Expansion of the veins of the stomach causes. What is varicose veins of the stomach

22.04.2020 -

Furuncles

Cardiologist

Higher education:

Cardiologist

Kabardino-Balkarian State University named after A.I. HM. Berbekova, Faculty of Medicine (KBSU)

Level of education - Specialist

Additional education:

"Cardiology"

State Educational Institution "Institute for the Improvement of Doctors" of the Ministry of Health and Social Development of Chuvashia

When you hear the word "varicose veins", swollen tortuous veins on the legs usually appear. So it is - the pathology most often affects the lower limbs, and it is here that it is visible to the naked eye. But a functional vascular disorder can occur anywhere. Varicose veins in the tissues of the stomach are also accompanied by structural changes - the vessels expand, lengthen, form knots and loops. Pathology develops against the background of hepatic lesions and is accompanied by minor or profuse hemorrhages.

Features of the defeat of the stomach

Varicose expansion of the blood vessels of the stomach is an extremely dangerous pathology. She may be:

congenital - vascular damage is diagnosed from the moment of birth. It is associated with genetic disorders, it can develop against the background of a complicated pregnancy;
acquired - the transformation of blood vessels causes high blood pressure in the portal vein. It is responsible for the blood supply to the liver. Violation of the hepatic blood flow makes the vessels fragile - at any moment they can burst.

Congenital varicose veins of the stomach are extremely rare. Usually, specialists diagnose an acquired form of pathology. And older patients are more susceptible to it. In the initial stages of development, varicose veins of the stomach are absolutely asymptomatic, and therefore it is rarely possible to diagnose the disease in a timely manner. There are several classifications of gastric varicose veins, but each of them is based on structural changes in blood vessels. According to the endoscopic classification, pathology is divided into three degrees:

1 - veins less than 5 mm in diameter, almost indistinguishable on the gastric mucosa;
2 - the diameter of the veins is increased to 10 mm, their single bulges are observed;
3 - veins with a diameter of more than 10 mm have multiple bulges, form nodes.

Reasons for the development of pathology

Varicose veins in the stomach cause an increase in blood pressure in the portal vein. And it, in turn, is provoked by the development of cirrhosis of the liver. Sometimes portal hypertension occurs due to congenital anomalies or squeezing of the vessel by a tumor, thrombosis, or a stone that comes out with cholelithiasis.

Increased pressure contributes to the redistribution of blood and its increased circulation through the lateral (collateral) vessels of the upper region of the stomach. Pathology develops gradually, squeezing the vessel by the tumor cannot cause sudden changes. It usually occurs precisely because of chronic cirrhosis of the liver. Its development is facilitated by:

alcohol abuse;
drug use;
uncontrolled intake of drugs;
hepatitis B and C;
prolonged cholestatic syndrome (decrease in the amount of bile entering the duodenum).

Sometimes cirrhosis occurs for other reasons, and varicose veins develop as a complication of liver damage. Other causes of varicose veins include:

functional disorders of the stomach and pancreas;
echinococcosis (helminthic disease);
tuberculosis;
polycystic (formation of cystic cavities);
fibrosis (proliferation of connective tissue);
sarcoidosis (formation of granulomas);
adhesions and cysts of various etiologies;
aneurysms of the vessels of the liver, spleen;
eosinophilic gastroenteritis (infiltration of the gastric mucosa with eosinophils);
intestinal obstruction;
general insufficiency of blood vessels and heart.

Sometimes the development of varicose veins of the stomach provokes a sharp load: fever, weight lifting.

Symptoms of the disease

Symptoms of pathology are individual, its clinical picture depends on many factors. Often at first the disease is asymptomatic, sometimes rapidly. But in any case, gastric varicose veins are accompanied by:

heartburn;
belching;
difficulty in swallowing food;
chest discomfort;
frequent heartbeat;
blood impurities in the stool.

There may be pain, weakness. The urge to vomit is not eliminated by changing the diet, eating foods that normalize digestion. The vomit contains mucus, in which blood clots are sometimes observed.

