variceal hemorrhage

yesterday a good friend of mine was surfing when he got a severe stomach cramp.  then he coughed up blood.  he knew that he better get out of the water so he caught a wave to come in.  well he passed out and was helped out by my son and his friends.  the fire dept. was there setting up for a 9/11 ceremony so their was help within a minute.  they took him to the hospital with internal bleeding.  turns out it was varices.  how serious is this condition?  he quit drinking 25 years ago but found out 15 years ago he got hcv.  he has hcv but has been denied treatment because he has cirrhosis.  has anyone on this forum received treatment when they had cirrhosis.  i'd like to give him hope for the future.  thanks so much.  belle

[crossroadsec]

Yes he can be treated. Many people live for decades and don't even know they have the disease until deco penation like esophageal bleedout or ascites. He needs to see a hematologist ASAP. Mine told me no tx n sent me to transplant hospital. They consider a lot of factore. I'm in my 9th week n virus is undetectable. There is hope... Karen :)

[eureka254]

I'm glad that your friend caught the wave in time to make it to shore.  Variceal bleeding can be life threatening... it's basically an internal blood vessel bursting open, and the loss of blood can incapacitate quickly, as you saw with your friend.  Hope he's recovering well.

Varices are common in cases of worsening cirrhosis.  The presence of varices indicates that your friend is experiencing decompensation -- symptoms that show the liver is losing significant function.  Varices is one of the signs of decompensation; other symptoms of progressing liver disfunction include jaundice (yellowing of sking, ascites (abdominal fluid), edema (swelling of tissues), and hepatic encephalopathy (loss of mental acuity due to ammonia retention).  Not all patients experience all these symptoms, but varices shows that your friend's cirrhosis is such that his liver is hardening, backing up blood flow, a condition called 'portal hypertension', which is why he has varices that burst.

Treatment of hcv in a decompensating liver is not always possible; much depends upon how bad the cirrhosis has become, and if treatment is a consideration, it should only be under the guidance of an experienced hepatologist because treatment carries risks of damaging an already injured liver.  Your friend really should be asking those questions of a hepatologist at Transplantation Center.

Early cirrhosis can sometimes be stabilized with sustained SVR; however, treating those who are decompensating has both significant benefits and serious risks.  What is important to realize is that your friend's liver disease is such that he should be seeking care with a Transplantation Center to investigate all his options.  

Hope that helps some, and best wishes to your friend. ~eureka

[HectorSF]

Belle,

There is hope. As others have said, he needs to be under the care of a heptologist (liver specialist) preferably at a liver transplant center. These are the only doctors qualified to treat him. He has a life-threatening illness and he needs treatment for and monitoring of his condition. There are a number of medicines that can help him manage the complications and symptoms of cirrhosis. For example he should be taking a beta-blocker to reduce his portal hypertension (high blood pressure) in the portal vein and its tributaries,which will help to prevent future bleeding episodes. Strenuous exercise raises the heart beat rate and raises blood pressure. This is probably why the varices burst. As mentioned these complication can be life-threatening. If help had not been around he could have bleed out. He needs to modify his lifestyle and diet also. Basically he needs to be cared for to minimize further damage to his liver and realize the limits his disease will require.

Unfortunately having had bleeding varices he has probably reached the point where he will be able to treat his hepatitis C but there are many things that can done to help him as he gets progressively sicker as his liver is unable to perform its functions. He probably already has other symptoms of decompensated cirrhosis that he may not be aware of.

All the best to your friend!
Hector

[belle19]

thank you both for the info.  i will pass this on to my friend.  i found out that this is his 3rd time with varices.  he looks good and he's in shape.  he surfs everyday.  hard to believe how sick he really is.  by the way, he was sent home this afternoon.  best wishes, belle

[belle19]

thank you so much for your reply.  i will very honored that you answered my post.  i've always valued what you write.  you seem to be very informed.  again thank you so much.  belle

[HectorSF]

Belle,

If you want, I can talk to him about my experience. Just send me a private message. As you probably know, I have hepatitis C, decompensated cirrhosis and liver cancer and I am waiting for a liver transplant in a year or year and a half if all goes well.

Anybody who surfs is "cool" in my book.
Thanks for helping your friend.
Cheers!
Hector

[belle19]

i will let my friend know about you.  he may be willing to communicate with you but 1st i'll have to ask.  i'll send you a private message after i talk to him.  thank you again.  belle