Varicose veins in the tissues of the stomach. Varicose veins of the stomach consequences Varicose veins of the stomach treatment

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Varicose veins veins of the stomach - a pathological condition characterized by the appearance of tortuosity and vascular sacs filled with blood. The disease develops against the background of severe chronic pathologies internal organs... Symptoms are most often absent before the development of dangerous complications. Hardware methods are used for diagnostics. The disease is treated with surgical and conservative methods.

Causes and symptoms

With the development of varicose veins of the stomach, the reasons may be as follows:

• Portal hypertension, characterized by increased pressure in the portal vein. A similar pathological condition is considered a complication of liver diseases (chronic viral hepatitis, cirrhosis and cancer, echinococcal cysts, benign tumors, tuberculous lesion).
• Compression of the portal vein. In this case, there is a slowdown in the outflow of blood from the vessels of the stomach and esophagus. The venous walls lose their elasticity and remain stretched. The risk of violation of the integrity of blood vessels increases. The portal vein is compressed by cysts, neoplasms, adhesions and stones that form in gallbladder.
• Increased pressure in the systemic circulation. A similar thing is observed with decompensated heart failure. Outflow of venous blood from upper divisions the body becomes difficult, the gastric vessels dilate, lengthen and become convoluted. Varicose veins with thin walls are formed. The rupture of such a section is the main reason for development.
• Congenital malformations the structure of blood vessels. In the stomach, varicose veins can occur due to malfunctioning valves causing blood to flow back.
• Age-related changes in the body. The elasticity of the vascular walls decreases, due to which they become unable to contract normally. The blood stagnates, causing the veins to dilate.

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The clinical picture of the disease includes:

• Pain in the stomach. The vascular walls are located in the thickness of the mucous membranes, which is why, with varicose veins, the latter are often damaged and inflamed. This contributes to the appearance of unpleasant sensations that arise regardless of food consumption.
• Heartburn, sour belching. They are the first signs of dysfunction of the stomach caused by impaired blood supply.
• Swallowing problems. They occur with varicose veins of the upper parts of the stomach, bordering the esophagus. Large knots obstruct the normal passage of the food bolus, causing pain... The appearance of a feeling of heaviness behind the sternum is also associated with the formation of venous nodes.
• Internal bleeding. They are accompanied by the release of vomit with bloody impurities, nausea, muscle weakness. The faeces become black due to the presence of clotted blood. With massive bleeding, the vomit has a bright red color, severe weakness is observed, consciousness is impaired, and sweating increases. The pressure drops and the heart rate rises.
• Signs of anemia. When frequent occurrence minor bleeding, the hemoglobin level decreases, dizziness appears, accompanied by pallor skin and decreased performance.

How is the disease diagnosed

Varicose veins of the stomach are detected using the following procedures:

• X-ray examination of the stomach. Helps to detect varicose veins on the surfaces of the stomach walls and lower esophagus.
• Esophagogastroduodenoscopy. An endoscope equipped with a camera and illumination is introduced into the stomach cavity. Through endoscopy, pathological changes are revealed, expressed in the appearance of nodular venous protrusions. If bleeding is severe, examination may be difficult. EGDS helps to make an accurate diagnosis, determine the stage of the disease and assess the risk of rupture of the venous wall.
• Organ ultrasound abdominal cavity... Examination of the liver helps to determine the disease that is the cause of varicose transformation of the gastric veins.
• General blood test. It is an auxiliary method aimed at identifying an indirect sign of bleeding - a decrease in the level of hemoglobin and platelets.

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Treatment methods

It is completely impossible to cure the disease. Treatment of gastric varicose veins is aimed at stopping and preventing bleeding, preventing the formation of new nodes, slowing the development of pathological changes.

Medication

The drug treatment regimen includes:

• Vasopressin. The drug narrows the blood vessels responsible for the blood supply to the internal organs, helping to reduce the pressure in the portal vein. Introduced intravenously.
• Hemostatics (Etamzilat). Promotes faster blood clotting, can be used to stop mild bleeding.
• Proton pump inhibitors (Omeprazole). Reduces the production of hydrochloric acid, preventing damage to the vascular walls.
• Iron preparations (Ferrum Lek). Eliminate the signs of anemia.

