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, the symptoms, which will be discussed in this article.
The disease develops due to increased pressure in the portal vein, reducing blood flow. This condition is called chronic hepatitis b, cirrhosis of the liver. There is a change in the structure of the blood vessels. On their walls are shaped in a variety of piers, and the shell of the capillary thinning.
A vessel having tortuous shape, the mucous membrane is hyperemic and is ulcers. This causes a massive haemorrhage, without prior symptoms.
Pathology code ICD 185, which is defined as the varicose veins of the esophagus, 185 (9) without bleeding, 185 (0) of bleeding.
What is this
Resistant hypertension (high blood pressure) in the portal Vienna, 2-4 times more than usual leading to diseases of the esophagus. A further increase of pressure (24 – 27 of the water.St) leads to rupture of the vessel and the development of bleeding.
Hypertension in the portal vein leads to a decrease in blood flow, the deformation of the blood vessels, their elongation and thinning of the walls. On the walls of blood vessels, raised bumps, where the blood. At elevated pressure increases the load on the capillary wall and can rupture.
On the diseases from the cardiovascular system varicose veins are very small and adapted 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 do not depend on the size of the varicose node, or from a member in the vascular wall and the jump in pressure in the portal vein.
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- overeating;
- increased physical activity;
- the increase in intra-abdominal pressure.
Sometimes the bleeding shows itself during sleep. There are factors that exacerbate the situation: the failure of the cardia, and reduction of blood clotting. Here dangerous than varicose veins of the esophagus.
With the disease, 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 liver disease due to cirrhosis, tumors, amyloidosis;
- stenosis of the portal vein (thrombosis, compression from the outside, multiple sclerosis);
- chronic insufficiency of the heart and the circulatory system.
At risk people who may receive the 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 cirrhosis of the liver.
Most often varicose veins of the esophagus develops in liver cirrhosis and chronic hepatitis. The abuse of alcohol there is a change in the structure of the parenchyma. There arise the scars that interfere with normal blood flow, slow it down, which is in the stagnation of blood and formation of varicose veins.
The stage of the disease
Isolated congenital form that occurs in newborns. But this pathology is rare and is coupled with other serious violations. The development of disorders causes by hereditary factors and pregnancy. The acquired form occurs in men over 50 years old and have bad habits.
Depending on the degree of vascular injury there are four types of diseases:
1 phase. This is the initial degree to which the varices in an amount that does not exceed 3 mm and are determined only by endoscopic examination. In the implementation of x-ray with contrast agent shows slow flow of blood, but not bleeding. While the esophagus opening to reduce "improper".
Phase 2. In this stage, the lumen of the vessel is not broken and varicose veins are not enlarged, but the blood vessels become tortuous structure. The diagnosis is confirmed by contrast radiography, which shows no clear contours of the vessel and the rounded protrusions. Not bleeding.
3 phase. There has been steady progress in certain parts of the vessels, the vein lumen is narrowed. Clearly visible varices, altered mucous membrane (thinning). This phase is characterized by a high risk for bleeding.
On the x-ray image shows the formation on the lining of the esophagus, in the form of polyps, as well as chiseled perforation of the mucosa. The condition is regarded as serious and requires immediate hospitalization.
Stage 4. There is a strong thinning of the mucous membrane of the vessels, the formation of polyps. Varices of the esophagus in this stage are in the form of clusters and substantially block the lumen of the esophagus. With the progression of the disease, you can turn it off. In the meantime the patient suffers from redness of the mucous membrane, the formation of the erosive defects. This condition is regarded as critical, because this causes frequent and large hemorrhages.
Varicose veins of the esophagus symptoms
The onset of the disease does not manifest itself. Therefore, patients seek treatment when the disease is already "gained momentum". For self-recognition of the disease 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 flour);
- pain in the region of the xiphoid process;
- impaired swallowing.
