding not depend on the size of the expansion of the host or of the state of the vascular wall, and pressure jump gate vienna.
Your cause:
- the excess power;
- enhanced the physical load;
- the increase in intra-abdominal pressure.
Sometimes, the bleeding is manifested during sleep. There are factors the aggravating circumstances the state: failure of kardia, as well as reduce blood clotting. Here is dangerous than varicose advanced veins of the esophagus.
When the disease varicose veins of the esophagus icd 10 code should know doctor.
Varicose veins of the esophagus: causes
The causes of their development are pathological processes, leading to portal hypertension vienna. This is:
- parenchymal disease of the liver caused by cirrhosis, tumors, amyloidosis;
- stenosis of the vein (thrombosis, a grip from the outside, multiple sclerosis);
- chronic insufficiency of the cardiovascular system.
To the risk group of people, that may appear varicose veins extension of the esophagus, are:
- >people with more than 50 years old (mostly men);
- patients with chronic pathology CAS and the digestive system;
- the patients cirrhotic.
More often the extension of the veins of the esophagus develops in cirrhosis and chronic hepatitis. When alcohol abuse occurs change of the structure of the parenchyma. There are formed scars, that interrupt the normal flow of blood, slow your occurs stagnation of blood and formation of varicose expansion of blood vessels.
The stage of the disease
Stand out, wearing a form, that can occur in newborns. But this condition rarely occurs and is accompanied by other serious violations. The development of violation causes a hereditary factor and during pregnancy. Purchased from the form observed in men, stepped 50 years of the border and have bad habits.
According to the degree of injury of the vessels highlight four types of the disease:
1 phase. It is the initial part of the degree, in which the varicose sites in value does not exceed 3 mm and are defined only when endoscopic study. During the performance of x-ray contrast can be seen in slow motion the circulation of the blood, but the bleeding does not. When you do this, the esophagus hole reduced "irregular".
Phase 2. At this stage of clearance of vessels is not disturbed and varicose veins is not increased, but vienna acquire meandering structure. The diagnosis is confirmed by contrast radiography, in which are visible are not clear, the outlines of the blood vessels and rounded protrusions. The bleeding does not.
3 phase. Can occur a strong expansion of some parts of the blood vessels, the lumen of the vein is reduced. Clearly visible varicose nodes, changed the mucous membrane (thinning). This phase is characterized high risk of bleeding.
In radiology, the visible image of education in the mucosa of the esophagus in the form of polyps, as well as the chiseled perforation of the mucosa. The state is considered as a heavy and requires urgent hospitalization.
4 phase. There is a great thinning of the mucosa and vessels, education for her polyps. Varicose sites of the esophagus in this phase have the appearance of fruit, and much overlap the lumen of the esophagus. When the progression of the disease can close it completely. During this period, the patient may occur flushing of the mucous membrane, the education it erosive defects. It is the state that is considered critical, since it causes frequent and heavy bleeding.
Varicose veins of the esophagus symptoms:
The beginning of the disease nothing if it does not. Therefore, patients seek medical help when the disease has already "gained strength". Auto-recognize the disease is not possible, since the initial expressions of the disease are similar to symptoms of disorders of the digestive system. So, if you have an extension of the veins of the esophagus, the symptoms will be the following:
- the appearance of lack of air;
- the presence of acid reflux (not depends of food intake);
- pain in the area xiphoid of the kidneys;
- violation of swallowing.
If you have varicose veins of the esophagus and the stomach, its main feature, the vascular, the drawing on the front skin of the abdominal wall in the form of "head of medusa". Your form the anomalies of vienna. This symptom appears already in the later period of the occurrence of the disease. Later, when it is bleeding, and the patient is present:
- hematêmese;
- blood in the stool;
- tachycardia;
- hypotension (drastic reduction in HELL);
- the shock of it all.
Diagnosis and treatment
Set the patient has varicose veins of the esophagus and the stomach such methods as:
- Ultra-sound study of the esophagus, abdominal organs;
- the general analysis of blood;
- x-ray with the application of the contrast.