Surgical intervention

To stop bleeding and eliminate varicose veins, the following operations are used:

• Bandaging. The section of the vessel located above the varicose veins is pulled together latex ring... In this way, the blood flow is blocked, as a result of which the bleeding stops, the signs of varicose veins disappear.
• Transconjugal intrahepatic shunting. During surgery, a hollow tube (stent) is inserted into the hepatic vein to connect the vessel to the portal venous system. The procedure is carried out by inserting a catheter into jugular vein... The operation reduces the pressure in the portal vein and normalizes the outflow of blood from the gastric vessels.
• Splenorenal shunting. The splenic veins are connected to the renal veins. This helps to reduce the volume of blood filling the varicose vessels and stop bleeding.
• Devascularization. During the operation, damaged bleeding veins are removed. Intervention is carried out when other methods are ineffective.

Sclerotherapy

During the procedure, a chemical substancegluing the walls of the vessel. The blood supply stops, the varicose veins disappear.

Diet therapy

Patients with gastric varicose veins are prescribed a strict diet. Food is boiled or steamed and then ground with a blender. It is not recommended to eat solid food and swallow large pieces. Food should be at a comfortable temperature. They refuse hot and cold dishes. Alcohol, baked goods, strong tea, salty and pickled foods, sour fruits and berries are excluded from the diet.

Varicose veins of the stomach are less common than similar pathologies of other organs. The disease requires specialized care in order to prevent the rapid development of complications and save the patient's life.

What is gastric varicose veins

Phlebectasia is characterized by an increase in the volume of the organ's venous vessels and the formation of blood clots in them. The initial stages of the development of the disease do not have symptomatic manifestations, which increases its danger. There are certain reasons for the occurrence of the pathological process - from genetic abnormalities to liver cirrhosis.

Features of the disease

Experts classify the disease into four sequential stages of progression:

1. The clinical picture does not have pronounced symptomatic manifestations, changes in the lumen of blood vessels are rare. Patients do not complain of deterioration, the problem is diagnosed using endoscopy.
2. Differs in tortuosity and unevenness of veins. General indicators increases do not exceed 3 mm, narrowing occurs for short periods of time. In cases of exclusion, spontaneous bleeding may occur.
3. It is characterized by a noticeable decrease in vascular lumen, their swelling. When diagnosed, nodes and a decrease in wall tone are detected. Symptomatic manifestations are present, the likelihood of bleeding increases.
4. It is determined by the significant depletion of the mucous membranes of the stomach, pronounced narrowing of the lumens and prominent nodes. From large node damaged small veins diverge - their condition can provoke bleeding at any time.

The formation of varicose veins takes significant periods of time - periodic compression gradually leads to the occurrence of characteristic changes.

Secondary division informs about the factors of its formation:

• purchased option - occurs when increased rates pressure in the portal vessel, which is responsible for the supply of blood to the liver, as the pathology increases, the veins acquire softness, increased fragility, violation of their integrity can occur at any second;
• hereditary - the pathological process is detected from the moment of birth, can be formed as genetic predisposition or a burdened pregnancy;
• congenital - refers to rare formations.

In most cases, the acquired version of varicose veins of the stomach is diagnosed.

Causes of occurrence

The main source of the pathological condition is the portal form hypertension, provoking an increase in veins in the digestive organ. Sometimes the problem is formed against the background of liver cirrhosis - as a consequence of multiple scars. Less common prerequisites for the disease include:

• liver pathologies that cause disturbances in blood circulation;
• the formation of blood clots on the venous vessels;
• compression of the portal vein by a tumor-like process;
• insufficient performance of the cardiovascular department.

In the case of a history of hepatitis and cirrhosis of the liver, it is necessary to visit more often preventive examinations of a gastroenterologist - to capture the disease at the initial stages of its onset. Under the negative influence of these factors, the stomach becomes vulnerable and easily exposed to disease.

Who is at risk

Average statistics indicate that most of the sick belong to certain subgroups:

• gender - the male sex is more likely to suffer from gastric varicose veins;
• age period - the problem is diagnosed after the 50th birthday;
• concomitant diseases - in the presence of ailments of the liver, pancreas, heart muscle and liver.

Patients with cirrhosis are especially distinguished - according to clinical research, only one person in ten is not sick.

