Diagnosis

If you have cirrhosis, your doctor should screen you for esophageal varices when you're diagnosed. How often you'll undergo screening tests depends on your condition. Main tests used to diagnose esophageal varices are:

• Endoscopic exam. A procedure called upper gastrointestinal endoscopy is the preferred method of screening for esophageal varices. Your doctor inserts a thin, flexible, lighted tube (endoscope) through your mouth and into your esophagus, stomach and the beginning of your small intestine (duodenum).

  The doctor will look for dilated veins, measure them, if found, and check for red streaks and red spots, which usually indicate a significant risk of bleeding. Treatment can be performed during the exam.

• Imaging tests. Both abdominal CT scans and Doppler ultrasounds of the splenic and portal veins can suggest the presence of esophageal varices. An ultrasound test called transient elastography that measures scarring in the liver can help your doctor determine if you have portal hypertension, which may lead to esophageal varices.
• Capsule endoscopy. In this test, you swallow a vitamin-sized capsule containing a tiny camera, which takes pictures of the esophagus as it goes through your digestive tract. This might be an option for people who are unable or unwilling to have an endoscopic exam. This technology is more expensive than regular endoscopy and not as available. Capsule endoscopy can only help find esophageal varices and does not treat them.