Esophageal Varices – Symptoms, Causes & Prevention

Causes of esophageal varices: Veins in the esophagus enlarge and become abnormal. This occurs when the blood flow to the liver is blocked by a scar or blood clot in the liver. To compensate this blockage large volumes of blood flows through smaller blood vessels. This condition is most common in people with serious liver disease.

Esophageal varices cause bleeding: There is a risk of these blood vessels leaking or even rupturing – causing life-threatening bleeding.

A number of drugs and medical procedures can help prevent or stop bleeding from esophageal varices.

Signs and symptoms of esophageal varices

A gastroenterologist may suspect esophageal varices if he or she notices the signs and symptoms of liver disease including:

  • Easy bruising or bleeding
  • Jaundice (yellowish eyes and skin)
  • Ascites – fluid buildup in the abdomen

Signs and symptoms don’t manifest with esophageal varices unless they bleed. However, bleeding esophageal varices cause the following signs and symptoms:

  • Bloody, black or tarry stools
  • Vomiting blood
  • Lightheadedness
  • Loss of consciousness if there is severe bleeding

What are the causes of esophageal varices?

When there is a blockage of blood flow to the liver due to scar tissue, esophageal varices form. When this happens, blood begins to back up in the portal vein (large vein) increasing pressure (portal hypertension). The increased pressure forces the blood to sneak through smaller veins – especially the veins in the lower part of the esophagus. These small veins swell, rupture and bleed.

Causes of esophageal varices

Thrombosis or blood clot in the portal vein or splenic vein that feeds portal vein can cause esophageal varices.

Liver cirrhosis or scarring of liver due to a large number of liver diseases – such as fatty liver disease, alcoholic liver disease, hepatitis infection and primary biliary cirrhosis – can lead to liver cirrhosis.

Schistosomiasis is a parasitic infection common in Africa, East Asia and Middle East. It can damage the lungs, liver and intestines and other organs.

What are the risk factors for esophageal varices?

Esophageal varices will bleed if you have:

  • Severe liver cirrhosis
  • Large varices – These varices are at increased risk of bleeding
  • Portal hypertension – when pressure in the portal vien increases, the risk of bleeding increases.
  • Continued alcohol use with severe liver disease

What should you do if you have liver disease?

If you have been diagnosed with liver disease, then quit smoking if you smoke and don’t drink alcohol. Lose weight if you have excess body weight and eat a healthy and balanced diet. Be careful with chemicals use. Follow all precautions and instructions if you use any cleaning agents, insect sprays and other household chemicals. Protect yourself from getting exposed to hepatitis A, B and C viruses.

If you want to know more about the causes of esophageal varices, and the most appropriate treatment of esophageal varices, meet Dr. Datta Ram U.

Common But Preventable Causes of GI Disorders?

Common causes of stomach discomfort By Dr. Datta Ram U

Digestive health is important for your overall health. It is not always the disorders that can cause GI health issues, but your lifestyle factors too can play an important role in preventing the onset of some of the common GI disorders. The following are some of those factors:

Being Stressed

Stress can be one of the most common reasons for your abdominal discomfort. If you are under constant mental stress, it affects the health of your digestive system. Stress disturbs the balance of gut microbiota. Therefore, your brain has a very strong or established link with your digestive system – the brain GI axis. There is always a bi-directional communication between your brain and the GI tract. Your digestive tract also has more neurons. If a person remains in stress for long, there is a possibility of a wide range of digestive tract symptoms – such as alterations in the balance of normal microbial flora of the stomach, abdominal cramping, bloating, inflammation, loss of appetite, weight loss or weight gain.

Not Drinking enough Water

Water is an elixir of life because without water survival of human beings is not possible. If you don’t drink water or your water intake is inadequate, then you will become prone to Digestive track issues. Water helps in digestion of food by helping breakdown food and help intestines to absorb nutrients most effectively and faster. The risk or possibility of digestive tract disorders increases if your water intake is not adequate. Water helps improve assimilation and absorption of food, removal of toxins and cleansing your digestive system. It helps soften stool and prevent constipation. To prevent all types of common GI health issues, you must – first of all – drink enough water throughout the day.

