Varices

[Mamamjo]

I was diagnosed with cirrhosis due to NAFLD in February . Just had a gastroscopy which shows I have grade 2 varices. I have been started on beta blockers and will go back in 3 months for recheck and possible banding. Rather scary stuff!

3 questions:

Does banding hurt?

I have been going to the gym, to get fit and lose weight, but some sites say this is not good as it can raise the blood pressure and so enlarge the varices. What’s the sensible thing to do?

Will having this diagnosis affect flying/travelling and my insurance?

[Brett11]

I can only answer one question. I’ve had 10 Bandings done. Didn’t hurt a bit.

Cheers,

Brett

[Chelle_]

Hi Mamamjo. Sorry to hear your going through a rough time. I have banding done every 8ish weeks. normally between 1-7 bands, they don't really hurt. they are more uncomfortable. Be sure to be sedated. I would speak to your doctors about exercise, they can normally give you a plan to follow. I was doing my own thing, lifting too heavy weights and over doing the cardio when I had a horrific bleed. I haven't exercised in about 18 months now. I hate it but I understand. I think they like you to keep fit, but with walking or light exercise. If you have had a bleed insurances can increase, yes. However you need again to speak to your doctors and insurance company.

I am on beta blockers too, I have been for about 4 years now. They can make you feel a bit sick and dizzy so take it easy - don't go crazy!

[Mamamjo in reply to Chelle_]

Thanks Chelsea, that’s vet helpful

[Millie09 in reply to Chelle_]

What's grade 2 varices? .i thought varices was just simply that. Burst veins.. and you don't know about them untill you get a bleed. 🤔🤔x . Sorry if im being thick chelle lol xx

[Chelle_ in reply to Millie09]

Ha no not thick, always best to ask if you don’t know. They are graded in order or appearance. So grade one are straight, grade two a bit bendy etc. I think there are 3 grades in total x

[Millie09 in reply to Chelle_]

Oh i see, i never knew they came in shapes lol, thanks for the info chelle. 😊😁x.

[AyrshireK in reply to Millie09]

Oesophageal varices are like varicose veins they are like big bulges in the thin blood vessels of the oesophagus. Portal hypertension basically means all the blood that would previously be happily filtered through the healthy liver can no longer do so due to the scarring and damage and it begins to back up in other blood vessels of the body - when it backs up into thinner blood vessels that arn't meant to handle that amount of blood the walls of the blood vessels bulge outwards to accommodate this extra blood and that (in the oesophagus) would be called a varices. Banding of varices involves putting a rubber band around that bulge in order to cut off the bulge so that it eventually shrivels up and can't burst.

My hubby had 42 varices banded but only ever had 7 that actually burst. Also due to portal hypertension he also had aneurysms in his splenic artery which was the same type of bulge but in a much more serious location - if an aneurysm/bulge had burst in this major artery it would have almost certainly been fatal.

Katie

[Millie09 in reply to AyrshireK]

Hi Katie.

I had a general idea on varices, but i did not know you could have so many!.

That's quite scary in a way , one thing i have never had since 10yrs diagnosis yet i have had ascites 4 times, malnutrition, bleeding but not varices it was rectal ...

They did find a duodenal ulcer but i was treated for that and underwent the heliobactori test which was negative.

Your hubby has been through a lot hasn't he, bless. Does make me wonder why i have not had these myself considering my high fibroscan read . My best wishes to you both

Linda

[Hidden]

Hi Mamajo,

Welcome to the forum.

You may find our publications on NAFLD and cirrhosis useful to look at. Here are the links;

britishlivertrust.org.uk/wp...

britishlivertrust.org.uk/wp...

We would suggest that you discuss an exercise plan with your own doctors that will be safe for you. We would also suggest you discuss any travel plans with your liver doctors as they will need to assess if it is medically safe to travel or fly.

Warm wishes

Trust1

[Mamamjo in reply to Hidden]

Thanks. These are very useful links.

[Saintgeorge]

Hi, I was diagnosed with grade 2 varices in 2014 and take beta blockers. I am 71 and enjoy light exercise fitness walking and cycling and have flown short flights, paying a bit more insurance. Never drink, smoke and keep bmi good. I have been 👌 OK, touch wood. Stay well and best wishes.

[Mamamjo in reply to Saintgeorge]

Thanks Saintgeorge. Most encouraging

[heslinjones]

I paid for multi trip cover over 1 year £1300. Just had a bleed in Thailand total hospital costs £17000. Pay the insurance if you travel a lot

[Roy1955]

I was diagnosed with "barely noticeable" varices about 12 months ago, travel insurance cost tripled (about £20 a day for European cover and India cost me double) and I can only get single trip cover because insurance companies consider our condition can change too fast to offer cover in advance.

