Cirrhosis Complications: Variceal Bleeding
Variceal bleeding happens when large veins get swollen and rupture. This can happen in the esophagus, stomach, and rectum. It's caused by a condition called portal hypertension. This is high pressure in the veins that filter blood from the intestines through the liver. This high pressure makes the walls of the veins weak. Then they can rupture.
What puts you at risk?
The more severe the liver damage is and the larger the varices (enlarged veins) are, the greater your risk is for variceal bleeding.
Variceal bleeding can be a life-threatening emergency. After varices have bled once, there is a high risk of bleeding again within 6 weeks. The risk gradually goes down after that. If varices are not treated, bleeding can lead to rapid and severe blood loss and death.
How is it diagnosed?
Having enlarged veins (varices) usually causes no symptoms. But they may be found during an endoscopy exam of the esophagus.
Endoscopic screening for varices is recommended for anyone who has been diagnosed with cirrhosis. If your first exam does not find any varices, you can be checked again in 2 to 3 years. You may need more frequent exams if you have large varices or have already had an episode of variceal bleeding. Even if you are treated for your varices with beta-blocker medicines or variceal banding, there is a risk for recurrent bleeding.
How is it treated?
Treatment for variceal bleeding includes two types of endoscopic procedures. They are:
- Variceal banding. A doctor uses an endoscope to place a rubber ring around the enlarged vein. This will stop blood flow through the vein to help prevent it from bleeding again. This may need to be done several times to control bleeding.
- Sclerotherapy. A doctor injects a special chemical directly into the enlarged vein to close off and scar so blood can't flow through it.
Endoscopic treatment is usually used along with medicines taken regularly, such as:
- Beta-blocker medicines. They lower the pressure in the veins.
- Vasoconstrictor medicines. They constrict blood vessels and reduce blood flow to the portal vein.
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Current as of: February 27, 2026
Author:
WebMD Ignite Staff
Clinical Review Board
All WebMD Ignite education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Current as of: February 27, 2026
Author:
WebMD Ignite Staff
Clinical Review Board
All WebMD Ignite education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.