Esophageal Varices: Diagnosis, Management, and Main Nursing Interventions

Abstract

Background: Esophageal varices (EV) are a leading cause of upper gastrointestinal bleeding (UGIB) and represent a significant health issue worldwide. They commonly arise due to portal hypertension, which can be a result of cirrhosis or other conditions such as schistosomiasis and portal vein thrombosis. Acute variceal bleeding (AVB) is a life-threatening complication that requires timely diagnosis and management to reduce mortality. While endoscopy is considered the gold standard for diagnosing and assessing EV, non-invasive methods such as elastography and artificial intelligence are being explored.

Aim: This review aims to evaluate the diagnosis, management strategies, and the role of nursing interventions in the management of esophageal varices, with a focus on prevention, treatment, and monitoring.

Methods: A comprehensive review of the literature was conducted, examining various diagnostic techniques, including esophagogastroduodenoscopy (EGD), elastography, and emerging technologies such as artificial intelligence. The management strategies, including pharmacological and endoscopic interventions, were assessed, with particular attention to nursing interventions in managing variceal bleeding.

Results: Key findings include the importance of early diagnosis and risk stratification for esophageal varices, with EGD and elastography playing pivotal roles. Primary prophylaxis through nonselective beta-blockers and endoscopic band ligation is essential to prevent first-time bleeding. Nursing interventions, including monitoring for signs of bleeding, patient education, and medication administration, are crucial in managing patients with EV.

Conclusion: Esophageal varices are a serious medical condition requiring comprehensive management strategies. Nurses play a critical role in the management, prevention, and monitoring of these patients, emphasizing the importance of early detection, pharmacological therapy, and endoscopic interventions.