The clinical picture of gastric varicose veins

The initial stages of phlebectasia do not have obvious symptomatic manifestations, which makes it difficult to correctly determine the diagnosis. The gradual progression of the disease gives rise to clear clinical signs:

• a feeling of discomfort and heaviness in the chest area;
• an increase in the volume of the abdominal cavity - due to the fluid accumulating in it;
• dilated venous vessels lead to the formation of a jellyfish head - a symptom characterized by the creation of a pattern of enlarged veins;
• trouble breathing freely after physical or physical activity;
• spontaneous heartburn, not dependent on food intake;
• problems with swallowing.

At this stage of formation, rare patients pay attention to the problem and consult a gastroenterologist. Most patients come after a rupture of thinned blood vessels. The reason for the visit is the growing clinical picture:

• vomiting with blood particles;
• decrease in level blood pressure;
• accelerated heartbeat with disturbed rhythm of contractions;
• painful sensations in the epigastric region and other parts of the abdomen;
• state of shock.

Violation of the integrity of blood vessels can cause both minor and massive hemorrhage. The patient needs an emergency surgical care - in case of inaction, the disease will become fatal.

Diagnostic measures

When contacting a polyclinic, the patient is sent for a consultation with a gastroenterologist. The doctor collects anamnesis: the time of occurrence of negative manifestations, personal feelings of the patient, existing diseases. Visual examination with palpation examination allows for a preliminary diagnosis.

For confirmation, the patient is sent for separate laboratory and instrumental examinations:

• all options for blood tests - to identify hidden inflammatory processes and other deviations;
• the study of blood clotting indicators;
• Ultrasound - the technique allows you to determine the altered blood vessels;
• fibroesophagoscopy - with the help of the apparatus, the stomach is thoroughly examined, the condition of the mucous membranes, the places of violation of the integrity of the vessels are revealed.

If concomitant diseases are detected, the patient is sent to additional diagnostics, in order to identify the reasons for their formation.

Modern methods of treatment

Varicose lesions of the gastric veins are not independent diseases and do not require specific therapy. Portal hypertension, as one of the reasons for the development of a pathological process, is stopped with the help of certain drugs that are recommended by the attending physician.

If there are prerequisites for its elimination, conservative therapy or surgical intervention can be prescribed. Most cases of gastric varicose veins require a donor liver transplant.

Medicinal direction - includes the following subgroups of drugs:

• vasodilators - to increase the lumen of blood vessels;
• hypertensive - to stabilize blood pressure levels;
• nitrates - to improve the functionality of the portal vein, lower pressure.

In addition to these medications colloidal solutions are widely used, multivitamin complexes, antacids and astringents.

Surgical direction - carried out using three main methods:

1. Ligation of problem veins - during the manipulation, a specialized rubber bandage is used. The technique is considered highly effective.
2. Intrahepatic bypass surgery is prescribed to lower blood pressure. The main goal of the technique is to create a connection between the portal and hepatic vessels.
3. Splenorenal shunting - involves the union of the veins of the left kidney and spleen with a shunt. Produced for prophylactic purposes - to prevent spontaneous bleeding.

Dietary - is included in the mandatory comprehensive program for the treatment of varicose lesions of the gastric vessels. The dietary requirements are as follows:

• frequent small meals - up to 6 times a day;
• the last supper - not less than three hours before the night's rest;
• enriching the daily menu with products with a sufficient content of useful elements;
• a sufficient amount of incoming liquid volumes - up to two and a half liters;
• a ban on alcoholic, low-alcohol products, tea, coffee, sweets, seasonings and spices, baked goods.

Dishes are served warm. Allows cooking by boiling, stewing, baking or steaming.

Folk remedies

Homemade recipes are not very effective for varicose veins - most cases require surgery. The use of folk techniques is agreed with the attending physician. Traditional healers include commonly used medicines:

• a large spoonful of Japanese sophora is brewed in a glass of boiling water, consumed four times a day, the general course of treatment should not exceed two months;
• rose hips and red rowan fruits are taken in equal volumes - in a large spoon, poured with half a liter of liquid, boiled for five minutes, cooled and consumed in half a glass during the day.

Possible complications of pathology

The problematic complications of varicose blood vessels of the stomach include spontaneous bleeding. They can arise from any reason - the thinned mucous membrane cannot create a full-fledged barrier.

