How do gastroesophageal varices occur in patients with cirrhosis? Blood from all abdominal viscera, including the esophagus, stomach and intestines, spleen, gallbladder and pancreas, converges to a vessel called the portal vein, which is then injected into the liver for metabolism, refining nutrients and removing toxins, and the nutrient-filled blood flows from the liver to the heart, from which it is distributed throughout the body. Blood flow from the portal vein to the cirrhotic liver increases in resistance, and the pressure in the portal vein increases. Patients with cirrhosis all have varying degrees of portal hypertension, which causes dilatation, distortion and thinning of the walls of the vessels in the viscera as the pressure also increases. The general vasodilatation of the abdominal viscera does not have adverse consequences; the only vessels at risk are the gastroesophageal veins. Because the esophagus is very narrow and has a lot of food passing through it, it tends to bleed if the food is coarse, hard, or irritating; the stomach also bleeds when the stomach grinds food as the vessels in the stomach wall dilate, twist, and thin the walls. Because of the high portal vein pressure, rupture of the varices of the gastroesophagus often occurs with massive bleeding and vomiting or blood in the stool. What is the severity of blood vomiting and blood in the stool? Blood rushes out from the rupture of the varices in the gastroesophagus, vomiting large amounts of blood when it occurs rapidly, or it stays in the stomach and intestines and turns black with stomach acid and is excreted as tarry stool when it occurs more slowly. What is the severity of vomiting blood and blood in stool? If there is a lot of bleeding in a short period of time, shock will occur and life threatening if not rescued in time. Bleeding can induce liver failure, ascites, liver coma, and kidney failure. After one bleeding, it is bound to recur. How to prevent blood vomiting and blood in stool for mild and moderate varices? Every patient needs a gastroscopy to see if there are gastroesophageal varices at the time of diagnosis of cirrhosis. Patients with gastroesophageal varices found by gastroscopy need to prevent bleeding. The first time bleeding occurs, it will often recur, so it is important to prevent the first bleeding. Do not eat hard, irritating foods and never drink alcohol. If you still have hepatitis activity (positive HBV DNA and elevated transaminases), you need to take nucleoside analogs, and after one or two years of negative HBV DNA and normal transaminases, the mild gastroesophageal varices will deflate and the moderate and severe ones will be reduced. For mild and moderate varicose veins, you can take medicine, a kind of medicine which can reduce the pressure of portal vein called “propranolol”, also called “insulin”; for severe varicose veins, you need ligature or surgery to “cut off the flow “. How to take “Propranolol”? You need to have an electrocardiogram first to see if there are any contraindications to taking this drug. You need to get an arm-type electronic blood pressure monitor so that you can count your pulse rate correctly. Adjust the dosage according to the pulse count. Take 10 mg of each tablet of “Takeaway”, 1 to 3 tablets each time, 3 times a day. It is important to control the pulse rate to 60 beats per minute or less to decide the amount of medicine. How to prevent blood vomiting and blood in stool for severe varicose veins? If there is also hypersplenism (a significant decrease in platelets), the spleen needs to be removed surgically and the blood vessels outside the stomach need to be ligated (called “disconnection” in medical terminology). If there is no hypersplenism, or if it is not very severe, surgery is not necessary, as long as the varicose veins are ligated under gastroscopy.