Hello, my fiancé had his first endoscopy this morning and they banded 2 varices. They said there was some bleeding so his stool might be darker next time he goes. They prescribed him 40mg of Pantoprazole, twice a day for 2 months then once a day after that. My questions are, is 2 banded varices a bad thing? I know it’s not great but is he in danger? Also, is anyone else taking Pantoprazole for heart burn? Thank you!
Banded varices : Hello, my fiancé had... - British Liver Trust
Banded varices
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Mywildlove
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Sadly varices often occur in patients with portal hypertension due to cirrhosis. My husbands condition only came to light when he had a massive upper GI bleed due to 7 burst varices - he has subsequently had 42 varices banded and this has eradicated his varices for now. My hubby was having horrendous heartburn up until diagnosis and we never thought anything of it - he has been diagnosed with portal hypertensive gastropathy which is change to the stomach lining - again due to portal hypertension. Hubby is prescribed Omeprazole - 2 x 20mg per day to reduce stomach acid and protect his stomach and oesophagus. Pantoprazole is a medicine (often prescribed short term) that reduces stomach acid and it will help protect his stomach and oesophagus.
Your partner might find eating and drinking a bit painful over coming days as when food passes by the banded area it causes discomfort. Soft diet until he can tolerate more normal stuff. The longest my hubby went was 10 days on soft food, normally about 3-4.
Best wishes.
Katie
Thank you so much for replying and the well wishes. I was so hoping he wouldn’t have to have any banded but the nurse said it’s common (?). He doesn’t have ascites anymore as far as we know, does ascites make it worse? Or vice versa?
I promised my fiancé donuts from Tim Horton’s after he was done (as a treat since he no longer eats foods that aren’t healthy usually) and he ate 4 with no problem. Of course he was still loopy from the sedation when he ate them.
It’s been 78 days today since he was diagnosed and quit drinking. I hope so much that he won’t have issues with bleeding varices again and will continue to get better. I’ve read a lot of stories from people who had bleeding varices but their liver continued to “heal” and they didn’t have many complications. I’m just trying to stay positive for both of us and not lose my sanity. Thank you again Katie!
My hubby has't ever had ascites and only the one episode of bleeding. 42 varices banded over two years - none since 2014.
Well done on the doughnuts - soft stuff all the way for hubby. They normally advise soft diet for 24 hours to prevent dislodging bands.
Hope your partner continues to improve.
Katie
I was on pantaprozole for the first 2 months after the hospital last year. Makes sense why they are prescribing it given the situation. Long term use of it however can cause bacteria to form in the small intestine which is toxic to the liver. So a two month course should be ok. But if they suggest after that to stay on it i would raise my concerns about it. Katies husband not having any new varices in 5 years now after 42 banding intially is very inspiring to hear indeed, so try and focus on that 🙂.
Mywildlove• in reply to
Thank you for that info Phoenix, that in itself is worrisome! I’m hoping that with no booze and a continued healthy diet, there will be no more varices. The ascites just went away about a month ago so maybe that’s what the varices are from? Idk my mind is racing. I have to keep telling myself that it’s not even been 3 months since this all happened and he stopped drinking. I know things can and will happen but things can also improve. Thank you so much Phoenix, you are really good at calming people down 😊
• in reply toMywildlove
Your always very welcome 🙂.
It wouldnt be from the ascites, it would be from the portal hypertension. Good news is that I have been told by my hepotologist last month that if the liver continues to improve with abstinence than yes the occurance of varices are very likely to continue to decrease as well. She believes that even varices that are present will likely shrink as the liver continues to improve. So that definately gives hope for us both. XX
Mywildlove• in reply to
Dang it, I knew it was from portal hypertension but I messed up haha I was hoping that the varices could go away possibly with time and healthy lifestyle! Did you have any banding done before? I’m sure you’ve either told me or I’ve read it on here somewhere, my memory is hell these days. I know I’ve read about people getting really sick and having varices banded then their livers get better and they live a fairly normal life. Lots actually. So fingers crossed for you and my fiancé!
• in reply toMywildlove
I have not had anything banded no. My initial scope in the hospital didnt find any varices. I havent had a scope since.
GrandmaDylan• in reply to
Hi Phoenix, I had a gastroscopy in August last year which was clear but when I had my next one in November they found early varices. I'm having yet another gastroscopy on Monday. How long is it since your gastroscopy?
• in reply toGrandmaDylan
Im over due for one its been over a year. Was supposed to be last month but waitinf for a call to reschedule
Hi, it all probably feels very scary at the moment but varaces can settle. My dad has had to have regular banding for several years, it can be very unplesent sadly but there are periods where they settle and my dad hasn't needed banding for a year now, where as at one point he was having to go virtually every month.
