Variceal Banding in Jalandhar — Oesophageal Varices Emergency Treatment

Oesophageal varices are enlarged veins in the lower esophagus caused by portal hypertension — increased blood pressure in the portal vein due to liver cirrhosis. As blood pressure builds, these veins swell and become fragile. They can rupture spontaneously — causing sudden massive vomiting of blood (haematemesis). The first variceal bleed has a 15–20% mortality rate without immediate treatment at a facility like Innocent Hearts Hospital, Jalandhar.

No. Variceal banding is performed under IV sedation — you are completely comfortable during the procedure. After the procedure, patients may experience mild chest discomfort or difficulty swallowing for 24–48 hours as the banded varices swell slightly before shrinking. This is normal and managed with antacids and a soft diet. The discomfort is far less than the danger of an untreated variceal bleed.

Most patients require 3–5 banding sessions to completely eradicate all varices. Sessions are scheduled every 2–4 weeks — each session bands remaining visible varices. After eradication, surveillance endoscopy is done every 6–12 months to check for recurrence. Portal hypertension (the underlying cause) persists, so new varices can develop over time — regular surveillance is essential.

Yes — varices can recur because the underlying portal hypertension persists. This is why regular surveillance endoscopy (every 6–12 months) is essential after eradication. If new varices form, they are banded again before they grow large enough to bleed. Additionally, treating the underlying liver disease — stopping alcohol, treating Hepatitis B/C — helps reduce portal pressure and slow variceal recurrence.

All cirrhosis patients with Grade 2–3 varices should have elective banding before any bleed occurs — this is called primary prophylaxis. Grade 1 varices are managed with non-selective beta blockers (propranolol/carvedilol). The goal is to prevent the first bleed entirely, because the first bleed itself carries a 15–20% mortality. Dr. Ankit Anand offers a complete cirrhosis surveillance programme at GastroNova Clinic, Jalandhar.

Non-selective beta blockers (propranolol, carvedilol) reduce portal pressure and lower bleeding risk — used for Grade 1 varices or in combination with banding after eradication. However, for Grade 2–4 varices — especially actively bleeding — Endoscopic Variceal Ligation (banding) is the definitive gold-standard treatment. Sclerotherapy (injection of sclerosant) is a less preferred alternative. Surgery (porto-systemic shunts) is rarely needed in the era of effective endoscopic treatment.

Every cirrhosis patient should have an endoscopy to screen for varices at diagnosis — and every 1–3 years thereafter. If Grade 2+ varices are found, start banding. Stop alcohol completely if alcohol is the cause. Get Hepatitis B or C treated. Take prescribed beta blockers consistently. Avoid NSAIDs (aspirin, ibuprofen) which increase bleeding risk. And know that Innocent Hearts Hospital, Nakodar Road, Jalandhar is available 24/7 for any variceal emergency. Call Dr. Ankit at +91 73470 58754 immediately if any bleed occurs.