Inflammable veins and arteries are extremely dilated in sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension, commonly due to cirrhosis
Most the esophageal varices found at lower esophagus due to portal hypertension.
The varices that found at upper esophagus (Downhill varices) occur less frequently and are due to obstruction of the superior vena cava secondary to certain malignancy eg lymphoma, thymoma, thyroid tumor, or bronchogenic carcinoma. They are often asymptomatic.