why are patients with cirrhosis at risk for bleeding for things other than varices? what are the precautions that should be taken?
Ans) Patients with cirrhosis is at risk of bleeding as It's often due to scarring of the liver, or cirrhosis. This increased pressure in the portal vein causes blood to be pushed away from the liver to smaller blood vessels, which are not able to handle the increased amount of blood.
- The primary aim in treating esophageal varices is to prevent bleeding. Bleeding esophageal varices are life-threatening. If bleeding occurs, treatments are available to try to stop the bleeding.
Treatment to prevent bleeding:
Treatments to lower blood pressure in the portal vein may reduce
the risk of bleeding esophageal varices. Treatments may
include:
Medications to reduce pressure in the portal vein. A type of
blood pressure drug called a beta blocker may help reduce blood
pressure in your portal vein, decreasing the likelihood of
bleeding. These medications include propranolol (Inderal, Innopran
XL) and nadolol (Corgard).
Using elastic bands to tie off bleeding veins. If your esophageal
varices appear to have a high risk of bleeding, or if you've had
bleeding from varices before, your doctor might recommend a
procedure called endoscopic band ligation.
Using an endoscope, the doctor uses suction to pull the varices into a chamber at the end of the scope and wraps them with an elastic band, which essentially "strangles" the veins so they can't bleed. Endoscopic band ligation carries a small risk of complications, such as bleeding and scarring of the esophagus.
- Both shunt surgery and sclerotherapy have been abandoned for primary prevention, mainly because of the high incidence of complications.
- The current treatment strategies for medium/large-sized varices are NSBBs or EBL, which are both effective in decreasing rates of bleeding and mortality. NSBBs are splachnic vasoconstrictors which reduce portal pressure and increase portal resistance through a decrease in portal venous inflow. Endoscopic treatments have no effect on portal circulation as they act locally by obliteration of varices.
why are patients with cirrhosis at risk for bleeding for things other than varices? what are...
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