Diagnosis of vascular lesions

If varicose veins of the abdominal cavity are suspected, the patient is prescribed a medical examination. Diagnosis usually includes:

clinical and biochemical analysis of blood (concentration of platelets, leukocytes, cholesterol, liver enzymes, bilirubin);
fibroesophagoscopy (assessment of the condition of the veins, mucosa, identification of the causes of bleeding and signs of pathologies with similar symptoms);
contrast radiography (detection of damaged vessels);
duplex scanning of blood vessels (study of the anatomy of blood vessels and the degree of their stretching).

It is possible to identify vascular changes and their causes by analyzing the symptoms and data confirming the progression of liver cirrhosis.

Pathology therapy

With varicose veins of the stomach, it is important to prevent bleeding. If it does occur, everything possible must be done to stop the hemorrhage. Based on this, there are three main approaches to the treatment of pathology:

therapeutic;
endoscopic;
operational.

The first two are applicable in the early stages of the development of pathology or after effective relief of hemorrhage. Later stages are subject to surgical treatment, since there is a high probability of death caused by hypovolemic shock.

To control portal hypertension, cardiovascular drugs are used, in particular, beta-blockers that lower blood pressure, and nitroglycerin (effective only with prolonged use). Carrying out hemostatic therapy, the doctor chooses the best way:

medicinal effect;
transfusion of blood or plasma;
introduction of colloidal solutions.

Damaged veins are removed by electric current (electrocoagulation). To stop bleeding, use bandages (rubber discs) or special probes that compress damaged areas of blood vessels. In parallel, carry out therapy aimed at enhancing blood coagulation. There are other methods of therapy for gastric varicose veins:

sclerosing - the introduction of a special solution into a vein;
portosystemic intrahepatic stent shunting - implantation of a porto-caval anastomosis;
anastomosis - a decrease in the volume of the stomach;
sheathing of veins;
vein removal.

The decision to use a certain method is made on the basis of the anamnesis, research results and the patient's well-being. Sometimes the only cure is a liver transplant.

Disease prevention

The main preventive measure for varicose veins of the stomach is the organization of proper nutrition. To do this, you must follow some rules:

Eat at least four times a day - little by little, at regular intervals;
Do not eat at night;
Be sure to have breakfast;
Avoid using:

- alcoholic beverages;
- fried, sour, smoked, pickled, spicy foods;
- confectionery;
- strong tea, coffee, carbonated drinks;
- too cold and hot food.

You need to give preference to:

cereals;
vegetables;
poultry meat;
lean fish.

Products should contain rutin and vitamins that prevent vein fragility and promote normal blood circulation. It is important to periodically undergo a diagnostic examination and lead an active lifestyle, dosing physical activity.

High mortality in gastric varicose veins is due to the serious course of comorbidities and the severity of complications. Help with hemorrhages in such circumstances is often symptomatic, and the treatment of portal hypertension is not always successful. Therefore, increased attention should be paid to the prevention of pathologies that contribute to the development of varicose veins.

Varicose veins of the stomach develop when the blood supply to the organ is disturbed. The disease provokes a change in the structure of the vascular network, loops or nodes appear, expansion or narrowing occurs. Pathology can appear with liver diseases, mainly with cirrhosis. An invariable symptom is profuse bleeding.

Symptoms of varicose veins

The first stage of the disease does not manifest itself in the body, so it is difficult to determine the ongoing changes. With the development of pathology, the following symptoms may appear:

heaviness, dull chest pain;
an increase in the abdomen due to the large volume of accumulated fluid;
the appearance on the abdominal wall of noticeable dilated veins;
shortness of breath with minimal physical exertion;
heartburn, not depending on the products used;
difficulty swallowing food.

It is important to notice the presence of signs and consult a doctor in time. During treatment, urgent measures are needed in order to have time to eliminate possible damage to the body.

Attention: It is not often possible to determine the presence of varicose veins in time. The disease manifests itself mainly when the veins rupture. Bleeding makes all the signs of the disease more noticeable.

With bleeding, accompanying symptoms are possible:

vomiting with drops of blood;
blood in the stool and staining it black;
lowering blood pressure and increased heart rate;

Bleeding is often profuse, although there are exceptions. Treatment if any of the signs are detected should be started on time. Untimely assistance leads to a strong deterioration in the condition, a fatal outcome is possible.