The level of bleeding, the frequency of occurrence affect the final condition of the patient. With pathology, patients have constant vomiting and a chronic lack of iron ions.

Preventive measures

To prevent the onset of the disease, you must follow the recommendations of doctors:

• monitor liver health;
• follow all the instructions of specialists;
• stabilize blood pressure levels;
• avoid excessive addiction to alcohol, nicotine and drugs;
• switch to a healthy diet;
• carry out vitamin therapy;
• reduce the amount of lifting heavy objects.

To maintain the functionality of the gastrointestinal tract, you must adhere to the above tips.

Forecast of varicose veins of the stomach and lower esophagus

The pathological process is characterized by a high level of mortality due to complications and concomitant diseases. Progressive cirrhosis can lead to complicated bleeding.

The likelihood of a relapse of the disease varies between 55-75%. Mortality rate in the absence emergency assistance is within 50%.

The defeat of the gastric veins is a long process. In the initial phases of the disease, it can be stopped by protecting the body from spontaneous vascular rupture. The degree of damage to the vein wall is a predetermining factor for making a probable prognosis.

Disrupt work digestive system can varicose veins of the stomach. Pathology is accompanied by the formation of vascular loops and nodes, and the walls of the organ protrude. Perhaps the development of bleeding and accumulation of exudate in the peritoneum. The disease is accompanied by malaise and reduces the patient's quality of life. At the first signs of a malfunction of the stomach, you need to go to the hospital.

Causes of pathology

Varicose enlargement of the stomach is more often diagnosed in people with hepatitis or cirrhosis of the liver.

The disease occurs against the background high blood pressure in the portal vein, which can occur due to squeezing of the vessel by a blood clot or stone in the gallbladder. According to statistics, men are more prone to pathology. Causes of gastric varicose veins:

• intestinal obstruction;
• disruption of the stomach and pancreas;
• hepatitis;
• cirrhosis of the liver;
• heart failure;
• the formation of tumors and cysts.

Provoking factors

The expansion of blood vessels in the stomach is considered a dangerous pathology, accompanied by the formation of blood clots. At the initial stage of the development of the disease, there are no symptoms, which complicates the diagnosis. The reasons for the onset of pathological processes are considered:

The disease can develop against the background of frequent consumption of fast food.

• overuse alcoholic beverages;
• abuse of fast food and other junk food;
• unauthorized administration of drugs without a doctor's prescription.

Symptoms of gastric varicose veins

The clinical picture with the development of varicose veins of the fundus of the stomach is absent, and the signs that arise over time are difficult to distinguish from disturbances in the digestive tract. The following symptoms are observed:

• severe vomiting;
• abdominal pain;
• black vomit with an admixture of biological fluid;
• frequent irregular heartbeat.

Varicose veins of the stomach provoke heartburn. This symptom is rarely perceived by people as a precursor of a dangerous pathology, so the visit to the hospital is postponed. The advanced form of the disease is accompanied by the active release of biological fluids. The following symptoms are noted:

• accumulation of exudate in the peritoneum, significantly increasing the volume of the abdomen;
• painless vomiting;
• jumps in blood pressure.

Diagnostics

Effectively in this case, an ultrasound scan of the abdominal organs.

If you experience any symptoms that indicate a malfunction of the stomach and the development of varicose veins, you should definitely consult your doctor. The disease, detected at the initial stage of development, is easier to treat. The doctor collects anamnesis, specifies the characteristics of the patient's life and nutrition. Directs to general biochemical analysis blood. Indicators of liver function tests are of great importance. To confirm the diagnosis and identify the features of the course of the disease, the following diagnostic methods are used:

• esophagogastroscopy;
• radiography using a contrast agent;
• Ultrasound of the peritoneal organs.

What treatment is prescribed?

Drug therapy

You need to deal with gastric varicose veins immediately after detecting a problem. Otherwise, the disease can provoke severe bleeding, which is fatal.

The drugs should be selected by the doctor, not the patient himself.

With varicose veins, self-medication can cost a person his life. All doctor's prescriptions should be followed exactly. Based on the results of diagnostics, the patient is selected medications. Purpose of therapy:

• Reduce blood pressure.
• Restore the ability of diseased vessels to contract.
• Reduce the pressure of biological fluids.
• Rebuild affected veins.

