When blood pressure increases in the portal vein system, veins in the esophagus, stomach, and rectum enlarge to accommodate blocked blood flow through the liver. The presence of enlarged veins (varices) usually causes no symptoms. (They may be found during an endoscopy exam of the esophagus.) About 50 to 60 out of 100 people who have cirrhosis develop varices in the esophagus.1
Living with a chronic disease like hepatitis C can be depressing and nerve-wracking. It can also interfere with your relationships.
"People with hepatitis C experience a lot of stigma," says Alan Franciscus, executive director of the Hepatitis C Support Project in San Francisco. "It can be really hard."
You may avoid talking to friends or family about the disease because you're worried about how they'll react. You may feel a temptation to pull away from people you care about rather than risk them...
As the blood pressure in the portal vein system continues to increase, the walls of these expanded veins become thinner, causing the veins to rupture and bleed. This is called variceal bleeding.
The more severe the liver damage and the larger the varices, the greater your risk is for variceal bleeding.
Of the people who develop varices, about 30 out of 100 have an episode of bleeding within 2 years of the diagnosis of varices.2
Variceal bleeding can be a life-threatening emergency. After varices have bled once, there is a high risk of bleeding again. The chance of bleeding again is highest right after the first bleed stops and gradually goes down over the next 6 weeks. If varices are not treated, bleeding can lead to death.
Treatment for variceal bleeding can be challenging and may include medicines as well as endoscopic therapy (endoscopic banding or sclerotherapy). For more information, see:
The American College of Gastroenterology recommends endoscopic screening for varices for anyone who has been diagnosed with cirrhosis. If your first test does not find any varices, you can be tested again in 2 to 3 years.2 You may need more frequent testing if you have large varices or have already had an episode of variceal bleeding, even if you are treated for your varices with beta-blockers or variceal banding. Recurrent bleeding is common.