Cirrhosis?

[Mizcole]

Hi again just wanted some clarification in regards to Oesophageal varices. I was diagnosed with NASH in late 2019 after an endoscopy and ultrasound. I have had a Fibroscan each year and the last one last year was F1. In April I had another Endoscopy because my iron was low and they suspected I had bleeding varices. It was found that I had 3 grade 1 varices but no bleeding. I was surprised because I thought that this was associated with Cirrhosis. Am I to assume that my next Fibroscan will go from F2 to Cirrhosis? I also heard that to have varices I would have to have Portal hypertension?. It just makes me question my Fibroscan results and unfortunately my doctor isnt very forthcoming. I would also like to know if anyone has varices and how they are dealing with this. I have a large hiatus hernia that is causing me blockages and it needs to be removed but no-one wants to operate because it is located near the varices so i am wondering where this leaves me???

[Bluegreensky]

Hi Mizcole, I had an upper endoscopy in 2011 where I had 7 grade 3 Varices. They were “banded” though not bleeding, and I had year where I was checked every 2 months. I was then put on propranolol to slow my pulse because I had portal hypertension.

Sounds like you are at an early stage of varices. I do have cirrhosis of the liver, but I was diagnosed with PBC and NAFLD when I was 40. I am now 66 years old. I had only grade 1 varices for many years until 2020 when I had 3 more grade 3 varices banded. I was checked 3 months, then 6 months, then 9 months, and now I get checked once a year and I’ve been ok, but always grade 1, which I’ve been told is just the varices “flattened out.”

It was very scary to me, but I’m amazed that all of this can be managed so far…

I’d be glad to try to answer or at least discuss this with you further, so don’t hesitate to talk if you’d like to. Hope this helps you in some way -

Debi

[Mizcole in reply to Bluegreensky]

Hi Debi thankyou for your reply. I am wondering why mine weren't banded upon discovery but I think she said they weren't bleeding. I have been on a high dose blood pressure medication for years but I will ask re the Propranolol. I main concern at the moment is that my hiatus hernia that I have had for quite some time is giving me grief and the most severe reflux which is worse at night unless I am sitting up. I am getting complete blockages where my food is getting backed up in my Oesophagus. I have lost 7 kilos simply because I am eating very little due to my problems with my hernia. I have been told by my previous bariatric surgeon that he won't do a gastric bypass or repair my hernia so I am at a loss as to navigate through my issues with my hernia. I have an appointment next week with a gastro who sometimes does surgeries that others won't do and whilst I know this is radical and risky, I feel I have no choice.

[caseycharmer2233 in reply to Mizcole]

when you had the banding what were your healing and eating problems if any? I was told I have varices without bleeding that may need to be banded...just wanted to hear from someone who has had it done as to how long for recovery to do normal things and the food you can have.. and if you had pain ect...thanks if you care to reply OR if anyone on here cares to answer I would really appreciate it.

[Mizcole in reply to caseycharmer2233]

Hi hun, I didn't have them banded as they weren't bleeding but I am wondering if I should have as I need to have a hiatus hernia repair and it makes sense to have them done so I have an appointment next Thursday with a Gastro-enterologist so I will get his opinion.

[andrewax2 in reply to Bluegreensky]

Hi Debi. I had a family member diagnosed with an enlarged varice and there was one that was bleeding but appears to have stopped when she got her second endoscopy done and after being put on betablockers. Do you have general advice or tips on how to improve this?

[kraymates]

Hi Mizcole,

I have autoimmune hepatitis, which led to cirrhosis. I have had many esophageal varicies rupture. I had an endoscopy originally that found I have varicies, however they did not require banding at that time. Eventually the varicies ruptured and was identified when I realized I had internal bleeding. In my case, I went to the ER on a Friday, and my red blood count was just below lowest normal range and advised to keep an eye on it as it appeared closer to be maybe more hemroidal or something closer to that region. Come Monday, I was not feeling well and it appeared the internal bleed escalated. They did find 4 varicies that required banding, and I lost enough blood that I required a blood transfusion.

May situation shouldn't lead you to worry you will experience the same, and thankfully you are aware you have varicies and the medical plan is to keep tabs on it. I had to transition from a GI doctor to a hepatologist to have a better focus on my liver and the approach being taken to help get my liver enzymes and other numbers under control.

If your doctor is not very forthcoming, I would be looking for another doctor. They really should be really sharing any and all information you seek, and maybe completing better tests to understand what is truly causing this. In my case it was ultrasounds, biopsies, an MRI all to ensure a better understood what is the root cause. If I had gotten to the hepatologist sooner, I feel my situation might have been under better control sooner, and not escalated to where it got to.

My thoughts are with you that you get better information, and a more compassionate approach to better understanding and treating your situation.

Keith