Symptoms:

People with chronic liver disease and esophageal varices may have no symptoms.

If there is only a small amount of bleeding, the only symptom may be dark or black streaks in the stools.

If larger amounts of bleeding occur, symptoms may include:

• Black, tarry stools
• Bloody stools
• Light-headedness
• Paleness
• Symptoms of chronic liver disease (such as cirrhosis)
• Vomiting
• Vomiting blood

Signs and tests:

Physical examination:

• Bloody or black stool on rectal exam
• Low blood pressure
• Rapid heart rate
• Signs of chronic liver disease or cirrhosis

Tests to determine where the bleeding is coming from and detect active bleeding include:

• Esophagogastroduodenoscopy (EGD)
• Tube through the nose into the stomach (nasogastric tube) to look for signs of bleeding

Some doctors recommend EGD for patients who are newly diagnosed with mild to moderate cirrhosis to screen for esophageal varices and treat them before there is bleeding.