Causes of esophageal varices include: Risk factors Continued alcohol use. Your risk of variceal bleeding is far greater if you continue to drink than if you stop, especially if your disease is alcohol related. Complications Bleeding The most serious complication of esophageal varices is bleeding. Once you have had a bleeding episode, your risk of another bleeding episode is greatly increased. In some cases, blood loss is so great that you go into shock. This can lead to death. Prevention Don t drink alcohol. People with liver disease are often advised to stop drinking alcohol, since alcohol is processed by the liver. Drinking alcohol may stress an already vulnerable liver. Eat a healthy diet. Choose a plant-based diet that s full of fruits and vegetables. Select whole grains and lean sources of protein. Reduce the amount of fatty and fried foods you eat. Maintain a healthy weight. An excess amount of body fat can damage your liver. Obesity is associated with a greater risk of complications of cirrhosis. Lose weight if you are obese or overweight. Reduce your risk of hepatitis. Sharing needles and having unprotected sex can increase your risk of hepatitis B and C. Protect yourself by abstaining from sex or using a condom if you choose to have sex. Ask your doctor whether you should be vaccinated for hepatitis B and hepatitis A.