Pathological condition in which occurs vasodilation in the lower part of the tube in the esophagus or stomach, next to this, they are called varicose veins of the esophagus, the symptoms of which will be examined in detail in this article.
The disease develops, due to the increase of the pressure in the portal vein, reducing the outflow of blood. This condition is caused by the chronic current hepatitis c To cirrhosis of the liver. There is a change of the structure of the blood vessels. The walls are formed of various protrusion, and the shell of the capillary-thinner.
Vessels have helical form, and the mucosa hyperemic and ulceration. This leads to massive bleeding who do not have pre-symptoms.
Pathology has IBC code 185, which is defined as varices of the esophagus, 185 (9) without bleeding, 185 (0) with bleeding.
What is this
Stable hypertension (increased pressure) in the portal vein in 2-4 times more than the norm leads to diseases of the esophagus. The further increase of pressure (24 – 27 water.(f) leads to the rupture of the vessel and the development of bleeding.
Hypertension in the portal vein is the vein leads to a decrease in the outflow of blood, the deformation of blood vessels, the more and thinning of the walls. On the walls of blood vessels are formed of anxiety, where it blood. When there is excessive pressure increases the load on the wall of the capillary and it can rupture.
When pathologies of the cardiovascular system varicose veins has small dimensions and is found all over the surface of the tube of the esophagus. If the expansion is caused by the pathological processes taking place in the liver, the blood vessels are more dilated, and it affects them in the lower area of the esophagus.
Complications in the form of bleeding does not depend on the size of varicose location or the condition of the vascular wall, and the jump of the pressure in the portal vein is the vein.
The cause:
- over-consumption of food?
- enhanced physical activity?
- increase of intraventricular pressure.
Sometimes the bleeding is manifested during sleep. There are factors, aggravating situation: failure cardia, as well as the reduction of blood coagulation. This is dangerous varicose veins of the esophagus.
When the disease is varicose veins of the esophagus icd 10 code need to be aware of the doctor.
Varicose veins of the esophagus: causes
Causes for the development of pathological processes, leading to hypertension in the portal vein. Is:
- pulmonary disease of the liver caused by cirrhosis, tumors, amyloidosis?
- stenosis portal vein (deep, compression from the outside, sclerosis);
- chronic insufficiency of the cardiovascular system.
In the group of risk for people, that may appear varicose of the esophagus, include:
- >persons over the age of 50 years (usually men).
- patients who have chronic pathologies SSA and the DIGESTIVE system?
- patients with cirrhosis of the liver.
The most often varicose veins of the esophagus progresses to cirrhosis of the liver and chronic hepatitis c. Alcohol abuse occurs changes in the structure of the parenchyma. There are formed scars, which violates the normal flow of blood, slows down, with the result that occurs stagnation of blood and formation of varicose blood vessels.
The stage of the disease
Secrete the innate form which is observed in newborns. But the pathology is rare and is accompanied by other serious violations. Development violations causing hereditary factor and during pregnancy. Acquired form is seen in men, ran over 50-year-old abroad, and have bad habits.
Depending on the degree of damage to the blood vessels secrete four types of the disease:
1 phase. This is the original area in which varicose veins nodes in an amount that does not exceed 3 mm and is defined only when endoscopic study. During the x-ray with contrast seems to slow blood circulation, but not leaking. When you do this, esophageal foramen is reduced "abnormal".
2 phase. At this stage the lumen of the vessel is not broken and varicose veins are not enhanced, but the veins acquire a helical structure. The diagnosis is confirmed with the help of contrast radiography, in which it is visible is not a clear outline of the blood vessels and rounded protrusion. Bleeding no.
3 phase. There is persistent extension of certain sections of blood vessels, lumen of the vein limited. It is clearly visible varicose veins sites change the mucosa (dilution). This phase is characterized by a high risk of bleeding.
The radiology picture seems education in the mucosa of the esophagus in the form of polyps, as well as carved perforation of the mucosa. The situation is considered as a serious and requires urgent hospitalization.
4 phase. There is marked thinning of the lining of blood vessels, the training of the polyps. Varicose veins the nodes of the esophagus at this stage have a view of grapes and significantly overlap with the lumen of the esophagus. With the progression of the disease can be completely closed. At this time the patient had hyperemia of the mucosa, education, the corrosive defects. This situation is considered as critical, since it causes frequent and massive bleeding.
Varicose veins of the esophagus: symptoms
The beginning of the disease there is nothing to show. Therefore, patients seek medical help when the disease has already "accelerated". This is to recognize the disease is not possible, because the initial manifestations of the disease are similar to the symptoms of disorders of the digestive system. So, if you have varicose veins of the esophagus, the symptoms are as follows:
- the appearance of shortness of breathfor?
