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Suggest Treatment For Esophageal Varices
Question: Hi My mother is approaching 60 and is diagnosed with Oesophagus Varices small, she has grade 1 liver rest liver functioning is fine, She had an engioplasty and hence taking medicines for blood thinning, please advice how serious is her condition? Is it mandatory that all varices will bleed, Can varices bleed even under mediciation? How to ensure that bleeding does not occur.
Brief Answer:
Yes, risk of bleeding present.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. As the liver disease progresses, the esophageal varices will increase in size.
2. Need to watch for bleeding in sputum, or during vomiting or in stools. Dark colored or blood colored stools are indicative of bleeding internally.
3. Varices usually do not bleed, unless they progress. Usually medical management involves beta blocker therapy, which she might be already under due to angioplasty.
4. Yes, once varices rupture, bleeding could be more due to blood thinners. But risk is comparatively low.
5. Control of further progression of liver disease is important. Avoid further liver toxins like alcohol, etc. Weight reduction and low fat diet along with moderate exercises will be helpful.
In case of any bleeding immediately go to ER.
Surgical procedures to reduce portal hypertension or sclerotherapy or variceal ligation maybe helpful if bleeding starts and persists.
Repeat endoscopy to check for progression after 1-2 years necessary.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Yes, risk of bleeding present.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. As the liver disease progresses, the esophageal varices will increase in size.
2. Need to watch for bleeding in sputum, or during vomiting or in stools. Dark colored or blood colored stools are indicative of bleeding internally.
3. Varices usually do not bleed, unless they progress. Usually medical management involves beta blocker therapy, which she might be already under due to angioplasty.
4. Yes, once varices rupture, bleeding could be more due to blood thinners. But risk is comparatively low.
5. Control of further progression of liver disease is important. Avoid further liver toxins like alcohol, etc. Weight reduction and low fat diet along with moderate exercises will be helpful.
In case of any bleeding immediately go to ER.
Surgical procedures to reduce portal hypertension or sclerotherapy or variceal ligation maybe helpful if bleeding starts and persists.
Repeat endoscopy to check for progression after 1-2 years necessary.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. What could be the possible reasons for my mother developing these varices as according to doctor her liver is fine and grade 1 fatty liver is there in almost every adult?
2. Can varices heal overtime, can they be reversed? Can they be controlled? Is it possible that varices disappear?
3. Is it possible to lead a good normal life along with varices or is it like you are always at risk of spitting blood (always sitting on a time bomb)?
4. Does varices effect life expectancy of a human being if it's not due to cirrohsis and how?
5. With proper medication is it a surity that the varices will not bleed? Or medicines do not gurantee that bleeding will not occur?
6. Is it a really really serious condition?
7. How to ensure that bleeding does not happen, is there a way?
2. Can varices heal overtime, can they be reversed? Can they be controlled? Is it possible that varices disappear?
3. Is it possible to lead a good normal life along with varices or is it like you are always at risk of spitting blood (always sitting on a time bomb)?
4. Does varices effect life expectancy of a human being if it's not due to cirrohsis and how?
5. With proper medication is it a surity that the varices will not bleed? Or medicines do not gurantee that bleeding will not occur?
6. Is it a really really serious condition?
7. How to ensure that bleeding does not happen, is there a way?
Brief Answer:
Varices cannot be reversed.
Detailed Answer:
Hi,
Thanks for asking again.
1. Most commonly liver cirrhosis or any scar formation is common cause. Other than that thrombus formation in the veins, which can cause block could be. However, as ultrasound is clear, the cause is at present not known.
2. No, Varices cannot be reversed. Yes, it can be controlled. Varices usually do not disappear.
3. Yes, possible. It might not progress. Only followup is necessary. If liver is good and no further scar formation or thrombus block is seen, there is not reason to lead a normal good life.
4. No, it does not. Its very much controllable and treatable
5. Not 100%, but mostly sure. Bleeding - very low probability. Only need to watch for blood in vomit or stools or dark colored stools.