Sclerotherapy

To eliminate varicose veins, a diseased vessel often has to be removed. With the help of an endoscope, a special sclerosing drug is injected into the dilated vein. Under its influence, the walls of the vessel stick together. As practice shows, the method is applied several times until a scar forms at the site of the affected vein. A single procedure does not give the desired result.

Surgical intervention

It is impossible to eliminate varicose veins of the stomach with drugs. Drug treatment helps to slow down the development of the pathological process. In severe cases, an operation is performed. The following methods of carrying out the procedure are distinguished:

Liver bypass surgery may be one way to correct the problem.

• Ligation of the enlarged veins of the stomach. A special rubber band is used. The technique is much more effective than sclerotherapy.
• Liver bypass surgery. The procedure is performed under X-ray control to reduce pressure.
• Connecting the veins of the left kidney and spleen by a shunt. Interferes with the flow of body fluid.

Cardiologist

Higher education:

Cardiologist

Kabardino-Balkarian state University them. H.M. Berbekova, Faculty of Medicine (KBSU)

Education level - Specialist

Additional education:

"Cardiology"

GOU "Institute for Advanced Training of Doctors" of the Ministry of Health and Social Development of Chuvashia

When you hear the word "varicose veins", swollen, sinuous veins in the legs are usually presented. So it is - pathology most often affects lower limbsand it is here that she is visible to the naked eye. But functional vascular dysfunction can occur anywhere. Varicose veins in the tissues of the stomach are also accompanied by structural changes - the vessels dilate, lengthen, form knots and loops. Pathology develops against the background of hepatic lesions and is accompanied by minor or profuse hemorrhages.

Features of stomach damage

Varicose enlargement of the blood vessels of the stomach is an extremely dangerous pathology. She may be:

• congenital - vascular damage is diagnosed from the moment of birth. It is associated with genetic disorders, it can develop against the background of a complicated pregnancy;
• acquired - vascular transformation causes high pressure blood in the portal vein. She is responsible for the blood supply to the liver. Disruption of hepatic blood flow makes the vessels fragile - they can rupture at any time.

Congenital gastric varicose veins are extremely rare. Usually, experts diagnose the acquired form of pathology. And elderly patients are more susceptible to it. On initial stages development of varicose veins of the stomach is absolutely asymptomatic, and therefore it is rarely possible to diagnose the disease in a timely manner. There are several classifications of gastric varicose veins, but each of them is based on structural changes in the vessels. According to the endoscopic classification, pathology is divided into three degrees:

• 1 - veins less than 5 mm in diameter, almost indistinguishable on the gastric mucosa;
• 2 - the diameter of the veins is increased to 10 mm, their single bulging is observed;
• 3 - veins with a diameter of more than 10 mm have multiple bulges, form nodes.

The reasons for the development of pathology

Varicose veins in the stomach cause an increase in blood pressure in the portal vein. And it, in turn, is provoked by the development of liver cirrhosis. Sometimes portal hypertension results from congenital anomalies or compression of a vessel by a tumor, thrombosis or escaping gallstone disease stone.

Increased pressure contributes to the redistribution of blood and its increased circulation along the lateral (collateral) vessels of the upper region of the stomach. Pathology develops gradually, squeezing a vessel by a tumor cannot cause sudden changes. It usually occurs precisely because of chronic liver cirrhosis. Its development is facilitated by:

• alcohol abuse;
• drug use;
• uncontrolled intake of medications;
• hepatitis B and C;
• prolonged cholestatic syndrome (a decrease in the amount of bile entering the duodenum).

Sometimes cirrhosis occurs for other reasons, and varicose veins develop as a complication of liver damage. The causes of gastric varicose veins also include:

• functional disorders of the stomach and pancreas;
• echinococcosis (helminth disease);
• tuberculosis;
• polycystic (formation of cystic cavities);
• fibrosis (proliferation of connective tissue);
• sarcoidosis (granuloma formation);
• adhesions and cysts of various etiologies;
• aneurysms of the vessels of the liver, spleen;
• eosinophilic gastroenteritis (infiltration of the gastric mucosa with eosinophils);
• intestinal obstruction;
• general vascular and heart failure.

Sometimes the development of varicose veins of the stomach provokes a sharp load: fever, weight lifting.

Symptoms of the disease

Symptoms of pathology are individual, its clinical picture depends on many factors. Often at first, the disease is asymptomatic, sometimes rapidly. But in any case, gastric varicose veins are accompanied by:

• heartburn;
• belching;
• difficulty swallowing food;
• discomfort in the chest area;
• frequent heartbeat;
• impurities of blood in the feces.

Pain, weakness may be observed. The urge to vomit is not eliminated by changing the diet, eating foods that normalize digestion. The vomit contains mucus, which sometimes contains blood clots.

Diagnosis of vascular lesions

If you suspect varicose veins of the abdominal cavity, the patient is prescribed a medical examination. Diagnosis usually includes:

• clinical and biochemical blood test (concentration of platelets, leukocytes, cholesterol, liver enzymes, bilirubin);
• fibroesophagoscopy (assessment of the condition of veins, mucous membranes, identification of the causes of bleeding and signs of pathologies with similar symptoms);
• contrast radiography (detection of damaged vessels);
• duplex scanning of blood vessels (study of the anatomy of blood vessels and the degree of their stretching).

It is possible to identify vascular changes and the causes that caused them by analyzing the symptoms and data confirming the progression of liver cirrhosis.

Pathology therapy

With gastric varicose veins, it is important to prevent bleeding. If it does occur, it is necessary to do everything possible to stop the hemorrhage. Based on this, three main approaches to the treatment of pathology are practiced:

• therapeutic;
• endoscopic;
• operational.

The first two are applicable to early stages development of pathology or after effective relief of hemorrhage. Later stages are subject to surgical treatment, since there is a high probability of death caused by hypovolemic shock.

To control portal hypertension, cardiovascular therapy drugs are used, in particular, beta-blockers, which lower blood pressure, and Nitroglycerin (effective only with prolonged use). Carrying out hemostatic therapy, the doctor chooses the best way:

• medication;
• blood or plasma transfusion;
• the introduction of colloidal solutions.

Damaged veins are removed with electric current (electrocautery). To stop bleeding, bandages (rubber discs) or special probes are used to squeeze the damaged areas of the vessels. In parallel, therapy is carried out aimed at enhancing blood coagulation. There are other treatments for varicose veins:

• sclerotherapy - the introduction of a special solution into a vein;
• portosystemic intrahepatic stent shunting - portocaval anastomosis implantation;
• anastomosis - a decrease in the volume of the stomach;
• suturing of veins;
• removal of veins.

The decision to use a particular method is made based on the history, research results and the patient's well-being. Sometimes the only cure is a liver transplant.

Disease prevention

The main preventive measure for gastric varicose veins is organization proper nutrition... To do this, you must follow some rules:

1. Eat at least four times a day - little by little, at regular intervals;
2. Do not overeat at night;
3. Be sure to have breakfast;
4. Exclude use:

• • alcoholic beverages;
  • fried, sour, smoked, pickled, spicy foods;
  • confectionery;
  • strong tea, coffee, carbonated drinks;
  • too cold and hot food.

You need to give preference:

• cereals;
• vegetables;
• poultry meat;
• lean fish.

Foods should contain rutin and vitamins to prevent breakage of veins and promote normal blood circulation. It is important to periodically undergo a diagnostic examination and lead an active lifestyle, dosing physical activity.

High mortality with gastric varicose veins is due to the serious course of concomitant pathologies and the severity of complications. Help with hemorrhages in such circumstances is often symptomatic, and therapy for portal hypertension is far from always successful. Therefore, increased attention should be paid to the prevention of pathologies that contribute to the development of varicose veins.

Varicose veins of the stomach and lower esophagus is a disease characterized by a violation of the outflow of blood from the veins of these organs and a change in their structure (the vessels expand, become unnaturally winding, long and form nodes).

Esophageal varicose veins, gastric varices: causes

Usually, varicose enlargement in the stomach and esophagus occurs due to such a phenomenon, which is called portal hypertension (increased pressure in the portal vein system), of various etiologies. Normal pressure in that blood vessel in a normal state does not exceed 6 mm of mercury. With an increase in this indicator to 12–20 mm Hg, there is a violation of blood outflow and varicose veins. Portal hypertension is a consequence of thrombosis or compression of the portal vein, gallstone disease and some ailments of the pancreas, stomach and liver, including:

• Cirrhosis and chronic hepatitis;
• Echinecoccosis;
• Polycystic;
• Fibrosis, including congenital;
• Sarcoidosis;
• Malignant and benign neoplasms;
• Aneurysms of the arteries of the spleen and liver.