- the presence of heartburn (does not depend on the meals);
- pain in the region of the xiphoid process is?
- violation of swallowing.
If you have varicose veins of the esophagus and of the stomach, the main symptom — stroke picture to the skin of the anterior abdominal wall in the form of a "head of medusa". The are pathologically altered in vienna. This symptom is already displayed in a subsequent period, leakage of the disease. Later, when you see bleeding, the patient is present:
- hematemesis it?
- the blood in your stool?
- tachycardia?
- hypotension (a sharp decrease in the ΔΙΑΦΉΜΙΣΗΣ);
- the shock of it.
Diagnosis and treatment
Determined the patient's varicose veins of the stomach and the esophagus by methods such as:
- The ULTRASOUND study of the oesophagus, the organs of the abdominal cavity;
- general blood testyou?
- x-ray using contrast.
Setting the diagnosis, take into account that the bleeding may cause ulcerous defeat of the esophagus, decaying volume. Is a longitudinal rupture of the mucosa in the upper part of the stomach or distal region of the esophagus caused by frequent vomiting.
With the confirmation of the diagnosis of varicose veins of the esophagus treatment is assigned depending on the degree of destruction of the vessels of the tube of the esophagus. If the disease is detected if you see bleeding, the treatment facing the stand:
- had a blood transfusion?
- vasoconstrictor medications?
- hemostatic treatment?
- electrocautery of the ship?
- the pressure on the affected vessels special control.
After that carried out therapeutic activities aimed at the prevention of relapse (recurrence) attack. If there is varicose veins of the esophagus in cirrhosis of the liver, treatment of the underlying disease. Is focused on restoring the function of liver tissue. Also the patient is advised to give up bad habits, avoid strenuous physical exercise.
- Prescribe antacids (medicines, reducing the acidity of gastric juice), to warn the unwanted irritation of the mucous membrane of the esophagus.
- Astringent drugs, which reduce inflammation.
- Vitamin treatment.
When the diagnosis of varicose veins of the esophagus treated with drugs may be completed by surgery to prevent recurrence possible performance.
Bandage – over varicose set out small discs of rubber. Introduction astringent solution into the affected vein. To carry out the procedure you need to have at least four times a year. Completely erased all of the broken veins, do not attach the restoration.
In cirrhosis of the liver, the patient can not do the classical surgery. In this case, carried out endoscopic alloy vessels in the esophagus. The procedure is the ligation of vessels of a nylon loop or elastic rings.
Special detour, during which they connect portal and hepatic vein. This gives you the ability to normalize the pressure in the blood vessels.
Dietary nutrition
In the diagnosis of varicose veins of the esophagus treatment includes many measures, including compliance with certain rules of operation.
Diet varicose veins of the esophagus involves the use of the products, capable to enhance the elasticity of blood vessels, strengthening them and preventing the formation of clots.
Featured food products should contain the vitamin In, With, and, also vegetable fibre:
- legumes?
- leaves salad?
- corn and olive oil?
- the citrus fruits?
- seafood?
- nuts?
- the vegetables and fruits.
The meat must be replaced with seafood or beef liver. It is not advisable to consume salty, spicy and spicy food, after which the patient drinks large quantities of water. This leads to swelling of the tissues. The recommended amount of fluids per day is 2 liters. Also, you can't drink whole milk, since it contributes to reduce the elasticity of blood vessels.
You can't use:
- alcohol?
- black tea and coffee?
- pastry for?
- canned and smoked it?
- sugar.
In the preparation and consumption of food has its own nuances. Cook food should be in two or method of cooking, and bake. To eat, have small portions, not to say that the dish should not be too hot or cold.
Preventive measures
For the prevention of the disease should contact a doctor. The treatment of diseases of the liver, if there are in the story. You should follow a proper diet, to get rid of bad habits, to lose weight. Also you don't need to expose the body from excessive physical exercise.
This concerns not only the type of activity, but the gym performing strength exercises. The physical exercise should not be excluded, but the execution will need to charge the device developed by the doctor of physical THERAPY especially for patients with varicose veins of the esophagus. This exercise aims to improve blood circulation, reduce the risk of blood clots, reduction of fat of cholesterol.
Also in the prevention of this disease as varicose veins of the esophagus plays a big role in a well-coordinated work of the DIGESTIVE system. Therefore, these patients, it is recommended to drink herbal teas herbshave choleretic action and improve digestion. For the prevention of reflux (casting) of the contents of the stomach into the esophagus the irritation of the mucous membranes, you need to sleep, raise the head of the bed to 10 cm.
The implementation of these directives will help to avoid the development of severe disease or relapse. And we should remember that contact with a doctor should with the first symptoms, to avoid serious complications in the form of profuse bleeding. Unwanted faced with the disease venous dilatation of the esophagus.