A pathological condition in which it appears in the dilation of blood vessels in the lower part of the tube of the esophagus or the stomach, adjacent to it, called esophageal varices, where the symptoms will be examined in detail in this article.
The disease develops due to an increase of pressure in the portal vienna, to reduce the outflow of blood. This state is called chronic course of viral hepatitis, cirrhosis of the liver. Occurs a change in the structure of the blood vessels. On the walls are formed from a variety of protrusion and the sheath of the capillary tapers.
The vessels have a serpentine shape, the mucosa is hyperemic and ulceration. This leads to a massive hemorrhage, have not pre-symptoms.
The disease has an ICD code of 185, which is defined as esophageal varices, 185 (9) without bleeding, 185 (0) with the bleeding.
What is
Stable hypertension (high blood pressure) in the vein portal 2-4 times more of the standard leads to diseases of the esophagus. A further increase of the pressure (24 – 27 waters.pt) leads to the rupture of the vase and the development of bleeding.
Hypertension in the portal vein and leads to a reduction of the outflow of blood, vascular malformations, their elongation and thinning of the walls. On the walls of the blood vessels forming the protrusion, where is going the blood. With the increase in pressure increases the load on the capillary wall and can break.
When heart disease, the systems of veins varicose has smaller and localized on the whole surface of the tube in the throat. If the extension is called the pathological processes that occur in the liver, the blood vessels are more dilated and imperfections are in the neighborhood of the bottom of the esophagus.
Complications such as bleeding not depend on the size of the host or by the state of the vascular wall, and by a rise in pressure in the portal vein.
The cause:
- the excess of food;
- strengthening the physical load;
- the increase in intra-abdominal pressure.
Sometimes the bleeding occurs during the sleep. There are aggravating factors condition: insufficiency of the cardia, but also reduce the clotting of the blood. Here's the danger of esophageal varices.
When the disease esophageal varices icd-10 code needs to know the doctor.
Esophageal varices: causes
The reasons for its development are the pathological processes that cause portal hypertension vienna. This:
- parenchymal disease of the liver caused by cirrhosis, tumors, amyloidosis;
- stenosis of the portal vein (thrombosis, squeezing out, multiple sclerosis);
- chronic insufficiency of the cardiovascular system.
Persons at risk that may appear in esophageal varices are:
- >people over the age of 50 years (mostly men);
- patients with a chronic disease of the CCC and of the GASTROINTESTINAL tract;
- patients cirrhosis of the liver.
More often the extension of the veins of the esophagus develops in liver cirrhosis and chronic hepatitis. The abuse of alcohol occurs a change in the structure of the parenchyma. There are formed scars, that interrupt the normal flow of blood, slows down, resulting in stasis of blood and formation of varicose veins blood.
The initial phase of the disease
Highlight innate module, which is observed in infants. But this disease occurs rarely, and accompanied by other serious disorders. The development of disorders, causes hereditary factor and during pregnancy. Purchased to the form observed in men, has reached the age of 50 years and with the bad habits.
According to the degree of vascular injury are four distinct types of disease:
1 phase. It is a first degree, in which varices are equal do not exceed 3 mm, and defined only when endoscopic research. During the course of an x-ray with contrast seen slow the circulation of the blood, but no bleeding. With this opening, the esophageal reduced "irregular".
Step 2. In this stage the lumen of the blood vessel is not broken and varicose veins are not increased, but vienna buy sinuous structure. The diagnosis is confirmed with the help of a contrast x-ray, where they are visible are not clear outlines of the blood vessels and rounded protrusion. No hemorrhage.
3 phase. We observe a strong extension of some parts of the blood vessels, the lumen of the vein is reduced. Are clearly visible varicose veins, altered mucosa (thinning). This phase is characterized by a high risk of bleeding.
On radiology the photos you can see the formation on the mucosa of the esophagus in the form of polyps, and also chiseled perforation of the mucosa. The state is considered as a heavy and requires urgent hospitalization.
4 phase. We observe a strong thinning of the mucosa, the blood, the formation about it polyps. Esophageal varices in this stage have a view of the clusters and overlap significantly the esophageal lumen. With the progression of the disease may turn it off completely. In this period, the patient is observed hyperemia of the mucosa, the formation of erosive defects. It has been considered as critical, because it is the cause of frequent and massive bleeding.
Esophageal varices: symptoms
The beginning of the disease does not manifest itself. Therefore, patients are turning to the doctor, when the disease is already "gained momentum". By only to recognize the disease is impossible, because the symptoms are similar to symptoms of disorders of the digestive system. So, if you have varicose veins of the esophagus, the symptoms are the following:
- the appearance of dyspnea;
- the presence of heartburn (does not depend on the meal);
- pain in the field of process xifoideo;
- disorder of swallowing.
