The gastrointestinal tract is filled with veins, and over time some may become abnormally enlarged. These varicose veins, or varices, can occur in the esophagus and stomach, as well as in and around the rectum (hemorrhoids).
Varices in the esophagus or stomach (gastric varices) often result from portal hypertension – an increase in the pressure within the portal vein, which carries blood from the digestive system to the liver. This pressure commonly occurs when blood flow to the liver is blocked due to cirrhosis of the liver, a scarring and hardening of the tissue. When the blood is forced back up into the portal vein, high levels of pressure can result, and so the blood is directed into smaller veins. These small veins could expand beyond capacity, and rupture.
A rupture will cause internal bleeding and can be serious. Even if they do not rupture, varices can leak blood. Variceal banding is a technique that stops the bleeding, similar to the way hemorrhoid banding works. Flexible bands are placed around the vein or cluster of veins to cut off their blood supply.
The gastroenterologist will access the varices using an endoscope, a long, flexible tube equipped with a lighted camera. The endoscope is inserted through the patient’s mouth and throat, into the esophagus, and through to the stomach (if the varices are in the stomach). Once the endoscope reaches the affected area, the doctor passes a small tool, called a ligator, through the tube to place the bands around the vein(s). In several days to a few weeks, the banded tissue will heal.
This procedure may be repeated in two-week intervals until the varices are gone.
Variceal banding is an outpatient procedure that will likely involve sedation, so fasting will be required (the doctor will advise on timing). The patient must arrive for the appointment with a ride home and with a complete list of current medications.
Conditions treated or diagnosed by this procedure: