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Causes
By Mayo Clinic staff
Esophageal varices sometimes form when blood flow to your liver is obstructed, most often by scar tissue in the liver caused by liver disease. The blood flow to your liver begins to back up, increasing pressure within the large vein (portal vein) that carries blood to your liver. This pressure (portal hypertension) forces the blood to seek alternate pathways through smaller veins, such as those in the lowest part of the esophagus. These thin-walled veins balloon with the added blood. Sometimes the veins can rupture and bleed.
Causes of esophageal varices include:
- Severe liver scarring (cirrhosis). A number of liver diseases can result in cirrhosis, such as hepatitis infection, alcoholic liver disease, fatty liver disease and a bile duct disorder called primary biliary cirrhosis. Esophageal varices occur in about 40 percent of people who have cirrhosis.
- Blood clot (thrombosis). A blood clot in the portal vein or in a vein that feeds into the portal vein called the splenic vein can cause esophageal varices.
- A parasitic infection. Schistosomiasis is a parasitic infection found in parts of Africa, South America, the Caribbean, the Middle East and Southeast Asia. The parasite can damage the liver, as well as the lungs, intestine and bladder.
- Budd-Chiari syndrome. This rare condition causes blood clots that can block the veins that carry blood out of your liver.
References
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Sept. 12, 2010.
- Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Alexandria, Va.: American Association for the Study of Liver Diseases. http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/Prevention%20and%20Management%20of%20Gastro%20Varices%20and%20Hemorrhage.pdf. Accessed Sept. 12, 2010.
- Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2013. Http://www.mdconsult.com/books/about.do?about=true&eid=$eid&isbn=978-1-4557-0295-4&uniqId=398813857-1936. Accessed Jan. 22, 2013.
- Coelho-Prabhu N et al. Current staging and diagnosis of gastroesophageal varices. Clinical Liver Disease. 2010; 14: 195.
- AskMayoExpert. Esophageal varices. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- What I need to know about cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis_ez/#prevent. Accessed Jan. 29, 2013.
- Schistosomiasis. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/schistosomiasis/gen_info/faqs.html. Accessed Jan. 29, 2013.
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