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Gastric Varices: Symptoms, Causes and Treatment
Written by Medicover Team and Medically Reviewed by Dr Burra Siva Kumar , Gastroenterologists Medical
Gastric varices are swollen veins that develop in the lining of the stomach. They occur when blood flow to the liver is blocked often due to liver disease causing blood to reroute through smaller veins in the stomach.
These smaller veins are not built to handle the increased pressure, so they stretch and enlarge. If they burst, it can result in serious and potentially life-threatening bleeding inside the digestive system.
What is Gastric Varices?
Gastric varices are enlarged veins in the stomach. They form when blood flow through the liver is blocked, causing pressure to build up in nearby veins. This condition is often linked to portal hypertension, which is high blood pressure in the vein that carries blood to the liver (the portal vein).
Unlike esophageal varices, which form in the esophagus, gastric varices are located in the stomach lining and can bleed suddenly and heavily, posing a serious medical risk.
What are the Causes of Gastric Varices?
The most common cause of gastric varices is portal hypertension, usually due to liver disease. When blood cannot flow normally through the liver, it backs up into other veins, including those in the stomach, causing them to swell.
Main causes include
- Cirrhosis: Long-term liver damage from alcohol, hepatitis B or C, or fatty liver disease.
- Portal vein thrombosis: A blood clot that blocks blood flow in the portal vein.
- Schistosomiasis: A parasitic infection that can affect the liver and lead to portal hypertension.
- Congenital liver disorders: Rare conditions that affect blood flow from birth.
- Liver cancer or tumors: These can press against veins and disturb normal blood flow.
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Get Second OpinionWhat Are the Risk Factors of Gastric varices?
Certain conditions increase the chance of developing gastric varices:
- Advanced liver disease or cirrhosis
- Alcohol abuse
- Chronic hepatitis infections
- Blood clotting disorders
- History of gastrointestinal bleeding
- Previous variceal bleeding
What Are the Symptoms of Gastric Varices?
Gastric varices often cause no symptoms unless they rupture and bleed. When bleeding occurs, it can be sudden and life-threatening.
Signs to watch for
- Vomiting blood (hematemesis), bright red or dark, like coffee grounds
- Black, tarry stools (melena)
- Lightheadedness or fainting from blood loss
- Sudden weakness or fatigue
- Low blood pressure
- Abdominal pain or a feeling of fullness in the upper stomach
In people with known liver disease, any of these signs should be treated as a medical emergency.
How Are Gastric Varices Diagnosed?
Gastric varices are usually diagnosed through a combination of clinical evaluation and tests. If bleeding is suspected, emergency testing is done.
Diagnostic methods include
- Upper endoscopy (EGD): A camera on a flexible tube is inserted through the mouth to see the stomach and detect varices.
- CT scan or ultrasound: These help evaluate liver health, blood flow, and signs of portal hypertension.
- Capsule endoscopy: A tiny camera capsule swallowed by the patient to view the digestive tract.
- Liver function tests: Blood tests that assess how well the liver is working.
- Portal vein Doppler ultrasound: Measures blood flow in the portal vein.
How Are Gastric Varices Treated?
Treatment depends on whether the varices have bled and how severe the bleeding is. The goal is to control bleeding, prevent rebleeding, and manage underlying liver disease.
Emergency Treatment for Bleeding
- Endoscopic glue therapy: A special tissue adhesive (like cyanoacrylate) is injected directly into the bleeding vein to seal it.
- Band ligation (less common than with esophageal varices)
- Medications: Drugs like octreotide reduce blood flow to the stomach to control bleeding.
- Blood transfusions: To replace lost blood and stabilize the patient.
Preventive (Non-bleeding) Management
- Non-selective beta blockers: Medications like propranolol are used to lower portal pressure.
- Monitoring with endoscopy: To check for new or enlarging varices.
- Treatment of liver disease: Managing hepatitis, avoiding alcohol, or considering liver transplant in severe cases.
Advanced Options
- TIPS (Transjugular Intrahepatic Portosystemic Shunt): A stent is placed in the liver to reduce pressure in the portal vein.
- Balloon-occluded retrograde transvenous obliteration (BRTO): A less common but effective procedure for gastric varices.
- Liver transplant: For those with end-stage liver disease and repeated variceal bleeding.
What Are the Possible Complications?
If not properly managed, gastric varices can lead to:
- Massive gastrointestinal bleeding
- Shock or loss of consciousness due to blood loss
- Death, if bleeding is not controlled
- Recurrent bleeding, which is common without treatment
- Anemia from slow or repeated blood loss
- Worsening liver function if underlying disease progresses
Timely medical care can reduce the risk of these serious outcomes.
Outlook and Healing Time
The outlook depends on whether the varices have bled, the severity of liver disease, and the success of treatment. Non-bleeding varices can often be managed with medications and close monitoring.
After treatment
- Recovery from endoscopic procedures is usually quick.
- Patients are often monitored in the hospital for a few days.
- Long-term management of liver disease is crucial for preventing recurrence.
When Should You See a Doctor?
If you have liver disease and experience signs like vomiting blood, black stools, or sudden weakness, seek emergency care immediately. These could be signs of bleeding gastric varices, which require urgent treatment.
Even without bleeding, people with liver disease should have regular check-ups to monitor for varices.
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Our Experience in Treating Gastric Varices
At Medicover Hospitals, we offer advanced care for complex gastrointestinal conditions like gastric varices. Our team of gastroenterologists, liver specialists, and interventional radiologists work together to provide fast diagnosis and effective treatment using endoscopy, imaging, and minimally invasive procedures.
With expert care, round-the-clock emergency support, and personalised treatment plans, we help you stay safe, prevent complications, and manage your liver health with confidence.
