Banding is used to treat oesophageal varices (varicose veins of the gullet), which are a result of a condition called Portal Hypertension.
What is Portal Hypertension?
This is a condition which can be caused by liver disease, liver damage, or a problem with blood vessels in and around the liver.
A restricted blood flow in the liver caused by this disease results in increased blood pressure in vessels in and around the liver. This back pressure causes the veins in the gullet and stomach to enlarge, these are called varices.
If one of these enlarged blood vessels ruptures severe bleeding can occur, causing vomiting of fresh blood or passing of black stools.
How are varices treated?
Banding is one of the treatments for varices. During your gastroscopy (procedure where a video camera is passed down your throat in order to examine your gullet) the endoscopist will decide after viewing your gullet whether banding is necessary.
What is banding?
While carrying out your gastroscopy, the Endoscopist can place rubber bands over the varices. This is done by sucking the varices into a device attached to the end of the scope which places a band around the varices. The blood supply in the vessel is stopped, eventually the varices will disappear, reducing the risk of rupture and bleeding from that vessel. It does not affect the normal blood supply to the gullet, varices are extra veins that have developed.
Before the procedure
Banding of varices can be carried out as an ‘emergency’ to stop severe bleeding. If this has happened to you, this leaflet will explain what happened. If you are attending for a planned procedure you would have received a gastroscopy information leaflet. You must read this leaflet as it contains important information with instructions for you to follow.
The procedure
All preparation is the same as for gastroscopy. You will be given sedation, attached to a monitor that records your pulse and oxygen is given during the procedure.
As you are having sedation it is important that you have an adult to pick you up and stay with you overnight.
After the procedure
You will be returned to the ward or recovery where your pulse and blood pressure will be monitored. If you did not have any throat spray you can have sips of water and you will be able to eat in 4 hours and drink normally in two hours.
You may have a sore throat for 24 hours. If the pain is severe and persistent you should inform the nursing staff. You will be able to leave the department when the sedation has worn off sufficiently and you are feeling comfortable.
What are the possible complications?
Banding is a safe procedure and complications are rare, but occasionally the following can occur:
- Scarring around the banded area can cause narrowing in the gullet for a short time, but this will resolve.
- Small ulcers can develop around the banded area, this can be treated with medication.
- In a few rare cases the gullet can perforate, this may require a stay in hospital or an operation.
Follow up appointments
Once varices have been diagnosed, several treatments (two to four) are often required.
When they have been successfully treated you will need an endoscopy at annual intervals to check the varices have not returned. If they have developed they can be banded again.
You will also have outpatient appointments. It is important you attend both treatments and clinic appointments or you will risk the varices bleeding. If you have any signs of bleeding (such as dark stools or vomiting blood) you must let your GP know immediately.
If you have any questions/problems before or after your treatment please contact us, we welcome any feedback to enable us to further improve the service we offer.
If you have any queries or concerns please contact:
The Day Surgery Unit
01935 384 339 (between 8am and 7pm)
The Endoscopy office
01935 384 793 (between 9am and 5pm)
The Clinical Site Manager
01935 384 525 (after 7pm)
