[Esophageal varices: physiopathology and treatment. The role of the lower esophageal sphincter].Ugeskr Laeger. 1989 Jun 12; 151(24):1529-31.UL
Development of esophageal varices depends on local esophageal factors and portal gradient, vascular resistance in the azygos vein or presence of other portosystemic collaterals. Esophageal varices are found in the lamina propria of lower esophageal sphincter (LES), the pressure of which exceeds the normal portal pressure. Factors reducing LES pressure promote development of varices and enlarge these. Contraction of LES leads to reduction of the variceal and azygos flows, decrease in the pressure gradient across the varix wall and diminishes the varices. Pharmacological contraction of LES arrests the endoscopically proved bleeding from esophageal varices. Manipulation of LES pressure appears to be a genuine alternative to the current methods of treatment of the bleeding esophageal varices.