Cirrhosis Support Group

For myself where as I don't have high blood pressure. I am taking 2 different types of blood pressure meds to help.

Good question. It would be great if you can avoid them. I'd sure like to know, too.

I'm sorry that I don't have that info. If you're scared, like I was, of varisces, here's what I do know about having them and prevent re-occurrence. If it's not helpful or what you were looking for, I'm sorry and sincerely apologize for missing the mark. It seems a palty offering, really, but here goes ...

I can only tell you what I experienced from having them.

I didn't get varisces for the first 5 or so years after progressing from "fibrosis" to "cirrhosis".

Varisceal banding ... if you do get them, has worked well for me in preventing re-occurance.

I had one minor bleed from the varisces which is how they discovered them. The "bleed" was black tarry stool, no vomiting, etc. Not too scary or serious really (honestly).

From what I've read it's a pretty lucky outcome. Because of the bleed, I now have progressed to decompensated cirrhosis, although most folks in end stage liver disease have way more serious symptoms than I do.

To prevent varisces, they have done varisceal banding on three occasions, and I take low dose nadolol - 40 mg. which seems to help prevent further troubles.

Banding is done during an endoscopy, and is painless and simple. In an endoscopy they give you conscious sedation and you're in and out in 15 minutes, banding included (where I am that's the procedure anyway). The first time was scary because I didn't know what to expect. I'm a pro now. I'm not being flippant, it is a simple procedure, and it's just like getting used to having blood taken so much, or so many ultrasounds, etc. You do get used to it.

My GI did an endoscopy every 6 months for 2 years while the banding was required (i.e. varisces were present that required the banding) and now I only have to go annually unless more varisces become apparent.

After the bleed I had to take pantoloc for acid reflux/indigestion for about 1 year. It took some time for my system to settle down after the bleed. I was hospitalized with gallbladder issues about a year later but that, too, settled down.

At the risk of too much information, I want to say this: the hospital my GI is at has a clinic with a psychologist. When they started saying "decompensated cirrhosis and varisceal bleed" to me, I needed her. She was incredibly knowledgeable as she specializes in end stage liver disease patients (just as she had previously specialized in end stage cancer patients) ... believe me she knows her stuff. Anyway ... she was able to bridge a gap between my GI doc and the info I needed. I was frustrated at not knowing what NEXT to expect. While I realized in receiving treatment with her that everything NEXT seemed pretty scary, it was good to know more facts.

I don't know if any of this helps. I sure hope so.

Preventing liver disease from progressing seems to be the most important thing we can do for ourselves. To that end, I try and rest lots, eat right, don't drink smoke or do drugs, and am lucky to have an extremely good quality of life with tremendous family and friends who suport me. At times that's not enough, is it? But I know there's much much more I could do to be in better health.

I'm hoping that by joining this group I'll get to know more.

Thank you so much for your posts.

FromCanada....I really appreciate your input.

So basically it is high blood pressure that causes varices?

Portal Hypertension causes varices. Portal hypertension occurs because the liver has effectively become a blockage rather than a conduit, so blood tries to find its own way around the liver. Basically varices are hemorrhoids of the throat.

Improved liver function will decrease portal hypertension, high blood pressure will increase it. Avoiding strenuous exercise will help keep your blood pressure down. Other than that there doesn't seem to be much you can do about it.

Taking diuretics such as Lasix will decrease blood pressure. A shunt (TIPS) is a solution but it comes with all sorts of nasty side effects!

Varices can be 'banded' or superglued to stop them leaking!

I'm glad I don't have varices!!!

Craig

Hi to fromcanada interesting post .

I think the cause of the varices is portal hypertension.
when the blood is not passing through the liver at the correct rate due to liver fibrosis
and so backs up and expands the veins in the gut

This is not the same as normal blood pressure, which may still be normal.

I have had the endoscopy no varices were found, but a pre ulcerous condition was seen and I was treated with Proton pump inhibitors PPI
I suppose once you have bled the fear of it starting again is always there.

Keep well
Regards

I did not say high blood pressure was the CAUSE of iy.
I'm sorry if I spoke out of content. I won't speak again.

Hi Rob4 support
I don't think Sockfuzz read your post correctly!

If they are doing a transjugular liver biopsy, the doc can measure the blood flow in the portal vein (portal pressure or gradient) if this number is above 12 then your chances of developing varices are much higher than if it is lesser than 12.
My son's gradient was 15 and when they did the first endoscopy, he had four varices although non were to the stage of bleeding, they banded and rebanded them until non reappeared.
The cirrhosis ends up not only on the outside of the liver but also builds scar tissue within the inside too. Along the areas where blood could flow at ease.. the veins start getting congested because of the tissue build up. (I had the hardest time realizing this fact!! I always assumed that cirrhosis was on the outter surface and it took me awhile to understand, through plenty of research sessions, the whole process)
There is no way to avoid varices, but having endoscopies every so often might let you stay ahead of them.
Good Luck {:o)

It is not everyone that gets them and a healthy diet and some exercise, MIGHT help preventing them. High blood pressure does not cause it, per se, however Doctors usually prescribe blood pressure meds as told by Rob, who should not worry about eventual errors, and our Canadian gal -pal.

I may be wrong (again) but it seems like varices is a lot less common that the other two nasties ascites and HE.
In fact in terms of popularity ranking it would classify them as follows:

1. Ascites (most common)
2. Encephalopathy
3. Varices

However, confusingly, varices often seems to be the first sign that something is going wrong!!!! particularly with alcoholic hepatitis....

Am I wrong?

Craig