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Screening for Esophageal Varices: When and How?
Published: Mar 02, 2024
Screening for esophageal varices is crucial for people with liver disease. Early detection can prevent life-threatening bleeding and improve survival rates.
Who Needs Screening?
Screening is recommended for people with decompensated cirrhosis (advanced liver disease with complications). It's also advised for those with compensated cirrhosis if they have certain risk factors. These include a liver stiffness measurement over 20 kPa or a platelet count below 150,000 per microliter.
The Screening Process
The main screening tool is an upper endoscopy, where a thin tube with a camera is passed down the throat to examine the esophagus. This allows doctors to see if varices are present and assess their size and appearance. The procedure is usually done under sedation for comfort.
Follow-Up and Surveillance
If no varices are found or only small ones are present, repeat screenings are scheduled based on the patient's condition. This could be every 1-3 years. For those with large varices or other high-risk features, treatment is usually started right away to prevent bleeding.
Frequently Asked Questions
It's the most reliable method, but non-invasive tests are being studied.
Most people don't feel pain due to sedation.
It depends on your liver condition and initial findings.
Key Takeaways
Regular screening for esophageal varices is a vital part of managing liver disease and preventing serious complications.
Discuss with Doctronic whether you need screening for esophageal varices based on your liver health.
References
- de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII - Renewing consensus in portal hypertension. J Hepatol 2022; 76:959.
- Kaplan DE, Ripoll C, Thiele M, et al. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology 2024; 79:1180.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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