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does pain signal an internal bleed?

Please can anyone help? My husband, who has varices, portal hypertension and some ascites, as well as an enlarged spleen and gallstones, has started to experience severe pain which 60mg of codeine hasn't shifted. He has pain most days but not so severe as today's. He says he had awful pain in the night, too. Is this new kind of pain a sign that he may be about to have an internal bleed - are they related? He refuses to get any medical attention as they usually think he's having a heart attack despite his protests, do unnecessary tests and send him home...I am very concerned about him. Thank you for reading this xxxx

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My hubby never experienced any pain even whilst having an internal bleed (he had 7 varices burst which is what first brought about the discovery of his cirrhosis). In the run up to him vomitting blood he felt uneasy at times, being unable to get comfortable but no pain. He was passing blood in his stools before he had the massive bleed.

The gallstones and enlarged spleen could be a source of pain - when my hubby's spleen died after aneurysm operation he was in absolute agony for weeks.

Men a blooming hopeless at seeking medical help but if you even suspected an internal bleed it should be examined as a matter of urgency, we've repeatedly been told that hubby was close to death due to his massive bleed.

Katie x


thanks Katie, that's very helpful - I have more idea now of what a bleed involves and I know how serious it is -at the mo he isn't vomiting blood I know that's the major 999 thing - probably it's a bad day, hope tomorrow he will feel better. All the best to you and your hubby xxxx


Hello Katie,

That's an interesting point that you mention your husband was passing blood in their stools prior to a major bleed.

I have a relative with suspected liver cirrhosis awaiting biopsy. She's had rectal bleeding on and off for a long time +had a colonoscopy but nothing was found. So possibly bleeding varices?? Although I thought she'd be vomiting blood if she had oesophageal varices.

Problem is she's flying soon and has been told that risk of varices from portal hypertension is rare and a risk of a major bleed is even rarer and has been told it's ok to fly, although everything i've read suggests otherwise.


My hubby was passing blood for some time in his stools so his varices were bleeding for a while before there was a massive bleed from 7 which lead to the vomitting of blood as it had begun to pool in his stomach and the body doesn't like that. His vomit was a mixture of fresh red blood and darker blood with the typical 'coffee granule' consistency they describe with burst varices.

If your relative is passing blood from an 'all clear' on the colonoscopy then it would indicate no piles or bowel varices but oesophageal varices a distinct possibility.

I don't know about the rarity angle on varices from portal hypertension it seems to be the thing everyone with cirrhosis gets checked on a regular basis via endoscopy. My hubby ended up having one every 5 weeks or so when his consultant went 'aggressive' on a banding regime resulting in 42 varices banded in a two year period - thankfully his last two endoscopies have shown his varices to be (currently) eradicated though he will continue to have an annual endoscopy (at least).

Normal information I've heard on flying with varices is that it is very dangerous, anyone with suspected varices is meant to have an endoscopy in the weeks prior to flying to ensure none are present since the increase of pressure in flight can lead to them rupturing, indeed, we had a guy on the British Liver Trust forum who was flying when his burst and the plane had to make an emergency landing in France for him to be hospitalised.

I think your relative really needs this situation clarifying before flying - it would also impact on travel insurance.



Hope your husband is better...don't listen to his protests and get medical help.

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thanks...he is a bit better again, the pain has lessened and he has been seen by his GP who can only suggest codeine as and when but is trying to get his first appt with a hepatologist put forward from October. Hope your relative will be OK. I would be very wary of any flying, however. xx


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