varices

[Rgd496]

Hi first time posting here. I have been dealing with liver disease for 28 years now , it has progressed to end stage liver disease. About 3 years ago they found i had esophageal varices they ended up bleeding a couple of weeks ago ended up in the hospital for a week receiving 3 units of blood they banded them but now when i eat i have pain in my chest has anyone experience this and does the pain go away also what are the odds of a rebleed thanks

[nash2 Partner]

Hi Rgd

I haven't had them yet myself but reports are very individual. Some people have a lot of pain others little to none so its hard to predict. Conceptually there is wounded tissue so it should resolve as it heals but it does persist for some people. Rebleeds are a risk so I imagine your doc will schedule you to be scoped from time to time as a precaution. The probability is a function of your portal pressure which most patients don't have measured but that probability is mostly an exercise as it all depends on your particular anatomy.

Good luck

Wayne

[BU2B]

I have yet to get to the bleeding stage but I am currently in the process of having multiple bandings performed.

To date I have had 11 ligations 6 1.5 months ago, 5 .5 months ago and at least 1 more to go at the end of this month. I found that the first time was the worst for nausea as my body really doesn't like blood where it's not supposed to be and a biopsy was done. It only took a day or two before my throat quit feeling like the turkey at a Thanksgiving day feast. The second time took quite a bit longer to get back to feeling normal and after 5 days I still had pretty significant discomfort from just trying to drink a cup of coffee. I'm not really looking forward to the third time and so on.... but it is better than the option of a bleed. Living where I do, it is 2.5 hours by ambulance 1 hour by plane to the nearest hospital that could do anything. Meaning a very good chance of getting on the plane and them taking my body off.

I know it's a bit hard to 'swallow' right now, but you really are very lucky to have been close enough to emergency facilities that could handle your situation and that the banding has been done. Taking it slow is not a bad thing if you need to.

My gastroenterologist is the one doing my bandings and the way both he and my Liver Specialist explained it varices are not to be taken lightly and though I don't really like the news - here is the sight I was directed to ncbi.nlm.nih.gov/pmc/articl...

Please note this IS NOT specific to FLD but does address varices and cirrhosis (Endstage Liver Disease) and is ONLY posted here for reference please have a detailed talk with your Hepatologist regarding your particular individual case - here's a summary of what the paper states:

Methods:

Between 1984 and 2001, 287 alcoholic cirrhotic patients (225 men, 62 women; mean age, 51.9 years; range, 24–87 years; Child-Pugh grades A, 39; B, 116; C, 132) underwent a total of 2565upper gastrointestinal endoscopic sessions, which included 353 emergency and 1015 elective variceal injection treatments. Variceal rebleeding, eradication, recurrence, and survival were recorded.

Results:

Before eradication of varices was achieved, 104 (36.2%) of the 287 patients had a total of 170 further bleeding episodes after the first endoscopic intervention during the index hospital admission. Rebleeding was markedly reduced after eradication of varices. In 147 (80.7%) of 182 patients who survived more than 3 months, varices were eradicated after a mean of 5 injection sessions and remained eradicated in 69 patients (mean follow-up, 34.6 months; range, 1–174 months). Varices recurred in 78 patients and rebled in 45 of these patients. Median follow-up was 32.3 months (mean, 42.1 months; range, 3–198.9 months). Cumulative overall survival by life-table analysis was 67%, 42%, and 26% at 1, 3, and 5 years, respectively. A total of 201 (70%) patients died during follow-up. Liver failure was the most common cause of death.

Conclusion:

Repeated sclerotherapy eradicates esophageal varices in most alcoholic cirrhotic patients with a reduction in rebleeding. Despite control of variceal bleeding, survival at 5 years was only 26% because of death due to liver failure in most patients.

Please note that my Liver Specialist was quick to point out that he does have one patient still kicking 10 years after multiple bandings.

All my best wishes for a speedy recovery. PLEASE do not hesitate to contact your Liver Specialist/Primary Care Physician/AND - or your EMS if symptoms and discomfort become noticeably worse.

[Rgd496 in reply to BU2B]

Thanks for the advice and the link. I go in to get my third banding in 2 weeks hopefully the pian won't get any worse

[kensimmons in reply to BU2B]

Great link. That article is from 16 years ago with 5 years of backward tracking data (thus making some of what is written about 21 years old) so I wonder if things are not even much better now?

Thanks again, good info.

[Kji378]

Hi 🙂

Yes I had a few but only two banded, they were Grade 2 Varices. I understand the pain I think, if it is the same. I have never had a bleed though touch wood.

After banding, it really hurt after I had eaten something. After swallowing, I could count to 5 and then argh, it would be the exact place in the esophagus that was banded. Foodies, stay away from bread or anything that can swell, I lived on rice pudding, custard, for 2 weeks. Some mashed potato even tinned tomato soup irritated, I presume as it was quite acidy. It does get better, ice cream, jelly, you could see what they say.

The tissues have taken a battering with all the poking and foreign objects, so it will be sore.

I hope this helps.

Take good care 🙂

[Rgd496 in reply to Kji378]

Thanks for the encouragement. I have notice breads are bad i ate a piece of dense wheat and honey bread yesterday and thought i was going to die. Hopefully this third banding will be my last and i can start healing.

[Kji378 in reply to Rgd496]

It's rotten isn't it. I can empathise. Do you know how many were banded and how many others need banding in three weeks?

[Rgd496 in reply to Kji378]

I had 4 banded when i had the bleed the second was a reband of 3 of the original and the third will be a reband of the same 3

[Kji378 in reply to Rgd496]

Oh crikey you must be in a lot of pain. You are in the US right? Do they grade the Varices the same as the UK ie Grade 1,2,3 ?

[Rgd496 in reply to Kji378]

Iam in the us they graded mine at a 2

[Kji378 in reply to Rgd496]

Good luck. 👍

Lots of thin soup, avoid bread.

Take good care, I hope this next one is the last for you.