Cause of Esophageal Varices and Symptoms

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Esophageal varices are enlarged, abnormal veins that may be found in the esophagus' lower part. Those with serious liver disease are most prone to this condition. So, what is the cause of esophageal varices? There are a few causes of this condition. Conditions that result in the blood flow to the liver being slowed will cause the enlarged, abnormal veins associated with this condition.


Cirrhosis, or severe liver scarring, is most often the cause of esophageal varices, more specifically a complication of cirrhosis. This may be caused by several different liver conditions, such as alcoholic liver disease, hepatitis infection, or primary biliary cirrhosis.

If a blood clot is located in the portal vein or the splenic vein, this condition can occur. Another condition known as Budd-Chiari syndrome causes blood clots that can cause a blockage in the veins responsible for transporting blood out of the liver. This syndrome is rare, however.

A parasitic condition known as schistosomiasis can damage the liver, as well as the intestine, lungs, and bladder. This may result in esophageal varices if due to the liver damage. This parasitic infection is most often seen in South America, the Caribbean, parts of Africa, Southeast Asia, and the Middle East.

Risk Factors

Many patients who have an advanced liver disease will also develop this condition, however, most will not experience bleeding. Certain risk factors increase the chance of varices bleeding. These may include:

  • High portal vein pressure: The more pressure that is present, the higher the risk of experiencing bleeding
  • Red marks on varices: Red marks indicate that the patient has a high risk of bleeding
  • Continuing to use alcohol: If the patient’s liver disease is related to alcohol, continuing to drink will increase their chance of experiencing bleeding
  • Large varices: The bigger varices are, the higher the chance they have of bleeding
  • Liver failure or severe cirrhosis: The more severe a patient’s liver disease, the higher the chance that they will experience bleeding


Unless they are bleeding, esophageal varices do not often cause symptoms. If bleeding is occurring, signs and symptoms may include:

  • Tarry, black, or bloody stools
  • Vomiting blood
  • In severe cases, shock may occur


Bleeding is the most serious complication associated with this condition. Once a patient experiences one episode of bleeding, his or her chance of experiencing another is significantly increased. For some patients, the bleeding can be so severe that he or she will lose a significant amount of blood and may go into shock. This may result in death.


University of Illinois Medical Center at Chicago. (2006). Bleeding Esophageal Varices. Retrieved on November 21, 2010 from the University of Illinois Medical Center at Chicago:

MedlinePlus. (2010). Bleeding Esophageal Varices. Retrieved on November 21, 2010 from MedlinePlus: