AI Summary Endoscopic sclerotherapy injects a sclerosing solution into or around bleeding esophageal varices, typically takes 20 to 45 minutes, and may require a hospital stay.
Medically reviewed.
Endoscopic sclerotherapy is an endoscopic procedure that treats bleeding esophageal varices, which are enlarged veins in the esophagus. A doctor passes a flexible endoscope into the esophagus and injects a sclerosing solution into or around the varices. The solution causes the veins to clot and scar, which helps control bleeding. It is used during active bleeding or when banding is not an option. Treatment decisions should always be individualized and guided by a healthcare professional.
This page covers endoscopic sclerotherapy: when it is recommended, how it works, what the procedure involves, benefits, risks, and follow-up care. You can also connect with a liver specialist near you for personalized guidance on whether sclerotherapy fits your care plan.
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ABOUT ENDOSCOPIC SCLEROTHERAPY
Endoscopic sclerotherapy is an endoscopic procedure. A doctor uses a flexible tube with a camera, called an endoscope, to reach the esophagus. Through the endoscope, the doctor injects a sclerosing solution into or around enlarged veins called esophageal varices. The solution causes the veins to clot and scar.
Varices form when pressure rises in the portal vein, the main vein that carries blood to the liver. This is called portal hypertension. Varices can rupture and cause dangerous bleeding. Sclerotherapy helps control that bleeding and helps prevent more of it.
Sclerotherapy is one of the endoscopic procedures used to treat varices. The other main option, endoscopic variceal ligation (EVL), places small rubber bands around the veins instead of injecting them. Sclerotherapy can also be used for gastric varices, which are enlarged veins in the stomach.
WHO SCLEROTHERAPY MAY BE SUITABLE FOR
Your healthcare provider may recommend endoscopic sclerotherapy if you have actively bleeding esophageal varices or need emergency control of variceal bleeding. It may also be used when EVL is not feasible or available, or when you need more treatment after variceal bleeding.
In most cases, EVL is the first choice. It is considered the gold standard for acute esophageal variceal bleeding because it is linked to better initial control of bleeding, lower rates of rebleeding, and fewer adverse events. Sclerotherapy is sometimes used when banding cannot be used.
Every patient's health profile is different. The choice between treatments belongs to you and a qualified healthcare professional, who will weigh your bleeding risk, your liver condition, and what is available at your hospital.
ELIGIBILITY OVERVIEW
Your healthcare provider may recommend endoscopic sclerotherapy if you have:
Before recommending sclerotherapy, your care team looks at several factors to decide whether it is the right option:
HOW SCLEROTHERAPY CAN HELP
During the procedure, the doctor injects a sclerosing agent into or around the varices. The agent irritates the vein walls, so the veins clot and scar. This collapses the vein and reduces blood flow to the treated varices.
With less blood flowing through them, the treated varices are less likely to bleed. That is how sclerotherapy controls active bleeding and helps prevent bleeding later.
Sclerotherapy does not treat the liver disease or the portal hypertension behind the varices. Providers pair it with medicines for portal hypertension, follow-up endoscopy, and lifestyle changes.
liver benefits
When liver disease raises pressure in the portal vein, enlarged veins called varices can form in the esophagus and bleed. Sclerotherapy treats these veins directly. In this way, it helps manage one of the most serious complications of portal hypertension.
The sclerosing solution makes the treated veins clot and scar, which reduces blood flow to them. With less blood flowing through them, the treated varices are less likely to bleed. Controlling bleeding protects your health while your liver condition is managed.
Sclerotherapy can control active bleeding and also helps prevent bleeding later. Your doctor may repeat the endoscopy to check how well treatment worked and decide whether you need more sessions.
Sclerotherapy does not treat the liver disease or the portal hypertension behind the varices. It supports your liver health best as one part of a plan that includes your prescribed medicines, avoiding alcohol if it applies to you, diet advice for liver disease, and regular follow-up.
Sclerotherapy injects a solution into bleeding varices so they clot and scar. It is used in emergencies or when banding is not possible, and your healthcare team decides when it fits your care.
TREATMENT PROCESS
You are told to fast before the procedure. You may receive intravenous (IV) medications.
The doctor passes a flexible endoscope into your esophagus. Through it, the doctor injects a sclerosing solution into or around the varices.
