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

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.