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ESophageal varices stage 2 and cirrhosis ?
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ESophageal varices stage 2 and cirrhosis ?

had an upper GI down today for what I thought would be Barrets or Gerd.  I wish.  I found myself in the recovery room and the nurse said the dr wants me to have a complete Abdominal Ultrasound.  He said they found a small hiatal hernia, heartburn, esophageal varices (stage 2) without bleed and gastritis without hemorrhaging.  also normal duodenum was random biopsies.  

Now I am having to go to get a complete ultrasound and rule out cirrhosis.  I drank socially more than 13 years ago but I haven't drank socially in 12 yrs or more. But am on meds for rheum arth.  I also had an internal hemorrhoid  but nothing now.  I had an int hemorrhoid removed last yr and my gastro thought it was caused by a anorectal varices...my colorectal surgeon said no and my pcp said my labs dont steer in that direction.  anyway a shock to me thinking my throat and now my liver.  

Anyone have words of advice or been thru this?    Thanks...Paula

Not sure about any of this though I read that prognosis is poor...really?
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446474_tn?1404424777
Hi.

"Esophageal varices are extremely dilated sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension  (high blood pressure in the portal vein which brings all the the nutrients from your GI track to your liver for processing), commonly due to cirrhosis (scarring of the liver); patients with esophageal varices have a strong tendency to develop bleeding."

When you get the results of the ultrasound we will know more. If the results are not definitive, you may need other tests. An ultrasound can only tell if you have advanced cirrhosis with nodules throughout the liver. Early cirrhosis does not have nodules so you could still have cirrhosis but the ultrasound can not detect early stages of liver disease.  Please try not to assume the worse. Even if you have cirrhosis of the liver it is not the end of the world. I have had cirrhosis since at least 2007 and I have had esophageal varices for a number of years. I take a beta-blocker to manage my varices and have endoscopies on a regular bases to monitor the condition of my varices.

I also have GERD occasionally so I understand the nature of that disease which is related to stomach acid issues. That doesn't mean you don't have both illness. GERD is a common GI disease. Cirrhosis not so common luckily, but it is not rare in people in their 50s and 60s especially.

By the way do you have any recent blood test results? Sometimes certain tests can indicate cirrhosis. If you do post them here and we can look at them.

There are many causes of cirrhosis, alcohol abuse is only one. Your gastroenterologist has the most expertise of all the doctors you mentioned as far as liver disease and varices are concerned. The others have no specialized training or experience with liver disease so I would take their opinions with a grain of salt. If you do have cirrhosis you should see a hepatologist who specializes in liver disease.

So wait for the results of your ultrasound and we will know more. Then we can help you with the next step or steps.

Hang in there!
Hector
4 Comments Post a Comment
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446474_tn?1404424777
Hi.

"Esophageal varices are extremely dilated sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension  (high blood pressure in the portal vein which brings all the the nutrients from your GI track to your liver for processing), commonly due to cirrhosis (scarring of the liver); patients with esophageal varices have a strong tendency to develop bleeding."

When you get the results of the ultrasound we will know more. If the results are not definitive, you may need other tests. An ultrasound can only tell if you have advanced cirrhosis with nodules throughout the liver. Early cirrhosis does not have nodules so you could still have cirrhosis but the ultrasound can not detect early stages of liver disease.  Please try not to assume the worse. Even if you have cirrhosis of the liver it is not the end of the world. I have had cirrhosis since at least 2007 and I have had esophageal varices for a number of years. I take a beta-blocker to manage my varices and have endoscopies on a regular bases to monitor the condition of my varices.

I also have GERD occasionally so I understand the nature of that disease which is related to stomach acid issues. That doesn't mean you don't have both illness. GERD is a common GI disease. Cirrhosis not so common luckily, but it is not rare in people in their 50s and 60s especially.

By the way do you have any recent blood test results? Sometimes certain tests can indicate cirrhosis. If you do post them here and we can look at them.

