Endoscopic Treatment of Gastric Varices

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What are gastric varices?

Some patients with portal hypertension may develop dilated veins (varices) in the stomach. These are usually located near the transition of the stomach to the esophagus or in the initial part of the stomach called the “gastric fundus”.

Gastric varices are generally large vessels that, when ruptured, cause high-volume gastrointestinal bleeding. Hence the need for their treatment.

Because they are voluminous, the substances that are used for the sclerosis of esophageal varices are not sufficient to “dry out” the varices of the stomach. Therefore, in these cases, we need to use a “biological glue” that when injected sticks to the tissue of the dilated vessel causing it to be obstructed.

This glue can be used during an episode of acute bleeding from these varices. In some cases, it can also be used to prevent this from occurring.

After a few weeks from the injection of the glue, the body expels it, and this process leads to the healing that “dries out” the dilated vein in that region.

Guidelines for the examination:

This procedure aims to treat gastric varices endoscopically.

The presence of an adult companion from the time the client arrives until the end of the procedure is an indispensable condition for the execution of the examination.

To undergo the procedure, the patient must have recent results of complete blood count, prothrombin time, and platelet count. In addition, previous endoscopies must be presented.

Medications with ASA (aspirin) and anticoagulants such as warfarin (Marevan®, Coumadin®), clopidogrel (Plavix®), and ticlopidine (Ticlid®), should be suspended seven to ten days before the procedure, evidently under the supervision of the attending physician.

On the eve of the procedure

The patient should have a light dinner, avoiding fatty food.

On the day of the procedure

Fasting for eight hours, even from liquids.

Attention: it is not possible to perform other invasive abdominal examinations on the same day, such as colonoscopy.

The procedure lasts, on average, 40 minutes, including preparation time.

At the end of the intervention, the patient needs to rest for about an hour.

Post-procedure care

Due to the use of sedatives, it is not possible to drive a car or other vehicles for the entire day after the examination. For the same reason, for a period of approximately eight hours after the procedure, the individual cannot perform tasks that require attention, such as working with machinery and sharp objects.

The medication used in anesthesia can cause a short period of amnesia.

The patient should rest for the remainder of the day, eating as medically recommended.

For the 3 days following the procedure, the patient should have a diet of only liquids and soft foods. They should avoid hot food and liquids.

They also should not engage in physical activity or carry weight for at least 3 days