RE: Esophageal Varices Bleed & other terminology

[Guest guest]

In a message dated 10/30/01 7:30:22 AM Pacific Standard Time, TerriMM@... writes:

In reading these posts, there are many references to esophageal varices bleeds, banding, ascites, etc.., I'm not familiar with these terms, would someone explain what they are?

Terri, here is an excerpt from Palmer's "Guide to Liver Disease":

The most serious complication of cirrhosis is bleeding esophageal and gastric varices. This complication occurs when the blood pressure in these blood vessels becomes so high (a condition known as portal hypertension) that they literally explode. When this happens, profuse, life-threatening bleeding results. In fact, it is estimated that between 30 and 50 percent of people could die within one to two monhths of their first episode of bleeding varices.

Doctors can stop the bleeding during an endoscopy by injecting a clotting agent directly into a dilated blood vessel (also known as a varix.) This procedure is known as esophageal and/or gastric sclerotherapy Alternatively, the doctor can stop the bleeding during an endoscopy by strangling the bleeding varix with a miniature rubber band. This procedure is known as esophageal and/or gastric variceal ligaton. Since these procedures stop the acute emergency but do not prevent recurrences, patients should be placed on a beta blocker (such as Inderol) . . . If the above-mentioned methods fail to stop recurrent bleeding, a man-made shunt should ber considered."

I strongly recommend that you keep Dr. Palmer's book on hand as a reference. Dr. Gorman wrote a similar guide, also very good.

Harper

[Guest guest]

In a message dated 10/30/01 8:45:53 AM Pacific Standard Time, dagelo@... writes:

Thank you Harper, I was dx AIH 1/ 2000. I do have cirrhosis, portal hypertension, hepatic encephalopathy, predisone induced diabetes, etc. I have gone through 4 endoscopies with bandings of large vessels....I remain alive on imuran 100, pred 10, corgard 80 (betablocker), lactulose 4 times a day, aldactone and lasix for asites, multi-vit, etc. I've had 2 liver biopsies with same dx of advanced AIH liver disease. However, I have been able to stabilize the disease process with proper medical care.

I wish you all blessings and love,

Good for you, !

harper

[Guest guest]

Thank you Harper, I was dx AIH 1/ 2000. I do have cirrhosis, portal hypertension, hepatic encephalopathy, predisone induced diabetes, etc. I have gone through 4 endoscopies with bandings of large vessels....I remain alive on imuran 100, pred 10, corgard 80 (betablocker), lactulose 4 times a day, aldactone and lasix for asites, multi-vit, etc. I've had 2 liver biopsies with same dx of advanced AIH liver disease. However, I have been able to stabilize the disease process with proper medical care.

I wish you all blessings and love,

[Guest guest]

In a message dated 10/30/01 3:11:37 PM Pacific Standard Time, suerivoire@... writes:

Harper,

What are the symptoms of esophageal varices bleeds?

Sue (Oregon)

Can someone else take up this discussion, as I'm not knowledgeable on this subject. I haven't had bleeds and am not a high-risk candidate for them.

Harper

[Guest guest]

anyone that wants to know about bleeds just ask.I have been banded about 15 times with some very serious bleeds in the beginning.

Greg

Houston, TX

[Guest guest]

Harper,

What are the symptoms of esophageal varices bleeds?

Sue (Oregon)

-----Original Message-----From: flatcat9@... [mailto:flatcat9@...]Sent: Tuesday, October 30, 2001 7:45 AM Subject: Re: [ ] Esophageal Varices Bleed & other terminologyIn a message dated 10/30/01 7:30:22 AM Pacific Standard Time, TerriMM@... writes:

