Banding Treatment for Esophageal Variceal Bleeding

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How to Deal With Esophageal Varices

If you're reading this article, either you or someone you know may have just discovered they have esophageal varices, quite possibly through a frightening trip to the emergency room. Esophageal varices are swollen blood vessels at the bottom of your esophagus which are very fragile and can bleed, sometimes with fatal results. It's important to understand why such varices develop, and how they can be prevented from threatening your life.


  1. Get an endoscopy to confirm the presence of esophageal varices.If they are bleeding, you will likely be rushed to an emergency room and given an endoscopy as soon as possible to determine the source of the bleeding. During the procedure, esophageal varices can be recognized and are often banded (endoscopic band ligation)in order to stop the bleeding and cut off circulation to the esophageal varices. Sclerotherapy is also an option. If an endoscopy cannot be performed, imaging tests are an alternative, although they are not preferred.
  2. Understand how varices develop.Esophageal varices are commonly associated with portal hypertension, whereby the portal vein (which normally drains blood away from your digestive system and associated glands and sends it to the liver for filtering) is under increased pressure, so blood is pushed through alternative routes. One of those routes is through the vessels in the esophagus, which aren't really equipped to handle such increased blood flow. Because they're doing overtime, so to speak, they are delicate and prone to rupturing.
  3. Determine the source of your portal hypertension.The most common cause is liver damage (cirrhosis), but it can also be the result of severe congestive heart failure, a blood clot somewhere in the portal vein system (thrombosis or Budd-Chiari syndrome), inflammatory disease (sarcoidosis), or a parasitic disease (schistosomiasis; more common in the developing world). Blood tests are necessary to pinpoint the cause. If liver damage is suspected (especially if the patient is an alcohol user or had a blood transfusion in the past), the physician may feel that a liver biopsy is necessary.
    • In Western countries, the most common causes are alcohol use and viral cirrhosis.
    • Hepatitis B is a more common instigator in the Far East and Southeast Asia, particularly, and South America, North Africa, Egypt, and other countries in the Middle East.
    • Schistosomiasis is more closely associated with portal hypertension in Egypt, Sudan, and other African countries.
  4. Manage your condition as recommended by a physician.
    • Diet - A dietitian will often recommend that you stop consuming alcohol and begin a low-sodium diet (unless your blood pressure in characteristically low, in which case a low-sodium diet may not be wise).
    • Medication - Your doctor may prescribe medication to lower your blood pressure, reduce acidity in your digestive tract, and combat the symptoms of hepatic encephalopathy (where toxins that would normally be filtered by the liver interfere with cognitive functions).
    • Surgery
      • A shunt, or a transjugular intrahepatic portosystemic shunt (TIPS), is a tube that carries blood from the liver back to your heart so that varices don't form. Because of complications that can result from having a shunt, it's usually a last resort, or a temporary measure until a liver transplant can be completed.
      • A liver transplant may be considered if there's severe or recurrent bleeding from varices that all other treatments have failed to prevent. You may be placed on a waiting list, and possibly face additional obstacles if your liver damage is due to alcohol consumptions.

Community Q&A

  • Question
    I have developed small red spots that itch and then bleed. They are located on my upper back, torso, and legs. Could these be symptoms of bleeding varices?
    wikiHow Contributor
    Community Answer
    No. Esophageal varices are located in your foodpipe, or esophagus. They are often related to alcoholism. They do not occur outside the esophagus. This sounds like a skin condition. See your primary care doctor or go to dermatologist.
  • Question
    Can I consume alcohol if I have varices?
    wikiHow Contributor
    Community Answer
    It is probably not a good idea. Alcohol can affect bleeding and consuming it may only aggravate the condition.
Unanswered Questions
  • Are there foods to avoid to help protect the varies from rupturing?
  • Is it safe to fly if have esopage?
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  • There are no symptoms of esophageal varices, even if they are bleeding. You may not know you have them until you vomit blood or go into shock, both of which are life-threatening situations. Consider it an emergency if you start exhibiting the symptoms of hypovolemic shock caused by loss of blood:
    • Rapid pulse
    • Pulse may be weak (thready)
    • Rapid breathing
    • Anxiety or agitation
    • Cool, clammy skin
    • Weakness
    • Pale skin color (pallor)
    • Sweating, moist skin
    • Decreased or no urine output
    • Low blood pressure
    • Confusion
    • Unconsciousness
  • Portal hypertension can also result in the formation of hemorrhoids.


  • If the esophageal varices have already bled once before, there is a 70% chance of them bleeding again, and a 30% chance of each subsequent bleeding episode being fatal.This is a sobering thought, so don't take your condition lightly, and don't take life for granted.

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Date: 07.12.2018, 03:14 / Views: 95252