What happens to esophageal veins in patients with esophageal varices?

In patients with esophageal varices, the esophageal veins experience dilation due to increased pressure in the portal vein system, often as a consequence of liver cirrhosis or other conditions that obstruct normal blood flow. This increased pressure leads to veins becoming engorged, forming varices that are significantly more susceptible to rupture. The rupturing of these dilated veins can lead to severe gastrointestinal bleeding, making this condition particularly dangerous.

The other potential outcomes related to the other choices do not align with the physiological response of the esophageal veins under heightened pressure conditions. For instance, they do not shrink and constrict, nor do they remain unchanged or become inflamed and painful typically. The primary concern with esophageal varices is the risk associated with their dilation and the potential for them to rupture, which is why this understanding is essential for effective clinical management.