If you have cirrhosis, your doctor should screen you for esophageal varices at the time you are first diagnosed. How often you'll undergo screening tests depends on your condition. Main tests used to diagnose esophageal varices are:
March 15, 2013
- Endoscope exam. A procedure called esophagogastroduodenoscopy is the preferred method of screening for the presence of varices. Your doctor inserts a thin, flexible, lighted tube (endoscope) through your mouth and into your esophagus and small intestine. The doctor will look for dilated veins, measure their size, if found, and check for red streaks (wales) and red spots, which usually indicate a significant risk of bleeding. Treatment can be performed during the exam.
- Imaging tests. Both CT and MRI scans may be used to diagnose esophageal varices. These tests also allow your doctor to examine your liver and circulation in the portal vein. CT is not recommended for detecting large esophageal varices, but it may be useful for screening for varices if endoscopy can't be done.
- Capsule endoscopy. In this test, you swallow a vitamin-sized capsule containing a tiny camera, which takes pictures of the esophagus as it passes. This may be an option for people who are unable or unwilling to undergo an endoscope exam. More experience is needed with this technology to confirm its value.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Sept. 12, 2010.
- Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Alexandria, Va.: American Association for the Study of Liver Diseases. http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/Prevention%20and%20Management%20of%20Gastro%20Varices%20and%20Hemorrhage.pdf. Accessed Sept. 12, 2010.
- Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2013. Http://www.mdconsult.com/books/about.do?about=true&eid=$eid&isbn=978-1-4557-0295-4&uniqId=398813857-1936. Accessed Jan. 22, 2013.
- Coelho-Prabhu N et al. Current staging and diagnosis of gastroesophageal varices. Clinical Liver Disease. 2010; 14: 195.
- AskMayoExpert. Esophageal varices. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- What I need to know about cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis_ez/#prevent. Accessed Jan. 29, 2013.
- Schistosomiasis. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/schistosomiasis/gen_info/faqs.html. Accessed Jan. 29, 2013.