To promote knowledge about liver health and care, and to enhance public awareness of interventional therapy for liver diseases, "Shared Famous Doctors," a program specially sponsored by GanoHerb, in collaboration with the Mengchao Hepatobiliary Hospital of Fujian Medical University, has launched a "Love Your Liver, Popularize Interventional Hepatology Week." Over the course of a week, we will take you on a journey into interventional hepatology, where you will learn about the principles, indications, advantages, and significant role of this advanced medical technology in the treatment of liver diseases.

 

 

Featured Physician: Dr. Li Ling, Vice Director of the Interventional Department, Associate Chief Physician, and Medical Doctor at the Mengchao Hepatobiliary Hospital of Fujian Medical University.

 

Topic: Liver disease patients need to be vigilant about esophageal varices.

 

Understanding Esophageal Varices

 

Esophageal varices occur when liver disease causes portal hypertension, leading to obstructed blood flow in the esophageal veins. As a result, these veins become twisted and enlarged. For instance, in patients with cirrhosis, the normal structure of the liver is damaged, making it difficult for blood to flow through the portal vein. This increased pressure can cause the normally healthy esophageal veins to become overwhelmed and gradually dilate, forming varices. In the early stages, esophageal varices often don't cause noticeable symptoms. However, as the condition progresses, it can pose a significant threat to the patient's health.

 

Dangers of Esophageal Varices

 

Risk of Rupture and Bleeding: This is the most severe complication of esophageal varices. When these varices become significantly enlarged, the vein walls thin out, making them highly susceptible to rupture, especially when triggered by factors like consuming coarse food or coughing forcefully. Once bleeding occurs, it is often profuse and difficult to control, leading to symptoms such as vomiting blood (hematemesis) or passing black, tarry stools (melena). In severe cases, hemorrhagic shock can develop, posing a life-threatening risk.

 

Increased Risk of Infection: After a rupture and bleed, the exposed blood provides an ideal environment for bacterial growth. Additionally, the patient's body is weakened and stressed, making them more vulnerable to secondary infections such as pneumonia or peritonitis. These infections can further complicate the condition and make treatment more challenging.

 

Impaired Quality of Life: Even in the absence of bleeding, the presence of esophageal varices can significantly impact a patient's quality of life. Dietary restrictions, constant worry about the condition, and increased psychological stress can all contribute to a diminished overall well-being.

 

Which Liver Disease Patients are Prone to Esophageal Varices?

 

Patients with cirrhosis: Cirrhosis is a common cause of esophageal varices. Various factors can lead to cirrhosis, including viral hepatitis (such as hepatitis B and C), alcoholic liver disease, and autoimmune liver diseases. These conditions alter the liver's structure and function, resulting in portal hypertension and a higher incidence of esophageal varices.

 

Individuals with chronic liver disease: Even those with chronic liver disease that has not yet progressed to cirrhosis can develop esophageal varices if their condition worsens over time. Chronic inflammation and fibrosis in the liver can gradually lead to portal hypertension, increasing the risk of variceal formation. For instance, patients with chronic hepatitis B who do not receive adequate antiviral treatment may experience disease progression, necessitating vigilance for the development of esophageal varices.

 

How to Prevent Esophageal Varices?

 

Active treatment of the underlying disease: For patients with liver disease, treating the underlying cause is crucial. For example, patients with viral hepatitis should adhere to prescribed antiviral therapy to suppress viral replication and slow the progression of liver disease. Patients with alcoholic liver disease should strictly abstain from alcohol to reduce further damage to the liver, control the disease at its source, and decrease the risk of developing portal hypertension and esophageal varices.

 

Dietary adjustments: Maintain a light, easily digestible diet. Avoid hard, hot, or excessively coarse foods, such as nuts and fried foods. These foods can easily scratch the fragile esophageal veins, leading to rupture and bleeding. Consume foods rich in vitamins and protein, such as fresh fruits and vegetables, lean meat, and fish. These can help strengthen the body's resistance and maintain liver function.

 

To avoid increasing intra-abdominal pressure: In daily life, it is important to avoid behaviors that can abruptly increase intra-abdominal pressure, such as forceful coughing, straining during bowel movements, and prolonged breath-holding. A sudden increase in intra-abdominal pressure can be transmitted to the esophageal veins, thereby increasing the risk of rupture and bleeding. For patients with constipation, dietary adjustments, moderate exercise, and, if necessary, the use of laxatives can help alleviate this condition.

 

The Importance of Regular Check-ups

 

Examination Items

 

Liver disease patients need regular check-ups to monitor the presence and progression of esophageal varices. Common examinations include endoscopy, which allows direct observation of the esophageal veins' shape and degree of varices, and is considered the "gold standard" for diagnosing esophageal varices. Abdominal ultrasound is also used to assess liver morphology and portal vein blood flow, indirectly evaluating the risk of portal hypertension and esophageal varices. Additionally, blood tests, such as liver function and coagulation function, can help assess the overall condition of the liver and provide supporting evidence for clinical decisions.

 

Examination Frequency

 

Generally, for patients diagnosed with cirrhosis or other conditions with a higher risk of esophageal varices, it is recommended to undergo endoscopy every six months to a year. For chronic liver disease patients with stable conditions, annual abdominal ultrasound and other relevant examinations are advisable to detect abnormalities early and take timely interventions to ensure health and safety.

 

Disclaimer: This article is intended for health education purposes, providing information to help readers understand diseases and medications. The content is not a substitute for medical advice and should be used for reference only. For any health concerns, please consult a doctor promptly.

 

 

Profile of The Doctor

 

Li Ling, Vice Director, Associate Chief Physician and Associate Professor at the Department of Interventional Radiology, Mengchao Hepatobiliary Hospital, Fujian Medical University, holds a Medical Doctorate. He is recognized as a high-level talent (Category C) in Fujian Province and serves as a member of the 8th Young Scholars Group of the Hepatology Branch of the Chinese Medical Association. Dr. Li is also an Executive Director of the 1st Council of the Integrative Medicine Interventional Branch under the China Information Association of Traditional Chinese Medicine, and a Standing Committee Member of the Expert Committee for Health Technology Promotion of the Chinese National Health Association. Furthermore, he is an Expert on Health Technology Promotion for the National Health Commission's Migrant Population Service Center and a Member of the 1st Committee of the Interventional Medicine Branch of the Fujian Medical Association. Dr. Li is a Standing Committee Member of the 2nd Committee of the Interventional Medicine Branch of the Fujian Society of Integrative Medicine, as well as a Standing Committee Member of the 1st Multidisciplinary Tumor Diagnosis and Treatment Committee of the Fujian Anti-Cancer Association. He is also a Member of the 2nd Tumor Interventional Therapy Committee of the Fujian Anti-Cancer Association, and a Standing Committee Member of the Oncology Green Therapy Branch of the Fujian Strait Cancer Prevention and Treatment Technology Exchange Association. Additionally, he serves as the Secretary of the Fujian Portal Hypertension Alliance and the Standing Committee Member and Secretary of the 1st Committee of the Interventional Radiology Branch of the Fuzhou Medical Association.

 

This article is sourced from FM1036 of Fujian News Radio.