Causes of varicose veins of the stomach

Home stomach - . The veins expand due to the increased pressure, the outflow of blood passes with disturbances. The condition may occur due to a blood clot, squeezing a vein. The following diseases of the pancreas or liver can affect:

cirrhosis or chronic hepatitis.
Sarcoidosis.
Malignant or benign tumor.
Aneurysms of the arteries of the spleen or liver.
Fibrosis.

The disease can be inherited, it can manifest itself at any time. With cirrhosis of the liver, the structure of the organ changes, the tissues grow and contribute to the cessation of its work. Varicose veins occur, being a serious complication of the first disease.

How the disease is diagnosed

Diagnosis of the disease is possible with instrumental examination. The following methods are used:

a blood test performed to examine the general condition of the body;
liver tests to detect coagulopathy;
x-ray with contrast to examine the state of the digestive system;
Ultrasound of the abdominal organs.

When detected, immediate measures are taken to prevent the development of the problem.

Additional Information: The classification of the disease involves dividing it into 3 stages. The first is a slight expansion of the veins, the last is bleeding in the stomach cavity.

Treatment

Pathology is most often detected at a late stage, which often leads to hypovolemic shock or death. The patient is entitled to immediate hospitalization, resuscitation. The first step is to stop the bleeding, stabilize the state of the body, replenishing the bcc.

Medical treatment

Treatment of varicose veins involves squeezing the problem area. This way you get rid of the bleeding. The effectiveness of treatment is 90%. When operating on damaged vessels of the esophagus, relapses are possible. Often another surgery is performed. To increase the chances of recovery, the following methods are used:

Introduction into a vein that has burst, a special solution to reduce the outflow of blood.
Monthly repetition of actions aimed at stopping possible internal bleeding.
The use of drugs that act on gastric juice to reduce pressure on the walls of blood vessels.
Astringents that stop possible bleeding.
Multivitamin complexes to increase the elasticity of blood vessels.

Surgical intervention

Activities are carried out in several ways: damaged veins are tied using a rubber bandage, intrahepatic material is shunted to reduce pressure. A special device is inserted into the liver to avoid the accumulation of blood in the cavities, preventing bleeding from opening. Actions are carried out using an X-ray machine to avoid possible errors.

The third method is splenorenal shunting. Used to prevent fluid accumulation. A shunt connects certain veins, preventing hemorrhage.

Folk remedies

To supplement the treatment with basic means, you can use traditional medicine. Activities improve bowel function, improve the choleretic process. For treatment, the following means are used:

Sophora japonica tincture. 1 st. l. drink is diluted in 1 glass of boiled water. Drink the composition 4 times a day before meals.
Rose hips or rowan berries: 1 tbsp. l., mixed with 0.5 l. water. The liquid with fruits is kept on fire for 5 minutes, then it cools down and is drunk. Use daily for 0.5 liters. composition, in parts, at regular intervals.
Drops from chestnut flowers (sold in a pharmacy). 30 drops of the solution are added to a glass of warm water. Drink a glass a day.
Propolis tincture. It is mixed and used similarly to the previous composition.
Liquid formulations of calendula, chamomile: mix them by adding 10 drops of each product to a glass of water. Use the solution in a warm form 4 times a day for at least a month.

Do not forget that the folk method of treatment does not help get rid of a dangerous disease, but only serves as an addition to the main treatment.

Diet

With varicose veins, you must follow the basic rules of nutrition. You need to eat at least 4 times a day. The load on the digestive system is significantly reduced, as the amount of food received at a time is reduced. It is forbidden to remain without food for a long time, even to be a little hungry. It is worth eating at the same time so that the gastric mucosa gets used to a constant routine. Skipping meals on a set schedule is not recommended.

Food should be thoroughly chewed - you should not rush when eating it. To develop such a habit, it is worth removing all distractions: TV, book, Internet. Avoid eating before bed. The last time to eat about 2 hours before a meal, no later.

The diet does not imply clear rules, experts usually prescribe general nutritional recommendations. With varicose veins of the stomach, you should not eat the following products:

fatty foods, fried foods, fast food and the like;
meat, poultry, fish are not prohibited for consumption, but are not recommended in large quantities;
smoked foods, pickles that can retain water in the body;
foods high in fiber;
fresh vegetables and fruits - they must be subjected to heat treatment;
alcoholic or carbonated, as well as caffeinated drinks;
substances that affect the cardiovascular system to any extent.