The procedure typically takes 20 to 45 minutes. The time depends on how many varices are treated and how severe the bleeding is.
Your care team monitors you after the procedure. Depending on how severe the bleeding was, you may need to stay in the hospital.
Your doctor may repeat the endoscopy later to check how well treatment worked and decide whether you need more sessions.
BENEFITS AND SAFETY
Endoscopic sclerotherapy is a non-surgical treatment performed through an endoscope. It can help stop active variceal bleeding, so it is useful in emergencies. It also treats a serious complication of portal hypertension. How well it works depends on your liver condition and how your body responds.
Like any procedure, sclerotherapy has risks. Common risks include chest pain, trouble swallowing, ulcers in the esophagus, and bleeding. Esophageal perforation, a tear in the esophagus, is rare. Your healthcare team will talk with you about benefits and risks before treatment and will watch you closely afterward.
For most people with bleeding esophageal varices, EVL is preferred over sclerotherapy. It is linked to better initial control of bleeding, lower rates of rebleeding, and fewer adverse events.
BENEFITS
The main benefit is control of active variceal bleeding. Ruptured varices can cause dangerous bleeding, so stopping a bleed is the central goal of the procedure.
The doctor works through a flexible endoscope, so there is no surgical operation. The procedure typically takes 20 to 45 minutes, depending on how many varices are treated and how severe the bleeding is.
Sclerotherapy can be used during acute hemorrhage, when quick action matters and your team needs to bring variceal bleeding under control.
If banding (EVL) is not feasible or not available, sclerotherapy gives your care team another way to treat bleeding varices.
Your healthcare provider will discuss the potential benefits and risks before treatment and will monitor you afterward. Ask your care team which symptoms after the procedure need urgent attention.
SUPPORTING YOUR RESULTS
Sclerotherapy treats bleeding varices, but it does not treat the liver disease or portal hypertension behind them. Daily habits and follow-up care remain an essential part of your plan.
These steps can support your recovery and help protect your liver over time. Your care team can tailor them to you.
Areas that may support treatment:
Common Questions
Endoscopic sclerotherapy treats bleeding esophageal varices, which are enlarged veins in the esophagus caused by portal hypertension. A doctor passes a flexible endoscope into the esophagus and injects a sclerosing solution into or around the varices. The solution makes the veins clot and scar, which helps control bleeding and helps prevent future bleeding. Ask your healthcare professional whether this procedure fits your liver condition and care plan.
You may need sclerotherapy if banding, called endoscopic variceal ligation (EVL), is not feasible or not available. Your provider may also recommend it for actively bleeding varices, emergency control of bleeding, or more treatment after variceal bleeding. EVL is usually the first choice because it is linked to better initial bleeding control, lower rebleeding, and fewer adverse events. Your healthcare professional will weigh your bleeding risk, your liver condition, and what your hospital offers.
The procedure typically takes 20 to 45 minutes. The time depends on how many varices are treated and how severe the bleeding is. Before the procedure, you are told to fast, and you may receive intravenous medications. Your care team monitors you afterward. Ask your healthcare professional what to expect in your situation, including whether you may need to stay in the hospital.
Endoscopic sclerotherapy has risks, like any procedure. Common risks include chest pain, difficulty swallowing, ulcer formation, and bleeding. Esophageal perforation, a tear in the esophagus, is rare. Your healthcare team will discuss the benefits and risks with you before treatment and monitor you afterward. Ask which symptoms after the procedure need urgent attention, and talk with your provider about any concerns before you decide.
No. Endoscopic sclerotherapy treats bleeding esophageal varices, not the liver disease or portal hypertension behind them. It helps control active bleeding and helps prevent future bleeding by closing off abnormal veins. You will still need prescribed portal hypertension medicines, follow-up visits, and liver-healthy habits. Your healthcare professional can explain how sclerotherapy fits into your overall treatment plan.
Your care team monitors you after the procedure, and you may stay in the hospital depending on how severe the bleeding was. Your doctor may repeat the endoscopy to check how well treatment worked and whether you need more sessions. Keep taking prescribed portal hypertension medicines, avoid alcohol if it applies to you, follow liver diet advice, and attend follow-up visits. Your healthcare professional can tailor these steps to you.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.