There are many causes of cirrhosis, alcohol abuse is only one. Your gastroenterologist has the most expertise of all the doctors you mentioned as far as liver disease and varices are concerned. The others have no specialized training or experience with liver disease so I would take their opinions with a grain of salt. If you do have cirrhosis you should see a hepatologist who specializes in liver disease.

So wait for the results of your ultrasound and we will know more. Then we can help you with the next step or steps.

Hang in there!
Hector
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89592_tn?1391278022
Thanks Hector.  It seems never ending at times.  I'm 63 and have had severe rheum arthritis since I was 32.  I seem to collect specialists like other people collect stamps.  

I've been on prednisone, hydrocodone and also took injectable Enbrel for 10 yrs till it turned on me so now I'm using Orencia.  I'm wondering if some of these "torturous" varices is just the way my body looks inside going every which way.

I dont feel like I have any of the cirrhosis symptoms at all.   CBC are all in normal range.  Platelets are at 142 and rising since I got off the enbrel.  My alt/ast were really low..well 100-110 while I was on enbrel but now they're starting to rise to 142 in April.  At that time my creatinine 1.0 normal, albumin 3.6 normal, Bun 16, normal.   ALT was 91 and ALT 54 but was going down after being on strong antibiotics for weeks.  Hoping they stay down.

I had an episode of bleeding which my gastro thought it was a anorectal varices and my pcp and colorectal surgeon said no.. Colorectal surgeon said they looked at the hemorrhoid when he removed it and could tell it was not but jury is out.  Grain of salt.

Now going in for the GERD dx...I get all this.  Hoping I don't have any Barretts, etc and get esophageal varices.  He also said I had gastritis so he biopsied that area.  

UGH...the ultrasound is worrisome to me.

My last labs were mid April so will go this week for more lab work and get back to you on those results. Gastr ordered ABD US, Complete Metabolic Panel, CBC, PT.  

Thanks Hector for your advice.....I just get tired of collecting all these new things going on...but maybe its just the ag.....err...maturing process.  

I appreciate your help.  Paula




When you get the results of the ultrasound we will know more. If the results are not definitive, you may need other tests. An ultrasound can only tell if you have advanced cirrhosis with nodules throughout the liver. Early cirrhosis does not have nodules so you could still have cirrhosis but the ultrasound can not detect early stages of liver disease.  Please try not to assume the worse. Even if you have cirrhosis of the liver it is not the end of the world. I have had cirrhosis since at least 2007 and I have had esophageal varices for a number of years. I take a beta-blocker to manage my varices and have endoscopies on a regular bases to monitor the condition of my varices.

I also have GERD occasionally so I understand the nature of that disease which is related to stomach acid issues. That doesn't mean you don't have both illness. GERD is a common GI disease. Cirrhosis not so common luckily, but it is not rare in people in their 50s and 60s especially.

By the way do you have any recent blood test results? Sometimes certain tests can indicate cirrhosis. If you do post them here and we can look at them.

There are many causes of cirrhosis, alcohol abuse is only one. Your gastroenterologist has the most expertise of all the doctors you mentioned as far as liver disease and varices are concerned. The others have no specialized training or experience with liver disease so I would take their opinions with a grain of salt. If you do have cirrhosis you should see a hepatologist who specializes in liver disease.

So wait for the results of your ultrasound and we will know more. Then we can help you with the next step or steps.

Hang in there!
Hector .
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1840891_tn?1383280315
Dont fret over the ultrasound – they are a piece of cake. In fact, they are so easy and relaxing that I tend to fall asleep during the process. They need you to breathe and hold your breath on command, so they don't ever let me stay asleep, but it's is still very relaxing. You just lie in a somewhat darkened room while they put some gel on a wand and rub it across different parts of your abdomen while having you take a small breath or a dep breath and hold it. They watch on a computer monitor as they do iy and they take measurements and photos. Sometimes they can set it up so you can see what they see and that makes it a lot more interesting. Best wishes!
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89592_tn?1391278022
Thank you....you're right.  It wasn't a bad test...just lengthy.

Thanks so much for your reply...
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