Important: The disease is dangerous because of the possibility of heavy bleeding into the stomach cavity. It is necessary to exclude any products that can exert a strong burden on the body. Do not use substances that will irritate the digestive system.

Risks and forecasts

Often deaths in varicose veins of the stomach occur due to untimely access to doctors. Complex pathologies that occur during the development of the disease quickly lead to a deterioration in the condition. Vascular problems, complicated by heavy bleeding, liver cirrhosis, are eliminated only at the initial stage of development.

Mortality in the presence of the disease is 50%. In about 79% of cases, internal bleeding can be stopped on time. The return of the disease with successful treatment is possible in 55% of cases. Given the statistics, do not forget about the right diet. The measures taken will delay or prevent the onset of the disease.

Varicose veins of the stomach is considered an extremely dangerous disease that can arise even from simple overeating. Everyone should carefully monitor the diet, the amount of food consumed and the quality of the purchased products so that the consequences of the disease do not turn out to be an unpleasant surprise.

A detailed description for our readers: gastric varicose veins causes on the site site in detail and with photos.

Varicose veins develop when the blood supply to the stomach is interrupted. The condition is usually accompanied by a change in the structure of the vessels, such as expansion, elongation, the formation of loops or knots. Pathology appears against the background of liver damage, in particular, with cirrhosis. Invariable companion of varicose veins in the tissues of the stomach are small or heavy bleeding.

Varicose veins of the stomach are dangerous pathologies. The condition is characterized by an increase, often expansion, of the veins of the organ with the formation of blood clots. The insidiousness of the disease lies in the absence of symptoms at an early stage, so timely diagnosis is almost impossible. Mostly men suffer from this disease. The main provoking factors in the development of the disease, as well as liver damage, are:

alcohol;
unhealthy diet;
uncontrolled drug treatment.

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Symptoms

Varicose veins of the stomach are distinguished by the scarcity of the clinical picture. Symptoms are often similar to other gastrointestinal pathologies. However, there are distinguishing features:

Hematemesis with black vomit, which indicates the discovery of gastric bleeding. Vomiting may be rapid with impurities of pink mucus.
Increased heart rate with frequent failures.
Soreness in the abdomen.

The initial stages of gastric varicose veins are often accompanied by severe heartburn, which, although it brings discomfort, does not cause the need to go to the doctor. As the pathology develops, gastric bleeding opens. This condition is accompanied by symptoms such as:

ascites, when free extrudate accumulates in the peritoneum, which provokes a strong increase in the size of the abdomen;
profuse, bloody vomiting that does not cause pain;
tachycardia with confused and rapid pulse;
hypotension, characterized by a sharp decrease in blood pressure;
hypovolemic shock, accompanied by a sharp decrease in the effective volume of circulating blood.

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Causes of varicose veins of the stomach

Varicose veins of the stomach appear as a result of portal hypertension or increased pressure in the portal vein. The normal pressure in this vein is up to 6 mm Hg. Art. If this value jumps to 12-20 mm Hg. Art., blood flow is disturbed and vasodilation occurs. The root cause of portal hypertension is compression of the portal vein, which can cause thrombosis or a protruding stone in cholelithiasis. Also, the causes of varicose veins of the stomach are:

dysfunction of the pancreas, stomach;
cirrhosis, hepatitis;
echinecoccosis;
tuberculosis;
polycystic;
acquired or congenital fibrosis;
sarcoidosis;
tumors, cysts, adhesions of various etiologies;
aneurysms of the arteries of the spleen or liver;
eosinophilic gastroenteritis;
bowel obstruction;
general

Sometimes varicose veins of the stomach are preceded by a sharp load: lifting weights, severe fever. Rarely the disease is congenital. The reasons for this anomaly have not yet been found.

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Diagnosis of the disease

Identification of varicose veins is possible only with instrumental examination. For this, the following methods are used:

General and clinical blood tests, which is necessary to assess the general condition of the patient.
Functional and hepatic examinations to determine coagulopathy.
X-ray with contrast (barium sulfate), performed to evaluate the functionality of the digestive tract.
Esophagogastroscopy, used to visualize the state of the internal walls of the stomach. The method is highly accurate, but requires increased attention and accuracy, since the affected tissues are fragile and bleeding can be provoked by the probe.
Ultrasound of the abdominal organs, which is necessary to confirm the diagnosis.