In reading these posts, there are many references to esophageal varices bleeds, banding, ascites, etc.., I'm not familiar with these terms, would someone explain what they are?Terri, here is an excerpt from Palmer's "Guide to Liver Disease": The most serious complication of cirrhosis is bleeding esophageal and gastric varices. This complication occurs when the blood pressure in these blood vessels becomes so high (a condition known as portal hypertension) that they literally explode. When this happens, profuse, life-threatening bleeding results. In fact, it is estimated that between 30 and 50 percent of people could die within one to two monhths of their first episode of bleeding varices. Doctors can stop the bleeding during an endoscopy by injecting a clotting agent directly into a dilated blood vessel (also known as a varix.) This procedure is known as esophageal and/or gastric sclerotherapy Alternatively, the doctor can stop the bleeding during an endoscopy by strangling the bleeding varix with a miniature rubber band. This procedure is known as esophageal and/or gastric variceal ligaton. Since these procedures stop the acute emergency but do not prevent recurrences, patients should be placed on a beta blocker (such as Inderol) . . . If the above-mentioned methods fail to stop recurrent bleeding, a man-made shunt should ber considered." I strongly recommend that you keep Dr. Palmer's book on hand as a reference. Dr. Gorman wrote a similar guide, also very good. Harper

[Guest guest]

Debby,

yes they have banded me at least 15 times and it's no fun at all.it doesnt hurt, except for the first time when i didn't have time to be sedated and he just forced it down there with me gagging and throwing up blood alll over him.

( sounds like fun doesn't it!!!!!!!!!!!!! )

Greg

[Guest guest]

Debby,

it doesn't hurt when they do it right. my doc. gives me Versed,Demerol,Inapsine,and sprays my throat to numb it so you dont gag.

Greg

[Guest guest]

Sue,

Esophageal bleeds are indeed frightening, but so is this disease. I have had 4 bleeds (had a lot of nausea at night, felt like my tummy was full, could smell blood on my breath). It is a serious condition and requires admittance to the hospital for a few days to monitor blood values and get transfusions. My GI does my endoscopes routinely (without pain..he puts me in twilight sleep and when I awaken, he tells me what he saw and did). I, and others, have taken the betablockers at night as the bleeds seem to occur then. Part of your physical assessment should include an endoscopic evaluation. The varices can be controlled by medications or banding (it doesn't hurt). If you have a doc that you trust.....keep him or her.

I place my faith in the Lord and I pray for all of us everyday,

[Guest guest]

You mean that you have had surgery on your stomach 15 times greg? OWEEEEEE

debby

Re: [ ] Esophageal Varices Bleed & other terminology

anyone that wants to know about bleeds just ask.I have been banded about 15 times with some very serious bleeds in the beginning.GregHouston, TX

[Guest guest]

, this is frightening. But, I don't think I could EVER go through an endoscopy again. The first one that diagnosed my celiac sprue was so horrific that I would be totally traumatized if I had to go through one of those again. I really don't know what I will do if they tell me I need to have one done! I was awake when they did the first one and screamed at the doctor because he was hurting me. All the nurse did was to hit me on the arm and tell me to lay still! I nearly threw up when they took that hose out of my mouth!

I am totally frightened...but guess I will cross that bridge when I come to it.

debby

Re: [ ] Esophageal Varices Bleed & other terminology

Sue,

Esophageal bleeds are indeed frightening, but so is this disease. I have had 4 bleeds (had a lot of nausea at night, felt like my tummy was full, could smell blood on my breath). It is a serious condition and requires admittance to the hospital for a few days to monitor blood values and get transfusions. My GI does my endoscopes routinely (without pain..he puts me in twilight sleep and when I awaken, he tells me what he saw and did). I, and others, have taken the betablockers at night as the bleeds seem to occur then. Part of your physical assessment should include an endoscopic evaluation. The varices can be controlled by medications or banding (it doesn't hurt). If you have a doc that you trust.....keep him or her.

I place my faith in the Lord and I pray for all of us everyday,

[Guest guest]

greg, what does the pain feel like and where does it occur?

debby

Re: [ ] Esophageal Varices Bleed & other terminology

anyone that wants to know about bleeds just ask.I have been banded about 15 times with some very serious bleeds in the beginning.GregHouston, TX

[Guest guest]

Dear Debby,

I didn't mean to frighten...my doc gave me demerol 100 mg and versed 10 mg IV, so I was in no pain...the first one (done by another doc) was very painful...you must tell your doc that you want to put in twilight sleep. If you feel any pain, yell for more anesthesia....they will give it to you. Be very aggressive about pain relief.

God bless,

[Guest guest]

, I know now that I MUST be forceful about the pain relief. What happened was that my oxygen level went way down to the 70% level and he would not give me any more sedation. I can understand his point, but I got scared and began hurting and when I get to hurting, I hyperventilate and then I don't get the oxygen that I should.

I know you did not mean to frighten me, but I am scared of the process. I won't let it happen unless I am out and not feel anything.

I am happy that you have had good results over the other times you had it done. I fear it too much. THe doctor only gave me versed. I do not believe they gave me demoral, for if they did, I would have been out like a light!

debby

Re: [ ] Esophageal Varices Bleed & other terminology

Dear Debby,

I didn't mean to frighten...my doc gave me demerol 100 mg and versed 10 mg IV, so I was in no pain...the first one (done by another doc) was very painful...you must tell your doc that you want to put in twilight sleep. If you feel any pain, yell for more anesthesia....they will give it to you. Be very aggressive about pain relief.

God bless,

[Guest guest]

Great....but how and where does the blood come from? This is all so new for me. I don't really want to find out, but I think that I must find out.

debby AIH 7/01

Re: [ ] Esophageal Varices Bleed & other terminology

Debby,yes they have banded me at least 15 times and it's no fun at all.it doesnt hurt, except for the first time when i didn't have time to be sedated and he just forced it down there with me gagging and throwing up blood alll over him.( sounds like fun doesn't it!!!!!!!!!!!!! )Greg

[Guest guest]

Debbie i'm a nurse of 30 years and newly diagnosed 6/01 to make it simple

esophageal varices are like engorged varicose veins in your esophagusfrom the

increaed pressure from your disaeased liver (portal hypertension) the

bleeding is venous not arterial when they rupture you bleed usually the

stomach gets full and the blood makes you vomit which causes more bleeding

that's why they band them.I know it sounds gory........Jo

[Guest guest]

debby,

The blood comes from an enlarged vein in your esophagus that "pops" after it can no longer tolerate the backup pressure of blood caused by portal hypertension. The banding procedure only takes about 5 minutes and you should be receiving oxygen through a nasal cannula. A bite block is placed in your mouth so you don't bite the tube and the endoscope introduced into the esophagus, stomach, and duodenum. If a vessel is enlarged the tube is taken out and the banding instrument used to tie the vessel. My doc always takes pictures while he is in there. I usually wake up in about 15 minutes and am groggy for about 2 - 4 hours. The next few days I eat clear liquids and then a low residue diet for several weeks. I hope you don't need to have this procedure but it has saved my life 4 times!

You are in my thoughts and prayers,

[Guest guest]

Ditto! Banding, scholerotherapy and tips shunt insertion for me....

Ask away!

Jen

On Tue, 30 Oct 2001 18:35:25 EST, wrote:

> anyone that wants to know about bleeds just ask.I have been banded about

15

> times with some very serious bleeds in the beginning.

>

> Greg

> Houston, TX

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[Guest guest]

Signs and Symptoms:

Black Stools not due to taking things like Pepto Bismal. Usally means a slow

bleed and a tablespoon of blood takes about 8 hours to reach the stool.

Burgundy colored stool usually indicates your bleeds are more rapid

Bright red blood in the stool....go to the ER or call 911 immediately...

Also.....Vomiting blood, loss of mental status.

My first major bleed was at a bus stop, I threw up after a tummy ache. It

wasn't messy, thought it was ketchup as I had a burger and fries about an

hour prior. It put me in the hospital for 5 days, blood transfusions, plasma

and a banding procedure was needed to stop the bleed. I didn't have loss of

mental status or changes for about another 2 hours when I verbally beat the

crap out of my former father in law in the ER later that night. I remember

it, just couldn't control myself.... did I have some explaining to do after

that.

