To prevent esophageal varices (varicose veins of the esophagus), attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Pleasure food consumption
- Alcohol (woman: > 40 g/day; man: > 60 g/day).
Primary prophylaxis
Primary prophylaxis aims to prevent a first esophageal variceal bleed. The risk of first esophageal variceal bleeding is approximately 30%. An increased risk of bleeding, which is considered an indication for primary prophylaxis, is said to exist if the so-called “red color signs” are detectable (stage III) and/or the variceal diameter is > 5 mm.
Primary prophylaxis is usually achieved by permanent use of non-selective beta-blockers, e.g. propranolol (see “Drug therapy“). The risk of bleeding can thus be reduced by approximately 50%.
If the risk of bleeding is high, ligation (see “Surgical Therapy” below) may also be indicated.