If you have varicose veins, the esophagus and the 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 problem appears in the later period of the disease. Later, with the emergence of bleeding in a patient being present:
- bloody vomiting;
- blood in the stool;
- tachycardia;
- hypotension (sharp drop in blood pressure);
- shock.
Diagnosis and treatment
Is determined by the patient's varicose veins of the stomach and the esophagus by methods such as:
- Ultrasound of the esophagus, abdominal cavity;
- General analysis of blood;
- x-ray with contrast.
Making a diagnosis, take into account that the bleeding can lead to ulcerative damage to the esophagus, decaying of the tumor. A longitudinal tear in the mucosa of the upper part of the stomach or the distal region of the esophagus caused by frequent vomiting.
Upon confirmation of the diagnosis of varicose veins of the esophagus, treatment of, respectively, the rate of vascular injury to the tube of the esophagus. If the disease is detected, when it appears the bleeding, then treatment is aimed at stopping:
- a blood transfusion;
- vasoconstrictors;
- styptic medicines;
- electrocoagulation of the affected vessel;
- the pressure on the affected blood vessels with a probe.
After that is performed the therapeutic interventions designed to prevent relapse (recurrence) attack. If you have varicose veins of the esophagus, cirrhosis of the liver, to treat underlying diseases. This is directed to the recovery and functioning of the liver tissue. Also, the patient should give up bad habits, avoid strong physical exercise.
- The prescription of antacids (medicines that reduce the acidity of gastric juice), to avoid unnecessary irritation of the esophagus.
- Astringent preparationsthat reduce inflammation.
- The Vitamin therapy.
When is the diagnosis of varicose veins of the esophagus drug therapy 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 per year. Completely remove all the damaged veins that are not recoverable.
Cirrhosis of the liver, the patient could not complete the operation. In this case, carried out endoscopic investigation of the esophagus vessels. The procedure is the ligation of the vessel with a nylon sling or elastic rings.
In particular, the bypass, connecting the portal and hepatic veins. It gives the opportunity to normalize the pressure in the blood vessels.
Diet
When is the diagnosis of varicose veins of the esophagus the treatment includes a number of measures, including compliance with certain rules of supply.
Diet for varicose veins of the esophagus includes the use of the products, capable to enhance the elasticity of blood vessels, strengthen them, and also prevents the formation of blood clots.
Recommended food should contain vitamin b, C and fiber:
- beans;
- lettuce;
- corn and olive oil;
- citrus;
- seafood;
- nuts;
- the vegetables and fruit.
Meat is replaced with seafood or beef liver. It is not recommended to eat salty, savory and spicy 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 do not drink whole milk, it reduces the elasticity of blood vessels.
You cannot use:
- alcohol;
- black tea and coffee;
- confectionery;
- canned and smoked meat;
- sugar.
In the preparation and eating of meals, has its own nuances. For cooking 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
For the prevention of the disease should immediately contact your doctor. Treatment of liver disease, if they are in the history. You need to follow the proper diet to get rid of bad habits and weight control. Also no need to the body excessive physical load.
This applies not only to activities, but also training in the gym with the implementation of power exercises. Exercise should not be excluded, but you need to perform exercises designed by physiotherapists specifically for patients with varicose veins of the esophagus. A range of exercises, whose goal is to improve the blood circulation, reduces the risk for blood clots, lower cholesterol deposits.
Also in the prevention of these diseases, such as varicose veins of the esophagus plays a big role, and well-coordinated work of the digestive tract. Therefore, in such patients it is recommended to drink infusions of medicinal herbsthat have choleretic effect, improves digestion and. To prevent reflux (regurgitation) of stomach contents into the esophagus with this irritation, you need to sleep, raise the head of your bed 10 cm.
Implementation of these recommendations will help to prevent development of the disease or its recurrence. And we need to remember to go to the doctor is necessary in the first symptoms to prevent serious complications such as excessive bleeding. It is therefore desirable to deal with the disease venous dilatation of the esophagus.