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Treatment

There are three approaches to treatment:

therapeutic;
medication;
surgical.

The first two schemes are used in the early stages or after effective relief of bleeding. Late stages are treated only surgically, as the risk of death associated with hypovolemic shock is high. The main approaches to the treatment of gastric varicose veins are presented below.

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Sclerotherapy

The essence of the method is the introduction of special medical glue into the affected vessels by endoscopic method. A certain frequency of the procedure is required, which is determined by the doctor individually. More often, the technique is applied once every 7 or 30 days, and ends with the formation of a persistent scar.

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Operation

Surgery can be done in three ways:

Ligation of dilated veins. For this, a special rubber bandage is used. The effectiveness of the technique is higher than sclerotherapy.
Shunting in intrahepatic tissues. The technique is necessary to lower the pressure. To do this, a stent is inserted into the middle of the liver. The procedure is done under X-ray control. The goal is to create a connecting bridge between the hepatic and portal veins.
Splenorenal shunting. The technique is used for preventive purposes - to prevent the development of bleeding. For this purpose, the veins of the spleen and the left kidney are combined with a shunt.

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Medical therapy for varicose veins

The essence of the method is the regular intake of such means as:

"Vasopressin" - to restore the normal state of constricted blood vessels;
nitrate containing "Nitroglycerin" - to reduce pressure in the portal vein;
"Somatostatin" or "Octreotide" - to lower blood pressure in the internal organs and restore the normal state of dilated vessels.

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diet therapy

For the treatment of varicose veins of the stomach, it is important to follow proper nutrition. The main principles are as follows:

Fractional meals in small portions - up to 6 times a day.
The last snack is 3 hours before going to bed.
Increase in the diet the number of foods rich in vitamins such as:
- vitamin E (greens, yolk, corn or sunflower oil);
- vitamin C (berries, potatoes, fresh peppers, all kinds of citrus fruits);
- rutin (nuts, tea, grapefruit, currant);
- bioflavonoids (cherries with sweet cherries);
- vegetable fibers (legumes, fresh vegetables and fruits).
Organization of abundant drinking - up to 2.5 liters of water per day.
Complete rejection of harmful products:
- alcohol;
- concentrated black tea, coffee;
- sweets and sugar;
- hot seasonings and spices;
- flour products.
Preferred cooking - boiling, baking in the oven, stewing, steaming.
Dishes must be warm.

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Prevention

The essence of preventive measures is to maintain a healthy state of the veins. For this you should:

monitor the condition of the liver;
exactly follow the doctor's recommendations;
regulate high blood pressure in a timely manner;
follow the rules of a healthy lifestyle (refusal of bad habits, proper nutrition).

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Complications

The most severe complication of varicose veins of the stomach is bleeding. They can even occur from overeating due to a strong thinning of the walls of the organ. The amount of bleeding can be different, as is their frequency. The outcome depends on this. Bleeding causes severe vomiting, chronic iron deficiency.

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Nerves and varicose veins

The state of the body and its performance depend on the stability of the nervous system. When a person is subjected to significant and prolonged stress, anxiety, depression, the digestive system suffers first of all. Neurological causes of the development of varicose pathology:

Chronic state of hatred.
Feeling of chronic fatigue, severe overexertion.
Decline in strength and spirit, disappointment and moral fatigue.

Therefore, during treatment, a positive attitude is important, the elimination of all irritating factors.

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Forecast

Mortality in gastric varicose veins is high due to the severity of complications and comorbidities. More often, bleeding problems with the vessels of the main digestive organ are associated with progressive cirrhosis.

In 79% of cases, bleeding stops on its own with a mortality rate of 50%. After successful relief of the disease, the risk of returning the disease is 55-75%.

Varicose veins of the stomach - a pathological expansion of blood vessels, which develops under the influence of increased pressure in the portal vein. Varicose veins of the stomach manifest themselves in the form of protrusion and swelling of the walls and the formation of nodes. Varicose veins of internal organs, including the stomach, is a fairly rare pathology that is difficult to diagnose at the initial stages of development.