Establishing a diagnosis, consider that the bleeding can cause ulcerative defeat of the esophagus, decaying tumor. Is a longitudinal rupture of the mucous membrane of the upper part of the stomach or the area distal of the esophagus caused by frequent vomiting.
When confirmation of the diagnosis of varicose veins of the esophagus-the treatment is prescribed, according to the degree of injury of the blood vessels the pipes of the esophagus. If the disease is discovered when it is bleeding, the treatment in terms of direction in their stop:
- the transfusion of blood;
- vasoconstrictor drugs;
- styptic medicines;
- electrocoagulation victim of the vessel;
- the pressure on the dead vessel special probe.
After that, they are carried out therapeutic activities, for the message of warning of relapse (repeat) heart attack. If you have varicose veins of the esophagus in cirrhosis, undergo treatment of the underlying disease. It is directed to the full recovery of the function of liver tissue. Also recommend that the patient to abandon the bad habits, avoid strong physical exercise.
- Prescribe antacids (medicines that reduce the acidity of the gastric juice), to warn of excessive irritation of the mucosa of the esophagus.
- Astringent medicinesthat soothe the inflammation.
- Vitamin therapy.
When the diagnosis of esophageal varices treatment with medications may be complemented by a surgery to warning of a relapse, it is possible to perform.
Bandage – about varicose extension are installed on small disks of rubber. Introduction styptic solution in the vein affected. To perform the procedure you need at least four times per year. Are completely removed all of the damaged veins, it is not recoverable.
In the cirrhosis patient can't do the classic operation. In this case, pass the endoscopic alloy vessels of the esophagus. The procedure is to wear the boat round robin, ties, rings or rubber bands.
Special variance, which connect the portal and hepatic vein. This gives the possibility to normalize the pressure in the vessels.
Diet
When the diagnosis of varicose veins of the esophagus the treatment includes a number of measures, including the compliance with certain rules of supply.
The diet when varicosasm expansion of veins of esophagus involves the use of products that enhance the elasticity of blood vessels, to strengthen them, and also prevents the formation of blood clots.
Featured products diet should contain vitamin A, c, and also fiber:
- pulses;
- lettuce leaves;
- corn and olive oil;
- citrus fruits;
- fruits of the sea;
- nuts;
- vegetables and fruit.
The meat is better to replace seafood or beef liver. It is not advisable to consume salty, spicy and salted, after which the patient drinks a large amount of water. This results in swelling of the tissues. The recommended amount of fluid per day is 2 liters. Also should not drink milk, because it promotes the loss of elasticity of the vessels.
Should not be consumed:
- alcohol;
- black tea and coffee;
- confectionery products;
- canned foods and smoked;
- the sugar.
The preparation and the use of dishes, has its nuances. Cook needs a couple or a cooking method and bake in the oven. Take the food you need in small portions, to not pass, the dishes should not be excessively hot or cold.
Prevention activities
To prevent disease you should immediately consult your doctor. Carry out treatment of diseases of the liver, if they have a history. It is necessary to observe proper nutrition, get rid of bad habits, keep the weight control. Also do not need to expose the body to excessive physical exertion.
It's not just the type of activity, and the practice in the gym with the execution of strength exercises. Physical exercises should not be deleted, but it is necessary to perform the loading, developed by the medical therapy for exercise, especially for patients with varicose veins of the esophagus. The complex of such exercises which aims to improve blood circulation, reducing the risk of formation of blood clots, reduction of cholesterol deposits.
Also in the prevention of such disease as varicose veins are veins in the esophagus the great role of well-coordinated work the GASTROINTESTINAL. Thus, patients are encouraged to consume herbal teas and medicinal, that have action anti anthelmintic and improve digestion. For the warning of reflux (casting) of the stomach contents into the esophagus thus, irritation of the mucosa, need for sleep, raising the head of the bed by 10 cm.
The implementation of these recommendations can help to avoid the development of serious disease or its recurrence. And you need to remember that consult your doctor need when the first symptoms to prevent serious complications such as heavy bleeding. It is not desirable to tackle the disease venous varicose veins of the esophagus.