Bleeding Esophageal Varices Varicose Veins
Compared And Contrasted

Considering bleeding esophageal varices varicose veins seem positively benign. Why so? What makes bleeding oesophageal (for the British spelling) varices so dangerous?

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Bleeding Varicose Veins

Bleeding esophageal varices varicose veins with the latter blue blebs that can bleed

"Blue blebs" bleed easily

After all varicose veins can bleed as well. Usually from very superficial vessels that often show as “blue blebs”. The deep colour gives away how close they are to the surface.

With minimal overlying skin minimal trauma, sometimes completely unnoticed, can cause major bleeding. It can be life-threatening.

But once noticed all that is needed to control it is slight elevation of the bleeding leg. That and direct local pressure on the bleeding spot.

Don’t brush aside such an episode. It will happen again.

You can lose a large portion of your blood volume quite rapidly.

But proper treatment will remove the risk completely.

Bleeding Esophageal Varices

In contrast bleeding esophageal varices cannot be elevated or have local pressure applied. Nor can the bleeding be seen immediately.

They will usually reveal themselves with vomiting of blood, passing blood in your motions, or feeling of faint as your blood pressure drops from blood loss.

It is a medical emergency. Difficult to deal with.

Management

Also long term treatment is more complicated than that required for varicose veins. The underlying conditions predisposing you to oesophageal varices are usually not correctable.

Controlling blood pressure by medication may lower the risk of bleeding recurrence.

Some treatments are similar to what we use for varicose veins. Injection of sclerosing solutions to shut the veins down. Or tying of the enlarged veins.

More dramatic management involves shunts to bypass the causative problem circulation.

Causes

If a clot in the vein draining the esophagus provoked the problem it can be managed.

But the most common cause, scarring or cirrhosis of the liver, is a non-reversible condition. Unless you have a liver transplant!

Contrasting Bleeding Esophageal Varices Varicose Veins Compared

Effectively the cause of the bleeding is similar in both conditions. Local rubbing or trauma breaks the overlying tissue.

But increased pressure alone induced by vomiting or coughing may cause bleeding esophageal varices varicose veins very much less so.

Varicose veins tend to have a more inherited tendency. Lifestyle causes do bring out both.

In varicose veins the provoking back pressure is due more to gravity once the vein walls weaken and the vein increases in size. The valves do not function, as I have covered.

Likewise back pressure creates oesophageal varices. But this is in the portal vein.

Bleeding esophageal varices varicose veins diagram showing varices location and portal circulation

Portal vein and esophageal varices location

The portal vein has a unique position and function in your body. Its continued venous circulation tracking from further veins after fine intermediary capillaries.

This allows your liver to screen and process all items being absorbed through the length of your gut. Before it hits the main circulatory system.

Alcohol levels begin reducing this way. Toxins can be deactivated early on.

Impeded Portal Vein Drainage

But this unique circulation also creates its Achilles' heel.

Blockage of the portal vein by clotting or stiffening liver tissue from scarring impedes drainage. Feeding veins become engorged. Similar to putting a tight band on your arm or leg.

As around the lower third of the oesophagus is drained through the portal system, this is the section that gets affected.

And can bleed…Life-threateningly.

Cirrhosis Causes

Liver scarring, or cirrhosis, commonly has been associated with alcoholism. But viral hepatitis, especially types b and c but also d all can result in cirrhosis.

A few reasonably rare metabolic diseases can cause it. So can some more severe drug reactions.

Interruption to bile draining from the liver to aid fat digestion also can produce such severe scarring. Whether this is from an inflammatory process or a failure to create them before birth.

The Fatty Liver

Alcoholic cirrhosis is preceded by fatty liver disease.

There is a non-alcoholic fatty liver disease with a significant proportion leading to cirrhosis. Even major clinics seem stumped as to why this occurs.

Yet there has been much discussion on the influence of sugar, specifically sucrose, in its creation.

Sucrose splits in the gut into glucose and fructose. Glucose is the basis of all cells’ energy.

Fructose though cannot be readily used within the body.

Effectively it gets detoxified by the liver creating oxidising by-products. Fatty deposits are produced. That plus triglycerides and uric acid in the blood. Hypertension ensues.

Gathering Storm

In attempting to reduce dietary fat to decrease heart disease sugar has been added to improve processed foods’ poorer flavour. More and more sugar is used.

Bleeding esophageal varices varicose veins and sugar's rising influence. Field of sugarcane.

Sugarcane in field - one source of sucrose

Combined with that are increasing glyphosate residues in foods. For industrial food production Roundup and its other versions (essentially glyphosate) are repeatedly sprayed.

In some instances genetically modified crops are used to survive this.

Wheat harvesting is managed by applying glyphosate a few days before. Residues remain.

Glyphosate does not directly affect human cells and enzymes. But it kills gut bacteria and other micro-organisms that help us digest food, including fructose. They also usually aid in producing extra nutrients for us.

All these changes along with GMO foods has created a perfect storm to provoke a very likely explosion in future bleeding esophageal varices varicose veins notwithstanding.

Wait and watch!