Band ligation of oesophageal varices

Oesophageal varices are swollen blood vessels not uncommonly found in the oesophagus (gullet) of the patients with liver cirrhosis (scarring of the liver). In some patients, as the disease progresses, the swollen blood vessels may burst and cause dangerous bleeding.

When a patient is found to have oesophageal varices, medicines can be prescribed to lower the risk of bleeding. In some patients, a procedure called ‘variceal band ligation’ may be needed to prevent or stop the bleeding. This procedure involves introducing a thin tube with an attached camera through the mouth and down into the oesophagus, tiny bands are then tied around the swollen blood vessels in the lower end of the oesophagus.

Histoacryl glue injection of gastric varices

Gastric varices are swollen blood vessels not uncommonly found in the stomach of the patients with liver cirrhosis (scarring of the liver). In some patients, as the disease progresses, the swollen blood vessels may burst and cause dangerous bleeding.

When a patient is found to have gastric varices, medicines can be prescribed to lower the risk of bleeding. In some patients, a procedure called ‘histoacryl glue injection’ may be needed to prevent or stop the bleeding. This procedure involves introducing a thin tube with an attached camera through the mouth and down into the stomach, a special chemical called ‘histoacryl glue’ is then injected into the swollen gastric blood vessels.

Gastrointestinal haemostasis (Endoscopic treatment of digestive tract bleeding)

Some patients with gastric or duodenal ulcers (sores on the lining of the stomach or the first part of the small intestine), and some patients with liver cirrhosis (scarring of the liver) and oesophageal or gastric varices (swollen blood vessels in the gullet and stomach) may have sudden dangerous bleeding. These bleedings must be immediately treated. This can be done by doing oesophago-gastro-duodenoscopy (OGD). During the procedure, a thin tube with an attached camera and light source will be introduced through the mouth and down into the stomach and duodenum to identify the source of bleeding. Depending on the underlying causes, several treatment options are available.

Haemorrhoid ligation

Haemorrhoids are swollen veins in the rectum (the lower part of the large intestine). They are usually hidden inside, though in some people, it can be seen or felt around the anus. They may cause pain or itchiness, and not uncommonly they can cause bleeding while passing motion.

The most important treatment in haemorrhoids is to keep one from getting constipation which can make it worse. There are also medicines to relieve the swelling, pain and itchiness. In some cases, treatment such as ‘rubber band ligation’ may be needed. In this treatment, tiny bands are tied around the swollen blood vessels.

Percutaneous endoscopic gastrostomy (PEG tube insertion)

Percutaneous endoscopic gastrostomy (PEG) is a safe and effective way to provide foods and medicines directly into the stomach. It is done for patients who are having long term difficulty in swallowing.

During the procedure, an endoscope (a thin tube with an attached camera and light source) is introduced through the mouth and down into the stomach, a suitable position for the PEG tube insertion will then be identified and a small incision is made in the belly wall where the PEG tube exits.

Sedation and pain killer will be given to help you relax and reduce the discomfort during the procedure.

Large volume abdominal paracentesis

Large volume abdominal paracentesis is a procedure whereby the large amount of fluid from the belly is drained.

Some patients with early cirrhosis (scarring of the liver) have no symptom, but as their disease progresses, symptom such as belly swelling due to fluid buildup may happen. Medicines can be prescribed to reduce the belly swelling. But in some patients, the medicines may not work, under this circumstance, large volume abdominal paracentesis will be needed to relieve the belly discomfort.