Esophageal Varices

Esophageal varices are enlarged veins in the lining of your esophagus, the swallowing tube that connects your mouth to your stomach. Varices are serious because they have weakened walls that can leak or break and bleed. Internal bleeding from a ruptured vein can be sudden, severe and life-threatening.

Esophageal varices occur in people with portal hypertension, which is high blood pressure in the portal vein that runs through your liver and the other veins that branch off from it. Abnormal pressure causes the thin esophageal veins to swell and enlarge. This most often occurs in people with liver disease.

How serious are esophageal varices?

Bleeding is the most serious risk of esophageal varices. Not everyone will experience bleeding, but up to 50% will. The risk increases as portal hypertension increases. When portal hypertension results from chronic liver disease — which is most of the time — it worsens as your liver condition worsens.

People with advanced liver disease (cirrhosis) have other concerns besides esophageal varices. But bleeding varices are the most common cause of hospitalization and death in people with cirrhosis. An episode of variceal bleeding has a mortality rate of around 20%, and bleeding often recurs (comes back).

How common are esophageal varices?

In people diagnosed with cirrhosis of the liver, 30% already have portal hypertension and esophageal varices at the time of diagnosis. Up to 90% will develop them over the next 10 years. In general, more severe cirrhosis leads to increasing pressure and larger varices, which are more likely to rupture.