Variceal Bleeding is a life-threatening problem of portal hypertension and has a high probability of occurring again. Bleeding in your digestive tract mainly stomach and esophagus is a serious complication that is related to cirrhosis. This bleeding happens in veins due to increase in blood pressure inside your veins that transport blood from digestive tract towards the liver. It is important to prevent re-bleeding or first bleeding. Variceal Banding is one of the methods of treatment of esophageal varices that are at high risk of getting ruptured. This procedure can be done many times to prevent enlarged varices and stops bleeding. A patient who is surviving the first episode of variceal bleeding has a risk of 60% of having recurrent hemorrhage within 2 years from the start of the episode. Therefore, a treatment to prevent first bleeding is important and those who have survived variceal bleeding should receive treatments to prevent the re-bleeding.
The procedure of Variceal Banding
In this procedure, a lightened endoscope is used and then an elastic band is placed surrounding the bleeding esophageal vein. Banding will help in cutting off the blood flow across the vein. This banded tissue will ultimately form small ulceration that gets healed after some days and weeks. This is the safest procedure that is done and it does not damage the esophageal wall and neither does increase pressure in the portal system. There is a need of monitoring while banded varices. Variceal banding becomes difficult to perform when the vein is actively bleeding.
Pre-Procedure: One should have full blood count test and coagulation profile. Keep your meal light at dinner time. Stop eating and drinking after midnight.
At the time of procedure: Before surgery, you will be given medicine via I.V in order to relax you. When you lie down on your left side, a device will be placed inside your mouth and the suction tube will be helpful in clearing all fluids. A scope is placed inside your mouth and down in esophagus. When varices are located then the scope is removed and the banding device is attached to end point of scope. Your doctor will insert back the scope in the esophagus and sucks the enlarged vein to band it.
Post-Procedure: Till your sedative wears off, you will be under the monitor. During four hours after the procedure, you can take only clear liquids. After four hours, you have to consume soft meals. For prevention of re-bleeding, medicines like beta-blockers and further variceal banding are important.
Be caution of risks!!
- Return of bleeding
- Puncture of the wall of the esophagus
- Sores in esophagus
- Return of bleeding
- Narrowing of esophagus