Why is this procedure done?
The esophagus is a tube where food passes through to get from the mouth to the stomach. Esophageal varices happen when veins that line this tube swell because the normal blood flow to the liver is blocked. This traps blood in the veins. The most common cause of the swollen veins in the esophagus is from cirrhosis or a scarred liver. The varices can leak or break open and cause very bad bleeding. ‚
One way to stop the bleeding is to inject a solution directly into the veins. This causes irritation and scarring that can stop the bleeding. Esophageal variceal injection is done to: ‚
- Stop bleeding
- Prevent further bleeding episodes
What will the results be?
If the varices are already bleeding, the injection will stop it. More bleeding may also be prevented. ‚
What happens before the procedure?
- If done as an emergency procedure, no preparations are needed.
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- Ultrasound
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the procedure room, the doctor will spray a numbing drug into your throat. This will make you stay pain free and comfortable during the procedure.
- The staff will put an IV in your arm to give you fluids and drugs.
- Your doctor will put a thin tube into your mouth. This tube has a tiny camera that helps your doctor see during the procedure. You may feel slight pressure on your throat while the doctor pushes air into your esophagus. The doctor will look for the enlarged or bleeding vein. A needle will be put down the thin tube to inject the vein.
- Your doctor may inject into different parts of the enlarged veins.
- Your doctor will look at the varices to see if bleeding has stopped. Your doctor will remove the needle and tube slowly.
- The procedure takes 30 to 60 minutes.
- Your doctor may need to repeat this procedure after 48 hours.
What happens after the procedure?
- You will be taken to the Recovery Room for monitoring for 2 to 3 hours or when the anesthesia wears off. Your doctor will tell you when you can go home. If you have been in the hospital, then you will go back to your room.
- You may have some discomfort and numbness in your throat after the procedure. This may become more painful when the anesthesia wears off. Your doctor may give you drugs for this.
- You will not be able to have any food or drink until your throat numbing drug wears off.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Your doctor will give you drugs that may help prevent more bleeding. Take all drugs as ordered by your doctor.
- It will be painful to swallow for a couple of days. Suck on ice chips to help relieve throat pain.
- Rest for the remainder of the day. Take it easy for a few days.
What follow-up care is needed?
- Your condition needs close monitoring. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- Your doctor will tell you if other tests are needed.
- Your doctor will tell you if the procedure needs to be done again.
- Your doctor may ask you to see to a dietitian.
What lifestyle changes are needed?
- Stop drinking beer, wine, and mixed drinks (alcohol).
- Limit salt in your diet. This can decrease extra fluid in your body. You may need to talk to a dietitian.
What problems could happen?
- The procedure does not work
- You throw up blood again
- Infection
- Injury to the esophagus
- Hoarse voice
When do I need to call the doctor?
- Signs of shock. These include fast pulse, cold skin with sweating, feeling like you are going to faint, pale skin, fast breathing. Shock is a medical emergency. Call for emergency help right away.
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher.
- Throwing up blood
- Sudden breathing problems
- Swallowing problems
- Dark bowel movements
- Swollen belly that gets worse
Where can I learn more?
American Gastroenterological Association ‚
http://www.gastro.org/patient-center/digestive-conditions/cirrhosis-of-the-liver#Complications ‚
American Liver Foundation ‚
http://www.liverfoundation.org/abouttheliver/info/cirrhosis/ ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