Varicose veins of the stomach

Varicose veins of the gastric vein can be congenital or acquired. Depending on how strongly ectasias (dilation of veins) are manifested, there are 4 degrees of varicose veins of the stomach:

There are no clinical manifestations of the disease. It is possible to establish the initial stage only with the help of endoscopic examination. At the same time, the veins in the stomach are slightly dilated, in small areas on single vessels.
The first signs of the disease appear, but they are so weak that it is impossible to suspect a pathology. Blood vessels acquire a tortuous character, areas of swelling and narrowing alternate.
The patient's condition is deteriorating. When conducting an endoscopic or x-ray examination, pronounced ectasias are visible.
Nodes are formed, the diameter of which is more than 1 cm greater than the lumen of the vein. Affected vessels are thin and weak. This condition threatens not only a sharp deterioration in the health of the patient, but also his life.

Causes

With varicose veins of the stomach, the causes of the development of pathology are different, the main of which is an increase in pressure in the portal vein, which leads to the formation of ectasias.

Varicose veins of the stomach are a consequence of other diseases:

liver pathology (cirrhosis, hepatitis, echinococcosis, etc.);
tuberculosis;
polycystic;
malignant or benign formations located in the region of the portal vein, and provoking its compression;
fibrosis or sarcoidosis;
aneurysms of arteries located in the liver or spleen;
diseases of the gastrointestinal tract (eosinophilic gastroenteritis, intestinal obstruction);
cardiovascular failure.

Provoking factors for the development of pathology include physical or mental overstrain, infectious diseases, accompanied by a significant increase in body temperature.

Based on which signs and symptoms of varicose veins prevail, the doctor develops an individual treatment regimen. After all, pathological varicose veins can be localized not only in the stomach, but also pass to the vessels of the abdominal cavity or esophagus, provoking new symptoms.

Signs and symptoms of the disease

Varicose veins of the stomach have similar symptoms with pathologies of the gastrointestinal tract. The main ones are nausea and heartburn.

Specific signs appear only in the later stages of the disease. First of all, this is bleeding from varicose veins. It manifests itself in the form of vomiting with blood impurities, which is not accompanied by painful sensations. The feces acquire a black tint, which indicates bleeding in the upper gastrointestinal tract.

In the abdominal cavity, fluid forms and begins to accumulate, which leads to the appearance of ascites.

In addition, there are pains in the heart area, increased heart rate, chest pain and shortness of breath, especially after physical or mental stress. A sharp decrease in blood pressure develops against the background of massive blood loss. In some cases, the patient's condition is complicated by hypovolemic shock.

Diagnostic measures

Varicose veins of the stomach are often accompanied by pathological dilatation of the veins in the esophagus. Diagnosis of the disease includes establishing the cause that provoked the occurrence of phlebectasia. Depending on this, an individual therapeutic scheme is developed.

The diagnosis is established on the basis of patient complaints, examination results, laboratory and instrumental research methods.

The doctor does not always associate heartburn with the development of gastric varicose veins, so if you have health complaints, you should undergo a comprehensive examination and not give up even the most unpleasant studies.

Varicose veins lead to the accumulation of free fluid in the abdominal cavity, as evidenced by an enlarged abdomen.

From laboratory tests, it is necessary to conduct general clinical studies of blood, urine and feces.

The most accurate method for diagnosing gastric varicose veins is esophagogastroscopy, which makes it possible to visually assess the state of the vessels of the organ, establish the presence of areas of pathological expansion, nodes and the exact place of bleeding. The study should be approached very responsibly so as not to provoke damage to thin vessels.

According to the results of esophagogastroscopy, one can not only verify the varicose veins of the stomach, but also establish the cause of the development of the pathology. This is evidenced by certain signs - a combined lesion of the vessels of the stomach and esophagus is a symptom of portal hypertension, selective stretching of individual sections of the vessels - about thrombosis of the veins of the spleen, etc.

Of the additional research methods, I use radiography with barium sulfate (radiocontrast substance), with which you can determine the functionality of the gastrointestinal tract.

Ultrasound examination will help to establish the lesion of the abdominal organs.

Methods of treatment of varicose veins of the stomach

Therapy for pathological expansion of the veins of the stomach is selected individually for each person, depending on the symptoms present and the stage of pathology.