Risk factorsBy Mayo Clinic staff
Although many people with advanced liver disease develop esophageal varices, most won't experience bleeding. Varices are more likely to bleed if you have:
- High portal vein pressure. The risk of bleeding increases with the amount of pressure in the portal vein (portal hypertension).
- Large varices. The larger the varices, the more likely they are to bleed.
- Red marks on the varices. When viewed through an endoscope passed down your throat, some varices show long, red streaks or red spots. These marks indicate a high risk of bleeding.
- Severe cirrhosis or liver failure. Most often, the more severe your liver disease, the more likely varices are to bleed.
- Continued alcohol use. Your risk of variceal bleeding is far greater if you continue to drink than if you stop, especially if your disease is alcohol related.
- 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.