I'm sure each case is slightly different and there is a lot of unpredictability but the body is an amazing thing so stay positive and try not to let anything worry you too much either. This illness has taught us that you can worry and worry about a particular thing and then something completely different happens so now we just try to take things as they come.
Wishing you all the best.
Rachel
Hi, the great thing about this forum is there are many people with inspirational stories. Liver disease caused by alcohol can have catastrophic effects if not discovered, as was the case with my sister. However what people often find is that once they stop drinking the liver is no longer being damaged provided a good healthy lifestyle is maintained. The liver is an amazing organ, which can regenerate and also do its very important jobs with only a small functioning part. When people are initially ill it may be the case that the liver is inflamed, and this may improve quickly without further insult. Ascites is caused by low albumin levels, and these are again likely to improve. I think you have many reasons to be positive, the biggest being your partners commitment to stopping drinking, and healthy lifestyle. Try to support him in this ( as you have been) and not worry about the things you can't control.
He is very fortunate to have you to look out for his best interests, and do all the worrying for him. I hope he knows how lucky he is??
Take care
• in reply toWass71
Well said!
Thank you so much Wass! His liver was inflamed and enlarged when he got really sick. We went to the ER and they did an ultrasound, that’s how he was diagnosed. The doctor in the ER said he thought it was early stages but then the GI doctor said it was end stage. Next week I am calling the GI to see about a referral to a hep doctor. His GI doctor has only seen him twice and told us last time that from now on, his job is just to check for cancer and varices and we don’t have to go back until August. I don’t feel like that’s enough and would like another US done at least, now that he’s compensated and the inflammation is gone. My fiancé is very committed to a sober and healthy lifestyle, that’s how he was for most of his life up until about 8 years ago. He started having a drink at the end of the day, he had 2 young kids and a very demanding job. Then he started really drinking heavily around 6 years ago, the worst of it being the winter of 2017/2018. I really don’t know why I told you all that but it helps me when I ramble haha I’m sorry about your sister, was her liver able to regenerate some?
Hi, don't worry about rambling on, that's what the forum is for. Its always good to get these things off your mind. In most cases, if the person is stable with cirrhosis its quite normal to have scans and bloods for cancer risk (AFP test) 6 monthly. So what your Dr has suggested isn't unusual. It might be a good thing to wait before having another scan to give it a good chance for the inflammation to improve. I think you're more likely to get a more accurate picture of how the liver is. Its very difficult for Dr's to give definitive diagnosis of stage when the liver is inflamed. An MRI scan might be useful as it shows more detail, but an ultrasound scan is good at seeing severe damage or normal liver but in between can be open to interpretation.
Sorry I didn't make it clear, but my sister died. She was 41, an alcoholic. She developed ascites and jaundice, went to hospital had a massive bleed and after 3 weeks in ICU, liver failure, kidney failure and dialysis, respitory failure which took a while to control. Her brain was affected and the meds she was given to stop the bleeding caused her feet and legs to go black. She would have lost part of her foot and toes on the other foot had she lived. she had another bleed and her heart then gave up. This was in 2010, its been very hard to come to terms with, and I feel I should have helped her more. However I also have liver illness due to an auto immune condition called Pbc. In fact I've had a call today to say the transplant unit have agreed to complete the assessment for transplant. So hopefully in the next couple of months I'll be on the transplant list. So anyway things have been tough. I can understand all your worries and concerns, but your man is in a good place, because he is no longer drinking. This has given him a second chance, and I hope he is able to deal with the complications of life without the use of alcohol in the future.
I wish you well, and best wishes to you both.
Take care
X
Hi Wass71, it must have been so horrible to see your sister deteriorate in so many ways; even after so long, I'm sure it's still not easy for you. I hope you get onto the list and get a transplant as soon as possible. Best wishes
Thank you. X
Wass, I am so sorry about your sister. After reading what you said about her, it made sense. I hope you get on the transplant list ASAP! ♥️
• in reply toWass71
Hi wass
Oh, such a sad story and with you being ill as well...
All the very best at the Assessment (where is it to be?) - on the one hand it isn’t nice having all the waiting but on the other hand it’s something to look really look forward to (well I did because I was desperate to get on the list 👍). Hmm now I am not sure they are different things.. blurry brain fog...
Good luck!!!
Miles
I was told that I would have gastroscopies every 3 years initially. Unfortunately i have other gastro issues as well which is why I'm having them so often.
I had varices that were found on the first endoscopy, I was lucky they said they weren’t bad enough to band. I also have portal hypertension.
