1. if doctor said "you are sitting on a time bomb", this probably means that at any time the portal pressure can elevate resulting in rupturing:
. lower end of esophagus: leading to hematemesis
. around th umblicus: caput medusae
and anal canal: hemmorhoids.
2. since hepato cellular function is the best predictor of bleeding from varices
, thus check with Liver
function tests [LFT] to rule out hepatic failure
3. treatment will depend whether the cause is pre-sinusoidal or post sinusoidal, [portal hypertension
is associated with splenomegaly
which favors extra hepatic obstruction] and hopefully your Doctor has find the aetiology of the same.
4. Rest: [reduction of physical activity reduces metabolic demands of the liver and increases renal perfusion].
. because your history suggests recurrent bleeding [for which bandaging was done], thus prevention is done by sclerotherapy
, banding, TIS [Transjugular intrahepatic portosystemic shunting], surgical shunt.
. prior to surgery prescription drugs like : vasopressin
, glypressin, somatostatin and octreotide
, propanol, nitrates,nitroglycerin
are used for prevention of recurrent bleeding, but your Doctor will be better to judge your Condition.
. In good-risk patients with variceal bleeding undergoing portal decompression, surgical shunt is more effective, more durable, and less costly than angiographic shunt (transjugular intrahepatic portasystemic shunt [TIPS]).