Hubby had his first banding of varices yesterday. This was the first he knew he had them. As he doesn’t have high blood pressure, (except upon waking in the morning), would he be advised to take any medication?
He needs to go back for additional banding in 4 and 8 weeks.
Thanks
Hi, not sure on your exact circumstances, but I had banding when I was 12/13 and had them every couple of months for a few years. Wasn't put onto blood pressure medication until I was fifteen I believe, so it may depend on your circumstances.
The blood pressure you speak of isn't the body blood pressure, but the blood pressure that builds up in the portal vein. More information about portal vein hypertension can be found here: britishlivertrust.org.uk/in...
Good Luck
Richard
It's portal hypertension which causes varices and sometimes they prescribe a beta blocker like carvedilol or propranolol to reduce portal hypertension.
This is totally different high blood pressure than that caused by circulatory problems.
My hubby has normally low general blood pressure and yet suffered from P/H, suffered a massive upper GI bleed from varices and ended up having banding every 6-8 weeks for two years resulting in 42 varices being banded.
Hubbies consultant never prescribed hubby any beta blocker saying it wouldn't do any good after he'd already had a massive bleed - she preferred to control and eradicate varices via an aggressive banding regime.
I am sure they'll do what is necessary to control your hubbies condition going forward.
Katie
I guess the biggest question we have now is, will the disease continue to progress? When first diagnosed in February, we were given the impression that with no alcohol and maintaining our healthy food and exercise, the road ahead would be good.
The Internal Medicine unit at our hospital here in Canada wouldn’t refer him to a Liver Specialist as they said his LFTs were returning to near normal levels by May and all he needed was for our GP to manage his care. She did finally put him on cholesterol medicine in July. It has been high since his 30’s, he’s now 62. It was never diet related.
I’m rambling now, but I feel like the warning signs were present for years and his care has been mismanaged.
Hopefully he will now be managed by a liver specialist, push for it. He obviously has cirrhosis and with cirrhosis liver blood tests can improve because the damaged bits don't actually give off the enzymes that cause the blood test to be out of sink, only the working bits do that and whilst they are coping they often return as near normal.
My hubby was first diagnosed with cirrhosis in April 2012 after a massive variceal bleed - his diagnosis came completely out of the blue since he's life long t-total and had none of the risk indicators for liver disease and it turns out his is due to an auto immune condition.
After a sustained banding regime, hubby was assessed and listed for transplant in 2014 but became stable enough to be delisted in 2015. He remains relatively stable, not 100% well by any means but ticking along. No varices have required banding since 2014.
Hopefully with proper care and monitoring your hubby can get a bit better, would transplant be offered in your country if his liver does deteriorate further?
Katie
Do the varices continue to form?
It is possible to eradicate them via repeated banding, the oesophagus scars up and this stops the veins for keeping bulging. In hubbies case it was discovered he also suffered from aneurysms in his splenic artery (also caused by portal hypertension). He underwent an embolization operation and this killed off his spleen and this has reversed his portal hypertension. In the last couple of years his annual endoscopy has revealed 'barely visible varices' higher up in his oesophagus but these arn't requiring banding.
The main vein feeding the liver is the portal vein. When the liver is damaged, this vein cannot take the same blood flow as before and so blood gets diverted to other veins in the body, usually the oesophagus and the stomach. These veins were not designed to take this extra blood flow and so eventually they become enlarged (like veins on the legs called varicose veins) and they rupture, resulting in bleeding. These enlarged veins in the oesophagus are referred to as varices and they try to prevent the bleeding by using the banding, which effectively strangles these enlarged veins, preventing further blood flow through them.
My Consultant prefers me to take Carvedilol in order to prevent further bleeding, but I cannot tolerate as high a dose as they would like. As others have said, the pressure in these varices is not caused by blood pressure due to the heart, but due to damage caused in the liver.
This is probably a lot more than you wanted to know, but I thought I would offer an explanation anyway. Carvedilol is the preferred choice of beta blocker in these circumstances.
I wish you and your husband all the very best in the future.
no banding required barely seen a varices
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Varices Banding
