Varices and Banding

[angse]

Hi everyone hope you are all keeping as well as you all can, I wonder if anyone can help me with this question, last year Feb 2013 lost 5 pts blood due to varices in esophagus, nearly died with that, I have endoscopys every six months, last one I had was last Jan 2014 I was told I had 1 and grade 2 varices which were not banded, I saw my gastroenterolgist last month and forgot to ask why, as the stress knowing that they are there is unbelievable, I am due for another one this month, I was just wondering if anyone knew a possible reason why no banding was done, I am on propranolol to keep portal hypertension down, grateful for any knowledge on this one. Thanks Kie

[gamesmaker]

HI. I had my oesophageal varices - grade 2 - banded at Kings, where I attend the liver unit. However I was recently seen at my local hospital for a different problem (investigations of anaemia) and the local hospital expressed surprise (when doing an upper endoscopy to look for a cause for the anaemia), that I had had banding without any GI bleed. Their policy locally was only to band if there was actual active bleeding - so nothing preventative. I have regular check endoscopies at kings (6 monthly) - thank goodness I am seen by a hepatologist and not managed locally. I have NASH cirrhosis with a high fibroscan result (27.5) and portal hypertension.

[angse in reply to gamesmaker]

Hi sorry about all your issues as well, like you I see heptologist at kings for blood work,liver scans every 6 months, and I have endoscopys done in Kent where I live every 6 months, when I was diagnosed with cirrohiss in 2013 my gastroenterolgist said he would send me for endoscopy to see if I had varices, I had that done in Jan 2013 the doctor who performed it said no varices, but two lesions present and he took biopsy of both, never did get results, then Feb 2013 I month later lost 5 pints blood through mouth, I had 5 veins banded as a result, my gastroenterolgist said if veins were there they would have been banded, so there you go, I am now on propranolol to keep pressure down,let's hope you get all your answers don't know if there killing or curing us, hopefully the latter, keep in touch and thanks for sharing your experience, its surprising how much we learn from others, and not doctors, Angse

[nbee]

Hi, I have had varicies was treated at southampton and mine were none bleeding but they still banded them, took 4 times once a month. Seems a bit strange gamesmaker that your local hospital said they only treat if there was active bleeding, thought the idea was to prevent this. I still have one small varicie as well but they said it didn't need treating which I presume is because its at no risk of bleeding. I still get checked out once a year at the moment and presume if it got any worse they would treat it. They are very good down at southampton but have heard kings are one of the best as well. All the best.

[Ph1ldad]

Hi Angsie, I was on a regular banding regime, every month for 7 months, having 32 banded varices, and never had any bleeding. Following a scan I was referred to Birmingham and they said that, unless there was evidence of bleeding they didn't recommend banding as there appeared to be little or no evidence that the procedure reduced the occurrence of subsequent bleeding. This suits me as I developed a phobia for the procedure! I know that I have grade 3 varices in the stomach which can't be banded and a few grade 1 and 2 in the oesophagus but, failing any development, they're staying where they are. Hopefully a transplant will reduce these significantly. I think the policy of preventive banding is falling by the wayside as there doesn't seem to be any evidence that the procedure offers any reduction of the risk of bleeding. On the contrary, the blood has to go somewhere so the pressure builds in the remaining vessels leading to yet more banding being required. Good luck Phil

[gamesmaker in reply to Ph1ldad]

There is such a difference across the country. My husband has just sadly passed away with a rare carcinoma of his common bile duct. He had so many specialist nurses he could contact if he had any queries at all about his diagnosis, treatment etc. I know I have said this before but there is a distinct lack of specialist nurses for the non malignant liver diseases. I asked about this at Kings and was told that there was specialist nurse cover for those undergoing transplant or those with drug or alcohol problems (which I don't) - but not for those with other liver diseases. I would just appreciate a specialist nurse who I could contact by phone or an appointment to see her if I had any questions at all relating to the diagnosis, treatment, specific tests, current research etc. I lobbied my MP about this inequality in the NHS - and she never even bothered to acknowledge my letter, let alone answer it (and she claims to have a specific interest in health matters).

[Ph1ldad]

I know what you mean. I was diagnosed and cured with hep C virus in the late nineties and essentially forgotten about until I needed surgery for a different problem. Glad of that tho because it meant they found the tumour early. I'm off for assessment for transplant on Wednesday. Already I'm seeing the difference. It took me a week chasing the hospital, consultants, secretaries etc to find out what was happening. Now I've got phone numbers and nurses by the bucketful. sometimes you just want to talk to someone. Just wish that the support for chronic liver conditions was in place in the non-specialist hospitals. Good luck for the future Phil

[gamesmaker]

Good luck Phil for your transplant assessment - post on here how you get on. Also good luck Angse with your ongoing treatment