How are esophageal varices diagnosed?

Regular screening for esophageal varices is recommended for people who have 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, and the camera sends images of the inside of the esophagus to a monitor. The physician looks at the images to detect enlarged veins and grades them by size. Red lines on the veins are a sign of bleeding.

The physician may also use the endoscope to examine the stomach and the upper part of the small intestine. 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.

Last reviewed by a Cleveland Clinic medical professional on 04/10/2019.


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  • Poza Cordon J, Froilan Torres C, Burgos García A, et al. Endoscopic management of esophageal varices. World Journal of Gastrointestinal Endoscopy. 2012 Jul 16;4(7):312-22.
  • Merck Manual Consumer Version. Gastrointestinal Bleeding. Accessed 4/17/2019.

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