What are the different grades of varices?

Grade I: Microcapillaries located in distal oesophagus or oesophago-gastric junction. Grade II: One or two small varices located in the distal oesophagus. Grade III: Medium-sized varices of any number. Grade IV: Large-sized varices in any part of oesophagus.

What does Grade 1 esophageal varices mean?

Based on the size, the esophageal varices are classified as follows. Grade 1: Esophageal varices appear to be straight and small in size. Here, the varices extend just above the levels of mucus. Grade 2: Esophageal varices get enlarged and twisted and occupy less than one-third of the inside space of esophagus.

What is high grade esophageal varices?

Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver.

What are Red Whale marks?

A wale mark, red wale sign or wale sign is an endoscopic sign suggestive of recent hemorrhage, or propensity to bleed, seen in individuals with esophageal varices. The mark has the appearance of a longitudinal red streak located on an esophageal varix.

What are Grade 3 varices?

When esophageal varices are discovered, they are graded according to their size, as follows: Grade 1 – Small, straight esophageal varices. Grade 2 – Enlarged, tortuous esophageal varices occupying less than one third of the lumen. Grade 3 – Large, coil-shaped esophageal varices occupying more than one third of the …

What are the 4 stages of cirrhosis of the liver?

Cirrhosis is classified into four stages that include:
  • Stage I: Steatosis. The first stage of liver disease is characterized by inflammation of the bile duct or liver. …
  • Stage II: Scarring (fibrosis) of the liver due to inflammation. …
  • Stage III: Cirrhosis. …
  • Stage IV: Liver failure or advanced liver disease or hepatic failure.

What stage of cirrhosis does varices occur?

Cirrhosis can be divided into 4 stages: stage 1, no varices, no ascites; stage 2, varices without ascites and without bleeding; stage 3, ascites+/-varices; stage 4, bleeding+/-ascites. Yearly mortality ranges from 1% in stage 1 to 57% in stage 4.

What is baveno criteria?

The Baveno VI criteria combines TE and platelet count for the prediction of the risk of varices. Patients with an LSV under 20 kPa and a platelet count over 150,000/ul are at a low risk of having varices requiring treatment and, therefore, do not require a screening endoscopy (16).

What reduces mortality in variceal bleeding?

Variceal bleeding is a decompensating event with a high risk of rebleeding following initial recovery. Measures to prevent recurrent variceal bleeding such as eradicating esophageal varices and improving liver function are important for reducing the risk of mortality.

What is the best treatment for esophageal varices?

Beta blockers — Beta blockers, which are traditionally used to treat high blood pressure, are the most commonly recommended medication to prevent bleeding from varices. Beta blockers decrease pressure inside of the varices, which can reduce the risk of bleeding by 45 to 50 percent [1].

Do esophageal varices go away?

Once varices develop, they can remain stable, increase in size (if the liver disease worsens), or decrease in size (if the liver disease improves). Esophageal varices are a potentially serious complication of cirrhosis.

What stage of cirrhosis does varices occur?

Cirrhosis can be divided into 4 stages: stage 1, no varices, no ascites; stage 2, varices without ascites and without bleeding; stage 3, ascites+/-varices; stage 4, bleeding+/-ascites. Yearly mortality ranges from 1% in stage 1 to 57% in stage 4.

What is the most common cause of esophageal varices?

Scarring (cirrhosis) of the liver is the most common cause of esophageal varices. This scarring cuts down on blood flowing through the liver. As a result, more blood flows through the veins of the esophagus. The extra blood flow causes the veins in the esophagus to balloon outward.

What is the most common complication of esophageal varices?

They form due to portal hypertension, which commonly is a result of cirrhosis, resistance to portal blood flow, and increased portal venous blood inflow. Variceal rupture is the most common fatal complication of cirrhosis. the severity of liver disease correlates with the presence of varices and risk of bleeding.

Can you eat with esophageal varices?

Eat healthy foods.

Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet. You may need to eat foods that reduce stomach acid. Stomach acid can get into your esophagus and cause the varices to break open and bleed.

Can you have varices without cirrhosis?

Cirrhosis is the most common cause of portal hypertension and varices in the Western world. However, varices can arise in patients with portal hypertension in the absence of cirrhosis or even in the absence of portal hypertension.

What happens when varices bleed?

Bleeding from varices is a medical emergency. If the bleeding is not controlled quickly, a person may go into shock or die. Even after the bleeding has been stopped, there can be serious complications, such as pneumonia, sepsis, liver failure, kidney failure, confusion, and coma.

What causes esophageal varices to rupture?

They develop when scar tissue or a blood clot in the liver interrupts blood flow and causes the veins in your lower esophagus to swell. Alcohol-related liver disease is a common cause of esophageal varices. Heavy drinking and excessive vomiting can cause them to bleed or rupture, which is a medical emergency.

Can acid reflux cause esophageal varices?

It has been postulated that acid reflux may contribute to esophagitis and variceal bleeding in cirrhotic patients, and it occurs at a high frequency (64%) in patients with liver cirrhosis and portal hypertension, irrespective of the etiology of cirrhosis and the grade of esophageal varices[8].

Can varices stop bleeding on their own?

Bleeding may not be serious. It may also stop on its own. Signs of bleeding are: Vomiting or coughing up blood that may look like coffee grounds.

Can coughing cause esophageal varices to rupture?

Conclusions: Constipation, vomiting, severe coughing, and excessive consumption of alcohol may precipitate rupture of EV.