Re: question re bleeding

August 2, 2006

An enlarged spleen can be the result of portal hypertension which

can also result in varicies. Although I haven't had a variceal

bleed, others in the group have. Below are excerpts from their posts.

Tim R

athan has written:

64680 Sep 24,2004

when I had my bleed. I got dizzy, nauseated and finally vomited.

Then I stood up and passed out. I ended up in the hospital for four

or five days and had to get four units of blood!

76548 Sep 12,2005

If your having black tarry stools you should go to the Emergency

Room ASAP. I had this a few years ago and it turned out I was having

a major GI bleed (from varices in my esophagus) which could have

been fatal if I hadn't gotten to the ER in time. Others in this

group have had similar experiences.

76553 Sep 12, 2005

I would add that if you start feeling dizzy when you stand up, or if

you feel sick, especially when you are standing it would be a good

idea to go to the ER. I was feeling sick for about 12 hours (chills,

dizziness, nausea etc.) before I started vomiting blood, and

actually ended up passing out once when I stood up too quickly. I

believe others here have had serious bleeds without ever vomiting at

all, so don't use that as your only criterion for going to the ER.

Hopefully there's someone with you too... I know that I was too weak

to make it to the phone for a while (about the time I passed out!).

If not at least be sure you have the phone within easy reach...

78218 Wed Oct 26, 2005

someone who's been vomiting blood shouldn't try to drive themselves

to the ER (or anywhere else). If there isn't someone else to drive,

call an ambulance. By the time I got to the hospital I was on the

verge of passing out due to blood loss (actually I did pass out just

before we left the house, but I revived after falling over...

luckily onto the bed). If you aren't in an ambulance, it is possible

to call ahead to the ER and let them know you're coming, and what's

wrong. That can help expedite things too.

Anyhow, I guess that having gone through this experience, and having

had my life saved by going to the ER (I probably wouldn't have made

it 'till morning if I'd decided to wait and call my doctor), I tend

to be very emphatic about it. There are other people here who've had

even closer calls that I did.... A GI bleed isn't something to mess

around with!

Aubrey Goldstein has written:

11476 May 10, 2000

the last day of work I had a full backpack of binders to return and

another to take home. I'm sure now that this effort caused my final

variceal bleed. Luckily for me, my clotting ability was still good

as I must have stopped bleeding at some point. I was more tired than

usual after coming home that day. The next morning the room spun

when I tried to get out of bed. Having had this happen two years

earlier after a bleed from an ulcer, I knew what was going on. I

slowly rolled out of bed and after staying on all

fours for a bit, sat up and waited for the room to stop spinning.

After sitting on the bed side for a bit I got dressed and we called

a cab to go to the hospital. ( I know it sounds a bit crazy.) But I

was feeling better by that point. After being examined, I went into

shock or perhaps had a vasovagal episode. They had to resuscitate me

and at the same time scope me and band my varices. I was aware

enough to know what was going on but I couldn't respond much.

Caroline, my partner, had to hold my hands to prevent me from trying

to pull the scope out!

8451 Jan 31, 2000

There is nothing you can do to stop the varices from happening.

However, you can do a few things to make sure the ones you have

don't bleed. Chew your food a lot so that it's soft and small in

size going down; no hard things that might irritate your varices. No

heavy lifting of anything, including you. Less than 10 lbs,

preferably less than 5 lbs. Be careful getting up. Do it slowly

especially from lying position.

Don't hold your breath when geting up, breath out continuously. This

prevents increased pressure in your abdomen and chest, reducing the

pressure in your veins. By the same token make sure you eat a lot of

fiber so that your bowel movements are soft and so you don't have to

bear down to pass them. Again doing a valsalva manouveur (bearing

down to stimulate your bowel) greatly increases the pressure in your

veins, increasing the risk of bleeding.

Don't drink alcohol, take ASA, or NSAIDs, gingko biloba, vitamin E.

All these things reduce your ability to clot which increases the

risk of bleeding and of bleeding to death from your varices.

I almost bleed to death from my varices prior to my tx. I would

suggest you talk to your MD as I think you should be listed. Enzymes

levels are not as important as signs of disease. And varices and

variceal bleeding are very important signs. Bleeding from my varices

moved me to number one on the O list.

8556 Feb 2, 2000

3. Hypertension may increase the risk of variceal bleeding. Others

have mentioned that beta blockers (inderal) may lower the risk of

bleeding by reducing blood pressure. Some people can take these

drugs but others become even more fatigued or it drops their BP too

low for them to function.

4. The only way to tell how bad your varices are or if you have them

is to have an endoscopy. MRIs and CT scans can show varices but they

can also miss them. Endoscopy can see them well and treat them with

banding or sclerotherapy if required.

5. Taking calcium and vitamin D may help but because there is a

problem with metabolism in patients with PSC and UC these

supplements may not help or may just prevent further loss. The other

problem is that calcium tablets are fairly large and may irritate

varices causing them to bleed!

August 2, 2006