Varices, vascular lesions, portal hypertensive gastropathy and erythematous gastritis

[Blueberriesandcream]

Hi I have have type 2 diabetes which seems to have turned into nafld. It now looks as if it's liver cirrhosis and the gastroscopy which I've had a week ago has shown varices:3 grade 2, vascular lesions: portal hypertensive gastropathy and gastritis: erythematous no bleeding. I have had my bloods done but no results yet - I just wondered if anyone can tell me what these things mean. Thank you so much.

[AyrshireK]

Portal hypertension is when the huge quantity of blood which would normally pass easily through a healthy liver can no longer do so because something in the liver is causing a blockage or slowing down flow (often associated with cirrhotic changes in the liver but not always - there are cases of non-cirrhotic portal hypertension). Because the blood flow is now restricted it starts to back up and tries to find alternative routes around the obstruction and this often means it buids up in smaller blood vessels which were never designed to carry such increased volume. In turn this causes the blood vessel walls to swell/bulge leading to varices and other changes in the gastro-oesophageul system (such as changes to the stomach lining).

If you have varices that are at risk of bleeding they should treat them by banding and/or may introduce a beta blocker (such as Carvedilol / Propanolol) to reduce the portal hypertension. They may also prescribe a PPI/Proton Pump Inhibitor to protect the stomach lining from excess stomach acid (Omeprazole or similar).

In light of a pre-existing NAFLD diagnosis they are obviously going to have to check whether this is indeed a worsening of your diagnosis i.e. is it now cirrhosis? There is no treatment other than what you can do yourself with regards to diabetes management, healthy diet and exercise and if it is cirrhosis then you'll go onto the monitoring regime for that - 6 monthly scans (to check for any liver changes, lumps, bumps etc.) and 6 monthly (or more frequent) bloods plus you'll need to keep an eye out for any symptoms of cirrhosis that may start to show.

Your doctors will have seen this all before and should take good care of you.

Katie

[Blueberriesandcream in reply to AyrshireK]

Thank you very much. That's really helpful.