Taking a Low Fiber Diet

Fiber is a plant-based complex carbohydrates. It is very important for your digestive system’s health. Fiber helps in digestion of food and making you full. Your gut microbial flora needs fiber – certain types of fiber to flourish. Your microbiota – the trillions of bacteria that inhabit your large intestine provides numerous health benefits. The good sources of dietary fiber are vegetables, beans, legumes, whole grains and fruits. The daily recommended fiber intake for women is around 25 grams and for men it is around 38 grams. Older men and women should consume slightly lesser amount of fiber than the daily recommended values. Fiber is very important in terms of reducing gas formation, constipation and bloating. It helps ease digestion, reduce abdominal pain and even minimize the risk of colon cancer.

Common Causes of Stomach Discomfort – Inactive Lifestyle

Sound sleep, proper eating habits and activity are important not only for your overall health, but also for your digestive health. Therefore, experts recommend a combination of proper diet, exercise and sleep. They also recommend not to take food that cause inflammation.

Eating a lot of dairy foods

Milk, milk-based products, and cheese have plenty of proteins and fats. They take longer time to digest and also have pro-inflammatory effect. Therefore, taking large amounts of dairy products can cause constipation, gas, bloating and abdominal cramps.

Bottom Line

Medical side effects, excessive use of laxatives, dietary supplements, functional stress, pregnancy, systemic issues and inflammation can also cause abdominal problems. These are some of the common but preventable causes of gastrointestinal disorders. Timely approach to a specialist doctor, proper medication, lifestyle changes, a set sleep and wake up routine, proper eating habits, drinking enough water and stress management can help prevent these disorders.

Acidity Problems – When to Take Action!

Acidity problems: The gastric glands of your stomach produce and secrete acid – which is necessary to digest the food. When excess acid is produced than needed for the digestion process, the condition is known as acidity. In some cases, normal stomach acid flows back to the esophagus. This condition is known as acid reflux (GERD). The most common symptom of this condition is a burning sensation and chest pain in the breastbone.

What are the common causes of acidity?

Acidity causes: In a majority of cases, lifestyle-related factors are responsible for acidity and stomach problems. They include the following:

  • Excessive eating (overeating)
  • Unhealthy eating habits
  • Excessive consumption of tea or coffee
  • Eating at irregular times or skipping meals
  • Eating just before sleeping
  • High intake of table salt
  • Consuming a sugary diet or a diet low in dietary fiber
  • Consumption of spicy food
  • Excessive consumption of fat-rich foods such as fried foods, doughnuts, pizza, extremely oily, fatty, and spicy foods
  • Excessive intake of carbonated drinks, caffeinated beverages, and soft drinks

Use of medications

Regular use of pain-relieving medications, over-the-counter medications, other temporary medications as well as prescription medicines can cause acidity problems. For instance, medications such as antibiotics, medicines for controlling high blood pressure, non-steroidal anti-inflammatory drugs; anxiety and depression medications can cause acidity.

What other disorders can cause acidity problems?

Irritable bowel syndrome, peptic ulcers, gastroesophageal reflux disease, and other conditions can also lead to acidity.

What are the other causes of acidity?

  • Eating gas-forming vegetables such as cabbage or cauliflower
  • Excessive consumption of non-vegetarian food
  • Lack of physical exercise
  • Frequent consumption of alcohol
  • Smoking
  • Excessive stress
  • Insomnia (Lack of sleep)
  • Mental health issues

Do you know – people who have dental health issues, connective tissue disorders, diabetes and asthma, and breathing problems – such as sleep apnea are more prone to acidity? In women, those who are approaching menopause, obese women, depressed women, and even pregnant women suffer from acidity.

What are the symptoms of Acidity and Acid Reflux Disease?

