What Are Varices? How Are They Related to Varicose Veins?
Varices are enlarged, twisted, and often painful veins that can occur in various parts of the body. While "varices" is a broad medical term encompassing a range of vein abnormalities, it is commonly associated with varicose veins, a specific type of vein disorder. In this blog, we will explore what varices are, their causes, symptoms, and treatment options, and clarify the relationship between varices and varicose veins.
What Are Varices?
Varices refer to abnormally dilated and tortuous veins that can develop in different areas of the body. They are most commonly seen in the legs, where they are known as varicose veins, but can also occur in the esophagus (esophageal varices), stomach (gastric varices), rectum (rectal varices), and other parts of the body. Varices are often the result of increased pressure within the affected veins, which can lead to their enlargement and distortion.
Are Varices Related to Varicose Veins?
Varicose veins are a type of varices caused by vein disease that specifically affect the veins in the legs. They appear as bulging, twisted, and discolored veins that are often visible just beneath the skin. While varicose veins are a form of varices, not all varices are varicose veins. Varices is a broader term that encompasses various types of abnormal vein conditions, including but not limited to varicose veins.
Varices and Varicose Veins: Commonalities and Differences
While the causes of esophageal and other varices and varicose veins differ significantly, both conditions are linked to increased pressure within the venous system—whether due to portal hypertension in the case of esophageal varices or valve failure in the veins of the legs for varicose veins. The management and treatment of these conditions also vary, with esophageal varices often requiring more urgent and complex medical interventions due to the risk of life-threatening bleeding, while varicose veins can frequently be managed with minimally invasive outpatient procedures.
Causes of Varices
The causes of varices, such as esophageal varices and varicose veins, are multifaceted and largely depend on the underlying conditions that lead to increased pressure in the venous system or damage to the veins themselves. Here, we delve into the primary causes of these conditions, highlighting the differences and similarities in their origins.
Esophageal Varices
According to the Mayo Clinic, esophageal varices are enlarged veins in the esophagus. This tube connects the throat and stomach and is often a consequence of severe liver disease such as cirrhosis of the liver. Cirrhosis, in turn, can result from a variety of liver diseases, including hepatitis infection, alcoholic liver disease, fatty liver disease, and a bile duct disorder known as primary biliary cholangitis. The progression of these liver diseases leads to the formation of scar tissue (cirrhosis), which obstructs blood flow through the liver. This obstruction causes blood to back up, increasing pressure within the portal vein system—a condition known as portal hypertension.
As a result, blood seeks alternative pathways through smaller veins, such as those in the esophagus, leading to the formation of esophageal varices. These veins are not designed to carry such high volumes of blood and can become dilated and burst, posing a risk of severe bleeding.
Varicose Veins
Varicose veins, on the other hand, are primarily caused by weakened or damaged valves in the veins, usually in the legs, resulting from chronic venous insufficiency. These valves are meant to keep blood flowing toward the heart, but when they fail, blood can flow backward and pool in the veins. This pooling causes the veins to become enlarged, twisted, and sometimes painful.
Several factors can contribute to the development of varicose veins, including:
Age: Aging causes wear and tear on the valves in the veins, increasing the risk of varicose veins.
Genetics: Several studies have shown that vein disease runs in families. Per the National Library of Medicine (NIH), children have a 90 percent risk if both parents have the condition and a 25-62 percent risk with one affected parent. Individuals run a 20 percent risk if neither parent has problem veins.
Being female: Women are more likely to develop varicose veins, possibly due to hormonal changes that relax vein walls during menstruation, pregnancy, and menopause. Hormone treatments, such as birth control pills, might also increase the risk.
Pregnancy: The increase in blood volume during pregnancy supports the growing fetus but can also enlarge the veins in the legs.
Obesity: Being overweight puts additional pressure on the veins, increasing the chances of developing problem veins.
Prolonged standing or sitting: This can impede blood flow, contributing to the development of varicose veins.
