Esophageal Varices – A Diagnosis You Didn’t Expect
Esophageal Varices: A Diagnosis You Didn’t Expect
Discussing Esophageal Varices with Your Healthcare Team
Have you visited your doctor for a routine check-up, only to get blindsided by a diagnosis like esophageal varices, and it leaves you feeling confused? It’s even more frustrating when you feel well. Perhaps you’ve recently added some healthy habits —like eating home-cooked meals with veggies or cutting back on processed foods, snacks or drinks.
When you feel fairly healthy, a diagnosis you didn’t expect, like esophageal varices, can feel like a real shocker—because how could anything be wrong if you’re feeling good? When this happens, let’s just say, your head can get bombarded with questions, concerns and worries that you didn’t have previously.
Before we jump into the topic, let’s start with the diagnosis.
What are Esophageal Varices?
Esophageal varices are characterized by abnormally enlarged veins in the lower esophagus. Obstructed blood flow in the portal vein can cause the condition. The portal vein is a large blood vessel that carries blood from the intestine and spleen to the liver.
When you experience any type of serious liver disease such as cirrhosis or various types of fatty liver disease, it can cause complications like esophageal varices—which can rupture or bleed.
Portal Hypertension
When circulation is working properly, blood from your intestine, spleen and pancreas enters your liver through the portal vein. However, when scar tissue blocks circulation through your liver—you can think of it like a blood flow traffic jam. As blood backs up, pressure builds in the portal vein—commonly referred to as portal hypertension.
When this happens, it forces excess blood into smaller, delicate veins in the esophagus, stomach and sometimes in your rectum. Excess blood can cause these delicate veins to balloon—and sometimes they rupture and bleed.
When varices develop, it’s generally common that they will continue to grow larger. This is why routine, ongoing care is so important when living with varices.
Chronic Conditions Linked to Esophageal Varices
Wondering how esophageal varices developed in your upper GI tract? Here are some common conditions linked to varices.
- Blood clot in portal vein[1]
- Hepatitis B or C[2]
- Parasitic infections[3]
- Severe congestive heart failure-though considered rare[4]
- Alcohol Use Disorder or continued heavy drinking with known liver damage[5]
- Cirrhosis of the liver – causing persistent inflammation[6]
Common Symptoms of Esophageal Varices
- Vomiting blood
- Decreased urination from unusually low blood pressure
- Black, tarry or bloody stools
- Excessive thirst
- Lightheadedness
- Shock, in severe cases
Sources: National Institutes of Health PubMed and Nature Reviews, Gastroenterology and Hepatology
What’s Next After the Diagnosis?
Once your doctor establishes esophageal varices as the diagnosis, the natural question becomes, now what?
In addition to juggling the usual everyday life challenges—from caring for family and pets—or tackling work life stressors—managing esophageal varices, a disease you’ve probably never even heard of, will invariably shift your health priorities as you learn how to manage it.
With everything on your plate, it may be hard to imagine how to squeeze in more doctor appointments, labs and follow ups—to arranging transportation for scheduled procedures that help your GI specialist diagnose and treat a GI condition that has now become the center of your world.
Waking up with questions on your mind before drifting off to sleep, or wondering what tomorrow will bring can feel unsettling at times.
The uncertainty a diagnosis brings might be the hardest part of your health journey. That’s why it’s important to find a supportive healthcare team that helps guide you through the struggles of this uncharted territory you’re dealing with.
When you find a provider that understands your individual needs and operates with shared decision making, it means your input is carefully considered. You also get to ask questions and get answers while navigating unexpected twists and turns. Don’t be afraid to speak up if you feel confused about diagnostic procedures or treatments your doctor would like you to consider.
Want to learn more about GI procedures? Visit our procedure page.
Will My Lifestyle Change?
Maybe you’re thinking about all the things you want to do – like travel to Spain – plan a hiking trip to a remote mountain top – or a winter snowshoeing getaway with friends, yet wonder if it’s safe. Perhaps you have concerns about a potential bleed, if a vein bursts. How do you still live your life when living with a condition like esophageal varices?
Quality of life matters. Try not to let the what-ifs stop you from living your best life. Do ask questions when meeting with your care team. This will help you plan ahead and feel more confident when making decisions that help you live the life you were born to live.
Discussing Health Goals with Your Care Team
When you have planned appointments with your doctor or GI specialist, it’s always a good idea to prepare some questions ahead of time. Thinking about health goals, here are some ideas to prepare you for your next appointment.
- Ask if it’s possible to prevent a future bleed
- Understand what caused your varices and what risk factors to be aware of
- Ask how to know which symptoms mean it’s time to call your doctor versus let’s go to the emergency room now
- How can you prevent or slow worsening liver disease
- Understand the goals of medications and procedures
- Learn ways to minimize fears while you continue working, traveling and spending time with loved ones
It’s important to keep up with your routine follow-up care to manage esophageal varices. Continued care allows your healthcare team to better monitor your condition and assess your risk factors. Follow up care may also help lower your risk of a life-threatening bleed – and inform your GI specialist if it’s necessary to intervene quickly as a preventive measure.
If you have any questions about esophageal varices or are seeking a second opinion, reach out to Gastroenterology of the Rockies. We’re here to help.
Want to learn more about liver health? Read our blog post Liver Disease: 7 Things To Know
Written by Elise Oberliesen, medically reviewed by Emily Marshall, PA-C with Gastroenterology of the Rockies, Oct 29, 2026
Sources
[1] https://www.ncbi.nlm.nih.gov/books/NBK448078/
[2] https://www.ncbi.nlm.nih.gov/books/NBK448078/
[3] https://www.ncbi.nlm.nih.gov/books/NBK448078/
[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC3977644/
[5] https://pubmed.ncbi.nlm.nih.gov/31854309/
[6] https://pubmed.ncbi.nlm.nih.gov/41023416/