The main goal of treatment for esophageal varices is to prevent ruptures and bleeding. Initially, this often involves steps to control portal hypertension. The doctor may prescribe beta-blockers to reduce blood pressure. These drugs work by blocking the effects of a hormone called epinephrine, making the heart beat slower and with less force. A person with esophageal varices may also require one of the following surgical procedures. Endoscopic sclerotherapy involves using an endoscope to perform minor medical tasks, such as injecting a medication into the swollen veins to make them shrink. Endoscopic variceal banding involves using the same tool to place a rubber band around a varice to prevent the vessel from bleeding. Additional treatments may be necessary for varices that bleed recurrently. A doctor may recommend a transjugular intrahepatic portosystemic shunt, or TIPS, procedure. This involves using an X-ray to guide the placement of a small tube to connect the portal vein with the hepatic vein. This creates a new channel for blood, reducing pressure in the portal vein. Another treatment option is a distal splenorenal shunt procedure. This connects the main vein of the spleen to the vein of the left kidney.