Endoscopy on Gullet

[LolaBow]

Hi all, I had my 6 mth scan last week, where the scanner scanned my liver, kidneys and spleen. ( I thought I was just having my liver scanned) . I went to hospital yesterday to get my results from my consultant. This is where I'm confused. My liver hasn't changed from early cirrhosis and my bloods are OK. What he did say was my platelets are low and I'm to have a endoscopy down my gullet has my veins could be either too thick or thin ( they won't know until they check) and they may have to be banded or I could bleed out?? Can anyone explain to me what this is?? I'm confused, and now abit worried I might start bleeding before I get my date for the procedure.

[AyrshireK]

Having an endoscopy is fairly common when you have cirrhosis.

The scan will have indicated that you probably have a degree of Portal Hypertension which is where blood that normally flows happily through a healthy liver can no longer do so because of the scarring within the liver. Because it can't flow easily it starts to back up in your veinous system and starts to find alternative routes in different veins around the body (imagine there is a traffic jam on a major road and cars start to try and find rat runs through narrow side streets etc. Same sort of thing) - this can lead to pressure building in small blood vessels which were never intended to carry such an increased volume and their walls start to bulge - these are known as varices and are commonly found in the oesophagus/gullet, sometimes also the stomach and less commonly the bowel. This is the reason you are having the endoscopy. Treatment for varices includes banding of any that look in any way likely to burst, putting a band round the bulge in the vein causes the banded area to shrivel up and scar so that more varices can't form there. (My hubby had an initial varices bleed that alerted medics to his cirrhosis and went on to have 42 varices banded over a 2 year period whereby his were eventually eradicated and he had no further ones).

Are you currently taking a beta blocker such as carvedilol or propanolol? These are often prescribed to reduce portal hypertension.

Your 6 monthly abdominal scan will always check out your other organs. It checks the liver for any changes - additional lumps and bumps that might give an early heads up for potential liver cancer (cirrhosis slightly increases the risk), it checks your spleen as this will often enlarge due to cirrhosis and is also the reason for your reduced platelet count. Having liver disease can impact the kidneys so they always check them and if they can see it they'll look at the gall bladder and pancreas. The scan can also identify the presence or not of ascites.

You can't know whether you'll have a bleed before your appointment (hopefully not) but signs to look out for are any blood in your bowel movements. If you are bleeding internally you may see fresh blood and/or your stools may become tarry and sticky. Any of these signs would mean an immediate trip to A&E. If you were to vomit blood (coffee granule like or fresh blood) then again immediate trip to A&E. (These were what alerted us to hubby having his massive first/only bleed).

They will give you the option of numbing throat spray and/or sedation at your endoscopy. Having the sedation means you need someone to drive you home and be on hand for the next 24 hours BUT it means you shouldn't be aware of the procedure which takes literally less than 5 minutes. (I sat with hubby enough times pre and post endoscopy to know he got whisked away and was back within 5 minutes even when he was having banding). You stay at the hospital for a wee while to sleep off sedation and I know my hubby would sleep again later. After banding your oesophagus can be sore for some days - imagine eating past a mouth ulcer but internally so soft diet is essential until it wears off.

Hope this answers some of your queries.

All the best,

Katie

[LolaBow in reply to AyrshireK]

Thank you so much for all this information, I'll definitely keep a check on any bleeding while waiting for the appointment.Kind Regards

Tina

[Petrina_gmfc]

Why don't you phone the liver nurse up and they can tell you what it means. Hope you get on ok let me how you get on

[LolaBow in reply to Petrina_gmfc]

Hi, I don't like bothering them, The lady who replied above explained it brilliantly, I'll let you know how u get on. Thank you for replying back

[SirRobert in reply to LolaBow]

I certainly would give them a call, they won’t mind at all. I rang them when I had an appointment through for an endoscopy (also received lots of helpful advice on here!). As Katie has detailed, they also described what to be aware of and talked through the process and why it’s common to be sent for one, which was really helpful and reassuring. Nice to be able just to chat it through. The paperwork-data entry checking my details took longer than the actual endoscopy! All the very best.

[LolaBow in reply to SirRobert]

Thank you, my appointment has come through, 2 weeks today 🤞

[Petrina_gmfc]

You are welcome

[taar]

AyrshireK is brilliant for advice. I wrote on here in Dec 2018 about vomiting blood and Katie told me to get to A&E immediately, I am so glad I did,,,4y later, liver transplant!

[Pie-eater]

I have the throat spray if they are just looking but if there’s a possibility of banding they put a cannula in so if they find any varices they can the sedate me.

[LolaBow in reply to Pie-eater]

Thank for this, I'll definitely want sedation, just had my appointment.. 2 weeks today.

[colin324]

They are checking for Varices - common with portal hypertension caused by cirrhosis. You can get them in lots of different places - they can do a CT scan with contrast to show where they are internally, but an OGD gastroscopy is the best way to visualise and possibly treat any varices found in the oesophagus, stomach, duodenum, etc. They can band, embolise or inject them with a chemical/glue to block them off.

I have annual MRCP and abdominal MRI, abdominal ultrasound (6 months after MRI scans), OGD gastroscopy, flexible sigmoidoscopy, ileoscopy, bi-monthly bloods to monitor the PSC, cirrhosis and the other issues that they cause.

I have varices around my stoma and in my oesophagus. The stomal one bleeds frequently - got my diagnosis following a massive bleed where I lost between a quarter and a third of my blood volume. They did say they could embolise the vein feeding the varix, but it could cause me to bleed elsewhere. The ones in my oesophagus didn't need treating, so I just stay on annual monitoring instead. My CT scan said no to TIPS as a treatment, so it looks like any more significant bleeds will put me on the transplant list.

[LolaBow in reply to colin324]

Thank you for this info.. hope you don't have to go on a transplant list. All the best .