Brief Answer: Need treatment to reduce portal pressure Detailed Answer: Hi XXXX Thanks for writing to XXXXXXX I went through your query and understood your concerns. Large varices develop in the esophagus or upper stomach are at risk for serious bleeding due to rupture of these varices. Once varices have bled, they tend to rebleed . Therefore, treatment is necessary to prevent the first (initial) bleeding episode as well as rebleeding. Treatments include medications and procedures to decrease the pressure in the portal vein, and procedures to destroy the varices. First i treat my patient with medication to reduce pressure in portal system, like propranolol, not controlled with this may add Octreotide . If pressure not controlled with this can go for upper endoscopy sclerotherapy or band ligation can be performed to obliterate varices and stop active bleeding and prevent rebleeding. To avoid further damage to liver need to consume balanced diet and multivitamin daily. avoid alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs, for example, ibuprofen). Low platelet count common in cirrhosis due to enlarged spleen which retains platelet in it. Reduction in portal pressure helps to reduce spleen size and improves platelet count. Hope this information helpful to you, Feel free to ask further related queries. I will be glad to answer them. Regards

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Brief Answer: Shunt is next line of management. Detailed Answer: Hi, Thanks for the query. As you are getting banding, which is not controlling your symptom. Then next level of management would be shunt. Which is going to reduce pressure and there by bleeding. Common cause for low platelet count in cirrhosis is collection of platelet in spleen. As your doctor has noticed reduced life span could be due to formation of antibodies. Once your portal pressure gets controlled, probably platelet count may return back to normal.If not cause could be antibody destruction. Hope this helps you. Feel free to ask further related query Regards

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