This disease can be congenital or appear in any period of life, regardless of age. As a result of impaired venous circulation due to the listed diseases or for other reasons. Most often, the disease is a consequence of cirrhosis of the liver, since this pathology is characterized by a change in the structure of the organ, modification and proliferation of its tissues, which, as the disease progresses, first lead to a weakening and then a complete cessation of the liver.

The clinical picture of gastric varicose veins

At the beginning, the disease is almost asymptomatic, without causing any discomfort to the patient. Sometimes patients have severe heartburn. This symptom, most often, remains unnoticed and does not serve as a reason for contacting a doctor. But even a doctor does not always associate heartburn with varicose veins of the digestive system. Therefore, the disease develops further and is complicated by bleeding, which is manifested by the following symptoms:

1. Ascites (accumulation of fluid in the abdomen that causes the abdomen to enlarge).
2. Painless vomiting of blood, usually profuse.
3. Tachycardia (palpitations)
4. Hypotension (lowering blood pressure).
5. In especially severe cases - hypovolemic shock.

Diagnostic methods for detecting the disease

At the initial stages, pathology can only be identified with the help instrumental methods diagnostics. Patients may be prescribed x-rays with contrast agent (barium sulfate). The most accurate way to establish the disease is esophagogastroscopy (internal examination of the esophagus and stomach). It is necessary to conduct the study very carefully, trying not to inflict injury, which could provoke bleeding.

After identifying dilated veins, the examination must be continued to establish the causes of the pathology. Portal hypertension most often leads to concomitant lesions of the veins of both the stomach and esophagus. When stretching individual sections of the vessels, splenic vein thrombosis can be suspected. In rare cases, the cause of esophageal varicose veins can lurk in eosinophilic gastroenteritis. As a result of damage to the intestinal mucous membranes, inflammation spreads to the smooth muscles, then fibrosis (tissue proliferation) and intestinal obstruction join.

Since the disease can be caused cancerous tumors, patients are often prescribed histological examination.

The main stages of treatment

Unfortunately, most often the disease is detected as a result internal bleeding, which can cause hypovolemic shock and even lead to death. In such cases, the patient needs emergency hospitalization and carrying out resuscitation measures. As soon as possible, you need to stop the bleeding and replenish the BCC.

After stabilization of the patient's condition, treatment of the underlying disease and procedures aimed at reducing the pressure of the portal vein and preventing bleeding are performed.

Now they use the following basic methods of solving the problem:

1. Sclerotherapy, which consists in endoscopic injection of an adhesive solution into the vessels of the stomach or esophagus. This procedure is repeated, depending on the severity of the disease, once a week or month, until a scar is formed.
2. Varicose vein ligation using a rubber band. The method is superior in effectiveness to sclerotherapy.
3. Intrahepatic shunting. Reducing pressure, by introducing a stent under X-ray control, into the middle zone of the liver to connect the hepatic and portal veins.
4. Splenorenal shunting. It is produced for the prevention of bleeding by combining the splenic vein and the vein of the left kidney with a shunt.
5. Drug treatment - the use of vasoconstrictor drugs (Vasopressin), nitrates to reduce pressure in the portal vein (Nitroglycerin), and Somatostatin (or its analogue Octreotide) to lower the blood pressure of internal organs and narrow the dilated vessels (taken for a long time).

Prevention of complications

In order to prevent the occurrence of life-threatening complications, in the form of profuse gastric bleeding from varicose veins, hemorrhage in the esophagus and stomach, acute liver failure, as well as ascites, a special regime is required.

In diseases leading to portal hypertension, a sparing diet is indicated. You need to eat in small portions 4-6 times a day. Do not eat later than four hours before bedtime. Preference should be given to boiled or steamed foods. Food that is too hot or cold should be avoided completely. It is necessary to prevent spicy and acidic foods from entering the esophagus.

It is required to avoid elevated physical activity, weights need to be rolled, but in no case lifted. We'll have to give up classes in the gym.

If you have problems with the liver, you should immediately consult a doctor who will prescribe treatment in the early stages of the disease. Beta-blockers are recommended for high portal pressure.