6. No, it is not. Its easily controllable and treatable.
7. Further progression, if cause is known, if controlled - vein would not increase in size and hence no bleeding. Continue usual life.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Varices cannot be reversed.
Detailed Answer:
Hi,
Thanks for asking again.
1. Most commonly liver cirrhosis or any scar formation is common cause. Other than that thrombus formation in the veins, which can cause block could be. However, as ultrasound is clear, the cause is at present not known.
2. No, Varices cannot be reversed. Yes, it can be controlled. Varices usually do not disappear.
3. Yes, possible. It might not progress. Only followup is necessary. If liver is good and no further scar formation or thrombus block is seen, there is not reason to lead a normal good life.
4. No, it does not. Its very much controllable and treatable
5. Not 100%, but mostly sure. Bleeding - very low probability. Only need to watch for blood in vomit or stools or dark colored stools.
6. No, it is not. Its easily controllable and treatable.
7. Further progression, if cause is known, if controlled - vein would not increase in size and hence no bleeding. Continue usual life.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor!
Attached are the reports of the test she has gone through.
1. As the cause of Varices is not known please tell what all test should she get done in order to find out the root cause.
2. Currently she is on the following medicines Met Xl 50, Rosavel A, one medicine for gar formation and one more I don't remember the name exactly.
3. What all medicines should not be taken together out of these.
4. Is she on right mediciation?
5. Are their side effects of these prescribed medicines too.
6. Please suggest a diet plan to be strictly folowed. She had gone angioplasty in 2011 and have increased level of tryglycerides.
7. Is it necessary that with the time the varices and liver condition has to deterioate, can it be controlled from getting worse.
Attached are the reports of the test she has gone through.
1. As the cause of Varices is not known please tell what all test should she get done in order to find out the root cause.
2. Currently she is on the following medicines Met Xl 50, Rosavel A, one medicine for gar formation and one more I don't remember the name exactly.
3. What all medicines should not be taken together out of these.
4. Is she on right mediciation?
5. Are their side effects of these prescribed medicines too.
6. Please suggest a diet plan to be strictly folowed. She had gone angioplasty in 2011 and have increased level of tryglycerides.
7. Is it necessary that with the time the varices and liver condition has to deterioate, can it be controlled from getting worse.
Brief Answer:
Both not necessarily progressive.
Detailed Answer:
Hi,
Thanks for asking again.
Based on your queries, my opinion is as follows:
1. Evaluation of portal venous pressure would be helpful. However, following up for an year, should show any varicose veins progression is present or not.
2. Medication helpful. Will reduce further risk of adverse cardiac events.
3. The medicine for gas/ gastritis formation? I assume. For gastritis, before food. All others can be taken together.
4. Yes, she is on necessary medication.
5. No, these medications are useful. They have no major adverse effects.
6. For increased triglycerides, increased unsaturated fatty acids food is necessary. High soluble fiber diet from fruits and vegetables is necessary. Otherwise, moderate protein, moderate carbohydrates with restricted fat as suggested above is necessary.
7. No, it is not necessarily progressive. Control of lipid profile will reduce further progression of liver disease. Varices, depends on cause. Evaluation after six months or year necessary.
Hope it helps.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Both not necessarily progressive.
Detailed Answer:
Hi,
Thanks for asking again.
Based on your queries, my opinion is as follows:
1. Evaluation of portal venous pressure would be helpful. However, following up for an year, should show any varicose veins progression is present or not.
2. Medication helpful. Will reduce further risk of adverse cardiac events.
3. The medicine for gas/ gastritis formation? I assume. For gastritis, before food. All others can be taken together.
4. Yes, she is on necessary medication.
5. No, these medications are useful. They have no major adverse effects.
6. For increased triglycerides, increased unsaturated fatty acids food is necessary. High soluble fiber diet from fruits and vegetables is necessary. Otherwise, moderate protein, moderate carbohydrates with restricted fat as suggested above is necessary.
7. No, it is not necessarily progressive. Control of lipid profile will reduce further progression of liver disease. Varices, depends on cause. Evaluation after six months or year necessary.
Hope it helps.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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