Bleeding Varices

What are bleeding varices?
Varices are dilated blood vessels usually in the esophagus or stomach. They cause no symptoms unless they rupture and bleed. Bleeding from varices is a life-threatening complication of portal hypertension. Portal hypertension is an increase in the pressure within the portal vein (the vein that carries blood from the digestive organs to the liver) due to blockage of blood flow throughout the liver.

This increased pressure in the portal vein causes the development of large, swollen veins (varices) within the esophagus and stomach. The varices are fragile and can rupture easily, resulting in a large amount of blood loss.

What causes bleeding varices?
The most common cause of portal hypertension is cirrhosis of the liver. Cirrhosis is scarring that accompanies the healing of liver injury caused by hepatitis, alcohol, or other less common causes of liver damage. In cirrhosis, the scar tissue blocks the flow of blood through the liver and slows its processing functions.

What are the symptoms of bleeding varices?
Symptoms of bleeding varices include:

How are bleeding varices treated?
Bleeding from varices is a medical emergency and treatment should be immediate. If the bleeding is not controlled quickly, a patient may go into shock or die. In severe cases, a patient may need to be placed temporarily on a ventilator to prevent the lungs from filling with blood. Aside from the urgent need to stop the bleeding, treatment is also aimed at preventing future bleeding. The following procedures help treat bleeding varices by reducing the pressure in these veins.

Can bleeding varices be prevented?
Treating the underlying cause of bleeding varices can help prevent their recurrence and treating liver disease earlier on may prevent their development. Certain medications, including the class of heart drugs called beta blockers, may reduce elevated portal pressure and reduce the likelihood of bleeding. Long-acting nitroglycerines are also sometimes used for this purpose.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit or This document was last reviewed on: 1/1/2004