Hello again..Long distance travel with cirrhosis

[KatoombaNSW]

Could anyone please advice..If my cirrhosis is well compensated and there are no signs of ascites or blockage in the portal artery, and no enlarged spleen,could I safely assume I do not have varices ? And would it be safe to travel from Australia to Europe? My specialist said there are 90% probability that I am free of varices. The only way to make sure is to do a gastroscopy,he said..Has anyone any experience or knowledge I can learn from? I dislike medical procedures unless absolutely necessary. And my specialist is happy for me to travel. I am still anxious..What to do?

[Hidden]

I would definitely follow your ‘specialists’ advice, I presume that they are either a Heptologist or Gastroenterologist Consultant? Take the gastroscopy, it is a long flight.

[Hidden]

I would imagine that the biggest concern would centre around a possible bleed from varices. While everything may appear to be normal now, there's no saying what will occur during a long haul flight. The dangers of deep vein thrombosis during long haul flights is now well known. I can't imagine any insurance company accepting this risk in your case.

It really would be a big gamble, l personally would avoid taking this trip for the time being. Is it really worth the risk dear friend?

[GrandmaDylan in reply to Hidden]

We cancelled a trip to Bali because of the really long flight but we would love to go to Singapore. I had a gastroscopy in july and another in November and should have had another a month ago which had to be postponed. I'm now having it on the 18th of this month. Between the july and November one I developed early varices so I will be interested to see if anything has changed. If I get the go ahead for a long flight and can get insurance we'll go to Singapore. If I've learned anything from this disease, it's don't put things off, do it while you can.

Some friends of ours when they found out that he had bowel cancer, he had the surgery but declined chemotherapy. They were told that he was signing his death warrant so they spent the kids inheritance on traveling to amazing places, there's barely a country they haven't visited. He is still with us, hale and hearty 20 years later!

[KatoombaNSW in reply to GrandmaDylan]

Thank you all for your wonderful responses..Not knowing what is going on inside you is really unsettling.. I am at the A stage of cirrhosis apparently, according to some classification.My specialist ( yes he is a gastrologist and hepatologist) told me if we could slow it's progress right down there is 70 % chance I will still be here in 10 years..Now that sounds fine,but when you think about it,it really tells me nothing..Because there is a big IF..

I get very anxious about medical procedures,even giving blood. So I picked a great disease , didn't I..

But I am heartened by your comments regarding gastroscopy, GrannyDylan..So I will go ahead and do it. And put the trip on freeze for now..Once I know what varices if any I am facing, I can decide then..

Thank you again for all your warm,caring responses.Much appreciated..Matteo X

[Hidden]

Hey there KatoombaNSW. One does not need to have a blockage or occlusion in the portal vein for varices to form. Varices can form even with a completely free flowing (patent) unobstructed portal venous system. What causes varices formation is the amount of pressure in the portal system. This is known as the hepatic venous pressure gradient or HVPG for short. Simply having cirrhosis scarring places pressure onto the liver causing the blood flow to back up and causing this HVPG to increase. What we know as portal hypertension. Whilst yes blockage or thrombosis would also further this complication, it is not required for the formation of varices. The absence of Ascites is also not a negative predictor for varices formation for the same reasons I mentioned previously. Unfortunately the only way to know for certain is by having a gastroscopy. I hear you on not wanting one though. I havent had one since I was in the hospital a year ago and I have been avoiding it for psychological reasons. But just because I havent done one again recently doesnt mean I'll give you that as advice. I need to at some point soon and you should if your doctor suggests to do so. Hope this helps my friend 🙂

[Katiesgran]

Hi I can completely understand where you are coming from. I also get very anxious about getting any procedures done but I would just say that in order to get travel insurance it’s better to have had a gastroscope. I was beyond terrified to get this but I can honestly tell you that, providing they give you sedation, this was a very easy procedure. I remember nothing about it other than having a very relaxing doze. Got immediate result fro my consultant and luckily no sign of varies. Your insurance will not be cheap. Better to get go ahead from consultant and must admit I am slightly apprehensive when I fly long haul but have not had any issues. You only have one life and for as long as possible I intend to live it.

[davianne]

Go for the gastroscopy before you travel, to be on the safe side, you know it makes sense.

I can't go to the USA & Canada to visit relatives, because the travel insurance costs too much, and I won't take the risk.

David

[Roy1955]

If you are diagnosed with varices your travel insurance will go sky high.