How To Avoid Esophageal Varices

Avoiding esophageal varices—enlarged veins in the esophagus that can rupture and bleed—requires preventing or managing the underlying cause: portal hypertension, most commonly from liver disease such as cirrhosis. Here’s how to reduce your risk:

1. Prevent Liver Disease (Especially Cirrhosis)

Avoid excessive alcohol use: One of the leading causes of liver cirrhosis.
Get vaccinated for hepatitis A and B and take precautions to avoid hepatitis C (e.g., safe sex, avoid sharing needles).
Maintain a healthy weight: Obesity increases the risk of non-alcoholic fatty liver disease (NAFLD).
Eat a liver-friendly diet: Low in saturated fats, refined sugar, and processed foods; high in fiber, fruits, and vegetables.

2. Manage Chronic Liver Conditions

Treat hepatitis B or C early if diagnosed.
Follow your doctor’s guidance for managing autoimmune, genetic, or metabolic liver diseases.
Regular liver function tests can help catch problems early.

3. Avoid Toxins That Harm the Liver

Limit use of medications and supplements that can be hepatotoxic (e.g., excessive acetaminophen).
Avoid exposure to industrial chemicals or environmental toxins harmful to the liver.

4. Monitor for Portal Hypertension If You Have Liver Disease

If you have cirrhosis, your doctor may recommend:
- Endoscopy screening to look for varices.
- Beta-blockers (e.g., propranolol or nadolol) to lower portal pressure.
- Avoiding NSAIDs (they can increase bleeding risk).

5. Avoid Activities That Increase Abdominal Pressure

Heavy lifting, straining during bowel movements, or chronic coughing can aggravate varices if you already have them.

6. Follow a Medical Plan If Diagnosed

If you’re already at risk or diagnosed with varices:
- Follow through with endoscopic surveillance and treatment (e.g., band ligation).
- Take prescribed medications consistently.
- Avoid alcohol and other liver irritants entirely.