Acidity Symptoms are not the same in all people. Bloating blenching, and gas formation indigestion is the most common symptoms of acidity. However, symptoms differ from person to person. For instance, chest pain and burning sensation below the breast bone are the most common symptoms of acid reflux. The other symptoms of acidity that are uncommon may include:

  • Indigestion
  • Constipation
  • Nausea
  • Restlessness
  • Heaviness in the stomach after taking meals
  • Post-meal discomfort and sometimes pain
  • Burning sensation and pain in the stomach
  • Bad breath
  • Burning sensation and pain in the chest
  • Frequent hiccups or burping for no apparent reason
  • Difficulty in swallowing food
  • A feeling of food being stuck in the throat
  • Burning sensation and pain in the throat
  • Bitter-taste or prolonged sour taste in the mouth due to acid reflux (regurgitation)

Bottom Line

Acidity problems once in a while are alright as you can set it right with some slight lifestyle modification – eating and sleeping habits. But when you frequently suffer from acidity and indigestion or any other acidity-related symptoms, there should be a cause for concern. If a person frequently suffers from bouts of acidity – what does it mean – say – he or she has symptoms lasting for two or more days per week – on a regular basis. It means that there might be an underlying cause associated with acidity. It is therefore advisable that they should consult a specialist doctor without wasting any time.

Hepatitis Causing Viruses (Hepatitis A, B, C, D, E)

Liver disease viral hepatitis

Liver problems can be caused due to many reasons. some of which may include consumption of alcohol, obesity (accumulation of fat in the liver), excessive use of certain medications, and viruses. Let us try to understand the different types of viruses that cause liver diseases. The disease progresses silently. However, there are some common signs and symptoms of liver disease – such as:

  • Yellow eyes and skin
  • Vomiting
  • Swollen legs
  • Dark colored urine

The viruses that cause liver disease can spread through blood, semen, impure water, or through contact with the person who is infected. The other causes of liver diseases may include:

  • Sharing of needles while being injected
  • Type 2 diabetes
  • Family history     

Liver Disease Viral Hepatitis                      

Hepatitis A – This type of liver disease spreads through contaminated food and water. It can also spread through dirty hands when the infected person cooks food for other family members. Symptoms may include abdominal pain, low-grade fever, and loss of appetite. A person with hepatitis A must get the proper intake of water eat a balanced diet and avoid the consumption of alcohol. Rest, medication and comprehensive treatment ensure complete recovery within a few months.

Hepatitis B – it is caused when the virus (HBV) is transmitted from one person to the other. It spreads through blood (use of unsterile syringes, needles, and blood transfusion), semen, and other body fluids. Chronic HBV infections may lead to liver cirrhosis, liver cancer, or liver failure.  Hepatitis B can be easily prevented by getting vaccinated. It is the most common vaccine-preventable liver disease.

Hepatitis C – Hepatitis c is also caused by a virus (HCV) that attacks the liver and causes inflammation.  People who are infected by hepatitis c are unaware as there are no symptoms. The appearance of symptoms may take many years.

symptoms may include – loss of body weight, dark color urine, and easy bruising.

It can be prevented by avoiding the usage of illicit drugs and avoiding unprotected sex. Be careful while getting a piercing or while getting tattooing done.

Hepatitis D – may be caused if you have hepatitis b. The infection can be an acute, short-term or long-term, and chronic liver disease. It is a serious liver disease and may lead to lifelong liver damage.

Symptoms may include

  • Dark colored urine
  • Tiredness
  • Yellow eyes and skin
  • Pain in belly

There is no vaccine to prevent liver disease and viral hepatitis D.

Hepatitis E – The common cause of hepatitis E is contaminated drinking water.

Symptoms may include

  • jaundice
  • stomach pain
  • loss of appetite

Many people with hepatitis E do not have any symptoms, especially children. It resolves on its own within five to six weeks with supportive care, rehydration, rest, and medication.

Prevention of Hepatitis

  • Avoid excess alcohol consumption
  • Follow a balanced diet
  • Exercise on a regular basis
  • Manage a proper body weight
  • Maintain a healthy lifestyle
  • Wash your hands with soap and water it prevents the spread of hepatitis A & E.

Avoid eating too many refined sugars as they may lead to fat build-up in the liver and can cause liver diseases.

Use medications judiciously

Don’t share items like syringes, needles, razors, and blades because hepatitis B and C – both serious and infectious liver diseases spread through blood and body fluids. Avoid high-risk sexual activities and multiple sex partners.

Be careful! Some drugs, dietary supplements, and herbs can damage your liver. For instance, comfrey, kava, and ephedra are known to cause liver damage.

Don’t breathe in toxins – home cleaning products, aerosol products, and some insecticides have chemicals that can damage your liver – avoid such products.

