endoscopy

Why are endoscopies done for Hep C patients?

[Bill1954]

The need for endoscopy is pretty much limited to HCV patients that have advanced to cirrhosis, Murariji. As the liver becomes extremely scarred, blood flow from the GI tract into and through the liver becomes obstructed; resulting in portal hypertension. This elevated pressure is distinct from systemic pressure, by the way; it can’t be monitored via blood pressure cuff, for instance.

As the portal pressure increases, blood seeks collateral flow, and the esophagus often becomes the ‘weak link’. Veins there become tortuous, similar to varicose veins in the legs; these varices tend to hemorrhage after time. An endoscopy can locate these, and through bad ligation the doctor can essentially place a rubber band over the trouble spot, which can remedy the problem; at least temporarily. I believe additional varices often occur; and of course, relieving portal pressure somehow, usually via TIPS or transplant will eventually be necessary.

I was told the procedure is relatively safe and effective.

Bill

[CoWriter]

Esophageal varices, by the way, are associated with having insulin resistance.

Co

[HectorSF]

I just had one done 5 hours ago. It was a yearly checkup.

If cirrhosis is expected, varices is a common symptoms of cirrhosis caused by hepatitis C. An endoscopy is when I long camera in put down the throat to visually see if a patient has enlarged varices and how enlarged they are. If it appears they might burst soon they can be "banded" to prevent that from happening.

It is used to exam cirrhotic patients with portal hypertension. As mentioned they develop because the normal blood flow to the liver is slowed because the liver is scarred and blood doesn't flow easily through it, so the blood finds an alternate way to travel up to the heart. So the blood flows through the esophageal veins which were not designed to handle this much blood pressure. So they can burst causing the vomiting of blood which can be life threatening.  
If you have varices, your doctor will prescribe prophylactic meds (such as Nadolol) which will reduce your heart rate and portal hypertension in hopes of stopping a bleeding episode.

Hectorsf

[murariji]

Thanks Bill and CoWriter. I gather it's not a good sign. Boy, this is quite a party.