Esophagus is the tube that connects throat to stomach. Bleeding Esophageal Varices or portosystemic collaterals is the abnormal dilation or enlargement of veins in the lower parts of the esophagus (swallowing tube) that is bleeding. Bleeding Esophageal Varices is a serious complication of cirrhosis (liver) disease and give poor outcomes. Bleeding Esophageal Varices that carries higher rate of mortality and morbidity.


The common cause for esophageal varices is scarring of liver or liver cirrhosis, chronic liver disease of any type leads to more blood flow through the esophagus. It may occur in the upper part of the stomach. The other cause of portal hypertension include portal vein thrombosis (blood clots inside the portal vein) and portal vein obstruction.


There are no symptoms related to esophageal varices, if small amount of internal bleeding occur shows only symptoms like dark or black streaks in the stools. If there is large amount of internal bleeding which leads to bloody stool, black stool (malena), vomiting blood (hematemesis), chronic liver diseases and light headedness.


The best way to prevent bleeding esophageal varices is to correct the cause of disease, if you have liver disease, have proper healthy diet with no alcohol consumption and maintain normal body weight. Prevention of the risk factors of hepatitis like having safe sex and avoiding contact with an infected person and avoiding sharing of personal hygeine products may help in the prevention of the disease.


The main task for the treatment is to stop bleeding as soon as possible. Terlipressin tightens blood vessels or leads to vasoconstriction, thus helps to stop the bleeding. Terlipressin appears to be as safe as other treatments and may reduce the mortality from variceal bleeding.

Terlipressin is a longer-acting vasopressin analogue used for the management of variceal bleeding, with fewer side effects than vasopressin. Terlipressin drug is the first line monotherapy useful where band ligation is not available. Terlipressin is used in the treatment of acute variceal haemorrhage. Terlipressin can be administered as intermittent injections instead of continuous intravenous infusion and it has a safer adverse reactions profile. Somatostatin and octreotide are used and are as effective as terlipressin in control of bleeding but have not been shown to reduce mortality.

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Terlipressin 1mg/10ml Injections