How are esophageal varices diagnosed?

Regular screening for esophageal varices is recommended for people with advanced liver disease. Screening is done by endoscopy. An endoscope is a thin, flexible tube with a light and a tiny camera on the tip. The physician passes the endoscope down the esophagus. The camera sends images of the inside of the esophagus to a monitor.

The physician looks at the image on the monitor to detect enlarged veins and grades them by size. Red lines on the veins are a sign of bleeding.

The physician may use the endoscope to examine the stomach and the upper part of the small intestine as well. This is called an esophogastroduodenoscopy (EGD).

Imaging by CT or MRI scan is also used to diagnose esophageal varices, often in combination with endoscopy. The pictures created by CT or MRI show the esophagus, the liver and the portal and splenic veins. They give the physician more information about the liver’s health than endoscopy alone.

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