If you have any additional concerns regarding liver disease or viral hepatitis, then contact Dr. Datta Ram U

BILE DUCT CANCER (Cholangiocarcinoma)

Bile is a fluid made by the liver. It helps in breaking down fats during digestion. Small tubes network called ducts connect the liver, gallbladder, and small intestine. Two small ducts emerging from the liver form left and right hepatic ducts. These ducts join outside the liver and form a common hepatic duct. The cystic duct connects the gallbladder to the common hepatic duct. Bile from the liver passes through these ducts and is stored in the gallbladder. During the process of digestion, the gallbladder releases bile that passes through the cystic duct to the common bile duct and then into the intestine.

What is bile duct cancer?

Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. Bile duct cancer is also called cholangiocarcinoma.

What are the types of bile duct cancer?

Intrahepatic bile duct cancer or intrahepatic cholangiocarcinomas: Cancer develops in the bile ducts within the liver. A low percentage of bile duct cancers are intrahepatic.

Extrahepatic bile duct cancer: This type of cancer develops outside the liver in the bile ducts. Cancer is of two types:  perihilar bile duct cancer and distal bile duct cancer.

Perihilar bile duct cancer: This type of cancer develops in the common hepatic duct region. It is also known as perihilar cholangiocarcinoma or Klatskin tumor.

Distal bile duct cancer or extrahepatic cholangiocarcinoma: This type of cancer develops in the region of the common bile duct.

What are the signs and symptoms of bile duct cancer?

The signs and symptoms of bile duct cancer include the following:

  • Fever
  • Itching
  • Weakness
  • Loss of appetite or weight loss
  • Upset stomach and vomiting
  • Pain in your belly or sides
  • Yellow skin or eyes (jaundice)
  • Dark urine
  • Light-colored stools

What are the risk factors for bile duct cancer?

The risk factors for bile duct cancer include:

  • Chronic ulcerative colitis
  • Blocking of bile ducts by inflammation and scarring due to primary sclerosing cholangitis – a progressive disease.
  • Infection with a Chinese liver fluke (parasite)
  • Cysts in the bile duct cause infection, inflammation, and swollen bile ducts. They block the flow of bile.

How is bile duct cancer diagnosed?

A surgical gastroenterologist will do a physical examination. The doctor will ask the patient about their general health, habits, lifestyle (smoking and drinking habits), and family history of liver disease and cancer. The doctor will also check for lymph nodes, masses, tenderness, and fluid buildup in the abdomen.

For an accurate diagnosis of cancer, a gastroenterologist may recommend the following tests:

  • blood tests
  • An ultrasound scan, endoscopy, and a CT or MRI scan

Percutaneous Transhepatic Cholangiography (PTC)

It is A specialized test in which a surgical gastroenterologist inserts a needle through the skin and into a bile duct. The doctor inserts a dye and then takes an X-ray.


Peroral cholangioscopy is often performed during ERCP. This specialized procedure is used to detect cancers in the bile ducts and collect tissue samples (biopsy)

Biopsy – cell sample collected from the bile ducts during cholangioscopy procedure. The cells are analyzed for abnormal growth and cancer.

Magnetic resonance cholangiopancreatography (MRCP) – A MRI machine takes images of bile ducts.

What is the treatment for bile duct cancer?

Bile duct removal: A surgical gastroenterologist removes the affected part of the bile duct if cancer is present in it. Lymph nodes are also removed.

Whipple procedure: This is a surgical procedure to remove the gallbladder, the head of the pancreas, the bile duct, a part of the stomach, and the small intestine. To kill leftover cancer cells after removing cancer, doctors prescribe chemotherapy or radiation therapy.

Systemic chemotherapy is used to treat unresectable, metastatic, or recurrent bile duct cancer.

Radiation therapy is used to treat bile duct cancer – both external and internal types are used. Radiation therapy helps in relieving symptoms and improving the quality of life as palliative therapy.

Other Procedures

To relieve symptoms associated with a blocked bile duct and to improve quality of life, an experienced surgical gastroenterologist performs the following types of surgical procedures: endoscopic stent placement, biliary bypass, and percutaneous transhepatic biliary drainage.