Surreal illustration of schistosomiasis treatment featuring river, boats, and dam.

Schistosomiasis and Gut Health: Long-Term Strategies for Managing Esophageal Varices

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Theo Raines in Health & Wellness December 2025 • 4 min read.

"Discover how a combined surgical and endoscopic approach can improve outcomes for patients with schistosomiasis-related esophageal varices, reducing rebleeding and enhancing quality of life."


Schistosomiasis, a parasitic disease affecting millions worldwide, poses significant health challenges, particularly in regions like Brazil. The infection, caused by parasitic worms, can lead to severe complications, with one of the most alarming being digestive hemorrhage due to ruptured esophageal varices. These varices, or abnormal, enlarged veins in the esophagus, develop as a result of the liver damage and portal hypertension associated with schistosomiasis.

The rupture of esophageal varices is a life-threatening event, demanding prompt and effective treatment. Historically, surgical interventions have played a crucial role in managing this condition, especially for patients who have already experienced one or more bleeding episodes. Among the surgical techniques, esophagogastric devascularization and splenectomy (EGDS) has become a common approach. This procedure aims to reduce portal pressure and prevent future bleeding by disconnecting the blood supply to the varices.

While EGDS has shown promise in controlling bleeding, the risk of rebleeding remains a concern. This has led to the integration of endoscopic treatments into the postoperative care of schistosomiasis patients. Endoscopic procedures, such as sclerotherapy, help to further reduce the size and risk of varices. In this article, we delve into the long-term effectiveness of combining EGDS with postoperative endoscopic management, examining how this integrated approach can improve outcomes and quality of life for individuals affected by schistosomiasis-related esophageal varices.

Why Combine Surgery and Endoscopy for Esophageal Varices?

Surreal illustration of schistosomiasis treatment featuring river, boats, and dam.

For individuals with schistosomiasis, the threat of bleeding from esophageal varices looms large, casting a shadow over their daily lives. Traditional treatments often involve managing acute bleeding episodes, but a more proactive, preventative strategy is needed to improve long-term outcomes. Combining surgical and endoscopic techniques offers a comprehensive approach to tackle this challenge head-on.

Esophagogastric devascularization and splenectomy (EGDS) serves as the foundation of this combined strategy. By surgically reducing the blood flow to the varices, EGDS decreases the likelihood of rupture and subsequent bleeding. However, surgery alone may not eliminate all varices, and new ones can develop over time. This is where postoperative endoscopic treatment steps in to maintain the results. Endoscopic procedures, such as sclerotherapy, can target and eliminate any remaining or newly formed varices, ensuring more complete and lasting protection against rebleeding.

  • Reduced Rebleeding Risk: Combining EGDS with endoscopic treatment significantly lowers the risk of future bleeding episodes.
  • Comprehensive Varices Management: Addresses both existing and newly developed varices, ensuring thorough treatment.
  • Improved Long-Term Outcomes: Offers patients a better quality of life with fewer hospital visits and complications.
The integration of surgery and endoscopy provides a multifaceted approach that addresses both the immediate and long-term risks associated with esophageal varices in schistosomiasis patients. This strategy not only reduces the physical burden of the disease but also offers psychological reassurance, empowering patients to live more confidently.

The Future of Schistosomiasis Management

The combination of surgical and endoscopic treatments represents a significant step forward in managing esophageal varices caused by schistosomiasis. By integrating these approaches, healthcare providers can offer patients more effective, long-term solutions that not only reduce the risk of bleeding but also improve overall quality of life. As research continues and techniques evolve, we can expect even more refined strategies to further enhance outcomes for those affected by this challenging condition. Empowering individuals with knowledge and access to comprehensive care remains the key to successful management of schistosomiasis and its complications.

About this Article -

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Everything You Need To Know

1

What is schistosomiasis and why is it a concern?

Schistosomiasis is a parasitic disease caused by parasitic worms, leading to liver damage and portal hypertension. This can result in the development of esophageal varices, which are enlarged veins in the esophagus. These varices can rupture, causing life-threatening digestive hemorrhage. Effective management of schistosomiasis is crucial to prevent such complications and improve the overall health of affected individuals. It's particularly significant in regions where the disease is prevalent, requiring comprehensive strategies for both prevention and treatment.

2

What is esophagogastric devascularization and splenectomy (EGDS) and how does it help?

Esophagogastric devascularization and splenectomy (EGDS) is a surgical procedure used to treat esophageal varices. It involves reducing blood flow to the varices to decrease the risk of rupture and bleeding. By disconnecting the blood supply, EGDS aims to lower portal pressure, addressing the underlying cause of varices development. While EGDS is effective in controlling bleeding, the risk of rebleeding necessitates additional treatments to ensure long-term success.

3

What are endoscopic treatments and how are they used for esophageal varices?

Endoscopic treatments, such as sclerotherapy, are used to manage esophageal varices by directly targeting and eliminating the varices. These procedures are often performed postoperatively after esophagogastric devascularization and splenectomy (EGDS) to address any remaining or newly formed varices. Endoscopic treatments enhance the effectiveness of surgical interventions by providing a more comprehensive approach to varices management. This combination reduces the likelihood of rebleeding and improves long-term outcomes.

4

Why is it beneficial to combine surgery with endoscopy for treating esophageal varices?

Combining esophagogastric devascularization and splenectomy (EGDS) with postoperative endoscopic treatment offers a comprehensive approach to managing esophageal varices. EGDS reduces blood flow to the varices surgically, while endoscopic procedures eliminate any remaining or newly developed varices. This integrated strategy reduces the risk of rebleeding, ensures thorough varices management, and improves long-term outcomes, leading to a better quality of life for patients. The combined approach addresses both immediate and long-term risks associated with esophageal varices in schistosomiasis patients.

5

How does combining surgical and endoscopic treatments affect the overall outcome for patients with esophageal varices?

Managing esophageal varices through a combined approach of esophagogastric devascularization and splenectomy (EGDS) and endoscopic treatment significantly improves patient outcomes. This strategy reduces the risk of rebleeding, manages both existing and new varices, and enhances the patient's quality of life. By addressing the immediate risks and providing long-term protection, this combined approach empowers individuals to live more confidently with fewer complications. Continuous research and evolving techniques promise further advancements in the management of this condition.

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