Anyone taking Atenolol for Esophageal Varices?

Hepatologist suggested my doctor put me on something to control Esophageal Varices, which after a test, were discovered in me. The severity is said to be medium. I've don’t some reading with contradicting beliefs from various doctors and clinical trials. However, all doctors seem to agree that a beta blocker like Atenolol is necessary for a long term use.

Just want to know if any of you are on this treatment at 25mg per day. I understand there are some risks, but that the result of lowering blood pressure and heartbeats can help reduce the development of a more serious Varices problem, which in some cases can cause death form unstoppable internal bleeding.

Anyone?

Thanks,

Magnum

[Bill1954]

No, I’ve never run across atenolol; as most of my exposure would have come from this forum. I was wondering how they diagnosed the varices; I’d assume with endoscopy or pill-cam? And did they explain why they couldn’t band when they were in there if that’s the case? I've also heard of sclerosis for banding, but I understand it's not done as frequently anymore. Just wondering; I treat with the same doc’s you do, but here in Sacramento.

Take care—

Bill

[cat33]

I have been on Atenolol for many years . Not for my Liver or Varcies. I take it for heart arrithmia. I am up to 200mg a day. I did have to go off of it to get a dobutomine stress echo. That was very uncomfortable for a few day feeling my heart beat irradically. The test was shear torchure I will never have it done again.

The reason they do the endoscopy or pill cam is to find out if you have varcies or any type of problems due to acid reflux or stomach ulcers.

So far I have not had any adverse side effects from the atenolol . So If they say it will help varcies i'd try it. At 25mg it can't be to bad.

cat33

[mikesimon]

"The effects of different types of adrenoreceptor blocking agents on portal venous pressure were studied in patients with cirrhosis and portal hypertension. Oral atenolol (selective beta 1 blocker), propranolol (non-selective beta 1 and beta 2 blocker), and prazosin (alpha blocker) were compared in three groups of eight patients. Haemodynamic measurements were made before and after two or three and eight weeks of therapy. The dose of beta blockers was sufficient to reduce the exercise heart rate by more than 25%. Propranolol and prazosin produced a sustained reduction in the mean portohepatic venous pressure gradient of the order of 25% and 18% respectively. The cardiac index was significantly reduced by propranolol but not altered by prazosin. Atenolol produced an early reduction in portohepatic venous pressure which, although not sustained, showed a good correlation with reduction in cardiac index. No such relationship was found with propranolol. All three drugs were well tolerated by these patients with advanced cirrhosis. Therefore propranolol and prazosin have proved to be effective agents for the reduction of portal venous pressure."
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1432238

I was on propanolol after I had a major bleed. I have read somewhere that propanalol is more effective than atenolol but I cannot remember the specifics. This article seems to agree that propanolol is the better drug for portal pressure. The entire article is at the above URL.

Mike

[giddyup]

hi Magnum,  About a year and a half ago I had an endoscopy. At that time they discovered  I had the beginnings of esphogeal varices. My hepatologist put me on a beta blocker, Nadolol. I find that it makes me sleepy but a lot of my meds do. The hepatologist told me that it is the most important drug for me to be taking and told me to take it at bedtime (which should help with the sleepiness) and she said most bleeds happen during the night between 3 and 5 a.m. I was scheduled to have the endscopy repeated over the summer but haven't gotten around to it.last week I finished 7 months of a trial (this time alinia, my VL went down to 1500 but never cleared) ,so  I will schedule another appt to have it done. The results may help make the decison about how soon I opt for another trial.

[JAP23]

Hi Magnum,
I am on Atenolol 25mg once a day for several months, and have had absolutely no side effects. I take it before going to sleep. My energy level is the same. I take my blood pressure daily as I was on the high side and now I am normal again. My pressure is normal for the most part for a change to a healthy diet (and I have so far lost about 25 lbs in 6 months), I eliminated most products with high salt, and replaced them with others. I am eating more vegetables too. I feel great!
Best wishes, JAP

[Magnum]

Monday I had the rest of my verices banded and don't have to take beta blockers now. I will not be tested for this for another 4-6 months. Thanks for the response...

Magnum

[Bill1954]

Magnum,

I’m wondering why they didn’t band them while they were in there with the endoscope originally. I thought that was the norm, rather than doing them at a later date--

Bill

[Magnum]

I think there may be two reasons.

1. Don't tell anyone, but sometimes doctors need to do more than one procedure to gather more money.

2. The most likely reason is that banding them all at once may result in too much of a physical hardship. I know that the first procedure required four verices being banded. I had pain for nine days, with the first the first few days with pretty noticeable pain in just swallowing. This past procedure (don't know how many he banded), resulted in much less pain, and now, four days later, there is hardly any pain.

All of this is foreign to me, but at least I'm glad I'm off the beta blockers because they were weirding me out...

Magnum

[Bill1954]

Oh cr@p, Magnum; of course, greenbacks :o). That was so obvious, but I missed it. Just like colonoscopies, they batch the patients for a money run. That and the stress of the procedure on the patient. Thanks for answering my question, and good luck going forward—

Bill