If you have varicose veins of the esophagus and the stomach, the main sign of a drawing on the skin of the anterior abdominal wall in the shape of a "head of medusa". His form pathologically altered in vienna. This symptom appears already in the next period of the incidence of the disease. Later, with the appearance of bleeding in the patient is this:
- hematemesis;
- blood in the stool;
- tachycardia;
- hypotonia (strong blood pressure drop);
- the shock.
Diagnosis and treatment
Defined the patient has varicose veins of the stomach and of the esophagus such methods as:
- ULTRASOUND research of the esophagus, the abdominal cavity;
- common analysis of blood;
- x-ray with the application of contrast.
Installing the diagnosis, consider that the bleeding can cause colitis in the defeat of the esophagus, decaying tumor. This longitudinal rupture of the mucosa of the upper part of the stomach or distal region of the esophagus, called the most common cause of vomiting.
At the time of confirmation of the diagnosis of varices is assigned to the treatment, therefore, the degree of vascular lesions of the tube in the throat. If the disease is discovered when you see the bleeding, the direct processing on his arrest:
- a blood transfusion;
- the administration of vasoconstrictor drugs;
- hemostatic drugs;
- electrocoagulation hit the ship;
- the pressure on the affected area blood special probe.
After that, carry out therapeutic activities aimed at warning of relapse (snooze) heart attack. If you look at esophageal varices in cirrhosis of the liver, to spend treatment of the underlying disease. Is directed to restore the function of the liver tissue. Also the patient is advised to give up bad habits, avoid heavy physical workloads.
- Prescribed antacids (medicines that reduce the acidity of gastric juice), to warn of excessive irritation of the mucosa of the esophagus.
- Binders drugsthat reduce inflammation.
- Vitamin therapy.
The diagnosis of esophageal varices medication treatment can be supplemented by surgical intervention for relapse prevention, it is possible to organize.
Bandage – above varicose are installed small rubber disks. Introduction hemostatic solution in the skin vienna. To make the procedure need to not less than four times a year. Are you completely removed all of the damaged of vienna, are not recoverable.
Cirrhosis of the liver, the patient can not do the classical operation. In this case they are endoscopic doping blood of the esophagus. The procedure consists in the ligation of the vessel in nylon rings or snap rings.
The particular bypass surgery, in which they connect the portal and hepatic vein. This gives the possibility to normalize the pressure in the blood vessels.
Diet
The diagnosis of esophageal varices treatment includes many measures, including the observance of certain rules of supply.
Diet for varicose veins of the esophagus involves the use of products, can strengthen the elasticity of blood vessels, strengthen them, and prevent the formation of blood clots.
Featured food products must contain vitamin A, vitamin C, and fibre:
- legumes;
- lettuce leaves;
- corn and olive oil;
- citrus fruits;
- fruits of the sea;
- nuts;
- vegetables and fruit.
The meat is better to replace the seafood or beef, liver. It is not advisable to use salted, spiced and spicy, after which the patient drinks large quantities of water. This causes swelling of the tissues. The recommended volume of liquid a day is 2 litres. Also, can not drink whole milk, because it contributes to reduce the elasticity of blood vessels.
Can not eat:
- alcohol;
- black tea and coffee;
- confectionery;
- canned and prepared meats;
- sugar.
In the preparation and consumption of dishes there are the nuances. Prepare the food to steam, or boiling, and cook. Take the food in small pieces, not to transmit, with dishes must not be too hot or cold.
Preventive measures
For the prevention of disease you should immediately seek medical attention. To make the treatment of diseases of the liver, if they have a history. It is necessary to adhere to a proper diet, get rid of bad habits, follow weight. Also, it is not necessary to expose the body to excessive physical stress.
This applies not only to the type of activities, but also in the gym with the execution of strength exercises. Physical exercises should not be excluded, but it is necessary to perform charging, developed by a doctor of THERAPY specifically for patients with varicose veins of the esophagus. The complex of such exercises and aims to improve the circulation of blood, reducing the risk of formation of blood clots, reducing the deposits of cholesterol.
In the prevention of disease such as varices and esophageal varices plays an important role in the work of the GASTROINTESTINAL tract. Therefore, in such patients it is advisable to drink herbal teashaving an effect choleretic and improving digestion. For the prevention of reflux (casting) of the stomach contents into the esophagus thus the irritation of the mucosa, sleep, raise the head of the bed by 10 cm.
Following these guidelines will help you avoid the development of severe disease or relapse. And we must remember that to consult the doctor when the first symptoms, to avoid serious complications of heavy bleeding. Desirable to deal with the venous disease varicose of the esophagus.