I stopped drinking and started eating well and I take propranolol for the portal hypertension and lansoprozole (only when needed) I’m not sure what worked to get rid of them, all of it I would imagine but on my last two endoscopes they have gone.
Hi, actually what you call 'rambling' is really helpful to me. It is so useful to hear people's stories, they all seem to be different, and especially the timescales; some people seem to have been drinking for decades, others much less time. Plus I am picking up lots of jargon that I can research: I didn't even know what varices were until I read your post and went to the dictionary. Very best of luck as your fiancé moves forward with tests and treatment
Hi
I wish you and your fiance lots of luck with everything. You will get lots of support on here. I've got Nash caused by meds from my drs. Your hubby is doing really well. Love and hugs Lynne xxxx
Thank you all so much for your help and well wishes. You don’t know it but you all keep me semi sane.
I’m sure those of you who maybe remember my posts are sick of me saying this, but I think the reason I am so upset about the varices (besides the obvious) is because I had that little bit of hope that just maybe it wasn’t cirrhosis and was actually alcoholic hepatitis. Today feels like getting the diagnoses all over again and it feels like a nightmare. I hate it so much. I want him back to his old gregarious self again. I want him happy and healthy and it makes me so mad. I feel so helpless and hopeless.
I’m also wondering now why the doctor didn’t prescribe him something like propranolol since he has varices. I take propranolol myself for mitral valve prolapse and tachycardia. Do they usually give that to people with cirrhosis who also have varices? Don’t worry, I would never ever give him anything that the doctor didn’t prescribe him. I’m just wondering and worrying.
I have been given beta blockers for the portal hypertension. Unfortunately I have low blood pressure and the beta blockers lower it further so I get quite dizzy when I stand up.
They cause my blood pressure to go a little low at times too but they benefit me more than not. It’s for different reasons though of course. I hope you’re doing well!
I was only prescribed a beta blocker after they diagnosed portal hypertension. This is what causes the varices. Portal hypertension was suggested by a registrar looking through my bloods and not by my Consultant. From what I can remember, they suspected portal hypertension, did an endoscopy, banded varices, then prescribed beta blockers. Hope that helps and all the very best to you both. Was impressed to read he was eating doughnuts after banding. Never been able to do that myself!!
So could he have varices and not portal hypertension? Or could they be from when he was decompensated? He’s only been compensated for a few weeks, maybe a month. I might have said that in a previous comment, forgive me if I repeat myself.
And really, not much can come between this man and donuts or baked goods when he gets a craving haha I don’t let it get out of control these days though. I made him cheese tortellini in a low sodium cream sauce with lots of spinach, asparagus, and broccoli for dinner. He ate a big plate of it, I had to keep telling him to take small bites because of the banding haha he worries me to death!
Portal hypertension is what causes varices. Blood that normally channels through a healthy liver without problem can't when the liver is damaged so it starts to back up in the portal veinous system and tries to divert via other blood vessels - often those which arn't designed to carry that much blood so the vessel walls bulge due to the increase in blood and hey presto that's what a varices is - the bulge in the blood vessel wall.
BTW - my hubby was never put on beta blockers (well he was for a week by a locum who prescribed carvedilol but immediately stopped by liver unit doctor who said they did no good once you'd had the size of bleed hubby had). Intensive banding is what got rid of his - every 6-8 weeks for over a year.
Katie
I’m glad your husbands went away! Do you happen to know if you get varices only when decompensated? Or can they happen anytime? My fiancé was just told about a month ago that he’s compensated so I was sure he wouldn’t have any varices. Thank you so much for the explanation, it’s a lot to take it when overwhelmed and worried so I come back often and read things over and over again.
Varices can happen even when compensated. The four stages of cirrhosis are defined as:-
Compensated
Stage 1 - No Varices / No Ascites
Stage 2 - Varices / No Ascites
Decompensated
Stage 3 - Ascites + / - Varices
Stage 4 - Bleeding + / - Varices.
Your fiance is in good hands, they are doing everything necessary to get him stable and once he is stable there is no reason whilst he can't live a long and normal life. He is no longer 'assaulting' his liver with the booze so it shouldn't be getting any worse. If he continues to eat well and exercise and stays off the booze plus does everything that medics say then fingers crossed all will be well.
When are you getting married by the way? My hubby was my fiance in April 2012 and by August we were married. We just had a quiet affair with a garden party buffet to celebrate with close friends and family after a quick (no frills) church ceremony - we didn't even have to do all the vows 'cos hubby struggles with remembering and couldn't repeat the full phrases so just had to say "I do" after the minister read the vows. No speeches, no first dance it was brilliant, relaxed and informal and many of our guests said it was the best wedding they'd ever been too.