Jen

On Tue, 30 Oct 2001 18:13:54 EST, wrote:

> In a message dated 10/30/01 3:11:37 PM Pacific Standard Time,

> suerivoire@... writes:

>

>

> > Harper,

> > What are the symptoms of esophageal varices bleeds?

> > Sue (Oregon)

> >

>

> Can someone else take up this discussion, as I'm not knowledgeable on

this

> subject. I haven't had bleeds and am not a high-risk candidate for them.

> Harper

_______________________________________________________

Send a cool gift with your E-Card

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[Guest guest]

GI anyone interested try this page out about bleeds

gayle trans/6-99 ^oo^

galye@...

[Guest guest]

In a message dated 10/31/01 6:59:10 PM Pacific Standard Time, tdcc2000@... writes:

ohhhhhhh how terrible! I am glad I don't have that part of it all yet!

debby

And perhaps you never will.

Harper

[Guest guest]

In a message dated 10/31/01 7:55:57 PM Pacific Standard Time, tdcc2000@... writes:

I do my very best when I get nauseated NOT to vomit! It is important to me that I don't throw up cause it is just the worst thing for me to do! WHen it gets too bad, I just gag and hold it in! Hard, but if vomiting causes more bleeds, then I think it must be important to not do it. I will try even harder now NOT to let this happen.

debby

Ask your doctor about this. It's possible that the strain of "holding it in" may be damagin.

Harper

[Guest guest]

ohhhhhhh how terrible! I am glad I don't have that part of it all yet!

debby

Re: [ ] Esophageal Varices Bleed & other terminology

Signs and Symptoms:Black Stools not due to taking things like Pepto Bismal. Usally means a slowbleed and a tablespoon of blood takes about 8 hours to reach the stool.Burgundy colored stool usually indicates your bleeds are more rapidBright red blood in the stool....go to the ER or call 911 immediately...Also.....Vomiting blood, loss of mental status.My first major bleed was at a bus stop, I threw up after a tummy ache. Itwasn't messy, thought it was ketchup as I had a burger and fries about anhour prior. It put me in the hospital for 5 days, blood transfusions, plasmaand a banding procedure was needed to stop the bleed. I didn't have loss ofmental status or changes for about another 2 hours when I verbally beat thecrap out of my former father in law in the ER later that night. I rememberit, just couldn't control myself.... did I have some explaining to do afterthat.Jen :)On Tue, 30 Oct 2001 18:13:54 EST, wrote:> In a message dated 10/30/01 3:11:37 PM Pacific Standard Time, > suerivoire@... writes:> > > > Harper,> > What are the symptoms of esophageal varices bleeds?> > Sue (Oregon)> > > > Can someone else take up this discussion, as I'm not knowledgeable onthis > subject. I haven't had bleeds and am not a high-risk candidate for them.> Harper_______________________________________________________Send a cool gift with your E-Cardhttp://www.bluemountain.com/giftcenter/

[Guest guest]

thanks for the link!

debby

Re: [ ] Esophageal Varices Bleed & other terminology

GI anyone interested try this page out about bleeds gayle trans/6-99 ^oo^ galye@...

[Guest guest]

I do my very best when I get nauseated NOT to vomit! It is important to me that I don't throw up cause it is just the worst thing for me to do! WHen it gets too bad, I just gag and hold it in! Hard, but if vomiting causes more bleeds, then I think it must be important to not do it. I will try even harder now NOT to let this happen.

debby

Re: [ ] Esophageal Varices Bleed & other terminology

Debbie i'm a nurse of 30 years and newly diagnosed 6/01 to make it simple esophageal varices are like engorged varicose veins in your esophagusfrom the increaed pressure from your disaeased liver (portal hypertension) the bleeding is venous not arterial when they rupture you bleed usually the stomach gets full and the blood makes you vomit which causes more bleeding that's why they band them.I know it sounds gory........Jo