Understanding the causes of varices, whether esophageal or varicose, is crucial for effective prevention, diagnosis, and treatment. While the underlying mechanisms differ, the impact on individuals' health can be significant, underscoring the importance of medical attention and care for those affected by these conditions.
Symptoms of Varices
The symptoms of varices can vary depending on their location. In the case of varicose veins, individuals may experience pain, aching, heaviness, swelling, and visible bulging veins in the legs. Esophageal varices, on the other hand, may present with symptoms such as vomiting blood, black or tarry stools, and abdominal pain. It is essential to seek medical attention if any concerning symptoms related to varices are experienced.
Here are the common symptoms associated with each type:
Esophageal Varices
- Symptoms of Bleeding Esophageal Varices: Vomiting large amounts of blood, black, tarry, or bloody stools, lightheadedness due to blood loss, and loss of consciousness in severe cases.
- Other Signs and Symptoms: Yellow coloration of the skin and eyes (jaundice), bruising, fluid buildup in the abdomen (ascites), decreased urine output, or easy bleeding. According to the Cleveland Clinic, about 50 percent of people with esophageal varices will experience bleeding.
Varicose Veins
- Common Symptoms: Veins that are dark purple, blue, or the same color as the skin, twisted and bulging veins, achy or heavy feeling in the legs, burning, throbbing, muscle cramping, and swelling in the lower legs, itching around the veins,
- Other Signs and Symptoms: Changes in skin color, including a reddish or brown discoloration in the lower legs, as well as a healed or active venous ulcer, are signs that chronic venous insufficiency has advanced and that blood flow problems are worsening.
If you experience any of these symptoms or have concerns about varicose veins, it's essential to seek medical attention from a board-certified vein specialist for an accurate diagnosis and appropriate management. Center for Vein Restoration is the industry leader and America’s largest physician-led vein center.
Our vein doctors are trained in all modern vein treatments to ensure the safest, most convenient patient experience, and the Intersocietal Accreditation Commission
(IAC) has evaluated and approved our facilities.
Achieving IAC accreditation demonstrates to referring physicians, patients, and insurers that our facilities have passed a thorough assessment, meet industry standards, and are dedicated to ongoing enhancements in quality.
Treatment Options for Varices
The treatment options for varices, including varicose veins and esophageal varices, encompass a range of approaches to alleviate symptoms, prevent complications, and address the underlying causes. Here are the treatment options for each condition:
Esophageal Varices
- Emergency Treatment for Bleeding Varices:
- Supportive care in the hospital, followed by an emergency upper endoscopy to diagnose and treat the bleeding.
- Preventive and Follow-Up Treatment:
- Variceal Band Ligation: Placing a rubber band around the varices to prevent bleeding. According to the National Library of Medicine (NIH), variceal band ligation is preferred to sclerotherapy for bleeding varices and nonbleeding medium-to-large varices to decrease bleeding risk.
- Medications: Beta-blockers to decrease blood vessel pressure.
- Long-Term Management of Underlying Causes:
- Management of liver disease, notably cirrhosis, is the most common cause of esophageal varices.
Varicose Veins
- Self-Care and Lifestyle Modifications
- Regular exercise, weight management, and avoiding prolonged standing or sitting.
- Wearing compression stockings to improve blood flow in the legs.
- Minimally Invasive Procedures
- Radiofrequency Ablation or Laser Ablation: Involves using laser energy to seal off the affected vein.
- Sclerotherapy: Injecting a solution into the affected vein causes it to scar and close. Blood then flows through healthier nearby veins.
- Ambulatory Phlebectomy: During this office-based procedure, tiny incisions are used to remove damaged varicose veins from the legs.
Individuals with varicose veins need to consult a healthcare professional to determine the most suitable treatment plan based on their condition and medical history.
Center for Vein Restoration is a nationally recognized leader in the treatment of varicose veins and spider veins. They offer a variety of nearly pain-free solutions to eliminate unsightly and uncomfortable veins. All 110+ CVR vein centers across the United States provide compassionate and affordable state-of-the-art vascular care.
CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.
Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you today.