Don't just dwell on all the liver stuff try and live life to the full.
Katie xx
Thank you so much for the info Katie! I’m a person who needs things broken down sometimes because my mind is constantly racing. This, and many other comments here, helped me a lot! And the positivity does wonders.
Your wedding sounds perfect! We are going to get married as soon as possible, just gonna go to the courthouse but have a party afterwards. Definitely getting a badass dress for it though haha I cannot wait to finally be his wife! ♥️ I’m trying really hard to focus on the positive with all of this, it’s just really hard sometimes. I’m hoping that changes as time goes on. Everyone here is so amazing and I hope you all know just how amazing you are!
Katie has explained fully below, so I won't repeat what she has said. In very simple terms, ( not suggesting you need simple terms, but... it might help) blood normally flows into the portal vein, a motorway road. When damage to the liver happens, the motorway flow starts to slow down and the traffic is diverted elsewhere onto smaller roads connected to the Motorway.
The smaller roads are not used to so much traffic and get backed up, this is like the veins in the oesophagus, where the banding is done.
I get checked for varices every 12 months. Once you have portal hypertension, you always have it, but it is managed. For me with beta blockers and yearly endoscopies.
I don't know if that helps at all?
By the way food sounds yummy, so we're all coming to yours later if that's okay.
All the very best to you both and I hope you have a lovely weekend. Things should calm down and it sounds as if your chap is getting good care
Thank you so much for helping me understand! They prescribed him a medicine for heartburn that keeps the acid in the belly down. I hope that helps too and he doesn’t need banding again.
Come on over! I love to cook and do a pretty good job at it! Haha
My hubby had his banded he had 3 during a huge bleed I nearly lost him & banding was the only way the bleeding could be stopped because the two attempts at using inflated balloon didn't work. Again this was the first sign that anything was wrong with his liver, luckily it happened at my dads before we were going to get the train back to London.
Can't remember what medication he was on.
Hope your fiance makes a speedy recovery
Thank you so much and I hope you and your husband are doing well!
Hi, don't worry about rambling here. I certainly did when my husband had bleeding varicies. There are some very helpful people here! My husband has now had 3 banding sessions. The second one was in the hospital where he went by ambulance nearly dead. That was a couple of months ago, actually less. Sometimes I feel like I'm in post traumatic shock from it still. I entered this forum to ask about long flights as we live in the US now but he still has a business in the UK that he flies to 3 to 4 times a year. Everybody said it was not a good idea to fly including the doctors and consultants so he eventually decided not to which was a good thing because he still needed another blood transfusion due to all the lost blood and his hemoglobin count being very low. One month later (2 weeks ago) he had his third banding session and he is now clear to fly at the end of May (I'm going with him this time) and they don't need to scope him again for 6 months. It is a real journey having a partner with this. Sometimes I think it is more stressful for us without it. My husband is not drinking at all and has a healthy diet. He doesn't exercise enough as he is always working (from his reclining chair) but there is only so much I can do and I'm pretty happy with the state of his health at the moment. Good luck and keep us informed.
I’m glad your husband is doing good and can fly again! I totally agree, I think I have PTSD from this as well. I was diagnosed with it when I was in my 20’s due to a horrific childhood so I’m familiar with the signs. I’m not good at handling things like this, I have a lot of issues with abandonment. The fear of him dying and me being without him is too much to bear. My fiancé also works from his chair, usually in his home office or sometimes from the bed haha he does make himself get up and walk around and it looks like some muscle is slowly coming back. I hope things continue to get better for you and your husband and I hope you take some time for yourself too. I know it’s hard to do that, I don’t want to leave his side and it causes me great anxiety when I do. But I also know it’s important to keep ourselves healthy, mentally and physically. 😊
And thank you so much!!
I appreciate your honesty but I guess cirrhosis isn’t a good sign either, is it? I’ve been reading a lot about it and it seems that many people have varices that need banding and then never get them again.
Hi wild
I can’t help but you have had some great replies 👍
Continue to wish you (both) good luck!
Miles
My other half had an endoscopy last year where they found "one small varix" which they weren't concerned about, so no banding. It's so hard not to get consumed by worry over all the what-if's that could possibly happen. I know you were hoping for a less permanent diagnosis. What I would say is just try and be happy with how well he's doing right now. By the way, that cheese tortellini sounds so tempting!
Variceal bleeds are not good. Best for your fiancé to have these checked out periodically and, as necessary, banded. Important part of surviving with liver disease.
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