Never had a bleed, normal bloods, no liver symptoms whatsoever, 2nd fibroscan shows marked improvement but insurance still consider me higher risk so cost reflects the risk.

[Phil64 in reply to Roy1955]

Can you tell me more about your improvement in your 2nd fibroscan, and what you did to lower it? I got 22 KPA with ALD and probably will not have an other fibroscan before September? Thanks

[Roy1955 in reply to Phil64]

First fibro score was 24 and I quit drinking right away. 6 months later repeat fibro was initialy 10.6 but they said thats not possible so repeated it again and got 15, Still a good result.

Bloods were initially high but now 100% normal

Individual fibro readings now ranged from 2.3 to 22 and classed as "variable" whatever that means!

Interestingly I saw my GI (also hep specialist) last week and he had just attended a seminar about a new fibroscan machine just being brought out.

Apparently the existing one is not accurate if you are overweight or have excess belly fat! (or that's what the sales team for the new machine told the meeting)

New one is 2 step, it uses ultrasound to calculate the fat depth and then a second measure to scan the liver, the two "scores" are then combined to give the liver stiffness with the body fat taken into consideration. It's not in general use yet though but I intend researching if any private clinics have one.

Main thing is that your liver can repair itself or last a LOT longer if you remove the cause of the damage.

[Phil64 in reply to Roy1955]

Thanks for the info. Gives me more hope. My only stubborn enzyme is GTT at around double "120ish". Did you have difficultly lowering your GGT? Have you done a Fibrosure / test "Blood Test" also?

[Roy1955 in reply to Phil64]

My GGT was 380, after 6 months was 90 and now 70. GI says that 70 is considered normal.

He also said GGT is not the one that matters and does not cause him great concern if it's higher than normal.

I have not had the fibrosure blood test. My Drs advice might apply to you as well but check with your own Dr.

Mine said "you have cirrhosis and it's compensated, no matter what tests we now do it will not change anything and you will still have cirrhosis, having extra tests just to try and get lower numbers will make no difference to the diagnosis and you will always have cirrhosis"

Your probably thinking that if you get lower numbers then "just a couple of drinks won't hurt" I know that's what keeps crossing my mind! But it only takes one drink to tip a compensated liver into a decompensated one, you don't know what drink that's going to be. It might be 1000 drinks time or it might be the next drink that's in your hand right now.

[Roy1955 in reply to Roy1955]

Assuming of course that alcohol is what's causing your high results.

[Phil64 in reply to Roy1955]

My doctor tells me I have cirrhosis. 20-22 KPA, CAP 291 is F3-F4 "ALD Chart", my ultrasound suggest Micro-Nodular contours, and my blood work other than GGT are good. I am just hoping I might borderline F3-F4 as it maybe reversible? I admit I have Liver Disease yet I just hope that my doctor over estimated since he told me that It was mild/early cirrohsis? Also, when I did my Fibroscan I had a BMI of 32 which I am now 27 on my way to 25. I would like to thank you for your patients, and wisdom, much appreciated.

[Roy1955 in reply to Phil64]

Don't know about the wisdom! I am still struggling with the diagnosis

Yes it can and probably will improve. You have had your warning though

You have cirrhosis but with average luck it won't kill you anytime soon. You must accept the fact that "normal" results don't mean it's gone though. Cirrhosis is for life, not just for Christmas!

[Brett11 in reply to Roy1955]

Cirrhosis is for life , not just for Christmas. That says it perfectly. I wish I thought of that. It’s soooo true.

[Mamamjo in reply to Roy1955]

Thanks Roy. I suppose it’s good to shop around with insurance companies. Would be nice if there was one that offered a bit more intelligent insight.!

[Roy1955]

replied above

[Hidden]

Hi there

I cant comment on the varices, but if you have been diagnosed with cirrosis make sure you get 6 monthly ultrasound of the liver and appropriate blood tests.

[Mamamjo in reply to Hidden]

Thanks. Yes I am now being looked after at the cirrhosis clinic which is run by an excellent specialist nurse. The gastroscopy was part of their routine screening.

[Scrags64]

Don't worry about varices. Get them to give you local anesthetic and you won't know anything about it. I've got my 26th gastroscopy on Wednesday. I've had over 70 varicies banded, but the last three times there was nothing there. Keep up the good work.